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All Journal Indonesian Journal of Health Science
Assyifa Ramadhani
Universitas Pembangunan Nasional Veteran Jakarta
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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The demographic bonus and shifting health insurance risk profiles among the productive age population in Indonesia: A literature review Assyifa Ramadhani; Reynanda Sabrina; Robby Firmansyah; Riswandy Wasir
Indonesian Journal of Health Science Vol 6 No 2 (2026)
Publisher : PT WIM Solusi Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54957/ijhs.v6i2.2187

Abstract

Background: Indonesia is currently experiencing a demographic bonus, with the productive age population accounting for 69.3% of the total population. While this presents an economic opportunity, it poses significant challenges to the health sector due to an epidemiological transition toward Non Communicable Diseases (NCDs), which contribute to 74% of global mortality. Objective: This study aims to analyze the impact of the demographic bonus on the shifting health risk profiles of the productive age group and its implications for claim trends and the sustainability of the health insurance system in Indonesia. Methods: A systematic literature review was conducted using the Google Scholar database. The search strategy employed keywords related to demographics, NCDs, and health financing, with a publication filter for the last ten years (2016–2026). Data were analyzed using a descriptive narrative approach to synthesize relevant findings. Results: The findings indicate that the dominance of the productive age population, coupled with unhealthy lifestyle behaviors, has triggered a rise in chronic disease prevalence requiring long term medical management. This shift directly correlates with a surge in healthcare service utilization and claim burdens within the National Health Insurance (JKN) scheme. However, current insurance benefit designs remain heavily focused on curative services (85.4%), while promotive preventive efforts at primary care facilities remain suboptimal. The imbalance between increased utilization and financing capacity potentially threatens risk pool stability and risks financial deficits. Conclusion: The demographic bonus may become an economic burden without an adaptive health system transformation. Strengthening promotive preventive policies and innovative chronic disease management are essential to control medical costs. Cross sector synergy is crucial to ensure a healthy productive age population and the long term sustainability of the JKN program.
Evaluation of health service efficiency and effectiveness policy through performance based budgeting and quality control of health services: A literature review Reynanda Sabrina; Assyifa Ramadhani; Robby Firmansyah; Riswandy Wasir
Indonesian Journal of Health Science Vol 6 No 2 (2026)
Publisher : PT WIM Solusi Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54957/ijhs.v6i2.2203

Abstract

The efficiency and effectiveness of health services represent one of the critical aspects in the management of public services, particularly in budget utilization and the implementation of health programs. Numerous studies indicate that performance-based budgeting and quality control of health services exert a significant influence on enhancing accountability as well as service quality within public service institutions. This literature review was conducted to evaluate the implementation of efficiency and effectiveness policies in health services through a performance-based budgeting approach and quality control of health services. The study employs a literature review method, with data sources obtained from Google Scholar and Garuda. The articles utilized are scientific journals addressing performance-based budgeting, service effectiveness, performance accountability, and quality control of health services. The findings of the review demonstrate that performance-based budgeting is capable of improving the effectiveness of service management and the accountability of public service institutions. Furthermore, quality control of health services, strengthening of reporting systems, and information technology support also contribute to the enhancement of service quality. Nevertheless, policy implementation continues to face several obstacles, including low human resource capacity, weak internal control mechanisms, and the suboptimal integration of reporting systems.
Evaluation of lean six sigma implementation in reducing patient waiting time in hospitals: A literature review Assyifa Ramadhani; Nadia Putri Untiami; Reynanda Sabrina; Acim Heri Iswanto
Indonesian Journal of Health Science Vol 6 No 3 (2026)
Publisher : PT WIM Solusi Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54957/ijhs.v6i3.2209

Abstract

The surge in National Health Insurance (JKN) participants to 267.3 million by the end of 2023 has significantly increased hospital operational workloads, leading to prolonged patient waiting times. Excessive waiting time reflects low process efficiency driven by non-value-added activities (waste). This issue severely diminishes patient satisfaction and contributes to global healthcare financial inefficiencies estimated at 20–40%. This study aims to synthesize empirical evidence regarding the effectiveness of DMAIC-based Lean Six Sigma (LSS) in reducing patient waiting times in hospitals, identify implementation challenges, and formulate strategic management recommendations. A systematic literature review was conducted by analyzing nine original research articles sourced from Google Scholar, PubMed, and PMC databases. Data were extracted based on methodology (DMAIC, VSM, pre-post trial), key findings, and field challenges, followed by a narrative synthesis. The synthesis demonstrates that LSS consistently and significantly reduces patient waiting times without requiring substantial capital investment. Primary barriers include Hospital Management Information System (SIMRS) instability, unergonomic facility layouts, manual prescribing practices, and slow adaptation to statistical competencies among staff. Effective improvement strategies focus on waste elimination, Lean tools application (5S, Kanban), and digitalizing administrative workflows. The implementation of DMAIC-based LSS proves to be an effective, measurable, and sustainable approach to reducing patient waiting times. Hospital management is highly recommended to integrate LSS as an internal quality regulation, enhance integrated IT infrastructure, and conduct periodic training on DMAIC methodologies for healthcare personnel.
The role of auditing in ensuring the quality of healthcare services: A literature review Nadia Putri Untiami; Reynanda Sabrina; Assyifa Ramadhani; Acim Heri Iswanto
Indonesian Journal of Health Science Vol 6 No 3 (2026)
Publisher : PT WIM Solusi Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54957/ijhs.v6i3.2248

Abstract

Audits, as systematic evaluation tools, play a strategic role in ensuring and improving the quality of healthcare services. This literature review aims to analyze the contribution of audits—including clinical audits, operational audits, and information system audits—to service quality standards in healthcare facilities. The method used was a systematic literature review with a narrative synthesis approach of nine selected scientific articles published between 2016 and 2026. The results of the study indicate that ISO 9001:2015-based internal audits, operational audits, clinical coding audits, and Hospital Management Information System (HMIS) audits have a positive impact on service effectiveness, patient safety, and the accuracy of clinical data. Audit implementation still faces various obstacles, such as the high workload of healthcare personnel, limited human resource competencies, the perception of audits as an administrative burden, and limitations in information technology infrastructure. The conclusion of this study emphasizes that optimizing audits requires the integration of human resource capacity building, the development of reliable information systems, and a supportive organizational culture of quality. The application of the Plan-Do-Check-Act (PDCA) cycle is recommended as a framework to drive continuous improvement in service quality.
Co-Authors A. Heri Iswanto Nadia Putri Untiami Reynanda Sabrina Riswandy Wasir Robby Firmansyah