A Case Study on the Implementation of Local Health Insurance Benefit Packages

Supriyantoro, Supriyantoro • Hendarwan, Harimat • Savithri, Youth
Journal article Buletin Penelitian Sistem Kesehatan • October 2014

Abstract

Background: The variation of benefit packages implemented by some local social health insurance schemes (Jamkesda) become an important issue in the effort to integrating them into National Health Insurance (JKN). This study aims to describe implementation of Jamkesda's benefit packages as a basic consideration in integration to JKN. Methods: Design of this study is case study with qualitative and quantitative aproaches, conducted 2013–2014 in all of districts/cities which already have Jamkesda. Primary and secondary data was collected. Primary data has been collected by focus group discussion, interview, observation, and self administered questioner. Secondary data collected from many sources such as articles, journal, official document, statistics data, and others. Results:Of this study show there is no significant relationship between fiscal capacity group and benefit packages (continuity correction, p value = 0.065). But, districts/cities with high fiscal capacity (high and very high) seem likely to have probability 1,920 bigger than lower capacity districts/cities in giving equal or more benefit than existing national social health insurance (Jamkesmas) (Mantel-Haenszel, Common Odds Ratio Estimates = 1.920; Confidence Interval 95% =1.008–3.658; asymp. Sig 2 sided = 0.047). There is variation of benefit packages between each Jamkesda. Qualitative results show there are many obstacles faced in giving benefit health services, such as limited community accessibility to health facilities, the absence of health workforce, and lack of health infrastructure and equipment. Recomendation: This study recommends to set a national minimum benefit packages and equalizing percetion of local decission maker.

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Buletin Penelitian Sistem Kesehatan

Buletin Penelitian Sistem Kesehatan (Bulletin of Health Systems Research) is an open access, peer... see more