Original Research Article
Year: 2017 | Month: April | Volume: 7 | Issue: 4 | Pages: 96-106
National Health Insurance Effects on Inpatient Utilization in Indonesia
Ahmad Nizar Shihab1, Armyn Nurdin2, Abdul Kadir3, HasbullahThabrany4, Idrus Paturusi3
1Postgraduate Student, 2Faculty, 3Professor,
Faculty of Medicine, Universities Hasanudin, Indonesia
4Professor, Faculty of Public Health, Universities Indonesia, Indonesia
Corresponding Author: Ahmad Nizar Shihab
ABSTRACT
Introduction: Disparities in geographic access, health facilities, human resources, health, and economic status of the community resulted in disparities in the utilization of inpatient health care. It is a challenge in achieving Universal Health Coverage (UHC) in Indonesia. The National Health Insurance Program (JKN) was an attempt by the Indonesian government to achieve UHC. Since it was first implemented in 2014, the membership of JKN includes 155.4 million people in 2015, rising to 171 million by 2016 from the total target of 254 million people in Indonesia to be achieved by 2019.
Aims & Objectives: This study aimed to analyze the effect of JKN on the utilization of inpatient care in government hospitals and private hospitals of the year before (2013) and one year after (2015) the National Health Insurance program (JKN) implemented.
Materials & Methods: This study uses a quantitative approach. Quantitative methods implemented through literature and statistical data analysis of Susenas (National Social Economic Survey) in 2013 and 2015.
Results: The study found that the program JKN increase the utilization of hospitalization both in the government and private hospitals. Number of percentages, delta values, and odds ratios illustrate that JKN program open wider access to the nationwide inpatient utilization. The increase in inpatient utilization can be influenced by several factors such as the increase in the number of health facilities collaborate with National Health Insurance Agency (BPJS), and the increasing number of JKN participants that got tuition assistance from the government for the poor and underprivileged citizens/Recipient Contribution (PBI). Although all the provinces in Indonesia increased in utilization, there are 17 provinces that are below the national average because of disparities in the availability of facilities and infrastructure, health human resources, and equity in participation of JKN.
Conclusion: JKN Program increases the utilization of inpatient care in government and private hospitals despite various disparities between provinces and regions of the major islands in Indonesia are still found.
Key words: Inpatient Utilization, National Health Insurance (JKN), Disparity, Universal Health Coverage (UHC).