National Health Insurance Participants Research Articles

Citizens' rights in obtaining optimization of the implementation of the national health insurance program

This study aims to analyze the rights of citizens in obtaining optimization of the implementation of the national health insurance program. This research is in the form of normative or doctrinal legal research/library research, using a statutory approach and conceptual approach. The results of the study reveal that the implementation of the right to health based on the mandate of the 1945 Constitution in Indonesia has not been maximally implemented. This can be seen from the application in terms of facilities, health workers and the application in terms of the national health insurance system. Optimizing the implementation of the guarantee with the issuance of Presidential Instruction of the Republic of Indonesia Number 1 of 2022 concerning Optimizing the Implementation of the National Health Insurance Program was also found to be disharmonized with the principle of Portability and the non-fulfillment of the value of justice or equality of National Health Insurance participants, especially the rules on migrant workers. Therefore, it is necessary to conduct an evaluation related to the fulfillment of citizens' rights to health, as well as to review the Presidential Instruction of the Republic of Indonesia Number 1 of 2022 concerning Optimizing the Implementation of the National Health Insurance Program, especially regarding the obligations of pilgrims and migrant workers to remain active participants, so that the value of the principle of benefits can be obtained by all JKN participants fairly.

The Role of Online Queues as a Moderator Between Service Quality and Patient Satisfaction for National Health Insurance's Participants

This study aims to provide new insight and fill the gap of previous research by adding online queues to moderate the effect of perceived service quality and the organization’s image on perceived satisfaction. Data were collected from 120 respondents who are members of National Health Insurance (JKN) who became patients at Prof. dr. I Goesti Ngoerah Gde Ngoerah Hospital Denpasar. Partial Least Square Structural Equation Modeling (PLSSEM) was used to analyze and test hypotheses. This research applied quantitative approach using a preexisting measurement scale. The results of this study prove that service quality has a positive and significant effect on customer satisfaction. Another finding from this study is that an organization's image does not significantly affect customer satisfaction. Online queues could not moderate the relationship between service quality and the organization's image on customer satisfaction. The practical implication of this research is that hospitals must continue to improve the quality of their services to increase patient satisfaction with the hospital

The Effect of Pandawa Service Quality and Switching Cost on Loyalty of National Health Insurance Participants

The Effect of Pandawa Service Quality and Switching Cost on Loyalty of National Health Insurance Participants

The Influence of National Health Insurance Participant Satisfaction in Mediating the Relationship of Service Quality and Brand Image Towards Participant Loyalty at RSU Balimed Denpasar

The irregularity of participants in paying National Health Insurance contributions shows that participants lack loyalty in paying contributions which are their routine obligations as participants in the National Health Insurance program. The aim of this research is to reveal the mediating impact of satisfaction on service quality and brand image on loyalty. This research is quantitative research conducted using a survey, using data samples from National Health Insurance participants with active membership and receiving services at the Bali Med Denpasar General Hospital, totaling 82 people with PLS-based SEM analysis. The research results showed that service quality had a positive and significant effect on satisfaction, brand image had no significant effect on satisfaction, service quality and brand image had a positive and significant effect on loyalty, and patient satisfaction was able to mediate the effect of service quality and brand image on patient loyalty. It is hoped that the results of the research can provide advice to related parties to improve the quality of health services, such as how to respond to existing complaints and communicate well with patients and this is expected to have a positive impact on the quality of services

Role of Socioeconomic Status in National Health Insurance Ownership in Indonesia's Rural Areas.

National Health Insurance (NHI) is one of the Indonesian Government's policies to increase public access to health services. The study analyzed the role of socioeconomic status in NHI ownership in rural Indonesia. Study Design: A cross-sectional study. The study population included residents of rural Indonesia. The study examined secondary data from the survey entitled "Abilities and Willingness to Pay, Fee, and Participant Satisfaction in Implementing National Health Insurance in Indonesia in 2019", involving 33225 respondents representing Indonesia's rural areas. The study was conducted from March to December 2019. The variables analyzed included NHI, socioeconomic level, age group, gender, education level, employment status, and marital status. In the final step, the study employed binary logistic regression to explain the relationship between socioeconomic status and NHI ownership. The results show that 63.8% of the population in rural Indonesia participated in the NHI. The poorer residents were 1.235 times more likely to have NHI than the most impoverished population (AOR 1.235; 95% CI 1.234-1.237). People with middle wealth status were 1.086 times more likely to have NHI than the poorest (AOR 1.086; 95% CI 1.085-1.087). The richer residents were 1.134 times more likely to have NHI than the poorest (AOR 1.134; 95% CI 1.133-1.136). The richest residents were 1.078 times more likely to have NHI than the poorest residents (AOR 1.078; 95% CI 1.077-1.079). The study concluded that socioeconomic status is related to NHI ownership in rural Indonesia. The analysis indicated that all socioeconomic categories were more likely to become NHI participants than the poorest in Indonesia.

Utilization of Primary Health Care Under National Health Insurance in Samarinda Municipality, East Kalimantan Province, Indonesia.

In Indonesia, basic community health services are provided to all citizens through Primary Health Care (PHC) settings under the National Health Insurance (NHI) scheme. The insurance is compulsory and provides basic community health needs. Based on a gatekeeper concept, the PHC is deemed to be the first contact point for all basic healthcare needs. Despite the commencement of services through PHC settings in 2014 under this concept, utilization in PHC settings remains lower than in hospital settings. This study aimed to assess factors associated with utilization of PHC under National Health Insurance in Samarinda Municipality, East Kalimantan Province, Indonesia. The research examined the utilization of services over six months. It employed a cross-sectional method and included 382 NHI participants in 10 districts of Samarinda Municipality. Each district was divided into urban and semi-urban areas based upon local government indicators representing the whole research area. A two-stage random sampling and purposive sampling approach was implemented to select the sample. The participants were interviewed using a structured questionnaire. Chi-square and multiple logistic regressions were conducted to determine the impact of factors on the utilization of PHC. Only 17.3% of participants used PHC services regularly. Three constitutive factors, type of NHI participants (Adj. OR: 2.62; p<0.005), accommodation (Adj. OR: 2.18; p<0.005) and awareness (Adj. OR: 3.27; p<0.005) most profoundly influenced the under-utilization of PHC by NHI participants. The study found that the type of NHI participant and the utilization factors of accommodation and awareness significantly influenced the degree of utilization of PHC facilities by NHI participants and that the differences arose from variations in knowledge and experience. Strengthening these factors will rely upon an expanded role of government and community collaboration, emphasizing the needs of NHI participants.

Factors Related to The Level of Compliance to Pay Contributions of National Health Insurance Participants Non-Wage Earners

Introduction: Nationally, in 2022 there are 15,679,006 participants of Non-Wage Earners in arrears of contributions, while in the working area of BPJS Kesehatan Kambi Branch there are 228,181 participants of Non-Wage Earner Workers in arrears with contributions. The number of participants who are delinquent due to non-compliance of Non-Wage Earner Workers participants in paying contributions. Objective: To measure the relationship between knowledge, number of family members and payment methods with the level of compliance to pay contributions for participants of the National Health Insurance Non-Wage Earner Workers in Jambi City in 2023. Method: This study is a descriptive study with a cross sectional design. Questionnaire research instruments, then univariate and bivariate analysis with chi-square test. Results and Discussion: The results of this study show that there is a significant relationship between knowledge (p-value = 0.000), number of family members (p-value = 0.000) and payment method (p-value = 0.018) with the level of compliance to pay contributions of national health insurance participants non-wage earners workers in Jambi City. Conclusion: there is a relationship between knowledge, number of family members and payment methods with the level of compliance to pay contributions of national health insurance participants non-wage earners workers in Jambi City.

Perception and Usage of Telemedicine Among National Health Insurance Participants in Padang City

The existence of a policy on the use of telemedicine in health facilities is applied almost all over the world. In Indonesia, Padang is one city of the achievements in that the use of telemedicine services remains low, even after the implementation of regulations on telemedicine services. This study aimed to determine the perceived convenience and benefits of using telemedicine services among National Health Insurance participants through the Technology Acceptance Model (TAM). This study was a cross-sectional survey. The sample of this study consisted of 100 National Health Insurance respondents registered at a first-level healthcare facility. The samples were collected using consecutive sampling and online questionnaire sheets carried out for three months in 2021. The analysis includes univariate, bivariate, and multivariate analysis. The results showed that 55% of respondents had a high level of accessibility in getting health services by using telemedicine, 54% of respondents had a good experience related to telemedicine officer services, 94% of respondents had perceptions of illness exist positive, 89% of respondents said that they had a perception of ease in using telemedicine services, and 80% of respondents had a perceived the benefits of telemedicine services. The utilization of telemedicine was affected by accessibility (p=0.000), staff service (p=0.000), perceived ease of use (p=0.022), and perceived benefit (p=0.001). The multivariate analysis indicated that the officer service was the most influencing the use of telemedicine services (OR=3.669). Healthcare facilities should improve their service quality and apply a more accessible and more valuable service for patients as end users.

Perception and Usage of Telemedicine Among National Health Insurance Participants in Padang City

Perception and Usage of Telemedicine Among National Health Insurance Participants in Padang City

Reasons for switching the primary health providers among national health insurance participants in Klungkung District, Bali Province, Indonesia

Background and purpose: National Health Insurance Provider (BPJS Kesehatan) facilitates the distribution of National Health Insurance (NHI) participants. High number of 1,947 NHI participants were switched primary health providers in Klungkung, Bali between July to December 2021.This study aims to explore the reasons for the switching of providers among NHI participants and the health providers’ efforts to minimize it. Methods: A qualitative descriptive study guided by an access theory was conducted in Klungkung District between December 2022 to March 2023. A total of 18 informants were purposively recruited, consisting of NHI participants (12 people), health service providers (4 people), BPJS Kesehatan (1 person) and staff of the district health office (1 person). Data was collected through in-depth interviews guided by interview guidelines. Data were analyzed using a thematic approach and presented in a descriptive narrative. Results: NHI participants in Klungkung District switched provider due to spatial and non-spatial reasons. Spatial reason was the distance and time to the health provider. Non-spatial reasons included (1) conflict in social relations due to service and negative attitudes of health workers, (2) economic considerations in the health system which are difficult to reach, and (3) external encouragement. Strategies that have been or can be implemented to minimize the switching of PHCs were adjusting operational hours, improving the infrastructures, administration through fulfilling accreditation, service quality and training for human resources. Conclusion: The dominant reason for switching of PHCs is associated with negative social interaction experiences related to human resources and service facilities at PHCs. PHCs are expected to be able to improve the quality of services through improving human resources and service delivery facilities.

Potential fraud and its’ prevention in the implementation of national health insurance at Dadi Regional Hospita

The National Health Insurance program started running in Indonesia on January 1, 2014. Along with the increasing number of National Health Insurance participants and health facilities, more criticism has emerged from various parties, including from National Health Insurance providers regarding the alleged fraud. Fraud can have a negative effect on finances, the standard of medical care, and the perpetrator's reputation. This study's goal was to assess the likelihood that fraud may occur at Dadi Regional Hospital in Makassar, Indonesia. The study also explored the procedures and policies in place for preventing the fraud. This qualitative study employed phenomenological design. The results of the study show that there is a fraud prevention system at Dadi Regional Hospital in the form of policy and guideline formulation, a culture of prevention, implementation of quality control, and cost control. Even though they already have a prevention system in place, there is still some lack of information being disseminated about the fraud prevention team established. There are still frequent discrepancies between the diagnosis code input in the National Health Insurance system and the patient's diagnosis Hence, the Internal Monitoring Unit is still in the process of establishing a fraud prevention system

Modern Contraceptive Use of National Health Insurance Participants before and during the COVID-19 Pandemic in South Kalimantan, Indonesia: Using Data from the Official Website of the National Population and Family Planning Agency.

This study aims to explore and analyze the modern contraceptive use of National Health Insurance (NHI) participants before and during the COVID-19 pandemic in South Kalimantan, Indonesia. This research is an ecological study using aggregated data from 13 Districts/Cities in South Kalimantan. This study used secondary data in 2018-2020 from the official website of the National Population and Family Planning Agency. Spatial analysis and paired T-test were used. There were 30.7% of Districts/Cities in stagnation and 30.7% in the decline of modern contraception use during the pandemic (2019-2020). In addition, the study showed that there were differences in the use of modern contraception before (2019) and during the COVID-19 pandemic (2020) among active family planning acceptors of NHI participants (p=0.048). The existence of NHI, especially recipients of contribution assistance, can increase the use of modern contraception in South Kalimantan. There are differences in the use of modern contraception before and during the COVID-19 pandemic among NHI participants.

Analysis of Contribution Assistance Recipients' Utilization of National Health Insurance Participants

Background: Contribution Assistance coverage for National Health Insurance Participants Participation among recipients is greater than that of non-participants, but the use of health services by National Health Insurance PBI participants in Indonesia remains relatively low. This study aims to determine in 2021 which factors influence the utilization of health services by National Health Insurance PBI group participants in Jambi City. Methods: This study is a quantitative cross-sectional investigation. The sample consisted of 106 random samples collected using the technique of accidental sampling. In this study, the independent variables were education, occupation, knowledge, attitudes, perceptions of health conditions, affordability, and information, while the dependent variable was health service utilization. Respondents filled out questionnaires to generate data. The data analysis consisted of univariate and bivariate (chi-square) tests. Result: This study's findings indicate that the majority of respondents, 61.3%, do not utilize health services. Knowledge (0.000), attitudes (0.003), perception of health conditions (0.012), and information are associated with the utilization of health services, according to this study's statistical analyses (0.000). In addition, there is no correlation between education (0.147), occupation (0.295), affordability (0.787), and the utilization of health services among National Health Insurance (JKN) PBI group participants. Conclusion: There is a correlation between knowledge, attitudes, perceptions of health conditions, and information and the utilization of health services by National Health Insurance for the PBI Group participants in Jambi City.

Physician's Legal Responsibilities in Providing Medicines Outside the National Formulary to National Health Insurance Participants

Doctors who give drugs outside the national formulary to National Health Insurance (JKN) participants have caused several polemics. Due to complaints from JKN participants, the government issued regulations regarding the preparation of the implementation of the National Formulary in administering the health insurance program. This hierarchy caused the Minister of Health to issue Regulation of the Minister of Health of the Republic of Indonesia Number 54 of 2018 Concerning the Preparation of the Implementation of the National Formulary. The purpose of this study was to analyze the legal ratio of the drug formulary in the National Health Insurance System and to analyze the liability of doctors who provide drugs outside the national formulary to National Health Insurance participants. This type of research uses a statute approach, a conceptual approach and a case approach. The statutory approach (statute approach) and the concept approach (conceptual approach). The legal material analysis method is deductive. The findings show that the legal ratio of drug formularies in the National Health Insurance System is caused by the existence of legal regulations regarding FORNAS due to problems that occur, including incompatibility with FORNAS and the e-catalogue, the FORNAS amendment rules apply retroactively violating the principle of legal certainty, there are no minimum rules of conformity. FORNAS in the Hospital/Region Formulary so that the Ministry of Health issues regulations regarding the preparation of drug lists with the issuance of regulations regarding FORNAS.; 2) The legal responsibility of doctors who give medicines outside the national formulary to National Health Insurance (JKN) participants includes the prescribing error stage regarding all requests for prescriptions based on the responsibility of doctors' ethical norms as well as legal responsibility based on civil, criminal and legal provisions. administration. Keywords: doctor, law, responsibility and JKN Abstra k: Dokter yang memberikan obat di luar formularium nasional pada peserta Jaminan Kesehatan Nasional (JKN) menimbulkan beberapa polemik. Adanya keluhan peserta JKN tersebut maka pemerintah menerbitkan aturan tentang penyusunan penerapan Formularium Nasional dalam penyelenggaraan program jaminan kesehatan. Hirarki tersebut menyebabkan Menteri Kesehatan telah mengeluarkan Peraturan Menteri Kesehatan Republik Indonesia Nomor 54 Tahun 2018 Tentang Penyusunanan Penerapan Formularium Nasional. Tujuan penelitian ini adalah untuk menganalisis rasio legis formularium obat dalam Sistem jaminan Kesehatan Nasional dan untuk menganalisis pertanggungjawaban dokter yang memberikan obat di luar formularium nasional pada peserta Jaminan Kesehatan Nasional. Tipe penelitian ini menggunakan pendekatan perundang-undangan (statute approach ), pendekatan konsep (conceptual approach) dan pendekatan kasus ( case approach ) . Pendekatan perundang-undangan (statute approch) dan pendekatan konsep (conceptual approach). Metode analisis bahan hukum adalah metode deduktif. Hasil temuan menunjukkan r asio legis formularium obat dalam Sistem Jaminan Kesehatan Nasional disebabkan dari adanya regulasi hukum tentang fornas disebabkan adanya permasalahan-permasalahan yang terjadi antara lain ketidaksesuaian FORNAS dan e-catalogue, aturan perubahan FORNAS berlaku surut melanggar asas kepastian hukum, belum ada aturan minimal kesesuaian FORNAS pada Formularium RS/Daerah sehingga Kementrian Kesehatan menerbitkan peraturan tentang penyusunan daftar obat dengan dikeluarkannya peraturan tentang FORNAS.; 2) Tanggung jawab hukum dokter yang memberikan obat di luar formularium nasional pada peserta Jaminan Kesehatan Nasional (JKN) meliputi tahap Prescribing error menyangkut segala permintaan dalam resep didasarkan tanggung jawab norma etik dokter serta tanggung jawab hukum yang didasarkan pada ketentuan hukum perdata, pidana, dan administrasi. Kata kunci : dokter, hukum, tanggung jawab dan JKN

ANALYSIS OF PROLANIS POLICY IMPLEMENTATION DURING THE COVID-19 PANDEMIC IN 2021

Data from Basic Health Research (Riskesdas) in 2018 shows that Diabetes and Hypertension dominate chronic diseases. The Director of BPJS Kesehatan has issued Circular No. 14 of 2020 concerning health services for national health insurance participants during the COVID-19 prevention period, especially Prolanis. The policy contains an appeal to postpone the provision of services in the form of mass gathering activities such as Prolanis Gymnastics, Club Education, and and other activities. Hence, this research is needed to describe the implementation of Prolanis policies during the COVID-19 Pandemic. The study used a descriptive research design with qualitative methods and George C. Edward III's theory of policy implementation model. The number of informants is 11 people. The data collection is done using observation, in-depth interviews, and document review. The study was conducted in May-June 2022 at the Krui Health Center, Pesisir Barat Regency, Lampung Province. The findings show that Prolanis activities, which were stopped during the COVID-19 Pandemic, resulted in uncontrolled hypertension and diabetes in the participants. There are also many Prolanis implementing officers and supervisors who are not aware of Circular 14 of 2020. This transmission failure resulted in implementing the policy not fully running correctly.

The impact of National Health Insurance online referral system on the access and quality of health services in Gianyar District, Bali, Indonesia

Background and purpose: The introduction of an online referral system aims to improve the quality and costs control of the National Health Insurance (NHI) or Jaminan Kesehatan Nasional. This study aims to determine the impact of the NHI online referral system implementation on access and quality of health services in Gianyar District. Methods: This is an explorative qualitative study conducted in Gianyar, Bali, Indonesia. Data was collected through semistructured in-depth interviews to a total of 26 informants recruited purposively. They were including policy makers in the health office and the NHI implementing organization (BPJS), heads of public health centres (puskesmas), private health facilities and referral healthcare facilities; and 13 NHI participants. Data collection was undertaken from May to August 2019. The interview results were thematically analysed based on the Health Care Reform Control Knobs Framework. Results: The study identifies several positive impacts of the online referral system, which include: the closer distance of patients accessing services, the easier it is to obtain information on services at referral health facilities, and the easier the hospital to promote its service products, the higher assurance of patients being accepted by the referral hospitals, patients with special conditions are better accommodated, the easier the administrative procedure, improved time, cost and working procedure efficiencies, increased punctuality of the services, and guaranteed data security that reduces the risk of lost or damaged referral documents. On the other hand, the online referral system has also resulted in negative impacts, some of them were system inconsistencies, information and communication technology (ICT) constraints, service discontinuity, service injustices and loss of patients’ loyalty. Conclusion: NHI online referral system generally have positive impacts on access and quality of health services, however, it is necessary to improve several aspects of the online referral system to better accommodate user needs and to optimize service.

Study on the Utilization of National Health Insurance Participants for Contribution Assistance Recipients Jambi City

The coverage of JKN PBI participation is higher than that of non-PBI participants, but the utilization of health services by JKN PBI participants in Indonesia is still relatively low. This study aims to determine what factors are related to the utilization of health services for PBI group National Health Insurance (JKN) participants in Jambi City. This study is a quantitative study using a cross sectional approach. The sample amounted to 106 samples with a sampling technique using accidental sampling. The independent variables in this study were education, occupation, knowledge, attitudes, perceptions of health conditions, affordability and information, while the dependent variable was the utilization of health services. Data were obtained by filling out questionnaires by respondents. Data analysis was performed using univariate and bivariate (chi-square) tests. The results of this study indicate that most of the 61.3% of respondents do not use health services. Based on statistical tests in this study indicate that factors related to the utilization of health services are knowledge (0.000), attitudes (0.003), perception of health conditions (0.012), and information (0.000). And there is no relationship between education (0.147), occupation (0.295) and affordability (0.787) with the utilization of health services for participants of the National Health Insurance (JKN) PBI group. There is a relationship between the variables of knowledge, attitudes, perceptions of health conditions and information with the utilization of health services for the participants of the National Health Insurance for the PBI Group in Jambi City.

Factors Affecting the Compliance of National Health Insurance Participants Segment of Non-Wage Recipients in Paying the Contributions

This study's objective is to investigate the variables influencing the compliance of the National Health Insurance (JKN) Participant Segment of Non-Wage Recipients (PBPU) in Paying JKN Contributions in the BPJS Health Work Area, North Tapanuli Regency. This sort of research is quantitative and employs a cross-sectional study design. This study's population consists of all Non-Wage Recipient Workers (PBPU) in Siborong-borong District, North Tapanuli Regency, a total of 12,323 persons, with a sample size of 99 calculated using a purposive sampling technique. The study used univariate, bivariate, and multivariate techniques. The findings of the chi-square test indicated that education (p = 0.066&gt; 0.05), occupation (p = 0.008 0.05), knowledge (p = 0.003 0.05), income (p = 0.000 0.05), and distance (p= 0.0010.05) were significantly correlated with each other. The logistic regression test reveals that income, with an Exp (B) value of 4,778, has the greatest impact on compliance with making JKN payments. This research concludes that employment, knowledge, income, and distance have a link with JKN contribution compliance, however education has no association with JKN contribution compliance. The community need socialization in order to raise public understanding and awareness of their monthly obligation to make JKN payments.

The effect of knowledge on paying regulation contributions for Independent National Health Insurance (NHI) participants post policy to increase NHI contributions in Muna District, Southeast Sulawesi Province

Until the end of 2021 the number of NHI participants has reached 229 million people, but the increase in the number of participations is not in line with the increase in compliance with paying NHI contributions. The purpose of this study was to determine the effect of knowledge on the regularity of paying NHI contributions for independent participants after the increase in contributions in Muna Regency, Southeast Sulawesi. The type of research used is the type of quantitative research using a cross-sectional study design. The research sample size used was 98 respondents. Techniques Data collection is done by means of interviews and field observations. Techniques Data analysis was carried out by means of Univariate analysis and bivariate analysis. The data presentation technique is done in the form of a frequency distribution accompanied by an explanation. The results showed that there was no effect of knowledge on the regularity of paying dues for independent NHI participants after the policy of increasing contributions in Muna Regency, Southeast Sulawesi Province with a value of P = 0.871 (p&gt;0.05). Conclusion; there is no effect of knowledge on the regularity of paying NHI contributions for independent participants after the policy of increasing the contribution. Recommendation; the need for SSA to improve education for NHI participants to provide understanding and encouragement so that the community continues to actively participate in paying NHI contributions.

The effect of the number of family members on contribution paying regularity independent National Health Insurance (NHI) participants post policy to increase NHI contributions in Bombana Regency, Southeast Sulawesi Province

Background: The National Health Insurance (NHI) Program has been implemented since January 1, 20214, but until now there are still many problems in service management, one of which is the high number of non-compliance in paying NHI contributions by participants. The need for improvement in service management as a solution to overcome these problems. Objective: The purpose of this study was to determine the effect of the number of family members on the regularity of paying NHI contributions for independent participants after the policy of increasing the contribution in Bombana Regency, Southeast Sulawesi Province. Methods: This research is a type of quantitative research with a cross sectional study approach. The sample of this study was all independent NHI participants, with a sample size of 273 respondents. Research data collection was carried out using a questionnaire instrument, interviews and field observations. Data analysis was carried out univariate and bivariate. The presentation of the data is done in the form of a frequency distribution table accompanied by an explanation. Results: The results showed that there was an effect of the number of family members on the regularity of paying contributions for SSA Independent participants after the policy of increasing NHI contributions with a value (P-Value = 0.037). Conclusion: There is an effect of the number of family members on the regularity of paying contributions for independent SSA participants after the contribution increase policy.