“Healthcare Use and Financial Burden of Mental Health Among the Elderly in Indonesia’s Outpatient System”

Abstract

The Elderly area population and group aged 60 or older, characterized by biological, physical, andpsychological aging. As Indonesia entered an aging population era in 2021, the growing elderly demographic has become increasingly vulnerable tomental health disorders. This study analyzed healthcare use and Financial burden of mental health service utilization among JKN Participant using secondary cross sectional data froma advanced referral health services (FKRTL) in 2024, The results indicate that utilization remains relatively low and concentrated among specific patients. While visits surged during the COVID-19 Pandemic (2020-2021), utilization generally decreases with age, with gender showing no significant effect.The most dominant diagnoses are anxiety/neurotic disorders (ICD-10 F40-F48), with the highest visit distribution in Regional 2 (32.2%). Significant geographic cost disparities were observed; the highest average costs occurred in urban hubs like DKI Jakarta (Rp.280,394), reflecting the concentration of subspealized facilities, while the lowest were in West Kalimantan (Rp.172,532). Notably the ration between billed costs and BPJS-verified costs remains consistent at 1:1 across all provinces. This study concludes that mental health services utilization and health care spending are unevenly distributed. These findings are expected to serve as abasis for formulating strategies to equalize mental health services for the elderlyacross Indonesia