Analysis of Factors Influencing BPJS Membership Status in the Independent (PBPU) and Non-Worker Segments
Abstract
Introduction: Universal Health Coverage (UHC) is a significant agenda outlined in the SDG 2030. In order to achieve UHC, Indonesia established the Social Security Management Agency (BPJS) in 2014. Nearly a decade after its establishment, BPJS experienced a financial deficit in its first six years, followed by a surplus during the COVID-19 pandemic. This has impacted the sustainability of BPJS Health. One of the factors contributing to the financial deficit is the non-compliance of participants in paying BPJS contributions, particularly in the Non-Wage Earner/Self-Employed/Independent (PBPU) and Non-Worker segments who are required to pay contributions individually. When participants fail to pay contributions for six consecutive months, their membership status is converted to inactive. From the 2022 BPJS Sample Data, it was found that 799,384 out of 2,305,435 (34.67%) participants had inactive membership status.
Objective: This study aims to analyze the factors influencing BPJS membership status in the Independent and Non-Worker segments.
Method: The method that used in this study is quantitative analysis of secondary data from the 2022 BPJS Sampel Data with the Linear Probability Model (LPM), Logit and Probit Models. The analysis is conducted using STATA to obtain univariate, bivariate and multivariate analyses.
Result: From a sample of 545,507 participants, if was found that 54.20% had inactive membership status. Factors such as age, gender, marital status, treatment class, healthcare facility type, and participant segmentation affect membership status. The LPM regression results indicate that the factors leading to inactive membership status are being of productive age, male, belonging to class 1 and 2, utilizing primary healthcare facilities, and being in the Independent segment.
Conclusion: Therefore, stateholders such as the central government and BPJS need to collaborate in efforts to reduce the number of inactive membership statuses.
References
2. United Nations. Transforming our world: the 2030 Agenda for Sustainable. In United Nations; 2015 [cited 2023 Nov 19]. Available from: https://sdgs.un.org/sites/default/files/publications/21252030%20Agenda%20for%20Sustainable%20Development%20web.pdf
3. Lagomarsino G, Garabrant A, Adyas A, Muga R, Otoo N. Moving towards universal health coverage: health insurance reforms in nine developing countries in Africa and Asia. Lancet. 2012 Sep 8;380(9845):933–43.
4. World Health Organization, The International Bank for Reconstruction and Development / The World Bank. Tracking universal health coverage 2023 global monitoring report [Internet]. 2023 [cited 2024 Jan 25]. Available from: https://www.who.int/indonesia/news/detail/16-11-2023-indonesia-in-the-2023-universal-health-coverage-global-monitoring-report
5. World Health Organization and International Bank for Reconstruction and Development / The World Bank. Tracking universal health coverage: 2017 global monitoring report. Geneva, Switzerland; 2017 Jan.
6. Prasetya D, Afrina E. Healthcare costs leave Indonesians out-of-pocket. 2022 Aug 17 [cited 2024 Jan 25]; Available from: https://eastasiaforum.org/2022/08/17/healthcare-costs-leave-indonesians-out-of-pocket/
7. Thabrany H. Jaminan Kesehatan Nasional. 2nd ed. Jakarta: PT Raja Grafindo Persada; 2014.
8. Rustyani S, Sofiawati D, Rahmawati B. Efisiensi dan Produktivitas BPJS Kesehatan Tahun 2014 – 2021 (Metode Data Envelopment Analysis dan Malmquist Index). Jurnal Jaminan Kesehatan Nasional. 2023 Dec 29;3(2):102–20.
9. Rainer P. Pertama Sejak 5 Tahun Terakhir, BPJS Kesehatan Defisit Tahun 2023. GoodStats [Internet]. 2024 Jan 16 [cited 2024 Mar 20]; Available from: https://goodstats.id/article/pertama-sejak-5-tahun-terakhir-bpjs-kesehatan-defisit-tahun-2023-Kb3VT
10. Trinugroho AT. Mitigasi Defisit JKN. Kompas.id [Internet]. 2024 Jan 13 [cited 2024 Mar 20]; Available from: https://www.kompas.id/baca/opini/2024/01/12/mitigasi-defisit-jkn
11. BPJS Kesehatan. Laporan Pengelolaan Program Tahun 2022 & Laporan Keuangan Tahun 2022 (Auditan). 2023 Jun;
12. Sunjaya DK, Herawati DMD, Sihaloho ED, Hardiawan D, Relaksana R, Siregar AYM. Factors Affecting Payment Compliance of the Indonesia National Health Insurance Participants. Risk Manag Healthc Policy. 2022;15:277–88.
13. Intiasari AD, Aji B, Masfiah S, Trisnantoro L, Hendrartini J. Factors affecting delayingpayment of national health insurance (BPJS Kesehatan)premium among participants of the informal sector in Banyumas Regency. Ann Trop Med Public Health. 2019 Dec 1;22(11).
14. Tsuroyya SL, Maharani C, Studi P, Masyarakat K, Kedokteran F, Negeri U, et al. Systematic Literature Review: Faktor yang Berhubungan dengan Kepatuhan Peserta PBPU dalam Membayar Iuran JKN Systematic Literature Review: Factors Related to PBPU Participant Compliance in Paying JKN Contributions. Vol. 12, Jurnal Kebijakan Kesehatan Indonesia : JKKI. 2023.
15. Adani J, Permatasari P, Pulungan RM, Setiawati ME. Faktor-Faktor yang Berhubungan dengan Kepatuhan Pembayaran Iuran JKN pada Peserta Mandiri di Kota Depok Tahun 2019. Jurnal Ilmiah Kesehatan Masyarakat. 2019;11(4).
16. Chen YC, Sun S. Gender Differences in the Relationship between Financial Capability and Health in Later Life: Evidence from Hong Kong. Innov Aging. 2023;7(6).
17. Noor LA, Wafa N, Fini F. Faktor-Faktor yang Memengaruhi Kepatuhan Peserta Mandiri Membayar Iuran BPJS di Kelurahan Benda Baru. Jurnal Kedokteran dan Kesehatan. 2020 Jul 2;16(2).
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-Non Commercial License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
The content of this website is licensed under a Creative Commons Attribution-ShareAlike 4.0 International (CC BY-SA 4.0) license.