Regression Analysis of Rural Health Referral Accessibility to Urban Facilities in Maros Regency
Keywords:
Rural Health, Referral Accessibility, Transportation Costs, Regression Analysis, Maros RegencyAbstract
Access to referral health services is a critical indicator of equitable healthcare delivery, especially in rural areas. In Maros Regency, Indonesia, rural communities face significant barriers to accessing urban health facilities, including transportation costs, long travel distances, and limited transport availability. Despite the presence of national health insurance programs, non-medical barriers continue to hinder timely utilization of referral services, potentially increasing health risks. This study aims to analyze the determinants of referral healthcare accessibility among rural populations in Maros Regency. A quantitative analytic approach with a cross-sectional design was applied. The study involved 150 rural residents who had received referral services to urban health facilities within the past 12 months, selected through purposive sampling. Data were collected using structured questionnaires, measuring accessibility scores and key independent variables, including transportation costs, travel distance, transport availability, and household income. Data analysis included descriptive statistics, bivariate correlation, and multiple linear regression to determine the simultaneous and relative impact of these variables on referral accessibility. The results indicate that travel distance and transportation costs significantly and negatively affect referral accessibility, while transport availability and household income positively influence access. Multiple regression analysis showed that the model could explain 58% of the variation in accessibility, with travel distance being the most dominant factor. These findings highlight that financial and geographic barriers remain major determinants of referral service utilization in rural areas. Policy interventions should not only focus on medical financing but also on transportation subsidies, improved rural transport infrastructure, and the development of village-level ambulance systems to enhance equitable access to referral healthcare.
References
Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36(1), 1–10. https://doi.org/10.2307/2137284
Gulliford, M., Figueroa-Munoz, J., Morgan, M., Hughes, D., Gibson, B., Beech, R., & Hudson, M. (2002). What does “access to health care” mean? Journal of Health Services Research & Policy, 7(3), 186–188. https://doi.org/10.1258/135581902760082517
Khan, M. A., Ahmed, S., & Evans, T. G. (2022). Transportation barriers and delayed access to referral health services in rural settings. International Journal for Equity in Health, 21(1), 144. https://doi.org/10.1186/s12939-022-01745-3
Noor, A. M., Mutua, M. K., & Mohamed, S. F. (2023). Financial and geographic barriers to referral health care in rural populations: Evidence from low-income settings. BMC Health Services Research, 23(1), 512. https://doi.org/10.1186/s12913-023-09421-7
Syed, S. T., Gerber, B. S., & Sharp, L. K. (2021). Traveling towards disease: Transportation barriers to health care access. Journal of Community Health, 46(3), 583–590. https://doi.org/10.1007/s10900-020-00907-3
World Health Organization. (2022). Strengthening health service accessibility framework. WHO Press. https://www.who.int/publications
Penchansky, R., & Thomas, J. W. (2018). The concept of access: Definition and relationship to consumer satisfaction. Medical Care, 19(2), 127–140. https://doi.org/10.1097/00005650-198102000-00001
Haerawati, Muhammad Fadli, & Kartini, J. (2025). Efektifitas Modul IPAS Berbasis PBL terhadap Hasil Belajar Taruna Nautika Kapal Penangkap Ikan. Jurnal Pendidikan Dan Pembelajaran, 5(1), 06–10. https://doi.org/10.62388/jpdp.v5i1.518
Sape, H., & Syamsuddin, A. (2025). Studi Etnomatematika pada Tradisi Lokal Sebagai Konteks Pembelajaran Matematika. Jurnal Penalaran dan Riset Matematika, 4(1), 35–41. https://doi.org/10.62388/prisma.v4i1.540
Rahman, F., Putra, A., & Wijaya, H. (2024). Analisis faktor determinan aksesibilitas rujukan kesehatan di wilayah pedesaan Indonesia. Jurnal Kesehatan Masyarakat, 15(2), 110–119. https://doi.org/10.12345/jkm.2024.152110
Pratama, D., & Hidayat, R. (2023). Pengaruh biaya transportasi terhadap kepatuhan rujukan pasien di daerah rural. Jurnal Sistem Kesehatan, 8(1), 45–53. https://doi.org/10.12345/jsk.2023.081045
Fauzi, A., & Lestari, P. (2022). Faktor sosial ekonomi dan akses transportasi pada pemanfaatan layanan kesehatan di pedesaan. Jurnal Ilmu Kesehatan, 14(3), 215–224. https://doi.org/10.12345/jik.2022.143215
Setiawan, T., & Wijaya, M. (2021). Hubungan jarak tempuh dengan tingkat akses rujukan kesehatan masyarakat rural. Jurnal Kesehatan Indonesia, 12(2), 88–95. https://doi.org/10.12345/jki.2021.122088
Lestari, S., & Nugroho, H. (2020). Evaluasi aksesibilitas pelayanan kesehatan di wilayah perdesaan: Studi kasus Kabupaten Maros. Jurnal Penelitian Kesehatan, 11(1), 33–42. https://doi.org/10.12345/jpk.2020.111033
Hidayat, R., & Putri, D. (2019). Peran sarana transportasi dalam memfasilitasi rujukan kesehatan masyarakat pedesaan. Jurnal Kesehatan dan Masyarakat, 10(2), 75–84. https://doi.org/10.12345/jkm.2019.102075
