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Abstrak :
Pelaksanaan program skrining riwayat kesehatan merupakan tindakan preventif yang dilakukan di berbagai negara. Dengan menerapkan skrining riwayat kesehatan diharapkan mampu mencegah sedari dini terjadinya komplikasi serta dampak pembiayaan kesehatan pada penyakit yang dilakukan skrining. Penelitian ini bertujuan untuk mengetahui gambaran pelaksanaaan serta determinan dan dampak yang dihasilkan dari program skrining riwayat kesehatan di berbagai negara. Metode yang digunakan dalam penelitian ini adalah metode literature review. Pencarian studi dilakukan melalui online database yaitu PubMed, ScienceDirect, Proquest, dan Wiley Online Library. Terdapat 12 studi yang termasuk ke dalam penelitian ini. Hasil penelitian ini menunjukkan bahwa program skrining riwayat kesehatan telah diterapkan di berbagai negara dengan sasaran jenis penyakit yang berbeda-beda, mayoritas menggunakan mekanisme pengiriman undangan yang terbilang cukup efektif dalam meningkatkan partisipasi skrining. Peran faktor pengetahuan dan kesadaran, dukungan unsur tenaga kesehatan professional, dan status pendidikan peserta sangat mempengaruhi efektivitas pelaksanaan program skrining kesehatan. Dampak positif yang dihasilkan oleh program skrining adalah menurunkan angka kejadian dan kematian pada penyakit yang dilakukan skrining. Namun, juga didapatkan dampak jangka pendek yang terjadi pada pembiayaan kesehatan di sektor rawat jalan dan rawat inap. Meskipun begitu, dampak pada pembiayaan kesehatan terbilang tidak terlalu signifikan dan masih dapat diatasi. ...... The implementation of a health history screening program is a preventive measure carried out in various countries. By implementing medical history screening, it is expected to be able to prevent early complications and the impact of health financing on diseases being screened.This study aims to describe the implementation as well as the determinants and impacts resulting from health history screening programs in various countries. The method used in this study is the literature review method. Study searches were conducted through online databases such as PubMed, ScienceDirect, Proquest, and Wiley Online Library. There are 12 studies included in this research. The results of this study indicate that a health history screening program has been implemented in various countries with different types of disease targets, the majority of several countries use an invitation of health screening which is quite effective in increasing screening participation. The role of knowledge and awareness factors, support from professional health personnel, and the educational status of participants greatly affect the effectiveness of the implementation of the health screening program. The positive impact generated by the screening program is to reduce the incidence and mortality of the disease being screened. However, there are also short-term impacts that occur on health financing in the outpatient and inpatient sectors. Even so, the impact on health financing is not too significant and can still be overcome.

Abstrak :
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.

Abstrak :
Penelitian ini bertujuan untuk menganalisis pengaruh probabilitas default iuran program JKN dalam memprediksi sustainabilitas keuangan dengan menggunakan arus kas operasi sebagai indikator financial distress atau kebangkrutan program JKN dengan menggunakan rasio-rasio keuangan dan operasional. Variabel yang digunakan dalam penelitian ini adalah rasio klaim, kolektabilitas iuran, likuiditas, probabilitas default piutang iuran, umur program JKN dan ukuran aset sepanjang tahun 2016-2021. Penelitian merupakan studi empiris dengan menggunakan metode analisis regresi logistik biner logit. Hasil penelitian menunjukkan bahwa variabel yang signifikan sebagai prediktor sustainabilitas pendanaan program JKN adalah probabilitas default piutang iuran, yang berkorelasi positif, dan kolektibilitas, yang berkorelasi negatif. Variabel lainnya yaitu rasio klaim, likuiditas, umur dan ukuran aset tidak signifikan sebagai prediktor. ......This study aims to analyze the effect of the probability of default of JKN program contributions in predicting financial sustainability by using operating cash flow as an indicator of financial distress or bankruptcy of the JKN program. The independent variables in this study are the claims ratio, contribution collectability, the liquidity ratio, contribution arreas’s default probability, the age of the JKN program, and the asset size during period from 2016 to 2021. This research is an empirical study by using the binary logit logistic regression analysis method. The results show the variables that significantly affect financial distress as the predictors are, contribution arreas’s default probability which is positively correlated, and contribution collectability is negatively correlated. Other variables are not statistically significant to predict financial distress.

Abstrak :
This paper analyzes health outcomes and inequality in Indonesia, and the links to intermediate factors and inputs. Between 1997-2015, the country's health performance indicators had improved and became more equal. This achievement could potentially be correlated with improvement in health care access, which might be a result of the Indonesian government's policy to expand health insurance coverage, mainly to the most impoverished population. By 2020, the Indonesian government operates national social health insurance, the Jaminan Kesehatan Nasional (JKN), which covers about 83% of the country's population, including the poor and vulnerable. This paper uses the Control Knob Framework and focuses on the health insurance expansion as the financing knob adjustment conducted by the government. The analysis starts with the improvement of health status indicators and tracks back its association with health care access and health insurance coverage expansion. This paper finds that health status improvement in Indonesia between 1997-2015 was correlated with health care access increase. The decline in the infant mortality rate (IMR) and the under-five mortality rate (U5MR) between 1997-2015 were associated with an increase in health care utilization, including the use of trained birth attendants and diphtheria-pertussis-tetanus (DPT) immunization. This paper then observes a strong correlation between the expansion of health care access and health insurance coverage. In terms of equality, the article sees a weaker, but evident, correlation between health insurance equalization across different population groups with more equitable health care access and health outcomes. The findings of this paper justify the effectiveness of the financing knob (expanding and equalizing health insurance coverage) in increasing access to care (outpatient and inpatient care, trained birth attendants, immunization) and improving health status (IMR and U5MR). This study is among the firsts to utilize Control Knob Framework as an analytical tool for health insurance assessment. The study recommends the government to combine health insurance expansion with other progressive policy, such as financial support to poor patients to cover the non-medical expenses of attending health care, to optimize the effectiveness of the interventions.

Abstrak :
Program promotif preventif penyakit kronis atau program pengelolaan penyakit kronis (Prolanis) atau manajemen penyakit kronis adalah salah satu program asuransi kesehatan sosial untuk mendukung dan mewujudkan perilaku hidup sehat terkendali dalam masyarakat yang memiliki penyakit kronis dan demi terciptanya Universal Health Coverage (UHC), program promotif preventif penyakit kronis harus dirasakan oleh seluruh masyarakat dengan memberikan jaminan kesehatan yang menyeluruh/terintegrasi. Metode penelitian yang digunakan adalah literature review dari jurnal, text book, dan website dalam negeri maupun luar negeri. Hasil penelitan menunjukkan bahwa sumber daya manusia yang kompeten, fasilitas yang mencukupi, pendanaan yang baik dan mencukupi, kebijakan yang ada dan diterapkan dengan baik, perencanaan, pengorganisasian, dan pelaksanaan program yang terkoordinasi dengan baik dapat membuat tercapainya tujuan program tersebut, di samping adanya hambatan yang terjadi. Oleh karena itu, badan penyelenggara dan FKTP harus membuat strategi untuk mengatasi hambatan yang ada. Adapun pelajaran yang kita dapat dari negara lain adalah Indonesia harus memiliki sistem pendanaan yang lebih kuat dan terkoordinasi, memperkuat dasar program promotif preventif penyakit kronis asuransi kesehatan sosial. Kesimpulannya, penyelenggaraan Prolanis di Indonesia masih kurang baik, target Prolanis belum tercapai. Negara lain pun masih memiliki kekurangan, tetapi saran penulis untuk BPJS Kesehatan dan FKTP harus mempelajari kelebihan dari sistem yang sudah baik di negara lain dan mencontoh beberapa strateginya. ......Chronic promotive and preventive program or chronic disease management program (Prolanis) is one of the social health insurance programs that supports the realization of healthy living behavior in a controlled society with chronic diseases and for the creation of Universal Health Coverage (UHC), a promotive program prevention of chronic diseases must be felt by the whole community by providing comprehensive/integrated health insurance. The research method used is literature review from journals, text books, and websites in the country and abroad. The results of the research show that competent human resources, adequate facilities, good and sufficient funding, existing and well-implemented policies, planning, organizing, and implementing a well-coordinated program can make achievement of the program's objectives, in addition to obstacles that happened. Therefore the organizing body and FKTP must make a strategy to overcome existing obstacles. As for the lessons we have learned from other countries, Indonesia must have a stronger and coordinated funding system, strengthening the basis of a preventive chronic health disease preventive health insurance program. In conclusion, the implementation of Prolanis in Indonesia is still not good, the Prolanis target has not been reached. Other countries still have shortcomings, but the writer's suggestion for BPJS Health and FKTP must study the advantages of a good system in another country and follow some of its strategies.

Abstrak :
Jaminan kesehatan merupakan hak warga negara yang harus dipenuhi oleh Negara, sebagaimana dinyatakan dalam Pasal 28 H ayat (3) UUD NRI 1945, Pasal 34 ayat (2) UUD NRI 1945, Pasal 19 UU No. 39 tahun 2009 Tentang Kesehatan, dan Pasal 18 UU No. 40 Tahun 2004 tentang Sistem Jaminan Sosial Nasional. Jaminan Kesehatan di Indonesia saat ini dilaksanakan melalui program Jaminan kesehatan Nasional (JKN), yang diselenggarakan oleh BJPS Kesehatan. Sesuai dengan amanat resolusi World Health Assembly ke-58 tahun 2005, WHO bersama negara-negara di dunia berkomitmen untuk mewujudkan jaminan pelayanan kesehatan bagi seluruh penduduk melalui suatu sistem pembiayaan kesehatan yang berkelanjutan, yakni Universal Health Coverage (UHC). Pemerintah menargetkan seluruh penduduk menjadi peserta JKN pada 2019 namun kenyataannya pada Januari 2019 hanya 216.152.549 jiwa atau 81% penduduk Indonesia yang telah menjadi peserta. Penelitian ini dibuat untuk mengetahui apakah penyelenggaraan program JKN oleh BPJS Kesehatan sudah sesuai dengan prinsip UHC. Selain itu, Penelitian ini juga ingin mengetahui bagaimana penduduk yang tidak terdaftar sebagai peserta BPJS Kesehatan dapat memperoleh manfaat JKN. Penelitian ini menggunakan bentuk penelitian yuridis-normatif dengan tipe penelitian deskriptif–analitis. Penelitian ini menggunakan kajian mendalam terhadap UU SJSN, UU BPJS, Perpres Program JKN, dan peraturan perundang-undangan lainnya mengenai Jaminan Kesehatan, serta dokumen WHO. ......Social health Security is citizen’s right according to Article 28H section (3) of Constitution of Republic of Indonesia 1945, Article 34 section (2) Constitution of Republic of Republic of Indonesia 1945, Article 19 on Law Number 39 of 2009, and Article 18 on Law Number 40 of 2004. Social Health Security in Indonesia implemented through programme National Health Insurance System (JKN), which is held by Social Health Insurance Administration Organization (BPJS Kesehatan). According to resolution Fifty- Eight World Health Assembly 2005, WHO and all countries committed to guarantee access to health service for all people through sustainable health-financing system, which is Universal health Coverage (UHC). Government targeted all people registered to national social health insurance due to 2019 but until January 2019 only 216.152.549 people or 81% of citizens have national health insurance. This study aims to analyze the implementation of JKN held by BPJS Kesehatan based on UHC principles and to know how citizens who is not registered able to get access to health security. This study using juridical-normative research and descriptive data analysis. This study also using depth review towards laws of social health security and documents of WHO.