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

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.

DOI