臺灣博碩士論文加值系統

Indonesia has enacted fiscal decentralization for six years. The first three years is a critical time for the continuance of this program. If it is considered less beneficial than the program will be likely to be suspended or dissolved. Important policy questions whether decentralization leads to more or less public/preventive health expenditure allocation, and whether local governments are effective in the provision of health care service. This study systematically examines these questions using data set on government health expenditure that are provided by the Indonesia’s Department of Health combined with secondary data from Indonesia Bureau of Statistic and Indonesia’s Demographic and Health Survey. The results show that local health expenditures decreased after devolution even though we could not assure whether it has any effect on children immunization coverage.

Title Page ……………………………………………………………………….. i
Approval Page …………………………………………………………………. ii
Abstract …………………………………………………………………………. iii
Acknowledgement ……………………………………………………….……. iv
Table of Contents ……………………………………………………………… v
List of Tables …………………...……………………………………………… vii
List of Figures ………..…………………………………………………………viii
I. Introduction
1.1. Background ……………………………………………………………….. 1
1.1.1. The History of Decentralization in Indonesia ……………………... 3
1.1.2. Sources of Healthcare Expenditure after Decentralization …….. 8
1.1.3. Public Health Expenditure after Decentralization ………………. 12
1.2. Problem Statements …………………………………………………….. 19
1.3. Objective …………………………………………………………………... 19
II. Theoretical Review
2.1. Allocation of Resources ……………………………………………….. 20
2.1.1. Allocative Efficiency ………………………………………………….. 21
2.2. Literature Review ………………………………………………………… 24
III. Methodology
3.1. Estimation Method ………………………………………………………. 26
3.2. Dependent variables …………………………………………………….. 28
3.2.1. Local Government Expenditures ………………………………….... 28
3.2.2. Health Service Outcomes …………………………………………….. 30
3.3. Independent Variables …………………………………………………... 31
3.3.1. Expenditure Estimations ……………………………………………… 31
3.3.2. Immunization Estimations ……………………………………………. 33
3.4. Hypothesis ………………………………………………………………… 33
IV. Result
4.1. Local Per-Capita Health Expenditures ……………………………….. 35
4.2. Health Service Outcome ………………………………………………… 37
V. Discussion and Conclusion
5.1. Discussion ………………………………………………………………… 41
5.2. Conclusion ……..…………………………………………………………. 48
5.3. Policy Implication ………………………………………………………… 49
5.4. Limitation …………………………………………………………………... 50
Reference

Table1.1. Recapitulation of Sleman District Health Budget …………………… 11
Table1.2. Recapitulation of East Sumba District Health Budget ……………… 11
Table1.3. Health Financing according to Institution in Kutai Kartanegara District …………………………………………………………………… 14
Table1.4. Proportion of Infectious Disease Eradication Program Budget
Resource in Banjarnegara District from 1997-2002 ………………… 17
Table1.5. Proportion of Immunization Program Budget Resource in Banjarne-gara District from 1997-2002 ………………………………………… 17
Table3.1. Average (three years) Per Capita Expenditures for Health ………… 29
Table3.2. Average (three years) Percentage Allocation of Total
Government Health Expenditures to Preventive Health, Curative Health, Administration and Training …………………………………… 29
Table3.3. Full Immunization Coverage of Children (1-5 years old) …………… 30
Table3.4. Independent Variable Means and Standard Deviation by Year for Expenditure Estimation ………………………………………………… 32
Table4.1.District and Municipality Preventive and Curative Expenditures Per-Capita …………………………………………………………………35
Table 4.2 Logistic Regression Estimates Fully Immunized Child with Per-Capita Health Expenditures …………………………………………… 38
Table 4.3 Fully Immunized Children According to Categories ………………… 40

Figure1. Hierarchy of Government Structure after Decentralization …………… 6

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