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Seven years since the national health insurance scheme (JKN) was introduced, coverage in DKI Jakarta Province has reached 85% of the population, but the average out-of-pocket (OOP) health expenditure of DKI Jakarta residents is twice that of the national expenditure. The high JKN coverage was accompanied by an increase in OOP in DKI Jakarta Province. This study focuses on understanding how health insurance ownership relates to health service utilization and cash health expenditure in DKI Jakarta Province. This study uses secondary data from Susenas Kor in 2021. The quantitative analysis conducted in this study includes two stages, the first stage using individual-level data to determine the determinants of individual health behavior on health service utilization. The second stage was carried out using household-level data to determine the tendency of health insurance utilization with out-of-pocket health expenditure in DKI Jakarta Province. This study found that the economic status of the population in quintile one (Q1) and quintile two (Q2) is the largest group of people who do not have health insurance. The results of the first stage of analysis show that DKI Jakarta residents prefer privately-run health facilities for outpatient utilization, while government-operated health facilities are slightly superior for inpatient utilization. Residents who have JKN will use it for outpatient and inpatient utilization. The results of the second stage showed that the out-of-pocket cash health expenditure of people with national health insurance (JKN) was lower than that of people without health insurance. Residents who have dual/combination health insurance (JKN and private) when utilizing health services are using private health insurance. The higher the economic status of the population, the higher their health expenditure. This study suggests that the government should pay close attention to the coverage of health insurance among people with low economic status. It also needs to encourage people to make more use of JKN when utilizing outpatient and inpatient care in order to further reduce financial risk, especially for people with vulnerable household members.
Kepemilikan asuransi kesehatan mempunyai pengaruh terhadap pemanfaatan sarana layanan kesehatan. Di Provinsi Jambi orang yang memiliki asuransi kesehatan dan memanfaatkan sarana layanan kesehatan masih rendah bila dibandingkan dengan persentase nasional asutansi kesehatan baru mencapai 33% dari jumlah penduduk, sedangkan yang memanfaatkan sarana layanan keseha1an rawat jalan baru mencapai 34,70% dan rawat inap baru mencapai 2,25%. Selain kepemilikan asuransi kesehatan pemanfaatan sarana layanan kesehatan dipengaruhi juga oleh faktor lain seperti, jenis kelamin, umur, pendidikan, pekerjaan, pendapatan, wilayah tempat tinggal (kota/desa) dan keluhan kesehatan. Penelitian ini menggunakan desain cross sectional dan bertujuan untuk mengetahui apakah kepemilikan asuransi kesehatan di Propinsi Jambi mempengaruhi pemanfaatan sarana layanan kesehatan untuk rawat jalan dan rawat inap, baik milik pemerintah maupun swasta. Data yang digunakan adalah data sekunder hasil Survei Sosial Ekonomi Nasional (Susenas) yang dilaksanakan pada tahun 2006 dengan menggunakan kuesioner VSEN2006.K. Populasi pada penelitian ini adalah penduduk Propiosi Jambi, sedangkan sampel adalah semUa individu yang diwawancarai atau yang di data oleh petugas pencacah. Untuk mengetahui hubungan masing-masing variabel digunakan uji bivariat, kemudian dilanjutkan dengan uji multivariat Uji statistik yang diperlukan pada analisis bivariat digunakan uji kai kundrat dan uji T, sedangkan untuk uJi analisis multivariat memakai uji regresi logistik. Hasil penelitian menemukan bahwa faktor kepemilikan asuransi kesenatan, kelompok umur, wilayah (kota/desa), dan ke1uhan sakit berhubungan dengan pemanfaatan sarana layanan kesehatan rawat jalan. Untuk rawat inap faktor yang berhubungan adalah kepemilikan asuransi kesehatan, kelompok umur, wilayah (kota/desa), keluhan sakit dan pendapatan. Penelitian ini merekomendasikan agar pemerintah memberikan pelayanan kesehatan yang merata, memberikan perhatian yang serius terhadap asuransi untuk orang miskin di Propinsi Jambi, baik dari segi pendataan maupun pendanaan.
Health insurance has influence on utilizalion of health care facilities in Jambi Province. Persentage of people who had health insurance and have utilized health care facilities were lower than national percentage. Health insurance covered only 33% in Jambi and only 34,7% of them have utilized out patient care, 2,25% of them have utilized in patient care of health centres. Bisides health insurance, health care utilization are influenced by other factors such: as sex, age, education, employment status, income, geogrofiphic (urban/rural) and symptoms illness. This research was designed as cross sectional study, aimed to know whether health insurance ownership in Jambi Province influenced the utilization of public or private health care centres, for out patient care and inpatient care. This research used data from the 2006 Nasional Socioeconomic Survey, called Susenas, Only data from questioner VSEN 2006.K was used in this research. Populations of the research was an people in Jambi province. All individuals interviewed in Susenas were enrolled as samples in this research. Bivariate analysis was to fird the relationship among variables. Those variables were then analyzed by multivariate analysis. Statistical test that was used for bivariate analysis were chi-square test and T-test, and test for multivariate analysis were logistic regretion test, The research findings found that factors such health insurance ownership, age, geographic (urband/rural), symptom of illness were related to outpatient health care. Utilization of inpatient hearth care were related to health insurance ownership, age, geographic (urband/rural), symptom of illness, and income. The findings of this research recommended government to increase equity in health care services, to give great intentios in health insurance for the poor in Jambi Province especia1ly in collecting data of the poor and funding system.
Penelitian ini bertujuan mengetahui peran jaminan kesehatan dan determinan yang mempengaruhi pemanfaatan pelayanan kesehatan oleh penyandang disabilitas di Indonesia pada tahun 2021 menggunakan data Susenas Maret 2021. Variabel terikat penelitian ini adalah pemanfaatan pelayanan kesehatan rawat jalan dan rawat inap di FKTP dan FKRTL. Data dianalisis secara bivariat dan multivariat dengan metode Binary Regression menggunakan model logit. Diketahui variabel kepemilikan jaminan kesehatan, pemanfaatan JKN, jenis disabilitas, tingkat keparahan disabilitas, jenis kelamin, pendidikan, status pekerjaan, status kawin, jumlah anggota rumah tangga, dan karakteristik tempat tinggal serta status ekonomi berpengaruh signifikan pada pemanfaatan layanan rawat jalan dan rawat inap (p-value 0,000 <0,005). Kepemilikan jaminan kesehatan non JKN atau kepemilikan jaminan kesehatan ganda (JKN dan non JKN) meningkatkan peluang pemanfaatan layanan baik rawat inap maupun rawat jalan. Terjadi penurunan kepemilikan jaminan kesehatan terhadap peningkatan status ekonomi penyandang disabilitas (propoor). Sebaliknya terjadi tren peningkatan pemanfaatan jaminan kesehatan terhadap peningkatan status ekonomi keluarga penyandang disabilitas (prorich).
This research aims to determine the role of health insurance and the determinants that influence the use of health services by people with disabilities in Indonesia in 2021 using Susenas data for March 2021. The dependent variable of this research is the use of outpatient and inpatient health services at FKTP and FKRTL. Data were analyzed bivariately and multivariately using the Binary Regression method using the logit model. It is known that the variables of ownership of health insurance, utilization of JKN, type of disability, severity of disability, gender, education, employment status, marital status, number of household members, and characteristics of residence and economic status have a significant effect on the utilization of outpatient and inpatient services ( p-value 0.000 <0.005). Ownership of non-JKN health insurance or ownership of dual health insurance (JKN and non-JKN) increases the chances of utilizing both inpatient and outpatient services. There has been a decrease in ownership of health insurance due to an increase in the economic status of people with disabilities (propoor). On the contrary, there is a trend of increasing use of health insurance towards increasing the economic status of families of people with disabilities (prorich).
Indonesia's health development geared to achieve national health insurance scheme (JKN).However, funding of health in Indonesia is still dominated by domestic funding through out-of-pocket (OOP). Catastrophic health expenditure of households will disrupt householdconsumption and can lead to poverty. By using secondary data of the National Social Surveys(Susenas) 2012, this study aims to prove health insurance ownership lowers catastrophic healthexpenditure of households in Indonesia in 2012. This study used a cross-sectional study designwith models probit and bivariate probit. The results found that the health insurance ownershiplowers catastrophic health expenditure in the amount 12.97% at the threshold 10% of totalexpenditure and 18.42% at 20% of total non-food expenditure. Health insurance ownershipprovides protection for catastrophic health expenditure in Indonesia in 2012.Keywords: Health insurance, Catastrophic health expenditure, Probit, Bivariate probit, Susenas.
Institutional delivery has an impact on decreasing maternal mortality. InIndonesia, institutional delivery increases every year, but there are still 30%-37%delivery at home. Unfortunately, the increase did not in line with maternalmortality reduction so that Indonesia did not achieve the fifth MDGs goal. Inorder to achieve Universal Health Coverage, Indonesia implemented JaminanKesehatan Nasional (JKN) for all. JKN integrated four types of health insurance.One of its benefits is maternal health services. Health insurance can addressfinancial barriers on delivery in health facility.Using secondary data of Riskesdas 2013 and Podes 2011, the study aims toinvestigate the effect of health insurance on institutional delivery in Indonesia.The estimation of the effect used probit and bivariate probit models to take intoaccount the issue of endogeneity of health insurance.The result found that health insurance tends to increase institutional delivery by39.52%. Furthermore, the increase is expected to reduce maternal mortality.Keywords: Health insurance, Institutional delivery, Probit, Bivariate probit.
Lack of dental health services utilization in Indonesia became a problem aslong as it becomes a constraint in increasing degree movies health in Indonesiabecause according to Undang-undang no 36 tahun 2009 that oral health servicesdone to nurture and increases public health degree movies. Data from the sudyshowed poor dental health service utilization whereas the prevalence of dentalcaries in Indonesia is quite high. Researchers would like to see the dental healthservice utilization determinants in Indonesia.This research is analysis of data secondary susenas 2012 that is researchquantitative to a draft cross sectional. This research see determina the utilizationof health services of health services teeth in Indonesia.The result analysis shows that a factor of age, gender, the status ofmarriage, the status of education, the status of the job and the satatus of thedwelling place of not show a very strong in the harness of health services inIndonesia, the teeth insurance, while a factor of possession economic status, theregion of domicile, and any disturbance activity showed a very strong against theutilization of health services teeth in Indonesia.Advice from this study is due to the powerful relationship betweeninsurance with the utilization of health service should tooth-reinsurance coveragesexpanded especially for the poor health services so that the utilization rise, canalso distribution dentist must be distributed properly.Key words :Determinant, Unmet Need, Utilization, Susenas 2012.
In addition to morbidity and mortality are high, financing catastrophic diseases(kidney failure, cardiovascular disease, cancer, thalassemia and hemophilia) thatabsorb very high cost should be a serious concern. The study aims to analyze thecost of catastrophic diseases based on the characteristics of participants.Quantitative research analytical uses claims data in the form of data BPJSparticipants and costs in 2014 amounted to 309 301 claims. The analysis showedsignificant difference in the average cost of catastrophic illness according tolength of stay, classes and class hospital care. Promotive, preventive and diseasemanagement of patients need to be improved to achieve cost effectiveness andefficiency of health care in ensuring the sustainability of national health insuranceprogram.Key words:Catastrophic diseases, hospital expenses, characteristic of participant, promotive,preventive and disease management.
Berdasarkan SK Gub DKI Jakarta No. 2086 tahun 2006, 44 Puskesmas di Provinsi DK] Jakarta ditetapkan menjadi unit yang menerapkan Pola Pengelolaan Keuangan Badan Layanan Umum Daelah ( PPK BLUD ) secara bertahap. Penelitian ini bertujuan untuk mengetahui gamharan realisasi anggaran kesehatan bersumber pemerintah provinsi di 42 puskesmas DKI Jakarta untuk periode tahun 2007-2009 paska menerapkan PPK BLUD. Desain penelitian adalah deskriptif. Data yang dikumpulkan adalah data sekunder yang berasal dari laporan keuangan puskesmas tahun 2007- 2009. Hasil penelitian menunjukkan bahwa realisasi anggaran di Puskesmas DKI Jakarta dari tahun 2007 sampai dengan 2009 cenderung meningkat yaitu Rp l7b.l66.506.28l (2007) , Rp 242.295.485.|2l (2008) dan Rp 247.076.8l0.111 (2009). Biaya perkapita berkisar dari USS 2 ( Jakarta Barat ) - USS 4,6 ( Jakarta Pusat ). Total pendapatan BLUD Puskesmasjuga menunjukkan peningkatan yaitu Rp 57.24l.949.0l7,- (2007), Rp 59.779.032.965 ,- (2008) dan Rp 65.745.497.256,- (2009). Realisasi anggaran rata-rata pertahun pada periode 2007-2009 untuk : upaya wajib 80%, program pzioritas 8l,08%. Berdasarkan sifat plogram : Kuratif 58%, preventif 2l%, promotif 0.98%. Berdasarkan jenis kegiatan : UK? 58%, UKM sebesar 22 %, Manajemen 13% dan investasi 6%. Berdasarkan kelompok belanja : BOP 85%. adum 8,56% , modal 5,76%. CRR 46,97%.
Under Decree of the Governor of DKI Jakarta Province No. 2086 ln 2006, 44 health centers in Jakarta Province enacted into units that implement the Financial Management Pattems Regional Public Service Board gradually. This research aims to reveal the health budget comcs in 42 health centers of the provincial govemment of DKI Jakarta for the period 2007-2009 afler applying Financial Management Panems Regional Public Service Board. The study design is descriptive. Data collected is secondary data derived from the consolidated financial health centers in 2007-2009. The results showed that the realization of budget in Jakarta Health Center from 2007 to 2009 tended to increase the l76,l66,506,28l IDR (2007), 242,295,481 121 IDR (2008) and 247,076,8l0,l ll IDR (2009). Per capita costs ranged fiom U.S. S 2 (West Jakarta) - U.S. S 4.6 (Central Jakarta). Total revenues Regional Public Service Board PHC also showed an increase of 57,24I,949,0l7 IDR (2007), 59,779,032,965 IDR (2008) and 6S,745,497,256 IDR (2009). Total expenditure per year on average for the period 2007-2009: the effort required 80% 8l.08% priority programs. Based on the nature of the program : Curative 58%, 21% preventive, promotive 0.98%. Based on the types of activities: UKP 58%, 22% SME, investment Management l3% and 6%. Based on expenditure groups: BOP 85%, ADUM 8.56%, 5.76% of capital. CRR 46.97% .