Background: Equal access to healthcare facilities, patient's satisfaction, and respect for the desire of the patient were recognized as the basic principles of each of the health care system. Each person must be given the opportunity to access health services in accordance with the requirements of their health. We aimed to prove the existence of disparities hospital utilization based on the category of urban-rural areas. Methods: The research used the 2013 Indonesian Basic Health Survey (RKD) as analysis material, that was designed a cross-sectional survey. With the multi-stage cluster random sampling method, 722,329 respondents were obtained. Data were analyzed using Multinomial Logistic Regression tests. Results: The results showed adults living in urban were likely to use hospital outpatient facilities 1.246 times higher than adults living in rural areas (OR 1.246; 95% CI 1.026 -1.030). The likelihood of utilizing at the same time outpatient and inpatient facilities at 1.134 times higher in adults living in urban than those in rural areas (OR 1.134; 95% CI 1.025 -1.255). While for the category of hospital inpatient utilization, there was no significant difference. Conclusion: There was a disparity in hospital utilization between urban-rural areas. Urban show better utilization than rural areas in outpatient and at the same time the use of inpatient care.

Diabetes is a chronic disease that requires regular and sustainable health management that involves proper treatment. Some diabetic patients use CAM, as well as conventional medicine, to maintain their health and control their blood sugar. This literature review aimed to 1) determine the prevalence of CAM used by patients with diabetes, summarize and evaluate the CAM use that includes: characteristics, patterns, types and reasons, 2) propose a conceptual model associated with CAM used by patients with diabetes. Systematic reviews were searched using an electronic database. The systematic reviews were published between 2005 and 2015 by using specific keywords. The number of systematic reviews obtained as a search result is 14 articles from 14 countries. The prevalence of CAM used by patients with diabetes ranged from 16.6% to 76%. Determinants associated with the CAM use were age, gender, family income, occupation, residence, and the characteristics of the disease, such as the length of time since diagnosed and complications. Most patients used CAM, along with the conventional treatment, and did not inform health professionals about the CAM use. The CAM use by patients with diabetes was relatively high and the confidence of patients believed the benefits of CAM. Therefore, integration with health professionals to develop CAM management is highly required.

One indicator to see the quality of health system performance was to look at the disparity in the utilization of healthcare facilities. The research objective was to analyze the disparity between regions in the utilization of health centers in rural areas in Indonesia. The results of the 2013 Basic Health Survey (Riskesdas) were used as analysis material. The 2013 Riskesdas was designed a cross-sectional survey. Respondents obtained 388,598 using the multi-stage cluster random sampling method. Binary Logistic Regression Test was used to analyze data. Data is obtained through a structured questionnaire. The results showed that there were statistically significant disparities between regions. All regions showed better utilization than the Papua region as a reference. The best utilization was in the Sumatra region, which was 3.781 times more utilizing health centers than the Papua region (OR = 3.781; 95% CI = 3.580-3.993). The utilization of health centres that approached the Papua region was the Nusa Tenggara region (OR = 1.582; 95% CI = 1.490-1.679) and the Maluku region (OR = 2.175; 95% 1.999–2.366). All three regions are all in the Eastern part of Indonesia. The research concluded there was a disparity in health center utilization between regions in rural Indonesia. Regions in the western part of Indonesia tend to have better health center utilization in rural areas. Research results could be used as a reference for making policies that focus on equality of services to reduce existing disparities.

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