Distribution trends of Indonesia's health care resources in the decentralization era

Indonesia has been decentralized since 2001, and we evaluated the distribution trends of physicians, puskesmas (community health centers), hospitals, and hospital beds in 34 provinces in Indonesia for 2000 to 2014. Inequality index of Gini showed improvement of the distribution of physicians and decreased from 0.38 to 0.29. The indices in distributions of hospitals and hospital beds also decreased from 0.26 to 0.17 and from 0.25 to 0.18, respectively. However, the index in the distribution of puskesmas increased from 0.19 to 0.28. We also investigated the legislative transitions of the laws concerning health resources and found the strong affects of compulsory work laws for physicians and the increment of health budget. In the decentralization era, the local governments have some political autonomy for the development of health resources; however, the national government should monitor the nationwide distribution of health resources and advice necessary recommendations to the local governments.