* Corresponding Author
Pengaruh Kepemilikan Jaminan Kesehatan terhadap Belanja Kesehatan Katastropik Rumah Tangga di Indonesia Tahun 2012
https://doi.org/10.22146/jkki.12186 Lena Elfrida Situmeang(1*), Budi Hidayat(2)
(1) Fakultas Kesehatan Masyarakat Universitas Indonesia
(2) Departemen Administrasi Kebijakan Kesehatan, Fakultas Kesehatan Masyarakat, Universitas Indonesia
(*) Corresponding Author
Abstract
Background: Indonesia’s health development geared to achieve national health insurance scheme (JKN). However, funding of health in Indonesia is still dominated by domestic funding through out-of-pocket (OOP). Objective: Catastrophic health expenditure of households will disrupt household consumption and can lead to poverty. Using secondary data of the National Social Surveys 2 (Susenas) 2012, this study aims to prove health insurance ownership lowers catastrophic health expenditure of households in Indonesia in 2012. Methods: This study used a cross-sectional study design with models probit and bivariate probit. Results: The results found that the health insurance ownership lowers catastrophic health expenditure amounted 12.97% at the threshold 10% of total expenditure and amounted 18.42% at 20% of total non-food expenditure. Conclutions: Health insurance ownership provides protection for catastrophic health expenditure in Indonesia in 2012.
ABSTRAK
Latar Belakang: Pembangunan kesehatan Indonesia diarahkan untuk mencapai Jaminan kesehatan Nasional (JKN). Namun, sebagian besar pendanaan kesehatan masih didominasi oleh rumah tangga melalui out-of-pocket (OOP). Pengeluaran biaya kesehatan katastrofik rumah tangga akan mengganggu konsumsi rumah tangga dan dapat mengakibatkan kemiskinan. Tujuan: Menggunakan data sekunder Survei Sosial Nasional (Susenas) tahun 2012, penelitian ini bertujuan membuktikan bahwa kepemilikan jaminan kesehatan menurunkan belanja kesehatan katastrofik rumah tangga di Indonesia tahun 2012. Metode: Penelitian dengan desain studi potong lintang ini, menggunakan pendekatan ekonometrik dengan model probit dan bivariat probit. Hasil: Hasil penelitian menunjukkan bahwa kepemilikan jaminan kesehatan menurunkan belanja kesehatan katastrofik sebesar 12.97% pada ambang batas 10% dari total pengeluaran dan sebesar 18.42% pada ambang batas 20% total pengeluaran non-makanan. Kesimpulan: Kepemilikan jaminan kesehatan memberikan perlindungan terhadap belanja kesehatan katastrofik di Indonesia pada Tahun 2012.
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Adisasmito, Wiku (2012). Sistem kesehatan.Jakarta: PT. RajaGrafindo Prakara.
Baeza, C. and T. G. Packard. 2006.Beyond survival: protecting households from health shocks in Latin America. Washington, DC: World Bank and Stanford University Press.
World Health Organization (2000). The world health report 2000 : health system : improving performance. Geneva, 23-46, 95-116.
Tangcharoensathien, V., Patcharanarumol, W., Ir, P., Aljunid, S.M., Mukti, A.G., Akkhavong, K., dkk. (2011) Health-financing reforms in south-east Asia: challenges in achieving universal coverage. The Lancet, 377: 863–873.
Xu, Ke, David B. Evans, K. Kawabate, R. Zeramdini, J. Klavus, and C. J. L. Murray (2003). Household catastrophic health expenditure: a multicountry analysis. The Lancet Vol 362.
Su, Tin Tin, Bocar Kouyate, Steffen Flessa (2006). Catastrophic household expenditure for health care in low income society: a study from Nouna District, Burkina Faso. Bulletin of World Health Organization; 84:21-27.
Hariyadi, Ki (2009). Determinan pengeluaran kesehatan katastrofik di Indonesia. Yogyakarta: Tesis Universitas Gadjah Mada.
Kementerian Kesehatan Republik Indonesia (2015). Profil kesehatan Indonesia 2014. Kementerian Kesehatan Republik Indonesia, Jakarta.
Made, Ni Ayu Sri Ratna Sudewi (2013). protektabilitas asuransi kesehatan sosial terhadap ekonomi pegawai negeri di Jawa Tengah dan di Yogyakarta. Depok: Disertasi Fakultas Kesehatan Masyarakat Universitas Indonesia.
Nadjib, Mardiati dan Pujiyanto (2002). pola pengeluaran rumah-tangga untuk kesehatan pada kelompok marjinal dan rentan. Makara Kesehatan Vol. 6 No. 2, 35-46
Kimami dan Maina (2015). Catastropic Health expenditures and impoverishment in Kenya. Health Policy Project.
Van Doorslaer, E., O. O’Donnell, R. P. Rannan-Eliya, A. Samanathan, S. R. Adhikari, et al. 2006. “Effect of payments for healthcare on poverty estimates in 11 countries in asia: an analysis of household survey data.” Lancet 368(9544): 1357–1361.
Wagstaff, Adam dan Eddy van Doodslaer (2003). Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993-98.
Ranson, M. K. 2002. “Reduction of catastrophic health care expenditures by a communitybased health insurance scheme in Gujarat, India: current experiences and challenges.” Bulletin of the World Health Organization 80(8): 613–21.
Republik Indonesia. Buku II nota keuangan beserta anggaran pendapatan dan belanja negara tahun tahun 2016.
Kementerian Perencanaan Pembangunan Nasional/ Badan Perencanaan Pembangunan Nasional (2015). Satu tahun pelaksanaan jaminan kesehatan nasional. Direktorat Perlindungan dan Kesejahteraan Masyarakat Kementerian PPN/ Bappenas, Jakarta.
Pujiyanti, Eka (2013). Protektabilitas jaminan kesehatan nasional terhadap tingkat pengeluaran biaya kesehatan tunai (out-of-pocket) rumah tangga di Indonesia : analisis data Susenas tahun 2012. Depok: Tesis Fakultas Kesehatan Masyarakat Universitas Indonesia.
Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav, 36, 1-10.
Freedman DA, Sekhon JS. Endogeneity in probit response models. polit anal [Internet]. 2010;18(2):138–50. Available from: http://pan.oxfordjournals.org/content/18/2/138.abstract
17 Cameron AC, Trivedi PK. Microeconometrics using stata [internet]. Vol. 5, Stata Press books. Texas: A Stata Press Publication; 2009. 706 p. Available from: http://stata.biz/news/statanews.23.4.pdf
Greene WH. Econometric analysis. 7th ed. USA: Pearson Education, Inc; 2012.
Card D, Dobkin C, Maestas N. The iImpact of nearly universal insurance coverage on health care utilization: evidence from medicare. Am Econ Rev [Internet]. 2008;98(5):2242–58. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600774/
Waters HR. Measuring the impact of health insurance with a correction for selection bias--a case study of Ecuador. Heal Econ. 1999/09/02 ed. 1999;8(5):473–83.
Cameron AC, Trivedi PK. Microeconometrics: methods and application. New York:
Xu, Ke, David B. Evans , Patrick Kadama, Juliet Nabyonga, Peter Ogwang Ogwal, Pamela Nabukhonzo, Ana Mylena Aguilar (2006). Understanding the impact of eliminating user fees: Utilization and catastrophic health expenditures in Uganda. Social Science & Medicine 62: 866–876.
Cavagnero, E., Carring, G., Xu, K., Rivera, A., & Mylena, A. (2006). Health financing in argentina: an empirical study of health care expenditure and utilization. Instituto Nacional de Saluad Publica.
Li, Ye, Qunhong Wu, Ling Xu, David Legge, Yanhua Hao, Lijun Gao, Ning Ning & Gang Wan (2012). Factors affecting catastrophic health expenditure and impoverishment from medical expenses in China: policy implications of universal health insurance.Bull World Health Organ, 90:664–671.
Preker, A., G. Carrin, D. Dror, M. Jakab, W. Hsiao and D. Arhin (2001). Role of communities in resource mobilization and risk sharing. HNP Discussion Paper, World Bank, Washington, D.C
Yip, W. & Berman P. (2001). Tergeted health insurance in a low income country and its impact on access and equity in access : Egypt’s school health insurance. Health Economics 10(3):207-20.
Made, Ni Ayu Sri Ratna Sudewi (2013). Protektabilitas asuransi kesehatan sosial terhadap ekonomi pegawai negeri di Jawa Tengah dan di Yogyakarta. Depok: Disertasi Fakultas Kesehatan Masyarakat Universitas Indonesia.
Ekman, Bjorn (2007). Catastrophic health payments and health insurance: Some counterintuitive evidence from one low-income country. Health Policy 83: 304–313.
Notoatmodjo, Soekidjo (2002). Metodologi penelitian kesehatan, edisi revisi. Rineka Cipta, Jakarta.
Somkotra, Tewarit dan Leizel P. Lagrada (2009). Which households are at risk of catastrophic health spending: experience in thailand after universal coverage. Health Affairs 28, no.3 (2009):w467-w478.
Chuma, J. and T. Maina. 2012. “Catastrophic healthcare spending and impoverishment in Kenya.” BMC Health Services Research 12: 413.
Ha, N.T.; Berman, P.; Larsen, U. (2002). Household utilization and expenditure on private and public health services in Vietnam.Health Policy Plann17, 61–70.
Gotsadze, G. (2005). Health care—Seeking behaviour and out-of-pocket payments in Tbilisi, Georgia.Health Policy Plann 20, 232–242.
Hidayat, Budi. Provider choice for outpatient health care services in indonesia: the role of health insurance. Buletin Penelitian Sistem Kesehatan – Vol. 12 No. 3 Juli 2009. 217-226
DOI: https://doi.org/10.22146/jkki.12186
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