Utilization of JKN Mandiri Participants Health Services in Barru General Hospital since Achievement of Universal Health Coverage (UHC) Participation

  • Dewi Sartika Postgraduate Magister Program, Postgraduate School of Hasanuddin University, Makassar 90245, Indonesia
  • Amran Razak Department of Health Policy and Administration, Faculty of Public Health, Hasanuddin University, Makassar 90245, Indonesia
  • Rahmatia Yunus Department of Economics, Faculty of Economics, Hasanuddin University, Makassar 90245, Indonesia
Keywords: JKN Mandiri, UHC, Service Utilization.

Abstract

The World Health Organization formulates three dimensions in achieving universal coverage, namely the first dimension is guaranteed population, the second dimension is guaranteed health services and the third dimension is the proportion of guaranteed health costs. Along with the introduction of JKN, the health service system is expected to gradually increase the reach of health services to the community towards Universal Health Coverage. Barru District has received an award from the Governor of South Sulawesi as a district that has achieved Universal Health Coverage (UHC) participation dimension in 2018. In membership of Health Social Security Organizing Agency, independent participants are non-permanent. Increased independent participation is not in line with its compliance in paying JKN contributions. In accordance with Presidential Regulation No. 82 of 2018, the guarantee status is not active when participants are late in paying contributions. Total contributions are in arrears and penalties must be paid off before service can be provided. This research was conducted to describe the utilization of JKN Mandiri Participants' health services at Barru General Hospital after achieving 100% Universal Health Coverage (UHC) participation in Barru District according to the three dimensions of UHC achievement, namely participation, health service aspects and financing aspects. This type of research is descriptive research through a qualitative approach.Qualitative data about information was obtained by Focus Group Discussion and in-depth interviews using interview guidelines, document studies, and direct observation. From the aspect of participation, there are still JKN Mandiri participants who do not adhere to paying contributions, from the aspect of health services, health services in Barru Hospital are good, from the aspect of financing, there are still out of pocket payments from JKN Mandiri participants.

References

Situmeang, L. E., & Hidayat, B. J. J. K. K. I. J. “The Effect of Health Insurance Ownership on Household Catastrophic Health Expenditures in Indonesia in 2012”, vol. 7, no. 1, pp 1-9, 2018.

Nugraheni, S. W. “Evaluation of the Implementation of National Health Insurance in DR Moewardi General Hospital Surakarta”. Jurnal INFOKES Universitas Duta Bangsa Surakarta, vol. 5, no. 2, 2015.

Kusumaningrum, A., & Azinar, M. J. H. “Community Participation in a National Health Insurance Independently”, vol. 2, no. 1, pp.149-160, 2018.

Presidential Regulation Number 82 of 2018 concerning Health Insurance. 2018.

Pangestika, V. F., Jati, S. P., & Sriatmi, A. J. J. K. M. “Factors Relating to the Participation of the Informal Sector in the Mandiri Health BPJS in Poncol Sub-District, Pekalongan Timur District, Pekalongan”, vol. 5, no.3, pp.39-48, 2017.

Agustina, R., Dartanto, T., Sitompul, R., Susiloretni, K. A., Achadi, E. L., Taher, A., . . . Shankar, A. H. J. T. L. Universal health coverage in Indonesia: concept, progress, and challenges. 2018.

Dartanto, T., Rezki, J. F., Pramono, W., Siregar, C. H., Bintara, U., & Bintara, H. “Participation of informal sector workers in Indonesia's national health insurance system”. Journal of Southeast Asian Economies, pp. 317-342, 2016.

AR, C. Compliance with Paying and Quality of BPJS Mandiri Patient Health Services in Haji General Hospital Makassar. Universitas Hasanuddin, Makassar. 2017.

Fatma, I. Relationship between Negative News of Health BPJS in Mass Media and Intensity of Word of Mouth Communication in Communities with the Level of Public Trust in the Quality of BPJS Health Services. Faculty of Social and Political Sciences. 2018.

BPJS Health. Encouraging Quality Improvement of Hospital Services for JKN-KIS Participants. BPJS Health Info. 2017.

Widiastuti, I. J. P. I. “Services of the Health Social Security Organizing Agency (BPJS) in West Java”. vol. 2, no. 2, pp.91-101, 2018.

WHO. The world health report: health systems financing: the path to universal coverage: executive summary: Geneva: World Health Organization. 2010.

Evans, D. B., & Etienne, C. Health systems financing and the path to universal coverage: SciELO Public Health. 2010.

Ramadhani, S. Factors Associated with Utilization of Health Services at Independent Participants in Health BPJS at Sumbersari Health Center 2017. 2017.

Siswoyo, B. E., Prabandari, Y. S., & Hendrartini, Y. “Informal Sector Worker Awareness of the National Health Insurance Program in the Special Province of Yogyakarta”. Jurnal Kebijakan Kesehatan Indonesia: JKKI, vol. 4, no. 4, pp. 118-125. 2015.

Endartiwi, S. S. Persepsi masyarakat terhadap kemauan untuk mendaftar menjadi peserta mandiri jaminan kesehatan nasional (JKN). Journal of Health Studies, 2(2), 81-92. 2018.

Rismawati, R., Lisnawaty, L., & Jufri, N. N. “Factors Related With Compliance Paying Of BPJS Mandiri Insurance/ Contribution In The Working Area Of Batalaiworu Public Health Center In 2017”. Jurnal Ilmiah Mahasiswa Kesehatan Masyarakat, vol. 2, no. 8. 2017.

(TNP2K), T. N. P. P. K. Travel to National Health Insurance. Jakarta. 2015.

Minister of Health Regulation Number 54 of 2014 concerning Hospital Classification and Licensing. 2014.

Yustina, I., & Aulia, D. Differences in Hospital Utilization by BPJS Patients in Medan City Private Hospital (Comparative Study in Indonesian Workers' Imelda Hospital and Martha Friska Hospital) 2017. 2018.

Anggraheni, N. V., Muhlisin, H. A., & Ambarwati, S. P. Factors Affecting Community Decision Making for Choosing Health Services in PKU Muhammadiyah Simo Hospital Boyolali District. Universitas Muhammadiyah Surakarta. 2012.

Gunawan, W. H., & Sugiarto, Y. Analysis of the influence of the quality of medical services and administrative services on patient loyalty (Study of inpatients at Pertamina Cirebon hospital). Fakultas Ekonomika dan Bisnis. 2013.

Laili, E. Effect of Characteristics of the Poor and Health Services on the Utilization of Services for the Pandan Regional General Hospital in Tapanuli Tengah District in 2007. 2008.

Hasbi, F. H. “Analysis of the Relationship between Patient Perception of Service Quality and Reuse of Outpatient Services in Poncol Semarang City Health Center in 2012”. Jurnal Kesehatan Masyarakat Universitas Diponegoro, vol. 1, no.2, 2012.

Purwantara, I. K. G. T., & Sandy, P. W. S. J. Service Quality of BPJS and General Patients in Hospitals in Buleleng, Bali. MIDWINERSLION Jurnal Kesehatan, vol.3, no. 2, pp. 236-240, 2018.

Minister of Health Regulation Number 51 of 2018 concerning Costs and Cost Difference in the JKN Program. 2018.

WHO. Making Fair Choices On The Path To Universal Health Coverage: Final Report Of The WHO Consultative Group On Equity And Universal Health Coverage. 2014.

Christasani, P. D., & Satibi, S. “Demographic Factor Study of Patient Satisfaction National Health Insurance at First Level Health Facilities”. Journal of Pharmaceutical Sciences and Community, vol. 13, no. 1, pp. 28-34. 2016.

Published
2019-07-03
Section
Articles