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"Jaminan Kesehatan Nasional (JKN) merupakan penerapan dari Undang-Undang RI Nomor 40 tahun 2004 tentang SJSN dan untuk pelaksanaannya diatur dalam Peraturan Presiden RI Nomor 12 tahun 2013 tentang Jaminan Kesehatan, termasuk tentang pola pembayaran kepada Fasilitas Kesehatan Rujukan Tingkat Lanjut (FKRTL) menggunakan sistem Indonesia System Case Base Groups (INACBGs). Sebanyak 52,87% penduduk Provinsi Riau telah menjadi peserta JKN pada tahun 2016. RSUD Petala Bumi merupakan salah satu FKRTL yang melayani pasien peserta JKN di Pekanbaru, dari data junjungan pasien rawat jalan tahun 2017 sebanyak 41,9% merupakan pasien JKN. Ditemukan adanya keterlambatan pengajuan klaim rumah sakit kepada BPJS Kesehatan sekitar 1-2 bulan dari batas waktu yang ditentukan sepanjang tahun 2017. Hal ini akan mengakibatkan penundaan pendapatan rumah sakit dimana pendapatan terbesar rumah sakit berasal dari pasien peserta JKN.Tujuan penelitian ini adalah untuk menganalisa penyebab keterlambatan pengajuan klaim pasien JKN di RSUD Petala Bumi ditinjau dengan pendekatan sistem yaitu faktor input (Man, Material, Method), proses dan output. Penelitian menggunakan metode penelitian kualitatif, pengumpulan data dilakukan dengan wawancara mendalam, observasi secara langsung dan telaah dokumen.Hasil penelitian menunjukkan bahwa keterlambatan pengajuan klaim pasien JKN di RSUD Petala Bumi disebabkan karena kurangnya kompetensi SDM pengelola dokumen klaim terutama tim Casemix, masih ditemukan resume medis yang tidak lengkap, SIRS yang masih belum computerized sehingga proses pengelolaan dokumen dilakukan secara manual termasuk billing system, dan belum ada kebijakan serta SOP tertulis dan baku yang menjadi pedoman pengelolaan dokumen klaim sehingga waktu yang diperlukan untuk mengelola dokumen klaim saat ini menjadi relatif panjang.Kesimpulan dari penelitian ini bahwa kualitas SDM pengelola dokumen klaim masih belum memadai, alur proses pengelolaan dokumen klaim membutuhkan waktu lama karena tidak one tap service, serta tidak tersedia instruksi yang baku dan seragam secara tertulis untuk dijadikan pedoman dalam pengelolaan dokumen klaim. Rumah sakit perlu meningkatkan kompetensi untuk SDM pengelola dokumen klaim, mempercepat pelaksanaan SIRS yang terintegrasi di rumah sakit dan menetapkan pedoman melaksanakan pengelolaan dokumen klaim untuk kelancaran pengajuan klaim agar menjadi tepat waktu.

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The National Health Insurance (JKN) is an application of the Republic of Indonesia Law Number 40 of 2004 concerning the SJSN and for its implementation is regulated in Republic of Indonesia Presidential Regulation Number 12 of 2013 concerning Health Insurance, including the pattern of payments to the Advanced Referral Health Facility (FKRTL) using the system Indonesia System Case Base Groups (INACBGs). As many as 52.87% of the population in Riau Province had become JKN participants in 2016. Petala Bumi Hospital was one of the FKRTLs that served JKN participants in Pekanbaru with 41.9% of outpatients being JKN patients. It was found that there was a delay in filing a hospital claim with BPJS Kesehatan around 1-2 months from the specified deadline for 2017. This would result in a delay in hospital income where the hospital's biggest income came from JKN participants.

The purpose of this study was to analyze the causes of late submission of claims for JKN patients at Petala Bumi Hospital in terms of the system approach, namely input, process and output factors. Research uses qualitative research methods, data collection is done by in-depth interviews, direct observation and document review.

The results showed that the delay in filing claims for JKN patients at Petala Bumi Hospital was due to a lack of competency in the human resource management of claim documents, especially the Casemix team. Medical resumes were still incomplete, SIRS was still not computerized so the document management process was manual including the billing system there is no policy and written and standard SOP that guides the management of claim documents so that the time needed to manage claim documents is now relatively long.

The conclusion of this study is that the quality of HR claim managers is still inadequate, the process of claim document management takes a long time because it is not one tap service, and there are no standardized and uniform written instructions available to guide the management of claim documents. Hospitals need to carry out workload analysis for human resource claim document managers, accelerate the implementation of integrated SIRS in hospitals and establish guidelines for carrying out claims document management for smooth filing claims to be on time."

"Nasional di Rumah Sakit (Analisis Data Sekunder Tahun 2017) Angka kejadian sectio caesaria terus meningkat baik di rumah sakit pemerintah maupun di rumah sakit swasta di Indonesia. Peningkatan jumlah persalinan melalui sectio caesaria ini juga dapat terlihat pada peserta JKN, dimana sejak tahun 2014 hingga 2017, operasi pembedahan sesar selalu menduduki peringkat pertama kode CBG terbanyak di rawat inap tingkat lanjutan dan menjadi penyerap biaya manfaat jaminan kesehatan tertinggi. Belum adanya dokumentasi formal berdasarkan evidence based yang memperlihatkan evaluasi implementasi kebijakan penjamina persalinan, khususnya kasus sectio caesaria, pada peserta JKN menjadi penyebab sulitnya para pemangku kebijakan dalam menyusun kebijakan.Metode penelitian yang digunakan dalam penelitian ini adalah metode implementation research dengan pendekatan kuantitatif. Metode implementation research digunakan melalui pengumpulan rekap data klaim sectio caesaria peserta JKN di rumah sakit sepanjang tahun 2017.Hasil analisis menunjukkan bahwa dari 5 variable yang diteliti terdapat 3 variable yang terbukti secara signifikan mempengaruhi rate section caesaria, yaitu: 1) Hak kelas perawatan peserta JKN (p= 0,020 dan t hitung= 2,327), dimana semakin besar persentase peserta dengan hak kelas perawatan I di suatu kabupaten/kota maka semakin tinggi rate sectio caesaria, 2) Jenis kepemilikan rumah sakit (p= 0,035 dan t hitung = -2,119), dimana semakin besar persentase RS pemerintah pada suatu kabupaten kota maka semakin rendah rate sectio caesaria dan 3) Jumlah dokter spesialis kebidanan (p= 0,05 dan t hitung = -1,957), dimana semakin banyak jumlah dokter spesialis di kabupaten kota (rasio dokter spesialis terhadap penduduk semakin kecil), maka semakin tinggi angka rate sectio caesaria. Sedangkan variable jenis kelas rumah sakit (p= 0,912 dan t hitung= 0,111) dan nilai PDRB Per Kapita (p = 0,135 dan t hitung = -1,498) tidak terbukti secara signifikan mempengaruhi rate sectio caesaria. Faktor determinan yang paling dominan terhadap rate sectio caesaria adalah hak kelas perawatan dengan nilai Koef. beta= 3,372.Perlu dilakukan berbagai upaya dalam mengendalikan rate sectio caesaria yang dilakukan baik oleh pemerintah, BPJS Kesehatan maupun manajemen rumah sakit. Manajemen rumah sakit sebagai salah satu aktor yang berperan penting dalam kesuksesan program JKN juga perlu melakukan beberapa upaya dalam rangka mengendalikan angka sectio caesaria, antara lain pembuatan kebijakan dan pedoman pencegahan kecurangan, pengembangan pelayanan kesehatan yang berorientasi kendali mutu kendali biaya, pengembangan budaya pencegahan kecurangan sebagai bagian dari tata kelola organisasi dan klinis.

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The incidence of sectio caesaria continues to increase both in government hospitals and in private hospitals in Indonesia. The increase in the number of deliveries through sectio caesaria can also be seen in JKN participants, where from 2014 to 2017 cesarean section surgery was always ranked first in the most CBG codes hospitalized at the advanced level and absorbed the highest cost of health insurance benefits. The absence of formal evidence-based documentation that shows an evaluation of the implementation of maternity insurance policies, particularly in cases of sectional caesarean section, for JKN participants is the cause of difficulties for policy makers in drafting policies.

The research method used in this study is the method of implementation research with a quantitative approach. The implementation research method is used through collecting recapitulation of claims data on JKN participants in hospitals throughout 2017.

The results of the analysis show that of the 5 variables studied there were 3 variables which proved to significantly affect the caesaria section rate, namely: 1) Right to care for JKN participants (p = 0.020 and t count = 2.327), the greater the percentage of participants with the right of class I care in a district / city, the higher the rate of sectional caesaria, 2) Types of hospital ownership (p = 0.035 and t count = -2.119) , the greater the percentage of government hospitals in a city district, the lower the rate of sectional caesarea and 3) the number of obstetricians (p = 0.05 and t count = -1,957), the increasing number of specialists in the district, the higher rate of Caesarean section. While the hospital class type variables (p = 0.912 and t count = 0.111) and the Per Capita GRDP value (p = 0.135 and t count = -1.449) were not proven to significantly affect the rate of caesarean section. The most dominant determinant factor for the rate of sectio caesaria is the right of treatment class with Coef value. beta = 3.372.

It is necessary to do various efforts in controlling the rate of sectio caesaria carried out by the government, BPJS Health and hospital management. Hospital management as one of the actors who played an important role in the success of the JKN program also needed to make several efforts to control the sectio caesaria number, including making fraud prevention policies and guidelines, developing health services oriented to cost control quality control, developing fraud prevention culture as part of organizational and clinical governance."

"Undang-Undang Nomor 40 Tahun 2004 mengamanatkan setiap orang berhak atas jaminan sosial melalui Sistem Jaminan Kesehatan Nasional (JKN) menuju Universal Health Coverage (UHC) pada tahun 2019. Sistem pembayaran kepada rumah sakit pada JKN melalui tarif Indonesian-Case Based Groups (INA-CBGs) melalui suatu sistem manajemen klaim dimana setiap kendala bisa menyebabkan tertundanya pembayaran klaim oleh BPJS Kesehatan dan mempengaruhi pendapatan rumah sakit. Kelangsungan keuangan fasilitas kesehatan sangat tergantung dari sistem manajemen klaim yang efektif. Rumah Sakit Umum Daerah Jati Padang sebagai Badan Layanan Umum Daerah perlu melakukan pengelolaan keuangan secara baik sehingga pelayanan kesehatan pada masyarakat dapat berjalan dengan baik. Salah satu sumber pendapatan jasa layanan BLUD adalah melalui pembayaran klaim BPJS Kesehatan. Terjadinya pending dalam pembayaran klaim pasien BPJS Kesehatan di RSUD Jati Padang mengakibatkan pendapatan jasa layanan rumah sakit terganggu.Tujuan penelitian adalah untuk menganalisis penyebab pending claims BPJS Kesehatan ditinjau dengan pendekatan sistem yaitu faktor input (Man, Method, Money, Material, Machine), faktor proses, output (pending claims). Penelitian ini merupakan penelitian kualititatif. Pengumpulan data dilakukan melalui telaah dokumen dan wawancara mendalam.Hasil penelitian menunjukkan adanya penyebab pending claims yang disebabkan oleh faktor input (Man, Method, Money, Material, Machine), proses dan output. Salah satu penyebab adalah pengisian resume medis yang tidak sesuai (output), disebabkan karena pengisian resume medis terlambat dan ketidaksesuaian isi resume medis (proses) yang diakibatkan oleh faktor input (Man, Method, Money, Material, Machine). Gambaran pending claims (output) di RSUD Jati Padang adalah karena ketidaksesuaian Administrasi Klaim (17.89%), pengisian resume medis (57.51%), ketidaklengkapan berkas penunjang klaim (13.42%), konfirmasi coding diagnosa dan prosedur (8.95%) dan konfirmasi grouping (2.24%). Pengajuan klaim kepada BPJS Kesehatan selalu dilakukan diatas tanggal 5, dengan rata- rata keterlambatan 6.6 hari. Total jumlah berkas klaim BPJS Kesehatan bulan Januari-September 2018 yang disetujui pada tahap 1 adalah sebesar 3759 berkas (92.36%) dengan total tagihan yang disetujui Rp 1.180.532.000 (74.38%). Diperlukan strategi dari manajemen rumah sakit untuk dapat mencegah dan mengurangi pending claims. Salah satunya dengan pemberian remunerasi kepada dokter spesialis, penyusunan Panduan Praktik Klinis dan kelengkapan SOP terkait adminitrasi klaim, adanya monitoring evaluasi berkala mengenai permasalahan proses klaim BPJS.

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The Indonesian Act No. 40 of 2004 mandates that everyone has the right to social security through the Indonesian National Health Insurance (JKN) in achieving Universal Health Coverage (UHC) in 2019. On JKN, the payment system to hospitals on JKN is set with Indonesian-Case Based Groups (INA- CBGs) tariff, through claim management system where each problem can cause delays in claim payments by National Health Care Security and affect hospital income. The financial sustainability of health facilities is highly dependent on an effective claim management system. Rumah Sakit Umum Daerah Jati Padang as a Regional Public Service Agency needs to manage financial management effectively so that health services delivery is well-provided. One of financial source for RSUD Jati Padang is through National Health Care Security claims payment. Every pending claim will be resulted in disrupted hospital revenue.

This research objective was to analyze causes factors of National Health Care Security pending claims using the system approach, which are input factors (Man, Method, Money, Material, Machine), process factors, output (pending claims). This research is a qualitative study. Data is collected with document review and in-depth interviews.

The results showed that there were causes of pending claims caused by input factors (Man, Method, Money, Material, Machine), process and output. One of the causes is improper medical resume filling (output), caused by delay in filling in medical resume and incompatibility of medical resume content (process) and triggered by input factors (Man, Method, Money, Material). The description of pending claims (output) at Jati Padang Hospital is due to discrepancies in claim administration (17.89%), filling in medical resumes (57.51%), incomplete claim support documents (13.42%), confirmation of diagnostic diagnoses and procedures (8.95%) and grouping confirmation (2.24%). National Health Care Security claims are submitted to National Health Care Security verificator pass the 5th, with an average delay of 6.6 days. The total number of National Health Care Security claim files for January-September 2018 approved firstly is 3759 files (92.36%) with the total bills approved at Rp. 1,180,532,000 (74.38%). Strategies are needed from hospital management to be able to prevent and reduce pending claims. One of them is by giving remuneration to specialists, preparation of Clinical Practice Guidelines and SOPs related to claim administration is conducted, hold periodic monitoring evaluations to monitor the claim managemant process."

"Penelitian ini terinspirasi dari Q.S. Yusuf 46-49 yang bertujuan untuk melakukan pengujian kepemilikan asuransi kesehatan nasional Askes dan Askeskin dalam konteks berjaga jaga pada 7 tahun terakhir 2007-2014, apakah mempengaruhi berkurangnya kerugian konsumsi atas dampak yang ditimbulkan dari eksposure berupa shocks penyakit kronis dan cidera kecelakaan yang dialami rumah tangga. Metode yang digunakan dalam penelitian ini berupa ordinary least square OLS dengan menggunakan data IFLS 4 dan 5. Konsumsi rumah tangga per kapita digunakan sebagai variabel dependen, sedangkan variabel independen utama yang digunakan berupa kepemilikan asuransi kesehatan nasional Askes dan Askeskin pada 7 tahun terakhir. Kebaruan yang ditemukan pada penelitian ini adalah terdapat perbedaan signifikansi pada Askes dan Askeskin, yang mana Askes signifikan terhadap pengurangan kerugian konsumsi yang terdampak dari guncangan penyakit dan cidera kecelakaan, sedangkan Askeskin tidak signifikan pada kedua kasus guncangan. Variabel lainnya yang signifikan berkontribusi terhadap konsumsi adalah wilayah tempat tinggal, akses pinjaman, jumlah anggota keluarga, status pernikahan kepala keluarga, Pendidikan kepala keluarga, jumlah anggota keluarga yang bekerja, kepemilikan tabungan, kepemilikan rumah, dan pendapatan per kapita.

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This study inspired by Q.S. Yusuf 46-49 which aims to test the households ownership of national health insurance Askes and Askeskin in context precautionary for the last 7 years 2007-2014, whether it affect the reduction in consumption losses on the impact caused by chronic diseases shocks and accidental injuries shocks. The method used in this study is ordinary least square OLS using IFLS 4 and 5. Per capita Consumption Expenditure PCE household is used as the dependent variable, while the main independent variable used is national health insurance ownership Askes and Askeskin in the last 7 years. Novelty in this study is that there is a significant difference in Askes and Askeskin. Askes is significant for reducing consumption losses that are affected by disease shocks and accident injuries, while Askeskin is not significant in both of shocks. Other variables that significantly contribute to consumption are the area of ​​residence, access to loans, the number of family members, marital status of the head of the family, education of the head of the family, number of family members who work, savings ownership, home ownership, and per capita income."

"Setelah dilaksanakan Program Jampersal cakupan linakes Puskesmas Cipaku tahun 2012 sebesar 76,8%, dibawah cakupan Dinkes Kota Bogor 88,8%, rujukkan resiko tinggi sebanyak 90,9%. KB pasca salin pengguna Jampersal hanya 7%. Penelitian bertujuan mengidentifikasi determinan pemanfaatan Jampersal. Jenis penelitian cross sectional, Informasi melalui wawancara kepada 145 responden. Hasilnya pengetahuan, sikap ,dukungan keluarga, dukungan tenaga kesehatan berhubungan dengan pemanfaatan Jampersal, dukungan keluarga determinan dominan terhadap pemanfaatan Jampersal (Pv=0,000 OR=12,048 95% CI (4,568-31,777). Disarankan Dinkes mengajak BPS meningkatkan partisipasinya mendukung Jampersal, peningkatan keterampilan bidan dalam konseling KB. Sosialisasi melalui ANC dan kelas ibu. Dukungan keluarga dibutuhkan dalam mempersiapkan administrasi dan mendampingi saat pemeriksaan.

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Once implemented birth assisted by skilled health personnel in Health Center Program Cipaku Jampersal coverage in 2012 of 76.8%, under the scope of Bogor City Health Office 88.8%, referral high risk as much as 90.9% higher. KB post partum beneficiaries Jampersal only 7%. The research aims to identify the determinants of utilization Jampersal. Type of cross-sectional studies, information obtained through interviews with 145 respondents. Results of the study of knowledge, attitude, family support, health support personnel associated with the use of Jampersal, family support dominant determinant of the utilization Jampersal (Pv = 0.000 OR = 12.048 95% CI (4.568 to 31.777). Suggested Health Office invites privately practicing midwives increase participation Jampersal support, skills midwives in family planning counseling. midwives are expected to socialize through the ANC and the ?kelas ibu?. Needed family support and assist the administration in preparing for the hearing."

"Sistem pembiayaan kesehatan memainkan peran kunci dalam kesuksesan jaminan kesehatan nasional, terutama dalam memastikan akses yang merata ke layanan kesehatan. Indonesia, Thailand, Singapura, dan Malaysia memiliki pendekatan yang berbeda dalam mengelola fungsi pembiayaan kesehatan untuk mencapai Universal Health Coverage (UHC). Penelitian ini membandingkan fungsi pembiayaan kesehatan di keempat negara tersebut melalui metode literature review dengan menggunakan data dari artikel jurnal akademik dan laporan resmi dari kementerian kesehatan masing-masing negara. Hasil penelitian menunjukkan bahwa Indonesia mengelola Jaminan Kesehatan Nasional (JKN) melalui BPJS Kesehatan dengan dana dari kontribusi peserta dan alokasi pemerintah. Thailand memiliki tiga skema utama: UCS (Universal Coverage Scheme), CSMBS (Civil Servant Medical Benefit Scheme), dan SSS (Social Security Scheme), yang didanai oleh kombinasi anggaran pemerintah dan kontribusi tripartit. Singapura menggunakan sistem 3M (Medisave, Medishield Life, dan Medifund) yang menggabungkan tabungan wajib dan subsidi pemerintah. Malaysia menerapkan sistem dua pilar, yaitu layanan kesehatan publik yang didanai pajak dan layanan kesehatan swasta yang didanai oleh berbagai sumber termasuk jaminan sosial dan asuransi kesehatan swasta.

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The health financing system plays a crucial role in the success of national health insurance programs, particularly in ensuring equitable access to healthcare services. Indonesia, Thailand, Singapore, and Malaysia each employ distinct approaches in managing health financing functions to achieve Universal Health Coverage (UHC). This study compares the health financing functions in these four countries through a literature review method, using data from academic journal articles and official reports from the respective ministries of health. The findings reveal that Indonesia manages its National Health Insurance (JKN) through BPJS Kesehatan, funded by participant contributions and government allocations. Thailand operates three main schemes: UCS (Universal Coverage Scheme), CSMBS (Civil Servant Medical Benefit Scheme), and SSS (Social Security Scheme), funded by a mix of government budgets and tripartite contributions. Singapore employs the 3M system (Medisave, Medishield Life, and Medifund), which combines mandatory savings with government subsidies. Malaysia utilizes a dual-pillar system, comprising publicly funded healthcare services supported by taxes and private healthcare services funded by various sources, including social insurance and private health insurance."

"Asuransi kesehatan merupakan salah satu skema asuransi sosial yang ada di Jepang Asuransi ini termasuk dalam Sistem Jaminan Sosial Jepang Fokus dari penelitian ini membahas tentang bagaimana asuransi kesehatan dapat diterapkan di Jepang Penelitian ini merupakan penelitian kualitatif dengan menggunakan metode deskriptif analisis Pengumpulan data dilakukan dengan metode studi dokumen Tujuan penelitian ini adalah untuk menjelaskan pelaksanaan asuransi kesehatan di Jepang khususnya Kokuho Analisa dimulai dengan pembagian tipe asuransi di Jepang sampai pada dampaknya terhadap penduduk Jepang Hasil dari penelitian menemukan bahwa ketanggapan serta konsistensi pemerintah merupakan faktor penting dalam penerapan asuransi kesehatan di Jepang Penerapan asuransi kesehatan ini berdampak pada munculnya kesadaran penduduk Jepang terhadap kesehatan serta persamaan bagi setiap penduduk untuk mendapatkan pelayanan kesehatan yang setara.

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Health insurance is one of social insurance scheme in Japan This insurance is one of the Social Security System of Japan The focus of this study discusses how health insurance can be applied in Japan This study is qualitative study using descriptive analysis method Data was collected through document study methods The purpose of this study is to describe the implementation of health insurance in Japan especially Kokuho The analysis begins with the types of insurance in Japan until the impact on the Japanese residents The results of the study found that the government 39 s responsiveness and consistency are important factors for the implementation of health insurance in Japan Application of health insurance has resulted in the emergence of the Japanese people awareness on health and equality for all residents to obtain health care."

"[ABSTRAKLatar Belakang: Jaminan kesehatan Nasional mempermudah masyarakat untukmengakses dan mendapatkan pelayanan kesehatan bermutu termasuk kesehatangigi. Dokter gigisebagai pemberi pelayanan kesehatan tingkat pertama diharapkanberpartisipasi dalam mendukung Program Jaminan Kesehatan Nasional. Tujuan:Diperolehnyapemahaman determinan kesediaan dokter gigi sebagai pemberipelayanan kesehatan dalam Jaminan Kesehatan Nasional. Metode: PenelitianCross Sectional terhadap dokter gigi praktek swasta menggunakan kuesioner.Datadianalisis menggunakanujichi square dan regresi logistik.Simpulan: Pengetahuantentang paket manfaat dan sikap terhadap kapitasi ditemukan memberikankontribusi terhadap kesediaan dokter gigi.

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ABSTRACTBackground:A national health insurance makes people easier to access andobtain quality health care including dental health. Dentists as the first level healthservice providers are expected to participatein supporting the National HealthInsurance Program. Objective: To elucidatedeterminants dentistwillingnesstobecomehealth care provider for the national health insuranceMethods: Crosssectionalstudy on private practice dentists using questionnaires. Data wereanalyzed usingchi square test and logistic regression.Conclusions: Knowledge onbenefit package and attitude toward capitation found to have significantcontribution to dentist willingness, Background:A national health insurance makes people easier to access andobtain quality health care including dental health. Dentists as the first level healthservice providers are expected to participatein supporting the National HealthInsurance Program. Objective: To elucidatedeterminants dentistwillingnesstobecomehealth care provider for the national health insuranceMethods: Crosssectionalstudy on private practice dentists using questionnaires. Data wereanalyzed usingchi square test and logistic regression.Conclusions: Knowledge onbenefit package and attitude toward capitation found to have significantcontribution to dentist willingness]"

"[ABSTRAKTingginya kejadian menunggak rata ? rata nasional 33% dalam pembayaran iuran Jaminan Kesehatan Nasional (JKN) oleh kepesertaan mandiri Badan Penyelenggara Jaminan Sosial Kesehatan dalam jangka panjang bisa mengganggu kelancaran, kelangsungan, dan keberlanjutan pembiayaan kesehatan. Terlebih lagi dengan adanya penyakit kronis pada peserta mandiri semakin memberikan beban ekonomi dan dampak negatif (adverse selection) bagi program JKN. Tujuan dari penelitian ini adalah untuk mengetahui apakah terdapat korelasi antara penyakit kronis pada peserta mandiri dengan kepatuhan membayar iuran Jaminan Kesehatan Nasional di Kota Depok. Metode penelitian cross-sectional dengan mengambil sampling keseluruhan peserta mandiri yang pernah mendapat layanan kesehatan di Kota Depok dari Januari 2014 ? Agustus 2015 didapat bahwa penyakit kronis dengan kepatuhan membayar iuran Jaminan Kesehatan Nasional di Kota Depok berbeda menurut kelas perawatan. Semakin rendah kelas perawatan peserta mandiri dengan penyakit kronis akan cenderung semakin meningkat. Oleh karena itu, distribusi proteksi risiko keuangan harus lebih berpihak atau pro kepada kelompok yang kurang mampu.

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ABSTRACTThe high occurences of arrears in paying dues towards the independent membership of the National Health Coverage upto 33% at national average in the long term may interfere/hinder the continuity and sustainability of the program. Moreover, the presence of chronic illness among the members will contribute more economic burden and negative impacts (adverse selection). The purpose of this study is to analyze whether the presence of chronic illness has correlations in connection with paying dues compliance among the independent member of the National Health Coverage in Depok, Jawa Barat, Indonesia. By taking the total sampling against the independent membership of National Health Coverage in Depok who have received treatment at the medical facilities found that chronic illness and the compliance of paying dues is unsimilar depend on class of treatment. The lower class of treatment, the members with chronic illness more comply. It is, therefore, important to distribute public financial risk sharing that more inclined to lower class of treatment/pro poor.;The high occurences of arrears in paying dues towards the independent membership of theNational Health Coverage upto 33% at national average in the long term may interfere/hinderthe continuity and sustainability of the program. Moreover, the presence of chronic illnessamong the members will contribute more economic burden and negative impacts (adverseselection). The purpose of this study is to analyze whether the presence of chronic illness hascorrelations in connection with paying dues compliance among the independent member ofthe National Health Coverage in Depok, Jawa Barat, Indonesia. By taking the total samplingagainst the independent membership of National Health Coverage in Depok who havereceived treatment at the medical facilities found that chronic illness and the compliance ofpaying dues is unsimilar depend on class of treatment. The lower class of treatment, themembers with chronic illness more comply. It is, therefore, important to distribute publicfinancial risk sharing that more inclined to lower class of treatment/pro poor.;The high occurences of arrears in paying dues towards the independent membership of theNational Health Coverage upto 33% at national average in the long term may interfere/hinderthe continuity and sustainability of the program. Moreover, the presence of chronic illnessamong the members will contribute more economic burden and negative impacts (adverseselection). The purpose of this study is to analyze whether the presence of chronic illness hascorrelations in connection with paying dues compliance among the independent member ofthe National Health Coverage in Depok, Jawa Barat, Indonesia. By taking the total samplingagainst the independent membership of National Health Coverage in Depok who havereceived treatment at the medical facilities found that chronic illness and the compliance ofpaying dues is unsimilar depend on class of treatment. The lower class of treatment, themembers with chronic illness more comply. It is, therefore, important to distribute publicfinancial risk sharing that more inclined to lower class of treatment/pro poor., The high occurences of arrears in paying dues towards the independent membership of theNational Health Coverage upto 33% at national average in the long term may interfere/hinderthe continuity and sustainability of the program. Moreover, the presence of chronic illnessamong the members will contribute more economic burden and negative impacts (adverseselection). The purpose of this study is to analyze whether the presence of chronic illness hascorrelations in connection with paying dues compliance among the independent member ofthe National Health Coverage in Depok, Jawa Barat, Indonesia. By taking the total samplingagainst the independent membership of National Health Coverage in Depok who havereceived treatment at the medical facilities found that chronic illness and the compliance ofpaying dues is unsimilar depend on class of treatment. The lower class of treatment, themembers with chronic illness more comply. It is, therefore, important to distribute publicfinancial risk sharing that more inclined to lower class of treatment/pro poor.]"