General Practitioners’ Autonomy in the Management of Non-Communicable Diseases (NCDs) in the JKN Era: Is It Feasible?

Abstract

Demographic, epidemiological, and nutritional transitions increase life expectancy, changes in lifestyles and behaviors of Indonesian people. These changes are resulting in a growing contribution of non-communicable diseases (NCDs) to morbidity and mortality, especially metabolic disorders, such as type 2 diabetes mellitus (DM), hypertension, and dyslipidemia. Approximately 10.9% of the Indonesian population above 15 years old suffers from type 2 DM (21.2 million) and 34.1% have hypertension (66.3 million) in 2018. These figures increase significantly from 2013 figure; 6.9% and 25.8% respectively1. The metabolic disorders, which in turn, are responsible for vascular problems such as renal failure, stroke, and heart attack. Not surprisingly, then, 60% of Indonesian national health insurance (JKN) funds are spent on the NCDs. This condition causes a deficit and threatens the sustainability of the JKN program.