scholarly journals Factors Of National Health Insurance, Factors Of Health Service And Factors Of Social Security Administrator Influence On The Satisfaction Of Independent BPJS Class One At Kertha Usada General Hospital

2020 ◽  
Vol 3 (2) ◽  
pp. 508-515
Author(s):  
Aditha Angga Pratama

Since 2004 Indonesia has campaigned for universal coverage as one of the improvements in health status. But until now there are still many Health insurance organizer (BPJS) participants who feel unsatisfied with the services they get, especially when Health insurance organizer participants are self-employed in class I inpatient services. The goal of this study is to identify the most dominant factor that can affect the satisfaction of Health insurance organizer participants' services in Kertha Usadha. The cross sectional survey research was conducted on 104 class 1 independent Health insurance organizer participants by simple random sampling. The selected Health insurance organizer participants were interviewed while in a state of hospitalization that was adjusted to the inclusion criteria of this study. The instrument used a structured questionnaire, with several related variables: characteristics, National Health Insurance factors, Health insurance organizer and health services. Variables were analyzed using Chi Square and then Logistic Regression with software. The results of this study found that 54.8% of B Health insurance organizer participants were satisfied with the services provided. While the results of multivariate analysis found that the factors influencing the satisfaction of Health insurance organizer participants were the National Health Insurance Factors that were good to moderate services (AOR: 1.2, 95% CI 0.8-1.43), good to less services (AOR: 3.4, 95% CI 1.5-7.53) and health service factors (AOR: 9.6, 95% CI 2.37-39.3). Health insurance organizer participant satisfaction is still low so it needs improvement in everything. So that later with increased satisfaction can improve the degree of public health

2018 ◽  
Vol 11 (1) ◽  
pp. 93-103 ◽  
Author(s):  
L.H. Mabuza ◽  
G.A. Ogunbanjo ◽  
K.E. Hlabyago ◽  
M. Mogotsi

Background: In 2012, the National Department of Health of South Africa launched the National Health Insurance (NHI) pilot program in 11 districts, towards universal health coverage for all South Africans. Health Care Practitioners (HCPs) are important role-players in its implementation. We decided to evaluate to what extent the HCPs were aware of the NHI program after three years of the pilot phase. Objective: To evaluate the awareness of HCPs about the NHI in the pilot Tshwane district of South Africa. Method: A cross-sectional survey was conducted among 1753 HCPs in Tshwane district. At 95% confidence level and 5% error margin, the sample size was 315 HCPs, but we over-sampled to 480. The study was conducted in 25 health facilities within the district. A pre-tested self-administered questionnaire was used. Results: A high proportion of HCPs were unaware of the objectives of the NHI program (p < 0.001); number of NHI pilot sites [(281; 59.4%) versus (145; 30.7%), p < 0.001]; rationale used to select pilot sites [(223; 46.9%) versus (193; 40.5%), p = 0.047]; role of the Integrated School Health Services (ISHP) [(250; 52.7%) versus (70; 14.8%), p < 0.001]; and specialists constituting the District Clinical Specialist Team (DCST) (p < 0.001). However, awareness regarding the Ward-Based Outreach Team (WBOT) leader was high [(236; 49.9%) versus (135; 28.5%), p < 0.001]. Conclusion: HCPs in Tshwane district demonstrated poor awareness of the NHI. This reveals that any awareness effort towards the NHI has not taken effect among the HCPs in this district.


Author(s):  
Adetola O Oladimeji ◽  
David A Adewole ◽  
Folashayo Adeniji

Abstract Background Bypassing occurs when patients knowingly visit a health facility other than the one they live nearest to. In Ibadan, southwest Nigeria, the majority of enrollees in the National Health Insurance Scheme (NHIS) receive medical care in just 12% of the available NHIS-accredited facilities. Given that enrollees access healthcare services at highly subsidized rates under the scheme, this study aimed to determine the factors responsible for the observed distribution of enrollees across these health facilities. Methods The study was a descriptive cross-sectional survey conducted among NHIS enrollees receiving care at outpatient departments of five randomly selected accredited health facilities in Ibadan. A total of 311 NHIS enrollees were consecutively recruited and a semistructured, pretested, interviewer-administered questionnaire was used to elicit information from respondents. Descriptive and inferential statistics were used to present results at 5% level of significance. Distance traveled by patients from their residence to the facilities was measured using Google maps. Results The mean age of respondents was 37.1±16.1 y. There were 167 (53.7%) males and 224 (72.3%) were married. The bypassing rate was 174 (55.3%). More than a third of enrollees, 127 (41.0%), reported that their hospital choice was made based on physician referral, 130 (41.8%) based on personal choice, 26 (8.4%) based upon the recommendation of the Health Management Organization (HMO), while 27 (8.7%) were influenced by friends/family/colleagues. Bypassing was positively associated with educational status (X2 = 13.147, p=0.004). Respondents who bypassed expended additional time and money traveling to the farther away hospitals, 35.1 (±34.66) min and 389.51 (±545.21) naira per visit, respectively. Conclusion The level of bypassing among enrollees was fairly high. Enrollees should be properly guided regarding the need to access healthcare in facilities closer to them by their HMOs and physicians in the case of referrals. This will reduce bypassing and the cost of travel leading to better outcomes among enrollees.


2019 ◽  
Vol 19 (2) ◽  
pp. 109-115
Author(s):  
Bela Sari ◽  
Haerawati Idris

The increasing of Independent National Health Insurance (NHI) membership is one of the indicators to achieve Universal Health Coverage. One of the challenges in extending such coverage is reaching it out to the informal sector. This study was aimed to analyze the determinants of Independent NHI ownership in Indonesia. This study used cross-sectional design, and the data were derived from Indonesian Family Live Survey (IFLS) 2014. 6,888 individuals aged ≥40 years were the sample of this study. To analyze the data, chi-square analysis and logistic regression were used. Based on the analysis, the proportion of respondent with Independent NHI is 16.6%. The ownership of independent NHI is influenced by the following factors: age 40-55 (PR=1.72 95%CI 1.41-2.09, p-value <0.001), Sumatra Island (PR=7.67 95%CI 5.55-10.59 p-value<0.001), very rich (PR = 2.26 95%CI 1.85-2.75 p-value <0.001), history of chronic disease (PR=1.33 95%CI 1.15-1.53 p-value<0.001), junior high school (PR = 2.21 95%CI 1.92-2.55 p-value<0.001), and urban (PR=1.79 95%CI 1.57-2.04 p-value <0.001). Region is the most dominant variable related to NHI ownership (p-value <0.001; Exp B= 7.03; 95% CI: 5.06-9.77). Independent NHI membership has not been maximal, yet. To increase this participation, the Social Security Administrator should approach each region with low NHI membership through promotion, socialization, and education about registration and the benefits of independent NHI.


2019 ◽  
Vol 9 (3) ◽  
pp. 239
Author(s):  
Ikechukwu Vincent Obi ◽  
Ijeoma Lewechi Okoronkwo ◽  
Emmanuel Chukwunonye Azuike ◽  
Kamtoochukwu Maduneme Obi ◽  
Ifunanya Rosemary Obi

The main objective of the National health insurance programme is to improve the health status of the populace in Nigerians. The healthcare provider provision of services in the programme has become a source of worry to government and other stakeholders. This study therefore sets out to examine the extent of healthcare provider adherence to NHIS operational guidelines. Design/Methodology: This is a cross-sectional survey using a questionnaire method. Sample size was calculated (demand side) using G-power 3.1 software and (supply side) Cochran formular and the calculated sample sizes were 1435 and 46 respectively. Multistage sampling technique was applied. Variables were analyzed using descriptive and T- test statistics with SPSS version 25. Result: Out of the 1435 enrollees 80% disagreed that providers provide laboratory services. Also, 91% of them disagreed that providers provide prescribed drugs. In contrast, both the enrollee (67%) and providers (69%) agreed that providers are polite while providing services. The Test value was set at 75%. The calculated T value for operational guideline for enrollees was 70.81 (p<0.05) on the opinion of the enrollees on extent of provider provision of services. The calculated T-value for operational guideline for providers was 2.40 (p<0.05) on the opinion of providers on the provision of services. Conclusion: The evidence from this study have identified areas in the service provision to be addressed by policy makers and in contrast showed that both the enrollees and providers agreed overall that the healthcare providers adhere to NHIS operational guideline.


2019 ◽  
Vol 2 (5) ◽  
pp. 375
Author(s):  
Yona Palin ◽  
Handry Darussalam ◽  
Eli Rahmawati

Abstract Until the end of 2015, Indonesia had the opportunity to fail to achieve the MDG targets. The MDG target for the Maternal Mortality Rate in 2015 was 102 per 100,000 births. This optimism was reconsidered after seeing the results of 2012 which experienced a significant increase of 359 per 100,000 births. Births in Muara Rapak Village area in 2016 were 598 live births and 2 born deads. A total of 597 births were helped in health facilities and 3 births were assisted by Traditional Birth Attendants / at home. The purpose of this study was to analyze the relationship of family income, birth costs, access to information, participation in National Health Insurance, with the selection of places of birth in Muara Rapak Village, Balikpapan Town. This study used a cross sectional design. The data collection technique was accidental sampling with a sample of 92 mothers who brought infants to visit the Muara Rapak Health Center, from October to November 2018. Data analysis techniques used bivariate data analysis with Chi Square test, p_value> α (0.05) concluded there was no relationship between variables. There were 79.3% of respondents choosing the place of birth at the hospital, 10.9% of respondents choosing the place of birth the maternity clinic, 6.5% choosing the place of birth at the Independent Practice Midwife, and 3.3% of respondents choosing the place of birth by Traditional Birth Attendants / at home. The results of statistical tests, for family income variables the value of p = 0.967, for birth of costs the value of p = 0.496, for access to information the value of p = 0.867, which means the value of p> 0.05, and for participation in National Health Insurance the value of p = 0.001 < 0.05. There is no relationship between family income, birth of costs, access to information, with the choice of place of birth. But between the participation of the National Health Insurance and the choice of place of birth, there is a relationship. Keywords: Income, costs, access to information, NHI, place of birth Abstract Hingga akhir tahun 2015, Indonesia berpeluang gagal mencapai sasaran–sasaran MDGs.Target MDG’s untuk Angka Kematian Ibu tahun 2015 adalah sebesar 102 per 100.000 Kelahiran Hidup. Optimisme tersebut menjadi pertimbangan kembali setelah melihat hasil tahun 2012 yang mengalami kenaikan signifikan yaitu sebesar 359 per 100.000 Kelahiran Hidup. Kelahiran di wilayah Kelurahan Muara Rapak pada tahun 2016 sebanyak 598 lahir hidup dan 2 lahir mati. Sebanyak 597 kelahiran ditolong di fasilitas kesehatan dan 3 kelahiran ditolong oleh dukun beranak / di rumah. Tujuan penelitian ini adalah untuk menganalisis hubungan pendapatan keluarga, biaya persalinan, akses informasi, kepesertaan Jaminan Kesehatan Nasional, dengan pemilihan tempat persalinan di Kelurahan Muara Rapak Kota Balikpapan. Penelitian ini menggunakan rancangan cross sectional. Teknik pengumpulan data adalah accidental sampling dengan jumlah sampel 92 ibu yang membawa bayi berkunjung ke Puskesmas Muara Rapak, mulai Oktober sampai dengan Nopember 2018. Teknik analisa data menggunakan analisis data bivariat dengan uji Chi Square, p_value > α (0,05) disimpulkan tidak ada hubungan antar variabel. Terdapat 79.3% responden memilih tempat persalinan di rumah sakit, 10.9% responden memilih tempat persalinan di klinik bersalin, 6.5% memilih tempat bersalin di Bidan Praktek Mandiri, dan 3.3% responden memilih tempat persalinan di dukun beranak/di rumah. Hasil uji statistik, untuk variabel pendapatan keluarga nilai p=0.967, untuk biaya persalinan nilai p=0.496, untuk akses informasi nilai p=0.867, yang berarti nilai p > 0.05, dan untuk kepesertaan Jaminan Kesehatan Nasional nilai p=0.001 < 0.05. Kesimpulan Tidak ada hubungan antara pendapatan keluarga, biaya persalinan, akses informasi, dengan pemilihan tempat persalinan. Namun antara kepesertaan Jaminanan Kesehatan Nasional dengan pemilihan tempat persalinan, terdapat hubungan.   Keywords: Pendapatan, biaya persalinan, akses informasi, JKN,  tempat persalinan


2019 ◽  
Vol 4 (1) ◽  
pp. 375
Author(s):  
Yona Palin ◽  
Handry Darussalam ◽  
Eli Rahmawati

Abstract Until the end of 2015, Indonesia had the opportunity to fail to achieve the MDG targets. The MDG target for the Maternal Mortality Rate in 2015 was 102 per 100,000 births. This optimism was reconsidered after seeing the results of 2012 which experienced a significant increase of 359 per 100,000 births. Births in Muara Rapak Village area in 2016 were 598 live births and 2 born deads. A total of 597 births were helped in health facilities and 3 births were assisted by Traditional Birth Attendants / at home. The purpose of this study was to analyze the relationship of family income, birth costs, access to information, participation in National Health Insurance, with the selection of places of birth in Muara Rapak Village, Balikpapan Town. This study used a cross sectional design. The data collection technique was accidental sampling with a sample of 92 mothers who brought infants to visit the Muara Rapak Health Center, from October to November 2018. Data analysis techniques used bivariate data analysis with Chi Square test, p_value> α (0.05) concluded there was no relationship between variables. There were 79.3% of respondents choosing the place of birth at the hospital, 10.9% of respondents choosing the place of birth the maternity clinic, 6.5% choosing the place of birth at the Independent Practice Midwife, and 3.3% of respondents choosing the place of birth by Traditional Birth Attendants / at home. The results of statistical tests, for family income variables the value of p = 0.967, for birth of costs the value of p = 0.496, for access to information the value of p = 0.867, which means the value of p> 0.05, and for participation in National Health Insurance the value of p = 0.001 < 0.05. There is no relationship between family income, birth of costs, access to information, with the choice of place of birth. But between the participation of the National Health Insurance and the choice of place of birth, there is a relationship. Keywords: Income, costs, access to information, NHI, place of birth Abstract Hingga akhir tahun 2015, Indonesia berpeluang gagal mencapai sasaran–sasaran MDGs.Target MDG’s untuk Angka Kematian Ibu tahun 2015 adalah sebesar 102 per 100.000 Kelahiran Hidup. Optimisme tersebut menjadi pertimbangan kembali setelah melihat hasil tahun 2012 yang mengalami kenaikan signifikan yaitu sebesar 359 per 100.000 Kelahiran Hidup. Kelahiran di wilayah Kelurahan Muara Rapak pada tahun 2016 sebanyak 598 lahir hidup dan 2 lahir mati. Sebanyak 597 kelahiran ditolong di fasilitas kesehatan dan 3 kelahiran ditolong oleh dukun beranak / di rumah. Tujuan penelitian ini adalah untuk menganalisis hubungan pendapatan keluarga, biaya persalinan, akses informasi, kepesertaan Jaminan Kesehatan Nasional, dengan pemilihan tempat persalinan di Kelurahan Muara Rapak Kota Balikpapan. Penelitian ini menggunakan rancangan cross sectional. Teknik pengumpulan data adalah accidental sampling dengan jumlah sampel 92 ibu yang membawa bayi berkunjung ke Puskesmas Muara Rapak, mulai Oktober sampai dengan Nopember 2018. Teknik analisa data menggunakan analisis data bivariat dengan uji Chi Square, p_value > α (0,05) disimpulkan tidak ada hubungan antar variabel. Terdapat 79.3% responden memilih tempat persalinan di rumah sakit, 10.9% responden memilih tempat persalinan di klinik bersalin, 6.5% memilih tempat bersalin di Bidan Praktek Mandiri, dan 3.3% responden memilih tempat persalinan di dukun beranak/di rumah. Hasil uji statistik, untuk variabel pendapatan keluarga nilai p=0.967, untuk biaya persalinan nilai p=0.496, untuk akses informasi nilai p=0.867, yang berarti nilai p > 0.05, dan untuk kepesertaan Jaminan Kesehatan Nasional nilai p=0.001 < 0.05. Kesimpulan Tidak ada hubungan antara pendapatan keluarga, biaya persalinan, akses informasi, dengan pemilihan tempat persalinan. Namun antara kepesertaan Jaminanan Kesehatan Nasional dengan pemilihan tempat persalinan, terdapat hubungan.   Keywords: Pendapatan, biaya persalinan, akses informasi, JKN,  tempat persalinan


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mariam John Munyogwa ◽  
Kaloli Sayi Ntalima ◽  
Secilia Ng’weshemi Kapalata

Abstract Background Obesity at the workplace has been associated with symptoms of lower self-esteem, increased individual and employer healthcare costs, increased absenteeism and presenteeism and reduced productivity. Therefore, this study was designed to study the prevalence and correlates of central obesity among formal sector employees in Dodoma City. Methods Study design was a cross-sectional survey conducted from March to June, 2019. Participants were employees from formal sector employment defined as those paid regular monthly wage and with either a secured permanent or temporary contract. Simple random sampling was used to select four out of fifteen large buildings hosting various establishments. Respondents were obtained conveniently and interviewed face to face. Central obesity was defined as a waist circumference greater than 102 cm for males and greater than 88 cm for females. Chi-square test was conducted to assess the differences among the groups. Simple and multiple logistic regression models were fitted to identify the correlates of central obesity. Results A total of 392 respondents (98% response rate) agreed and participated in the study. The overall prevalence of central obesity was found to be 41.8% (164/392). The prevalence of central obesity was significantly higher among females (67.4% p < 0.001), respondents aged ≥51 years (60%, p = < 0.001), administrators (55.1% p = < 0.05), respondents with salary of > 1,000,000 Tanzanian Shilling (TSh.) per month (54.4%, p = < 0.05), respondents who eat homemade meals at the workplace (64.2%, p = < 0.05) and respondents with hypertension (62.5%, p = < 0.05). Correlates of central obesity were found to be female sex (AOR = 9.53; 95% CI: 5.49, 16.78), increased age, eating homemade meals at the workplace (AOR = 2.32; 95% CI: 1.04, 4.19) and hypertension (AOR = 3.15; 95% CI: 1.41, 6.91). Conclusions The present study revealed high prevalence of central obesity among formal sector employees in Dodoma City. Scholars and stakeholders are urged to generate more evidences and design appropriate interventions to curb the situation.


2018 ◽  
Vol 48 (3) ◽  
pp. 568-585 ◽  
Author(s):  
Ashley Fox ◽  
Roland Poirier

Described as “universal prepayment,” the national health insurance (or single-payer) model of universal health coverage is increasingly promoted by international actors as a means of raising revenue for health care and improving social risk protection in low- and middle-income countries. Likewise, in the United States, the recent failed efforts to repeal and replace the Affordable Care Act have renewed debate about where to go next with health reform and arguably opened the door for a single-payer, Medicare-for-All plan, an alternative once considered politically infeasible. Policy debates about single-payer or national health insurance in the United States and abroad have relied heavily on Canada’s system as an ideal-typical single-payer system but have not systematically examined health system performance indicators across different universal coverage models. Using available cross-national data, we categorize countries with universal coverage into those best exemplifying national health insurance (single-payer), national health service, and social health insurance models and compare them to the United States in terms of cost, access, and quality. Through this comparison, we find that many critiques of single-payer are based on misconceptions or are factually incorrect, but also that single-payer is not the only option for achieving universal coverage in the United States and internationally.


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