(3.238.174.50) 您好!臺灣時間:2021/04/18 17:32
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果

詳目顯示:::

我願授權國圖
: 
twitterline
研究生:JokoMulyanto
研究生(外文):Joko Mulyanto
論文名稱:印尼成人自覺健康狀態:決定因素與分佈不均之研究
論文名稱(外文):Perceived Health Status in Indonesia: Determinants and Inequality Issue
指導教授:楊志良楊志良引用關係
指導教授(外文):Chih-Liang Yaung
學位類別:碩士
校院名稱:亞洲大學
系所名稱:健康管理研究所
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2005
畢業學年度:94
語文別:英文
論文頁數:103
中文關鍵詞:Perceived Health StatusDeterminantsIndonesiaIFLSInequality
外文關鍵詞:Perceived Health StatusDeterminantsIndonesiaIFLSInequality
相關次數:
  • 被引用被引用:0
  • 點閱點閱:131
  • 評分評分:系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:1
This study explored the determinants of perceived health status and the
income-related health inequality in Indonesia. Indonesia experienced considerable
result in term of health status achievement. However this achievement is relatively
lower than neighborhood countries. Severe economic crisis also influenced health
status of Indonesian especially in 1997. It is important to understand the determinants
of perceived health status and measure the degree of health inequality in Indonesia.
This study is secondary panel data analysis using data from three waves of
longitudinal study of Indonesia Family Life Survey (IFLS) in 1993, 1997, and 2000.
9125 adult individual panel respondents are included in the analysis. Perceived health
status is used to measure the adult health outcome. The predictor consisted of
socioeconomic status, individual lifestyle, physical environment, access to healthcare
services, and social environment. Concentration index, logistic regression, and GEE
model is used as statistical analysis method. Findings indicated the degree of income
related health inequality measured by observed concentration index has largest value
in 1997. Poor health status is concentrated disproportionately in poor income group,
but the degree of inequality is relatively small. Among the predictors of perceived
health status, age, employment, region, acute morbidity, access to safe water, and
outpatient visit are the important predictors. Surprisingly, income did not predict the
health status significantly. The use perceived health status as adult health outcomes
measurement should be carefully considered especially in low developing countries
setting.
This study explored the determinants of perceived health status and the
income-related health inequality in Indonesia. Indonesia experienced considerable
result in term of health status achievement. However this achievement is relatively
lower than neighborhood countries. Severe economic crisis also influenced health
status of Indonesian especially in 1997. It is important to understand the determinants
of perceived health status and measure the degree of health inequality in Indonesia.
This study is secondary panel data analysis using data from three waves of
longitudinal study of Indonesia Family Life Survey (IFLS) in 1993, 1997, and 2000.
9125 adult individual panel respondents are included in the analysis. Perceived health
status is used to measure the adult health outcome. The predictor consisted of
socioeconomic status, individual lifestyle, physical environment, access to healthcare
services, and social environment. Concentration index, logistic regression, and GEE
model is used as statistical analysis method. Findings indicated the degree of income
related health inequality measured by observed concentration index has largest value
in 1997. Poor health status is concentrated disproportionately in poor income group,
but the degree of inequality is relatively small. Among the predictors of perceived
health status, age, employment, region, acute morbidity, access to safe water, and
outpatient visit are the important predictors. Surprisingly, income did not predict the
health status significantly. The use perceived health status as adult health outcomes
measurement should be carefully considered especially in low developing countries
setting.
Title Page ………………………………………………………… i
Approval Page …………………………………………………… ii
Abstract ………………………………………………………………… iii
Acknowledgement ……………………………………………………… iv
Table of Content ……………………………………………………. vi
List of Tables ………………………………………………………. ix
1. CHAPTER ONE: INTRODUCTION …………………………………. 1
1.1. Background …………………………………………………………... 1
1.2. Problem Statements ………………………………………………… 5
1.3. Study Objectives …………………………………………………...5
1.4. Significance of the Study ……………………………………… 5
2. CHAPTER TWO: LITERATURE REVIEW …………………………… 7
2.1. The Multiple Determinants of Health ……………………… 7
2.2. Measuring Health Status and Health Status Indicators 10
2.3. Perceived Health Status …………………………………………..11
2.4. Health Inequality …………………………………………………...12
2.5. Measuring Health Inequality ……….…………………………… 15
2.6. Overview of Current Health Situation in Indonesia …… 18
2.6. Theoretical Framework ………………………………………….... 21
2.7. Conceptual / Operational Framework ……………………….... 22
2.8. Research Hypotheses ………………………………………… 23
3. CHAPTER THREE: RESEARCH METHODOLOGY .................... 26
3.1. Study Design ………………………………………………………….. 26
3.2. Data Description ………………………………………………….. 26
3.3. Survey Instruments ………………………………………………….. 29
3.4. Plan for Data Analysis ………………………………........... 30
3.4.1. Data Editing ……………………………………….…………. 30
3.4.2. Statistical Analysis ………………………………………… 31
3.4.3. Statistical Package ……………………………………………33
3.5. Variable Definition ……………………………………………… 33
3.5.1. Dependent Variable ………………………………………… 33
3.5.2. Independent Variables ………………………………… 34
4. CHAPTER FOUR: RESULTS ………………….…………………… 40
4.1. Descriptive Statistics ………………………………………………… 40
4.2. Analytical Statistics ………………………………………………… 48
4.2.1. Income-related Health Inequality Analysis ……… 48
4.2.2. Comparison of Determinants of Perceived Health
Status in 1993, 1997, and 2000 ………………………… 49
4.2.3. Panel Data Analysis of Determinant of Perceived
HealthStatus in Indonesia ………………………………… 55
5. CHAPTER FIVE: DISCUSSION AND CONCLUSION …………… 61
5.1. Discussion ………………………...……………………………… 61
5.1.1. Descriptive Results ………………………………………… 61
5.1.2. Income-related Health Inequality …………………… 63
5.1.3. Determinants of Perceived Health Status in
Indonesia ..................................... 65
5.1.3.1. Gender ……………………………………… 65
5.1.3.2. Age …………………………………………………… 66
5.1.3.3. Marital Status …………………………………… 67
5.1.3.4. Educational Level ………………………………… 67
5.1.3.5. Employment ……………………………………….... 69
5.1.3.6. Living Standards ………………………………….. 70
5.1.3.7. Geographical Characteristics …………………. 72
5.1.3.8. Physical Environment ……………………....... 74
5.1.3.9. Acute Morbidity Symptoms ………………………… 75
5.1.3.10. Access to Healthcare Service..............75
5.1.3.11. Tobacco Consumption ……………………….......77
5.1.3.12. Social Environment …….…………………….... 78
5.1.3.13. Time Effect …………………………………………… 80
5.2. Limitation of Study ……………………………………… 80
5.3. Conclusion ………………………………………………… 81
5.4. Policy Implication and Recommendation …………………… 84
REFERENCES ……………………………………………………............. 87
Ahmad, K., Tazen, J.H., & Chaturvedi, N. (2005). Self-rated in Pakistan: result of a national health survey. BMC Public Health, 5, 51-58.

Almeida, C., & Braveman, P., Gold, M.R., et al. (2001). Methodological concern and recommendations on policy consequences of the world health report 2000.Lancet. 357:1692–7.

Alonso, Y. (2004). The biopsychosocial model in medical research: the evolution of medical concept over the last two decades. Patient Education and Counseling, 53,239-243.

Andersen, R.M. (1995). Revisiting the behavioral model and access to medical care:does it matter?. Journal of Health and Social Behavior, 36, 1-10.

Anitua, C., & Esnaola, S. (2000). Changes in social inequalities in health in the Basque country. Journal Epidemiology Community Health, 54, 437 – 443.

Balabanova, D.C, & McKee, M. (2002). Self-reported health in Bulgaria: levels and determinants. Scandinavian Journal of Public Health, 30, 306-312.

Balanda, K., & Wilde, J. (2003). Inequalities in perceived health. A report on the all-Ireland social capital and health survey. Dublin: The Institute of Public Health in Ireland.

Bergner, M., & Rothman, M.L. (1987). Health status measures: an overview and guide for selection. Ann. Rev. Public Health, 8, 191-210.

Berkman, L.F., & Kawachi, I., eds. (2000). Social Epidemiology. New York: Oxford University Press.

Black, D., Morris, J.N., Smith, C., Townsend, P., & Whitehead, M. (1988). Inequalities in health: the black report. London: Penguin.

Blum, H.L. (1981). Planning for health. New York: Human Sciences Press.

Bobak, M., Pikhart, H., Hertzman, C., Rose, R., & Marmot, M. (1998).
Socioeconomic factors, perceived control and self-reported health in Russia. A cross-sectional survey. Social Science and Medicine, 47, 269–279.

Bobak, M., Pikharta, H., Roseb, R., Hertzmanc, C., & Marmot, M. (2000). Socioeconomic factors, material inequalities, and perceived control in self-rated health: cross-sectional data from seven post-communist countries. Soc. Sci. Med,51, 1343-1350.

Braveman, P., Krieger, N., & Lynch, J. (2000). Health inequalities and social inequalities in health. Bull World Health Organ, 78, 232–34.

Bunker, J.P, Frazier, H.S., & Mosteller, F. (1995). The role of medical care in determining health: creating an inventory of benefits. In Amick, B.C., Levine, S.,Tarlov A.R., Walsh, D.C., eds. Society and health. New York: Oxford University of Press

Chung, W. (2004). Income inequality and health: evidence from Indonesia. CLMR Discussion Paper Series 04/03. Crawley: Centre for Labour Market Research.

Clarke, J.N. (2004). Health, illness, and medicine in Canada. Toronto: Oxford University Press.

Dahlgren, G., & Whitehead, M. (1991). Policies and strategies to promote social equality in health. Stockholm: Institute of Future Studies.

Daniels, N., Kennedy, B.P., & Kawachi, I. (1999). Why justice is good for our health: the social determinants of health inequalities. Daedalus, 128, 215-51.

Dunn, J.R., Veenstra, G., & Ross, N. Psychosocial and neo-material dimensions of SES and health revisited: predictors of self-rated health in a Canadian national survey. Soc.Sci Medicine.In press.

Evans, R.G., & Stoddart, G.L., (1990). Producing health, consuming health care. Soc.Sci. Med, 31, 1347-1363.

Ferraro, K.F., Farmer, M.M., & Wybraniec J.A. (1997). Health trajectories:Long term dynamics among black and white adults. Journal of Health and SocialBehavior; 38(1), 38-54.

Ferraro, K. F., & Su, Y. P. (2000). Physician-evaluated and self-reported morbidity for predicting disability. American Journal of Public Health, 90,103–108.

Frankenberg, E., Beegle, K., Sikoki, B., & Thomas, D. (1998). Health, family Planning, and well-being in Indonesia during economic crisis: early results from Indonesian Family Life Survey. Labor and Population Program Working Paper Series 99-06. Santa Monica: RAND corp.

Gilmore, A.B.C., McKee, M., & Martin, R. (2002). Determinants of and inequalities in self-perceived health in Ukraine. Soc. Sci Medicine, 55, 2177 – 2188.

Gwatkin, D., Rutstein, S., Johnson, K., Pande, R., & Wagstaff, A. (2000). Socioeconomic differences in health nutrition and population. Washington DC :The World Bank.
http://www.worldbank.org/poverty/health/data/index.htm.

Hesmat, S. (2001). An overview of managerial economics in the health care system.New York: Delmar.

Hemstrom, O. (2005). Health inequalities by wage income in Sweden: the role of work environment. Soc. Sci. Med. 61, 637 – 647.

Hidayat, B., Thabrany, H., Dong, H., & Sauerborn, R. (2004). The effect of mandatory health insurance on equity in access to outpatient care in Indonesia. Health Policy and Planning, 19(5), 322 – 335.

Holmen, T.L., Barrett-Connor, E., Holmen, J., & Bjermer, L. (2000). Health problem in teenage daily smokers versus nonsmokers, Norway, 1995 – 1997. American Journal of Epidemiology,151(2), 148 – 155.

Houweling, T.A., Kunst, A.E., & Mackenbach, J.P. (2001). World health report 2000:inequality index and socioeconomic inequalities in mortality. Lancet, 357,1671–2.

Humphries, K.H., & van Doorslaer, E. (2000). Income-related health inequality in Canada. Soc. Sci. Med, 50, 663 – 671.

Idler, E.L, & Benyamini, Y. (1997). Self-rated health and mortality: review of twenty-seven community studies. Journal of Health and Social Behavior, 38,21-37.

Kaplan, G.A., & Camacho, T. (1993). Perceived health and mortality: A nine year follow-up of the human population laboratory cohort. American Journal of Epidemiology. 117: 292–298.

Kaplan, G.A., Goldberg, D.E., Everson, S.A., et al. (1996). Perceived health status and morbidity and mortality: evidence from the Kuopio ischaemic heart disease risk factor study. International Journal of Epidemiology, 25(2), 256-9.

Kawachi, I., Subramanian, S.V., & Almeida-Filho, N. (2002). A glossary for health inequalities. J. Epidemiol. Community Health, 56, 647-652.

Kennedy, B.P., Kawachi, I., Glass, R., & Prothrow-Stith, D. (1998). Income distribution, socioeconomic status, and self-rated health in the United States: multilevel analysis. BMJ, 317, 917-921.

Khang, Y.H., Lynch, J.W., Yun, S., & Lee, S.I. (2004). Trends in socioeconomic inequalities in Korea: use of mortality and morbidity measures. J. Epidemiol.Community Health, 58, 308 – 314.

Kleinbaum, D.G., Kupper, L.L., Muller, K.E., & Nizam, A. (1998). Applied regression analysis and other multivariable methods. Pacific Grove: Duxbury press.

Kunst, A.E., Bos, V., Lahelma, E. et al. (2005). Trend in socioeconomic inequalities in self-assesed health in 10 European Countries. Int. J. Epidemiol. 34, 295-305.

Leigh, H., & Reiser, M.F. The patient. Biological, psychological and social dimension of medical practice. New York: Plenum Press.

Lopez, R. (2004). Income inequality and self-rated health in US metropolitan areas: A multi-level analysis. Soc. Sci. Med. 59, 2409-2419.

Lundberg, O., & Manderbacka, K. (1996). Assessing reliability of a measure self rated health. Scandinavian Journal of Social Medicine. 350, 383-388.

Lynch, J.W., Smith, G.D., Kaplan, G.A., & House J.S. (2000). Income inequality and mortality: importance to health of individual income, psychosocial environment,or material conditions. BMJ, 320, 1200-1204.

Mackenbach, J.P., & Kunst, A.E. (1997). Measuring the magnitude of socioeconomic inequalities in health: an overview of available measures illustrated with two examples from Europe. Soc. Sci. Med, 44, 757-71.

Marmot, M., & Wilkinson, R.G., eds. (1999). Social determinants of health. New York: Oxford University Press.

Marmot, M., & Wilkinson, R.G. (2001). Psychosocial and material pathways in the relation between income and health: a response to Lynch et al. BMJ, 322, 1233 –1236.

Martikainen, P., Aromaa, A., Heliovaara, M., Dlaukka, T., Knekt, P., Maatele, J. , &Lahelma, E. (1999). Reliability of perceived health by sex and age. Soc Sci Med,48, 1117-1122.

Miilunpalo, S., Vuoria, I., Oja, P., Pasanen, M., Urponen, H. (1997). Self-rated health status as health measure: the predictive value of self-reported health status on the use of physician services and in the mortality of working-age population. J. ofClinic. Epid, 50, 517-528.

Mille Schalic, L., Hadden, W.C., Pamuk E., et al. (2000). The widening gap in death rates among income group in the United States from 1967 to 1986. Int. J. Health Serv. 30, 13-26.

Ministry of Health. (2001). Indonesia Health Profile 2001. Jakarta: Ministry ofHealth.

Møller, L., Kristensen, T.S., & Hollnagel, H. (1996). Self-rated health as a predictorof coronary heart disease in Copenhagen, Denmark. Journal of Epidemiology and Community Health. 50(4), 423-8.

Murray, C.J.L., Gakidou, E.E., & Frenk, J. (1999). Health inequalities and social group differences: what should we measure? Bull World Health Organ, 77,537–43.

Oomman, N., Lule, E., Vazirani, D., & Chhbre, R. (2003). Indonesia. Inequalities in health, nutrition, and population. HNP Discussion Paper. Washington: The World Bank.

Pamuk, E.R. (1985). Social class inequality in mortality from 1921 to 1972 in England and Wales. Population Studies, 39,17-31.

Patrick, D.L., & Bergner, M. (1990). Measurement of health status in 1990s. Ann.Rev. Public Health. 11, 65-83.

Patrick, D.L., & Wickizer, T.M.(1995). Community and health. In Amick, B.C.,Levine, S., Tarlov, A.R., Walsh, D.C. eds. Society and health. New York: Oxford University of Press

Purwanto, S., Stevenson, M., & de Klerk, N. (2003). Infant mortality and family welfare: policy implications for Indonesia. J. Epidemiol. Community Health, 57,493-498.

Regidor, E., Dominguez, V., Navarro, P., & Rodriguez, C. (1999). The magnitude of differences in perceived general health associated with educational level in the regions of Spain. J. Epidemiol. Community Health, 53, 288-293.

Regidor, E. (2004). Measures of health inequalities: part 1. J. Epidemiol. Community Health, 58, 856-861.

Regidor, E. (2004). Measures of health inequalities: part 2. J. Epidemiol. Community Health, 58, 900-903.

Rius, C., Fernandez, E., Schiaffino, A., Boras, J.M., & Rodriguez-Artelajo, F. (2004).

Self perceived health and smoking in adolescent. Journal Epidemiology and Community Health. 58, 688 – 689.

Seedhouse, D. (1985). Health: The foundation for achievement. Chicester: John Wiley and Sons.

Sen, A. (2002). Health: perception versus observation. BMJ, 324, 860 – 861.Shibuya,K., Hashimoto, H., Yano, E. (2002). Individual income, income distribution, and self-rated health in Japan: cross-sectional analysis of nationally representative sample. BMJ, 324, 1-5.

Slee, V., Slee, D., & Schmidt, H.J. (2001). Health care terms 4th ed. Minnesota:Tringia Press.

Shadbolt, B. (1997). Some correlates of self-rated health for Australian women.American Journal of Public Health, 87(6), 951-6.
Shield, M., Shooshtari, S. (2001). Determinants of self-perceived health. Health Report,13(1),35-52.

Shi, L. (1997). Health services research method. New York: Delmar Publisher.

Strauss J.K., Beegle, B., Sikoki, B., Dwiyanto, A., Herawati, Y., & Witoelar F.(2004). The third wave of the Indonesia Family Life Survey (IFLS3). Santa Monica: RAND corp.

Subramanian, S.V., Delgado, I., Jadue, L., & Kawachi, I. (2003). Income inequality and health: multilevel analysis of Chilean communities. J. Epidemiol. Community Health. 57, 844-848.
Tones, K., Green, J. (2004). Health promotion: planning and strategies. London:Sage Publications.

Van Doorslaer, E., Wagstaff, A., Bleichrodt, H., Calonge, S., Gerdtham, U., Gerfin M., et al. (1997). Journal of Health Economics, 16, 92 – 112.

Wagstaff, A., Paci, P., van Doorslaer, E. (1991). On the measurement of inequalities in health. Soc. Sci. Med. 33, 545-557.

Wagstaff, A. (2002). Inequalities in health in developing countries: swimming against the tide? World Bank Working Papers. Washington DC: World Bank.

Woodward, A., Kawachi, I. (2000). Why reduce health inequalities?. J. Epidemiol. Community Health. 54, 923-929.

World Bank. (2003). Adult health outcome. Quantitative techniques for health equity analysis - technical note 3. Washington DC: World Bank.

World Bank. (2003). Measuring living standards: household consumption and wealth indices. Quantitative techniques for health equity analysis - technical note 4.Washington DC: World Bank.

World Bank. (2003). The concentration index. Quantitative techniques for health equity analysis - technical note 7. Washington DC: World Bank.

World Health Organization. (1946). Constitution of world health organization.Geneva: WHO.

World Health Organization. (2000). World health report 2000.Health system:improving performance. Geneva: WHO Publication.
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top
系統版面圖檔 系統版面圖檔