Analisis Unmet Need Pelayanan Kesehatan pada Lansia di Indonesia dengan Regresi Logistik Biner Tiga Level

Iftina Ika Rahmawati, Christiana Anggraeni Putri

Abstract

Indonesia memasuki masa ageing population dengan tantangan yang muncul akibat populasi semakin menua. Lansia merupakan kelompok yang rentan dalam hal kesehatan, tetapi di tahun 2024 unmet need pelayanan kesehatan pada lansia masih cukup tinggi dan selama sepuluh tahun terakhir tidak mengalami penurunan yang signifikan. Penelitian ini bertujuan untuk menganalisis variabel-variabel yang memengaruhi unmet need pelayanan kesehatan pada lansia di Indonesia tahun 2024 berdasarkan karakteristik individu dan kontekstual. Data yang digunakan meliputi Survei Sosial Ekonomi Nasional Maret, Potensi Desa, dan publikasi Badan Pusat Statistik. Metode analisis yang digunakan adalah regresi logistik biner tiga level dengan random intercept. Hasil analisis menunjukkan unmet need lebih banyak terjadi pada lansia tua dengan tingkat pendidikan tidak bersekolah, masih bekerja, merokok, tidak memiliki jaminan kesehatan, serta tidak ada caregiver. Variabel usia kategori lansia tua, tingkat pendidikan kategori tidak sekolah, status bekerja, status merokok, kepemilikan jaminan kesehatan, pengeluaran, keberadaan caregiver, persentase penduduk miskin, rasio fasilitas kesehatan, rasio dokter, serta rasio anggaran belanja fungsi kesehatan berpengaruh signifikan terhadap status unmet need pelayanan kesehatan pada lansia. Nilai random intercept yang signifikan menunjukkan adanya perbedaan antar rumah tangga (ICC= 0,1560) dan antar kabupaten/kota (ICC= 0,1042) dalam peluang terjadinya unmet need pelayanan kesehatan. Nilai tersebut mengindikasikan bahwa sebesar 15,60% dan 10,42% dari total varians unmet need pelayanan kesehatan disebabkan oleh faktor tingkat rumah tangga dan kabupaten/kota.

Indonesia is moving toward an ageing population phase, accompanied by challenges arising from an increasingly older demographic. Older adults are a vulnerable group in terms of health; however, in 2024, the proportion of unmet healthcare needs among this group remains relatively high and has not shown a significant decline over the past decade. This study aims to analyze the factors associated with unmet healthcare needs among older adults in Indonesia in 2024 based on individual and contextual characteristics. The data used were drawn from the March National Socioeconomic Survey (Susenas), the Village Potential Survey (Podes), and publications by Statistics Indonesia (Badan Pusat Statistik). A three-level binary logistic regression model with a random intercept was applied. The results show that unmet healthcare needs are more prevalent among older adults of advanced age, those with no formal education, those who are still working, smokers, individuals without health insurance, and those without caregivers. Significant factors include age, education level, employment status, smoking status, health insurance ownership, expenditure, presence of a caregiver, poverty rate, health facility ratio, physician ratio, and health expenditure ratio. The significant random intercept indicates that differences exist between households (ICC = 0.1560) and regions (ICC = 0.1042) in the likelihood of experiencing unmet healthcare needs. These values suggest that 15.60% and 10.42% of the total variance in unmet healthcare needs are attributable to household-level and region-level factors, respectively.

Kata Kunci: Lansia, unmet need pelayanan kesehatan, regresi logistik biner tiga level.

Keywords: Older adult, unmet need for health services, three level binary logistic regression.

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DOI: https://doi.org/10.13057/ijas.v9i1.110631

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