Purpose – The health-care equity has been adopted as the principle in the health system in Indonesia since the enactment of Law No. 40 of 2004 concerning the National Social Security System. This study evaluates the achievement of health-care equity in Indonesia and investigates the spatial dimension of inequity by using a measure of inequity that can be decomposed completely into Theil index. Third, this study conducts a before and after comparison of the change in the degree of decentralization in Indonesia. Besides, this study also conducts a period with economic crisis and period without economic crisis comparison for within-area health-care inequity.
Design/methodology/approach – The secondary cross-sectional data originate from the Indonesian Socioeconomic Surveys of 1996, 1998, 2000, 2002, 2005, 2008, 2011, and 2014. The Theil index was used to describe the inequity in health care. Subsequently, the Theil index is decomposed into between- and within-region at the province and district level. This paper compares health-care equity before and after decentralization in Indonesia. This paper also compares the health-care equity between periods with and without an economic crisis in Indonesia.
Findings – The Theil index of health-care inequity provides an initial description that there was an improvement of equity in health care in 1996-2014. However, findings suggest the health-care inequity had worsened during the economic crisis of 1998 despite improved health-care equity, especially during the second phase of decentralization in the period of 2005-2014.
Value/Originality – The findings suggest that an increase in the degree of decentralization in Indonesia is associated with a lower degree of overall, within-province, within-district and between-district inequity in both outpatient health care and inpatient health care. In addition, the economic crisis is related to higher overall, within- and between-region health-care inequities.