The evaluation of Acehnese people's health insurance from the welfare perspectives

Muhammad Yani; Rachmad  Suhanda; Indrita  Iqbalawati; Diah Ayu  Puspandari; Hafasnuddin; Aditya  Candra; Teuku Muhammad  Ilzana; Teuku Muhammad  Khaled; Cut Rizka Rahmi

doi:10.15562/bmj.v12i1.4188

The evaluation of Acehnese people's health insurance from the welfare perspectives

Muhammad Yani ,

Rachmad Suhanda ,

Indrita Iqbalawati ,

Diah Ayu Puspandari ,

Hafasnuddin ,

Aditya Candra ,

Teuku Muhammad Ilzana ,

Teuku Muhammad Khaled ,

Cut Rizka Rahmi ,

pdf |
DOI: https://doi.org/10.15562/bmj.v12i1.4188 |
Published: 2023-02-22

Abstract

Link of Video Abstract: https://youtu.be/UEJWESqCEvo

Introduction: Indonesia has tried to implement the UHC system by implementing the National Health Insurance (JKN) program since 2014. To extend the coverage of JKN, the government of Aceh, one of the poorest provinces in Indonesia carries out Acehnese People's Health Insurance (JKA), which aims to improve the health and welfare of the people of Aceh. However, there has never been an evaluation of the usefulness of JKA related to the welfare of the Acehnese people. Therefore, this study aims to evaluate the impact of JKA on the level of welfare of the people of Aceh.

Methods: This was an ecological study with a cross-sectional approach to evaluate the correlation between welfare indicators (education, health, and housing) and Community Coverage Levels and Capitation Costs on Acehnese People's Health Insurance. All study data were taken from the Acehnese public health insurance accountability report and the people's welfare statistics report from the Central Statistics Agency. All data collected were analyzed using SPSS ver. 25.

Results: JKA has an average community coverage of about 2 million people with an average capitation payment of around 139 billion rupiahs from 2015 to 2021. Immunization coverage was significantly correlated with community coverage, non-capitation fee, and drug cost. In addition, drug costs are also significantly related to formal school coverage. Meanwhile, medical equipment cost was correlated with sanitation and internet coverage. However, other welfare indicators did not find a correlation between community coverage and capitation costs.

Conclusion: Some indicators of JKA were significantly correlated with several indicators of welfare in Aceh.

References

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Kruk ME, Chukwuma A, Mbaruku G, Leslie HH. Variation in quality of primary-care services in Kenya, Malawi, Namibia, Rwanda, Senegal, Uganda and the United Republic of Tanzania. Bull World Health Organ. 2017;95(6):408–18.
McIntyre D, Thiede M, Dahlgren G, Whitehead M. What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts? Soc Sci Med. 2006;62(4):858–65.
Ji JS, Chen L. UHC Presents Universal Challenges. Heal Syst reform. 2016;2(1):11–4.
Watkins DA, Jamison DT, Mills A, Atun R, Danforth K, Glassman A, et al. Universal Health Coverage and Essential Packages of Care [Internet]. 3rd ed. The International Bank for Reconstruction and Development / The World Bank, Washington (DC); 2017. Available from: http://europepmc.org/abstract/MED/30212154
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Fujikawa K. Settling with Autonomy after Civil Wars: Lessons from Aceh, Indonesia. Glob Policy. 2021;12(2):204–13.
Fuady MRF, Fuady M, Aulia F. Kemiskinan Multi Dimensi dan Indeks Pembangunan Manusia di Indonesia. TATALOKA. 2021;23(4).
Huang X, Yoshino N. Impacts of Universal Health Coverage: Financing, Income Inequality, and Social Welfare. SSRN Electronic Journal. 2017.
Holipah, Maharani A, Kuroda Y. Determinants of immunization status among 12- to 23-month-old children in Indonesia (2008-2013): a multilevel analysis. BMC Public Health. 2018;18(1):288.
Kuroki M, Liu X. The Effect of Health Insurance Coverage on Homeownership and Housing Prices: Evidence from the Medicaid Expansion. Soc Sci Q. 2021;102(2):633–48.
Zamzam AH, Abdul Wahab AK, Azizan MM, Satapathy SC, Lai KW, Hasikin K. A Systematic Review of Medical Equipment Reliability Assessment in Improving the Quality of Healthcare Services. Vol. 9, Frontiers in public health. Switzerland; 2021. p. 753951.
Tseng KK, Joshi J, Shrivastava S, Klein E. Estimating the cost of interventions to improve water, sanitation and hygiene in healthcare facilities across India. BMJ Glob Heal. 2020;5(12).
Nekui F, Galbraith AA, Briesacher BA, Zhang F, Soumerai SB, Ross-Degnan D, et al. Cost-related Medication Nonadherence and Its Risk Factors Among Medicare Beneficiaries. Med Care. 2021;59(1):13–21.
Dusetzina SB, Conti RM, Yu NL, Bach PB. Association of Prescription Drug Price Rebates in Medicare Part D With Patient Out-of-Pocket and Federal Spending. JAMA Intern Med. 2017;177(8):1185–8.
Yani M. Analisis Equity Jaminan Kesehatan Rakyat Aceh. Universitas Gadjah Mada; 2016.
Badan Pusat Statistik Aceh. Provinsi Aceh dalam Angka. Badan Pusat Statistik. Aceh; 2020.
Sulaiman A. Pengaruh Program Jaminan Kesehatan Aceh Terhadap Derajat Kesehatan Masyarakat Aceh. J Magister Ilmu Ekon. 2013;1(4):10–20.
Saputra E. Tantangan Dalam Koordinasi Jaminan Kesehatan Aceh. J Kependud Indones. 2016;8(1):17–27.
Adyas A. The Indonesian Strategy to Achieve Universal Health Coveragethrough National Health Insurance System: Challenges in Human Resources. Kesmas. 2021;16(4):221–7.
Rina S., Rosminah S. Willingness to pay and ability to pay for health care services at Zainoel Abidin public hospital Banda Aceh , Indonesia. Annu Int Conf Syiah Kuala Univ 2011. 2011;1(1):242–6.
Kesuma ZM, Chongsuvivatwong V. Utilization of the Local Government Health Insurance Scheme (JKA) for Maternal Health Services Among Women Living in Underdeveloped Areas of Aceh Province, Indonesia. Asia Pacific J Public Heal. 2014;27(3):348–59.
Heponiemi T, Jormanainen V, Leemann L, Manderbacka K, Aalto A-M, Hyppönen H. Digital Divide in Perceived Benefits of Online Health Care and Social Welfare Services: National Cross-Sectional Survey Study. J Med Internet Res. 2020;22(7):e17616.
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[1] World Health Organization. Everybody's business -- strengthening health systems to improve health outcomes : WHO's framework for action [Internet]. Geneva PP - Geneva: World Health Organization; Available from: https://apps.who.int/iris/handle/10665/43918

[2] World Health Organization. The world health report: health systems financing: the path to universal coverage [Internet]. Geneva PP - Geneva: World Health Organization; Available from: https://apps.who.int/iris/handle/10665/44371

[3] Xu K, Evans DB, Carrin G, Aguilar-Rivera AM, Musgrove P, Evans T. Protecting households from catastrophic health spending. Health Aff (Millwood). 2007;26(4):972–83.

[4] Kruk ME, Chukwuma A, Mbaruku G, Leslie HH. Variation in quality of primary-care services in Kenya, Malawi, Namibia, Rwanda, Senegal, Uganda and the United Republic of Tanzania. Bull World Health Organ. 2017;95(6):408–18.

[5] McIntyre D, Thiede M, Dahlgren G, Whitehead M. What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts? Soc Sci Med. 2006;62(4):858–65.

[6] Ji JS, Chen L. UHC Presents Universal Challenges. Heal Syst reform. 2016;2(1):11–4.

[7] Watkins DA, Jamison DT, Mills A, Atun R, Danforth K, Glassman A, et al. Universal Health Coverage and Essential Packages of Care [Internet]. 3rd ed. The International Bank for Reconstruction and Development / The World Bank, Washington (DC); 2017. Available from: http://europepmc.org/abstract/MED/30212154

[8] Mahendradhata Y, Trisnantoro L, Listyadewi S, Soewondo P, Marthias T, Harimurti P, et al. The Republic of Indonesia health system review [Internet]. Vol. 7, Health Systems in Transition. New Delhi PP - New Delhi: WHO Regional Office for South-East Asia; 2017. Available from: https://apps.who.int/iris/handle/10665/254716

[9] Fujikawa K. Settling with Autonomy after Civil Wars: Lessons from Aceh, Indonesia. Glob Policy. 2021;12(2):204–13.

[10] Fuady MRF, Fuady M, Aulia F. Kemiskinan Multi Dimensi dan Indeks Pembangunan Manusia di Indonesia. TATALOKA. 2021;23(4).

[11] Huang X, Yoshino N. Impacts of Universal Health Coverage: Financing, Income Inequality, and Social Welfare. SSRN Electronic Journal. 2017.

[12] Holipah, Maharani A, Kuroda Y. Determinants of immunization status among 12- to 23-month-old children in Indonesia (2008-2013): a multilevel analysis. BMC Public Health. 2018;18(1):288.

[13] Kuroki M, Liu X. The Effect of Health Insurance Coverage on Homeownership and Housing Prices: Evidence from the Medicaid Expansion. Soc Sci Q. 2021;102(2):633–48.

[14] Zamzam AH, Abdul Wahab AK, Azizan MM, Satapathy SC, Lai KW, Hasikin K. A Systematic Review of Medical Equipment Reliability Assessment in Improving the Quality of Healthcare Services. Vol. 9, Frontiers in public health. Switzerland; 2021. p. 753951.

[15] Tseng KK, Joshi J, Shrivastava S, Klein E. Estimating the cost of interventions to improve water, sanitation and hygiene in healthcare facilities across India. BMJ Glob Heal. 2020;5(12).

[16] Nekui F, Galbraith AA, Briesacher BA, Zhang F, Soumerai SB, Ross-Degnan D, et al. Cost-related Medication Nonadherence and Its Risk Factors Among Medicare Beneficiaries. Med Care. 2021;59(1):13–21.

[17] Dusetzina SB, Conti RM, Yu NL, Bach PB. Association of Prescription Drug Price Rebates in Medicare Part D With Patient Out-of-Pocket and Federal Spending. JAMA Intern Med. 2017;177(8):1185–8.

[18] Yani M. Analisis Equity Jaminan Kesehatan Rakyat Aceh. Universitas Gadjah Mada; 2016.

[19] Badan Pusat Statistik Aceh. Provinsi Aceh dalam Angka. Badan Pusat Statistik. Aceh; 2020.

[20] Sulaiman A. Pengaruh Program Jaminan Kesehatan Aceh Terhadap Derajat Kesehatan Masyarakat Aceh. J Magister Ilmu Ekon. 2013;1(4):10–20.

[21] Saputra E. Tantangan Dalam Koordinasi Jaminan Kesehatan Aceh. J Kependud Indones. 2016;8(1):17–27.

[22] Adyas A. The Indonesian Strategy to Achieve Universal Health Coveragethrough National Health Insurance System: Challenges in Human Resources. Kesmas. 2021;16(4):221–7.

[23] Rina S., Rosminah S. Willingness to pay and ability to pay for health care services at Zainoel Abidin public hospital Banda Aceh , Indonesia. Annu Int Conf Syiah Kuala Univ 2011. 2011;1(1):242–6.

[24] Kesuma ZM, Chongsuvivatwong V. Utilization of the Local Government Health Insurance Scheme (JKA) for Maternal Health Services Among Women Living in Underdeveloped Areas of Aceh Province, Indonesia. Asia Pacific J Public Heal. 2014;27(3):348–59.

[25] Heponiemi T, Jormanainen V, Leemann L, Manderbacka K, Aalto A-M, Hyppönen H. Digital Divide in Perceived Benefits of Online Health Care and Social Welfare Services: National Cross-Sectional Survey Study. J Med Internet Res. 2020;22(7):e17616.

[26] Smith A, Ranchod S, Strugnell D, Wishnia J. Human resources for health planning and national health insurance : the urgency and the opportunity. In 2018.

The evaluation of Acehnese people's health insurance from the welfare perspectives

Abstract

References

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