The Sustainability of Premium Payment of National Health Insurance's Self-Enrolled Members in Jakarta Greater Area

Nurhasana, Renny; Hidayat, Budi; Pujiyanto, Pujiyanto; Ratih, Suci Puspita; Dartanto, Teguh

doi:10.4081/jphr.2021.2392

Cited by 5 publications

(4 citation statements)

References 18 publications

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“…Majority of the participants had some form of certi cates. This is consistent with studies by [13,17] which revealed that majority(more than 60%) and more than a third had graduated from senior high school or more respectively. Likewise, the nding in this study supports another one by [18].…”

Section: Discussionsupporting

confidence: 92%

Determinants of Nonrenewal of National Health Insurance (Nhi) Membership Cards Among Healthcare Workers in the Kintamponorth Municipality, Bono East Region of Ghana

Hallidu

Sumaila

2022

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Introduction: National Health Insurance Scheme (NHIS) was implemented in Ghana in 2004 to serve as the lifeline to realizing Universal Health Coverage (UHC). Available evidence suggests that, formal sector workers do not promptly renew their expired NHIS membership cards. This study was therefore conducted to unearth factors responsible for the failure of healthcare workers in the Kintampo North Municipality to promptly renew their health insurance membership whenever it expires. Methods: A descriptive cross-sectional approach was used to conduct this study where three hundred and ninety-seven (397) participants were recruited using a proportionate stratified sampling technique. All variables with a p-value <0.25 at the bivariate analysis level were selected and put into multiple logistic regression analysis models for statistical significance (p-value < 0.05). Odds ratios with their corresponding 95% Confidence Interval were reported. A p-value < 0.05 was set as level of significance.Results: Almost all the respondents (94.0%) had NHIS membership cards; out of which 70.7% had valid membership cards. 40.0% did not renew their expired NHIS membership cards for more than 7 months. From the study, reasons given for health workers’ inability to promptly renew NHIS membership included: 212 (19.8%) indicated forgetfulness, busy schedules 191 (17.9%), procrastination 167 (15.6%), self-medication 170 (15.9%) and utilization of spiritual homes (4.5%). All socio-economic factors were significantly associated at the bivariate level (p<0.05). However, in the multiple logistic regression model, employment status, the type of health staff and monthly salary lost their statistical significance. Conclusion: NHIS subscription and membership renewals is high among healthcare works in the Kintampo North District of the Bono East Region of Ghana. However, there is the need to encourage those who do not renew their expired cards by ensuring that more NHIS cards renewal centers are established at close proximity to the health facilities. It will be prudent for NHIS to liaise with Government of Ghana (GoG) to put measures in place to facilitate automatic membership renewals for public sector workers who for some other reasons often fail to renew their cards.

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Section: Discussionsupporting

confidence: 92%

Determinants of Nonrenewal of National Health Insurance (Nhi) Membership Cards Among Healthcare Workers in the Kintamponorth Municipality, Bono East Region of Ghana

Hallidu

Sumaila

2022

Preprint

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“…Higher income among the population increases people's interest and awareness to comply with premium payments (Russell, 1996). Income is a facilitating factor directly influencing individual behavioral changes (Nurhasana et al, 2022). In this context, income is a factor that enables behavioral changes necessary to afford selfpayment of BPJS Kesehatan premiums.…”

Section: Resultsmentioning

confidence: 99%

The Influence of Motivation, Knowledge, and Ability to Pay on Compliance in Paying Premiums for Self-Participants in the National Health Insurance Program in West Lombok Regency

Saimi,

Khaliq,

Atmaja

2023

J. Prisma. Sains

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Compliance among participants in the self-funded health insurance scheme to pay premiums is crucial to facilitate access to healthcare services. Lack of knowledge, motivation, and the ability to pay are factors contributing to payment arrears. The aim of this research is to identify the factors influencing the compliance of self-funded health insurance participants in paying premiums in West Lombok Regency in 2022. This study is a quantitative research using a cross-sectional design. The population in this study consisted of 50,630 individuals. The research sample included 397 people selected using the Multistage cluster random sampling technique. Data analysis involved univariate and bivariate analysis, with chi-square and logistic regression tests. The research results indicate a correlation between the level of knowledge (0.03), motivation (0.000), and the ability to pay (0.000) with the compliance of self-funded health insurance participants in paying premiums. Meanwhile, the most dominant influencing factor is motivation (p=0.000; OR=32.410). Social Security Administering Agency - Health (BPJS - Kesehatan) is expected to enhance information and socialization efforts among participants regarding the national health insurance program so that the public is motivated to be more compliant in premium payments, and to provide flexible payment options for participants with irregular incomes in the form of installment payments.

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“…In the PPU scheme, gainfully employed workers must pay their insurance premiums monthly through their employer (Thaib and Samad, 2021). Additionally, the self-enrolled or Pekerja Bukan Penerima Upah (PBPU) scheme is a different non-subsidized scheme targeted at entrepreneurs and investors (Nurhasana et al, 2022). As of September 2022, 60.7% of JKN users were 'poor' and subsidized under the PBI scheme.…”

Section: Introductionmentioning

confidence: 99%

Income Disparity and Healthcare Utilization: Lessons from Indonesia’s National Health Insurance Claim Data

Nugroho,

Ahsan,

Kusuma

et al. 2023

Asian Pac J Cancer Prev

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Background: Indonesia’s National Health Insurance Program, known as Jaminan Kesehatan Nasional (JKN), has a variety of membership pathways for those wishing to gain access. Claim data from JKN offers a cost-effective way of observing who is accessing healthcare services and what types of services are being used. This study is a novel attempt to measure disparities amongst JKN users in their engagement with services, providing an opportunity to reflect on patterns of use. Methods: Using claims data collected from JKN users between 2015–2016, we used the Ordinary Least Square estimation model to compare health services utilization among subsidized and non-subsidized users. We focused primarily on the individual use of the hospital for outpatient and inpatient treatment. Results: Analysis reveals that subsidized users access primary healthcare services more frequently than non-subsidized users. Conversely, non-subsidized users access secondary and tertiary health care services more frequently than other users. Subsidized users who utilize secondary and tertiary health care tend to suffer more severe health illnesses than non-subsidized members. Conclusions: This study concludes that income disparity affects healthcare utilization. Non-subsidized members are more likely than subsidized members to access secondary and tertiary health care services. Our study offers evidence of the potential underutilization of secondary and tertiary healthcare (STHC) by subsidized members, which could lead to inefficiency since subsidized members seeking STHC treatment had severe health conditions, thus needing to be treated longer and requiring higher healthcare expenditures.

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The Sustainability of Premium Payment of National Health Insurance's Self-Enrolled Members in Jakarta Greater Area

Cited by 5 publications

References 18 publications

Determinants of Nonrenewal of National Health Insurance (Nhi) Membership Cards Among Healthcare Workers in the Kintamponorth Municipality, Bono East Region of Ghana

Determinants of Nonrenewal of National Health Insurance (Nhi) Membership Cards Among Healthcare Workers in the Kintamponorth Municipality, Bono East Region of Ghana

The Influence of Motivation, Knowledge, and Ability to Pay on Compliance in Paying Premiums for Self-Participants in the National Health Insurance Program in West Lombok Regency

Income Disparity and Healthcare Utilization: Lessons from Indonesia’s National Health Insurance Claim Data

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