THE EFFECT OF PARTICIPATION IN JKN ON UNMET NEEDS FOR HEALTHCARE SERVICES
Background: The National Health Insurance or Jaminan Kesehatan Nasional (JKN) program is one of the steps taken by the Indonesian government in developing Universal Health Coverage (UHC). However, increased participation in the National Health Insurance is not followed by an increase in met needs for healthcare services.
Aims: This study aimed to examine the effect of participation in the National Health Insurance on unmet needs for healthcare services in poor and non-poor population groups.
Methods: This study used data from the 2018 National Socio-Economic Survey/ Survei Sosial Ekonomi Nasional (SUSENAS) and Village Potential Survey/ Survei Potensi Desa (PODES). Data were processed using binary logistic model analysis to identify the effect of participation in the National Health Insurance on the unmet needs for healthcare services.
Results: Participation in the National Health Insurance, including beneficiary program for poor groups could reduce the risks of unmet needs for healthcare services by 7.7%, while non-beneficiary program could reduce the risks of unmet needs for health services for non-poor groups by 10.4%.
Conclusion: Both beneficiaries and non-beneficiaries affect the unmet needs for health services for both poor and non-poor groups. However, the non-beneficiary program is more elastic than beneficiary program to fulfill needs for both sample groups.
Keywords: Healthcare services, national health insurance, logit, unmet need
Başar, D., Dikmen, F.H. and í–ztürk, S. (2021) ‘The prevalence and determinants of unmet health care needs in Turkey', Health Policy, 125(6), pp. 786–792. Available at: https://doi.org/10.1016/j.healthpol.2021.04.006.
Boateng, E.Y. and Abaye, D.A. (2019) ‘A Review of the Logistic Regression Model with Emphasis on Medical Research', Journal of Data Analysis and Information Processing, 07(04), pp. 190–207. Available at: https://doi.org/10.4236/jdaip.2019.74012.
Burger, R. and Christian, C. (2018) ‘Access to health care in post-apartheid South Africa: availability, affordability, acceptability', Health Economics, Policy and Law, 15(1), pp. 43–55. Available at: https://doi.org/10.1017/s1744133118000300.
Choi, N.G., DiNitto, D.M. and Choi, B.Y. (2020) ‘Unmet Healthcare Needs and Healthcare Access Gaps Among Uninsured U.S. Adults Aged 50–64', International Journal of Environmental Research and Public Health, 17(8), p. 2711. Available at: https://doi.org/10.3390/ijerph17082711.
Connolly, S. and Wren, M.-A. (2017) ‘Unmet healthcare needs in Ireland: Analysis using the EU-SILC survey', Health Policy, 121(4), pp. 434–441. Available at: https://doi.org/10.1016/j.healthpol.2017.02.009.
Detollenaere, J. et al. (2017) ‘Do we reap what we sow? Exploring the Association between the Strength of European primary healthcare systems and inequity in unmet need', PLoS ONE, 12(1), pp. 1–13. Available at: https://doi.org/10.1371/journal.pone.0169274.
Fjí¦r, E.L. et al. (2017) ‘Subjective perceptions of unmet need for health care in Europe among social groups: Findings from the European social survey (2014) special module on the social determinants of health', European Journal of Public Health, 27(suppl_1), pp. 82–89. Available at: https://doi.org/10.1093/eurpub/ckw219.
Grossman, M. (2017) ‘1. On the Concept of Health Capital and the Demand for Health', in 1. On the Concept of Health Capital and the Demand for Health. Columbia University Press, pp. 6–41. Available at: https://doi.org/10.7312/gros17812-004.
Kim, Y. et al. (2019) ‘Poor People and Poor Health: Examining the Mediating Effect of Unmet Healthcare Needs in Korea', Journal of Preventive Medicine and Public Health, 52(1), pp. 51–59. Available at: https://doi.org/10.3961/jpmph.18.162.
Lindström, C., Rosvall, M. and Lindström, M. (2019) ‘Unmet health-care needs and mortality: A prospective cohort study from southern Sweden', Scandinavian Journal of Public Health, 48(3), pp. 267–274. Available at: https://doi.org/10.1177/1403494819863530.
Misnaniarti, M. et al. (2018) ‘Ketersediaan Fasilitas dan Tenaga Kesehatan Dalam Mendukung Cakupan Semesta Jaminan Kesehatan Nasional', Jurnal Penelitian dan Pengembangan Pelayanan Kesehatan, pp. 6–16. Available at: https://doi.org/10.22435/jpppk.v1i1.425.
OECD (2019) ‘Health at a Glance 2019 (Summary in English)'. OECD. Available at: https://doi.org/10.1787/e88a7402-en.
Otieno, P.O. et al. (2021) ‘Unmet need for primary healthcare and associated individual and household-level factors in Kenya: results from a national survey', BMJ Open, 11(5), pp. 1–6. Available at: https://doi.org/10.1136/bmjopen-2020-041032.
Rudiyanto, A. (2020) Metadata Indikator Pilar Pembangunan Sosial Pelaksanaan Pencapaian Tujuan Pembangunan Berkelanjutan/ Sustainable Development Goals (TPB/SDGs). Edisi II. Jakarta: Kedeputian Bidang Kemaritiman dan Sumber Daya Alam, Kementerian Perencanaan Pembangunan Nasional/ Badan Perencanaan Pembangunan Nasional. Available at: https://sdgs.bappenas.go.id/website/wp-content/uploads/2020/10/Metadata-Pilar-Sosial-Edisi-II.pdf.
Shrestha, R. (2021) ‘Health insurance for the poor, healthcare use and health outcomes in Indonesia', Bulletin of Indonesian Economic Studies, 57(1), pp. 85–110. Available at: https://doi.org/10.1080/00074918.2020.1753655.
United Nations (2022) ‘About the 2030 Agenda on Sustainable Development OHCHR and the 2030 Agenda for Sustainable Development'. Available at: https://www.ohchr.org/en/sdgs/about-2030-agenda-sustainable-development.
Wellay, T. et al. (2018) ‘Demand for health care service and associated factors among patients in the community of Tsegedie District, Northern Ethiopia', BMC Health Services Research, 18(1). Available at: https://doi.org/10.1186/s12913-018-3490-2.
WHO and World Bank (2017) Tracking Universal Health Coverage: 2017 Global Monitoring Report. Washington, DC: World Health Organization. Available at: https://doi.org/10.1596/978-92-4-151355-5.
Copyright (c) 2023 Farikh Alfa Firori, I Dewa Gede Karma Wisana
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
1. As an author you (or your employer or institution) may do the following:
- make copies (print or electronic) of the article for your own personal use, including for your own classroom teaching use;
- make copies and distribute such copies (including through e-mail) of the article to research colleagues, for the personal use by such colleagues (but not commercially or systematically, e.g. via an e-mail list or list server);
- present the article at a meeting or conference and to distribute copies of the article to the delegates attending such meeting;
- for your employer, if the article is a ‘work for hire', made within the scope of your employment, your employer may use all or part of the information in the article for other intra-company use (e.g. training);
- retain patent and trademark rights and rights to any process, procedure, or article of manufacture described in the article;
- include the article in full or in part in a thesis or dissertation (provided that this is not to be published commercially);
- use the article or any part thereof in a printed compilation of your works, such as collected writings or lecture notes (subsequent to publication of the article in the journal); and prepare other derivative works, to extend the article into book-length form, or to otherwise re-use portions or excerpts in other works, with full acknowledgement of its original publication in the journal;
- may reproduce or authorize others to reproduce the article, material extracted from the article, or derivative works for the author's personal use or for company use, provided that the source and the copyright notice are indicated.
All copies, print or electronic, or other use of the paper or article must include the appropriate bibliographic citation for the article's publication in the journal.
2. Requests from third parties
Although authors are permitted to re-use all or portions of the article in other works, this does not include granting third-party requests for reprinting, republishing, or other types of re-use.
3. Author Online Use
- Personal Servers. Authors and/or their employers shall have the right to post the accepted version of articles pre-print version of the article, or revised personal version of the final text of the article (to reflect changes made in the peer review and editing process) on their own personal servers or the servers of their institutions or employers without permission from JAKI;
- Classroom or Internal Training Use. An author is expressly permitted to post any portion of the accepted version of his/her own articles on the author's personal web site or the servers of the author's institution or company in connection with the author's teaching, training, or work responsibilities, provided that the appropriate copyright, credit, and reuse notices appear prominently with the posted material. Examples of permitted uses are lecture materials, course packs, e-reserves, conference presentations, or in-house training courses;
