How Border Region Status in West Kalimantan Moderates the Healthcare Accessibility Index 20 18
DOI:
https://doi.org/10.26623/ebsj.v10i2.16198Keywords:
Healthcare Accessibility Index, GRDP per capita, health expenditure, border regions, PCAAbstract
Healthcare service availability remains uneven across regions in Indonesia, particularly in border areas. Although previous studies have examined the relationship between regional economic conditions and healthcare accessibility, limited attention has been given to whether border status moderates this relationship. This study addresses this gap by examining factors associated with the Healthcare Accessibility Index (HAI) and testing the moderating role of border status in the relationship between per capita gross regional domestic product (GRDP) and healthcare service availability in West Kalimantan, Indonesia. Using panel data from 14 regencies and cities for 2020–2023, this study constructs a composite HAI through Principal Component Analysis (PCA), based on the ratio of health center, ratio of hospitals, and ratio of healthcare workforce per 10.000 population. The index captures the relative availability of healthcare facilities and human resources rather than the full range of healthcare accessibility dimensions. Fixed-effects panel regression is employed, with an equal-weighted HAI used for sensitivity analysis. The results indicate that per capita GRDP is positively and significantly associated with HAI, while population density has a positive association at the 10% significance level. Government health expenditure and poverty are not statistically significant. The interaction between per capita GRDP and border status is negative and significant in both index specifications, suggesting that the positive association between economic performance and healthcare service availability is weaker in border areas. The study’s novelty lies in treating border status as a moderator, extending analysis beyond the direct associations of socioeconomic factors with healthcare availability. The findings highlight the need for geographically responsive health policies and targeted investment in healthcare facilities and personnel to reduce regional disparities.
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