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Despite improvements in healthcare access through the National Health Insurance (JKN) program, Indonesia continues to face challenges such as uneven distribution of facilities, limited healthcare professionals, and low public trust in domestic services. These conditions have led many Indonesians to seek medical care abroad, resulting in an estimated foreign exchange loss of up to IDR 165 trillion per year. This study aims to analyze factors associated with the types of overseas health services chosen by Indonesians using data from the 2023 Indonesian Health Survey (SKI). A quantitative cross-sectional design was applied, covering 38 provinces. Over the past three years, medical check-ups were the most frequently selected service, followed by surgical procedures and other treatments. Predisposing factors, including age, gender, marital status, education level, and employment status, showed no significant relationship. In contrast, enabling factors such as health insurance ownership, availability of complete facilities, and destination country were significantly associated with service type. Need factors, particularly medical history, were not significantly related. These findings highlight the need to develop nationally prioritized services, improve preventive care quality, strengthen health service integration, and expand wellness-based services.
Chronic Kidney Disease (CKD) poses a significant financial burden, making the utilization of Advanced Outpatient Services (AOS) crucial, especially for National Health Insurance (JKN) participants. This cross sectional study involved 498 CKD patients who used AOS in 2023. The results showed that age, sex, marital status, membership segmentation, class of care entitlement, and facility ownership were significantly associated with AOS utilization (p<0.05). Age ≥65 years was the most dominant factor (AOR: 1.48; 95% CI: 1.29–1.69). All variables had a significant influence on the utilization of AOS among CKD patients.
Background: Health is a basic human need and a fundamental right of every citizen, as guaranteed by the 1945 Constitution of Indonesia. One of the government's strategic efforts to ensure this right is through the National Health Insurance (JKN) program, managed by BPJS Kesehatan since 2014. This program aims to achieve universal health coverage, improve access, and ensure equity in healthcare services in Indonesia. However, the implementation of this program faces various challenges, such as unequal distribution of healthcare workers, limited infrastructure, and disparities in service quality. Data from the 2023 Indonesia Health Profile and the 2023 Indonesia Health Survey (SKI) show that primary healthcare facilities, such as puskesmas, are the most frequently accessed by the public, although accessibility and service quality remain key issues. According to Anderson's Model, access to healthcare services is influenced by predisposing, enabling, and need factors. This study analyzes the utilization of healthcare services in Indonesia using data from the 2023 SKI, which evaluates trends in access and utilization of healthcare facilities over the past five years. Objective: This study aims to analyze the utilization of healthcare services based on 2023 SKI data. Methods: This study employs a cross-sectional design using secondary data from the 2023 SKI. The study population consists of JKN participants spread across 38 provinces. Analysis was conducted using chi-square tests and simple logistic regression to identify the relationship between the independent variables (predisposing factors: age, gender, education level, and employment status; enabling factors: health insurance ownership, travel time to healthcare facilities, and costs required to access healthcare facilities) and the dependent variable (utilization of healthcare facilities). Results: The study revealed significant relationships between age, gender, education, health insurance ownership, travel time, and costs to access healthcare facilities and the utilization of healthcare services in the past year. Conclusion: There is a significant relationship between predisposing and enabling variables and the utilization of healthcare facilities.
Latar Belakang: Skizofrenia merupakan gangguan mental kronis yang menimbulkan beban signifikan terhadap sistem pembiayaan kesehatan, terutama dalam program Jaminan Kesehatan Nasional (JKN). Penyakit ini memerlukan perawatan jangka panjang dan rawan kekambuhan, sehingga berkontribusi terhadap tingginya angka kunjungan dan pembiayaan di fasilitas kesehatan, khususnya pada layanan rujukan. Tujuan: Mengetahui besarnya biaya pelayanan kesehatan peserta JKN dengan skizofrenia dan faktor-faktor yang berhubungan dengan biaya tersebut. Metode: Penelitian kuantitatif dengan desain cross-sectional menggunakan data sekunder BPJS Kesehatan tahun 2024. Sampel terdiri dari 1.597 peserta aktif JKN dengan diagnosis skizofrenia selama satu tahun. Analisis dilakukan secara univariat dan bivariat menggunakan SPSS versi 25. Hasil: Total biaya pelayanan mencapai Rp16.896.391.354. Rata-rata biaya rawat jalan Rp314.929 dan rawat inap Rp5.050.107. Biaya signifikan dipengaruhi oleh usia, hubungan keluarga, kelas hak rawat, segmentasi peserta, wilayah kepesertaan, jenis dan kepemilikan FKTP/FKRTL, kunjungan ke FKTP, dan tipe FKRTL. Kesimpulan: Skizofrenia memberikan beban biaya tinggi pada JKN. Diperlukan pembiayaan berbasis kebutuhan serta penguatan layanan jiwa di tingkat primer dan komunitas untuk efisiensi sistem.
Background: Schizophrenia is a chronic mental disorder that poses a significant burden on the healthcare financing system, particularly within Indonesia’s National Health Insurance (JKN) program. The condition requires longterm care and is prone to relapse, contributing to high healthcare utilization and costs, especially at referral level facilities. Objective: To determine the total healthcare costs for JKN participants diagnosed with schizophrenia and to identify factors associated with those costs. Methods: This quantitative study employed a crosssectional design using secondary data from BPJS Kesehatan (Indonesia’s Social Health Insurance) for the year 2024. The sample consisted of 1.597 active JKN participants diagnosed with schizophrenia over a 12 month period. Data were analyzed using univariate and bivariate techniques in SPSS version 25. Results: The total healthcare cost amounted to IDR 16.896.391.354. The average outpatient cost was IDR 314.929, while the average inpatient cost was IDR 5.050.107. Factors significantly associated with higher costs included age, family relationship status, treatment class, participant segmentation, region of enrollment, type and ownership of primary and referral healthcare facilities (FKTP/FKRTL), number of visits to primary care, and type of referral facility. Conclusion: Schizophrenia places a substantial financial burden on the JKN system. A need-based financing approach and strengthened mental health services at the primary and community levels are essential to improving efficiency and sustainability.
Penelitian ini bertujuan untuk mengetahui hubungan faktor umur ibu, pendidikan ibu, pekerjaan ibu, jarak, waktu tempuh, alat transportasi, penolong persalinan, dan kabupaten dengan pemanfaatan pelayanan kesehatan imunisasi dasar di Kabupaten Ketapang, Sanggau, dan Sintang tahun 2007. Penelitian ini adalah penelitian kuantitatif dengan rancangan cross sectional yang menggunakan data sekunder yaitu data Riskesdas tahun 2007. Hasil analisis faktor yang berhubungan dengan pemanfaatan pelayanan kesehatan imunisasi dasar di Kabupaten Ketapang, Sanggau, dan Sintang adalah faktor pendidikan ibu dan jarak ke fasilitas UKBM maupun non UKBM. Berdasarkan hasil analisis multivariat, faktor yang paling berpengaruh adalah alat transportasi. Saran dari penelitian ini adalah agar dinas kesehatan perlu kerjasama lintas sektor dengan dinas perhubungan. Ketersediaan alat transportasi umum sebagai faktor pendukung akan mempermudah akses bagi masyarakat ke fasilitas kesehatan untuk memanfaatkan pelayanan kesehatan imunisasi dasar. Peningkatan pengetahuan ibu pentingnya imunisasi melalui media komunikasi seperti siaran radio daerah, poster dan lain-lainnya. Selain itu mobilisasi petugas kesehatan ke lokasi yang sulit dijangkau perlu diaktifkan.
This study is aim to determine the relation factors of maternal age, maternal education, maternal employment status, the range to health facility (UKBM and non UKBM), travel time, availability of transportation, maternity helper, and municipal with utilization of health services for the basic immunization in Ketapang, Sanggau, and Sintang district in 2007. This study is a quantitative research with cross sectional design using secondary data from Riskesdas 2007. The results of related factors to the utilization of health services for the basic immunization in 3 districts are maternal education and the range to health facility (UKBM and non UKBM). The result of multivariate analysis, the most influential factor is the availability of transportation. Suggestions from this study are the health authorities need to cooperate with other sectors, such as local transportation department. The availability of public transportation as an enabling factor to access health facilities for utilizes the health services of basic immunization. Improving knowledge for mother regarding the benefit of basic immunization through radio broadcasts, posters and others. In addition to the mobilization of health workers is difficult to reach locations that need to be activated.
