Determinants of payment compliance of the national health insurance among non-salaried participants

Abstract

This study analyzed the compliance of non-salaried participants, in paying the monthly premium of the National Health Insurance (known as Jaminan Kesehatan Nasional, JKN) in Indonesia. The sustainability of this program is essential to realize universal health coverage (UHC) in the country, and its success heavily relies on the compliance of its participants in paying the premiums. Non-salaried workers constitute a membership category with a lower level of compliance in paying premiums compared to salaried workers and premium contribution beneficiaries. This study used the logit regression method and revealed significant findings. Specifically factors such as age, income stability, payment point, decision maker, and distance to health facilities were found to be associated with the compliance of private participants in paying the monthly premium of the JKN program. The study identified that older age is linked to higher compliance, and having a stable monthly income increases the probability of payment. Respondents who utilize bank auto-debit services for payments exhibit a higher level of compliance compared to those who make payments at modern mini-markets or e-commerce platforms. The joint decision-making by both spouses to participate in the JKN Program leads to higher compliance compared to decisions made solely by one spouse. Furthermore, the study discovered that a greater distance to health facilities corresponds to an increased likelihood of compliance in paying the monthly premium.