Abstract
Background:The National Health Insurance (NHI) program is the Indonesian government's national health program. However, health insurance coverage has not been maximized. This study aims to analyze the factors associated with health insurance coverage in Indonesia. Methods:Cross-sectional data were obtained from the Indonesian Demographic and Health Survey 2017. A total of 39,580 respondents were selected using two-stage stratified cluster sampling. The data come from the DHS Questionnaire Phase 7. The variables include age, education level, wealth quintiles, residence, the number of children who are alive, maritalstatus, current employment status, earnings,and health insurance status. The data were analyzed using chi-squared and binary logistic analyses. Results:The prevalence of health insurancecoverageintheIndonesian populationis 62.3%. Respondent age [AOR=0.875; 95% CI=0.763-0.967], education level [AOR=0.437; 95% CI=0.410-0.466], wealth quintile [AOR=0.762; 95% CI=0.713-0.815], residence [AOR=0.762; 95% CI=0.713-0.815], marital status [AOR=0.718; 95% CI=0.625-0.825] and earnings [AOR=1.245; 95% CI=1.177-1.316] are related to health insurance coverage.However, the number of children who are alive and respondentswhowerecurrently working were not significantly related to health insurance coverage in Indonesia. Conclusion:The government needs to pay attention to the characteristics and demographic conditions of the Indonesian population to be able to achieve maximum health insurance coverage. Maximum coverage through the provision of appropriate information should be promoted.
Highlights
The National Health Insurance (NHI) is the Indonesian government’s program which provides people with the chance to access health services for health promotion, illness prevention, illness treatment, and rehabilitation at an affordable cost. 1,2 The Indonesian government started the NHI program in 2004, provided in the form of the Social Security Administrator (SSA) which is divided into two sectors namely the Social Security Administrator for Health (SSAH) and the Social Security Administrator for Employment (SSAE)
There have been several previous studies regarding health insurance coverage. These studies have analyzed some of the determinants of insurance coverage, such as knowledge, 8–12 cost, 8,12 attitude and family support[9,11,13,14], age[14,15] region, history of chronic disease, economic status, residency, 15 ability to pay, 13,16 willingness to pay, average monthly expenses,13 risk aversion, amount of loss, income,16,17 information,11,18,19 religiosity, beliefs, 18 education, 10,15 income, 10,11 motivation, intention, 10 institutional policies, 17 perception, 10,19 social support, 19 distance, and socialization [12,20] this study presents new findings that determine the importance of NHI factors consisting of wealth quintile, residence, number of living children, marital status, current employment status and earnings
This is due to the large number of residents and the demographic characteristics of the population that allow for the achievement of greater NHI coverage
Summary
The National Health Insurance (NHI) is the Indonesian government’s program which provides people with the chance to access health services for health promotion, illness prevention, illness treatment, and rehabilitation at an affordable cost. 1,2 The Indonesian government started the NHI program in 2004, provided in the form of the Social Security Administrator (SSA) which is divided into two sectors namely the Social Security Administrator for Health (SSAH) and the Social Security Administrator for Employment (SSAE). That the administrative system of the SSAH in Indonesia, which is related to health care services, lacks a sufficient quantity of essential care offices of reasonable quality This is in addition to inadequate access to explicit medications and clinical supplies, the mistargeting of low-income and middle income populations, the issue of inappropriate behavior, and unforeseen weak data frameworks .4. These problems hamper the participation of the Indonesian people in NHI, meaning that full coverage is difficult to achieve. Maximum coverage through the provision of appropriate information should be promoted
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