Evaluasi manfaat program jaminan kesehatan daerah bagi masyarakat kota Yogyakarta
Date
2012
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Kebijakan dan Manajemen Kesehatan, Universitas Gadjah Mada, Yogyakarta, ID
Abstract
Background: The Program of Community Health Insurance
Scheme (Jamkesda) in Yogyakarta Municipality is organized
by the Technical Unit Regional Health Insurance Provider (UPT
PJKD) with funds from the municipal budget. The rules about
membership, benefits and amount of Jamkesda are appointed
in the Mayor Regulation. There has been no comprehensive
research about benefits and the perceived difficulty when
using Jamkesda. Therefore, this research aims to determine
this issue.
Methods: This was an observational study using quantitative
and qualitative methods. The quantitative respondents (n
= 154) were selected accidentally when the patients were
being treated at two hospitals in Yogyakarta and were based
on the recapitulation of the claims in the previous month. The
qualitative respondents (n = 10) were selected by purposive
sampling for patients with chronic illnesses and with very high
claims. Data collection was taken by questionnaire and guideline
for in-depth interviews to Jamkesda participants who had
been treated in the two hospitals.
Results: The respondents perceived that Jamkesda was
beneficial despite objecting to 51.30% of the cost sharing.
Therefore, in in-depth interviews five respondents expressed
that they had to borrow money to pay for it. A total of 61.04%
respondents used a letter of recommendation from Department
of Social, Labor and Transmigration (those with no health
insurance). Difficulty in handling the identity of membership
was only experienced by 16.23%, while 78.57% had no problem
in it. Those who found difficulty were looking for a solution
to the government administrator as RT/RW, parliaments, NGOs
and neighbors. Around 78.57% of respondents did not understand
about the Jamkesda service limit; they only knew information
relating to their current interests. A total of 89.61%
respondents knew that Jamkesda was an aid. All respondents
in in-depth interview and around 73.38% respondents
paid the cost sharing more than 10% of total claims. From the
total household expenditure, almost all (99.35 %) were catastrophic
as the health spent more than 40% of their household
expenditure whereas 73.38% earned below the minimum wage
income.
Conclusion: High cost sharing can result in large catastrophic
expenses. Therefore, there is a need for reassessing the
Jamkesda benefit package in order that the financial protection
of household can be achieved.
Description
item.page.type
Journal Article (peer-reviewed)
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Text
Keywords
HEALTH INSURANCE, INDONESIA, MUNICIPAL GOVERNMENT, POLICY MONITORING, HEALTH EXPENDITURE, HOUSEHOLD EXPENDITURE, METHODS OF PAYMENT, MEDICAL INDIGENCY, OUT-OF-POCKET PAYMENTS, HEALTH POLICY
Citation
Rohadanti, Riyarto, S., & Siwi Padmawati, R. (2012). Evaluasi manfaat program jaminan kesehatan daerah bagi masyarakat kota Yogyakarta. Jurnal Kebijakan Kesehatan Indonesia, 1(2): 77-83.