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"This paper is a literature review laying out empirical evidence of healthcare access inequity within an implementation of social health insurance (SHI) programs. The research question of this paper is: in what way, and how, inequity in healthcare access potentially happens, even if a type of SHI covers the whole, or most, of a society. This paper is mainly motivated by the implementation of Jaminan Kesehatan Nasional (JKN), an SHI program in Indonesia. Even though the program aims to create better equity in healthcare access, the existing health system and the program’s design may prevent the achievement of this goal. By laying out evidence on how healthcare access inequity in other countries remains within an SHI mechanism, this paper illuminates that JKN may face the same risk. In reviewing the papers, this study applied Goddard and Smith’s (2001) concept of healthcare access inequity in the area of availability, quality, cost, and information. The findings suggest that healthcare access inequity could happen despite the implementation of an SHI program. Four types of circumstances that might have led to healthcare access inequity include geographical disparities of health facilities; adequacy of insurance program’s reimbursement and healthcare providers’ financial motive; healthcare providers’ prejudices toward patients; and unequal personal advantages of health treatment seekers. When applied to the context of JKN implementation in Indonesia, the risks of healthcare access inequity are imminent, mostly due to the uneven concentration of health facilities, the program’s segmented tariff rates, and the socioeconomic diversity among JKN members. The findings imply that JKN members might be at risk of healthcare access inequity. While the risks are plausible, this study is limited to predicting the potential inequity within JKN, mirroring from the empirical evidence. This study signifies the need for further empirical research on this area, which will potentially inform policymakers to improve the program."

"Disparitas antara layanan kesehatan diabetes melitus antara kota dan kabupaten masih menjadi tantangan di Indonesia meskipun sudah ada Jaminan Kesehatan Nasional. Akses ini menjadi penting karena pasien sangat bergantung terhadap manajemen diabetes melitus tipe 1 untuk menjaga kualitas hidupnya. Penelitian ini bertujuan untuk mendapatkan gambaran akses layanan kesehatan pada pasien diabetes melitus tipe 1 di Indonesia tahun 2015-2022 berdasarkan kabupaten/kota. Penelitian ini menggunakan data sampel BPJS Kesehatan tahun 2015-2022 dengan desain penelitian cross sectional. Analisis statistik deskriptif dilakukan untuk melihat proporsi pada setiap karakteristik pasien berdasarkan kabupaten/kota. Hasil penelitian menunjukkan sebanyak 3,8% pasien memiliki akses adekuat dengan mayoritas adalah laki-laki, berada dalam segmentasi PBI, berobat ke wilayah kota apabila tinggal di wilayah kabupaten, berobat ke wilayah kabupaten apabila tinggal di wilayah kota, dan memiliki komorbid hipertensi. Perluasan jaminan manfaat program Prolanis dan pedoman manajemen penyakit diabetes melitus tipe 1 menjadi hal yang penting untuk meningkatkan akses pada pasien.......Healthcare access disparity between cities and regencies in diabetes mellitus healthace is a challenging issue despite Indonesia already have National Health Insurance. This access become an important subject because type 1 diabetes mellitus patients depend on good management to maintain their quality of life. The aim of this study is to describe the healthcare access among type 1 diabetes mellitus patients based on regency-city status. This study used Indonesia National Health Insurance 2015-2022 Sample Data with cross sectional as its study design. The results showed that 3,8% type 1 diabetes mellitus in patients in Indonesia have adequate access with majority of them are men, in PBI scheme, seeking treatment in the city if they lived in the regency, seeking treatment in the regency if they lived in the city, and have hypertension as a comorbid. The expansion of Prolanis program and type 1 diabetes mellitus management guidelines are important to improve patients’ access to healthcare."