Claim Missing Document
Check
Articles

Performance contracts in the procurement of primary care services under the national health insurance program and lessons learned from the Netherlands: A literature review Evita Mutiara; Siti Rahima Kiram; Salsabila Firdausi; Cahya Arbitera; Riswandy Wasir
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.v6i3.2260

Abstract

Primary health care plays a crucial role in the National Health Insurance (JKN) program, making performance contracts essential for improving the quality and efficiency of services. Lessons learned from the Netherlands can serve as a reference for strengthening their implementation in Indonesia. This study evaluates performance contracts in the strategic procurement of primary health care services under the JKN program and identifies lessons from the Netherlands to improve service quality. This study is a literature review of eight articles published between 2017 and 2026 to analyze performance contracts in the procurement of primary care services under the JKN and lessons from the Netherlands. Performance contracts have proven effective in improving the efficiency and quality of primary care services when designed with balanced incentives between cost control and service quality achievement. The success of their implementation is highly dependent on relevant performance indicators, an integrated information system, and continuous monitoring and evaluation. The Dutch experience demonstrates that a combination of population-based payments, shared savings, contractual flexibility, and strong regulation can provide important lessons for strengthening strategic purchasing and improving the quality of primary care services within the JKN. Performance contracts have the potential to improve the efficiency and quality of primary care services if supported by relevant indicators, an integrated information system, and ongoing monitoring. Lessons from the Netherlands show that population-based payments, shared savings, and strong regulations can serve as a model for strengthening the implementation of performance contracts within the National Health Insurance (JKN) program.
Evaluation of health financial protection policies through cost control and strengthening of JKN benefits: A literature review Salsabila Firdausi; Evita Mutiara; Siti Rahima Kiram; Riswandy Wasir
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.v6i3.2277

Abstract

The National Health Insurance (JKN) has increased population coverage in Indonesia through financial protection determined by cost control, service payment governance, and benefit design. Its implementation has not completely eliminated the financial burden on households, with high out-of-pocket (OOP) spending on healthcare services and the associated risk of catastrophic health expenditure (CHE). This study aims to map the drivers of OOP spending and the risk of CHE, as well as strategies for improving financial protection. The method used is a literature review through searching articles obtained from several databases, namely Google Scholar, Garuda, Sciencedirect, Scopus, and Pubmed between 2017 and 2026. The results of the study indicate that JKN participation has proven effective in reducing OOP health expenditure by households, contributing to a reduced risk of CHE. However, the risk of CHE is still influenced by various other factors, such as the number of family members, high utilization of healthcare services, and limited healthcare facilities. Strengthening strategic purchasing, increasing benefits and equal access to healthcare services, and sustainable JKN financing are needed to improve financial protection. Thus, JKN has a role in reducing OOP expenditure which has an impact on reducing the risk of CHE, but financial protection is not yet fully optimal so that cost control and strengthening of JKN benefits are needed.
Ketepatan Sasaran Subsidi JKN dan Implikasinya Bagi Keberlanjutan Pembiayaan Kesehatan di Indonesia Melalui Pembelajaran Thailand Nadya Nur Syafina Putri; Meutya Zahra Saphira; Cahya Arbitera; Riswandy Wasir
PrimA: Jurnal Ilmiah Ilmu Kesehatan Vol. 12 No. 1 (2026): PrimA: Jurnal Ilmiah Ilmu Kesehatan
Publisher : LPPM STIKES Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47506/414wfs89

Abstract

Ketidaktepatan sasaran subsidi pada program Jaminan Kesehatan Nasional segmen Penerima Bantuan Iuran (JKN-PBI) menjadi isu krusial yang berkaitan erat dengan tekanan fiskal dan ancaman keberlanjutan pembiayaan BPJS Kesehatan di Indonesia. Penelitian ini bertujuan untuk mengevaluasi ketepatan sasaran subsidi JKN-PBI serta implikasinya terhadap keberlanjutan pembiayaan, dengan membandingkannya terhadap Universal Coverage Scheme (UCS) Thailand guna merumuskan rekomendasi kebijakan. Metode yang digunakan adalah literature review dengan pencarian artikel melalui Google Scholar, PubMed, dan ScienceDirect menggunakan operator Boolean dalam rentang waktu 2016–2026. Hasil kajian menunjukkan tingginya inclusion error dan exclusion error pada JKN-PBI yang memperbesar beban fiskal BPJS Kesehatan, sementara UCS Thailand lebih pro-poor melalui strategic purchasing berbasis kapitasi dan DRG serta integrasi data penerima manfaat. Reformasi JKN-PBI melalui integrasi data penerima manfaat, penguatan strategic purchasing, dan layanan kesehatan primer diperlukan untuk mewujudkan ketepatan sasaran subsidi dan keberlanjutan pembiayaan JKN.
Memanfaatkan Data untuk Meningkatkan Pengambilan Keputusan Berbasis Bukti dalam Sistem Kesehatan Indonesia : Memanfaatkan Data untuk Meningkatkan Pengambilan Keputusan Berbasis Bukti dalam Sistem Kesehatan Indonesia Nabiilah Salsa Zain; Nadiyatul Ulya; Riswandy Wasir; Novita Dwi Istanti
Afiasi : Jurnal Kesehatan Masyarakat Vol. 9 No. 1 (2024): Afiasi
Publisher : Universitas Wiralodra

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31943/afiasi.v9i1.352

Abstract

Abstrak Sistem kesehatan Indonesia menghadapi beberapa masalah salah satunya yaitu proses pengambilan keputusan. Untuk meningkatkan kualitas layanan dan efisiensi pengelolaan sistem kesehatan, pengambilan keputusan yang tepat dan efektif sangat penting untuk dilakukan. Pendekatan berbasis bukti data, juga dikenal sebagai praktik berbasis bukti (EBP), menekankan penggunaan bukti ilmiah yang kuat, seperti hasil penelitian dan data kesehatan, dalam proses pengambilan keputusan dalam sistem kesehatan. Penelitian ini bertujuan untuk memanfaatkan data untuk meningkatkan pengambilan keputusan berbasis bukti dalam sistem kesehatan Indonesia. Penelitian ini merupakan tinjauan literatur. Sumber data tinjauan literatur ini didapatkan dari PubMed dan Google Scholar. Data penelitian diambil dari tahun 2019-2024. Berdasarkan tinjauan literatur yang telah dilakukan menghasilkan sistem kesehatan Indonesia sedang meningkatkan aksesibilitas dan kualitas layanannya, meskipun terdapat tantangan seperti keterbatasan fasilitas, sumber daya yang terbatas, serta kemampuan pengumpulan dan analisis data yang tidak memadai. Kata kunci: Analisis, Evaluasi, Pengambilan keputusan berbasis bukti, Sistem informasi kesehatan, Strategi untuk meningkatkan penggunaan data Abstract The Indonesian health system faces several problems, one of which is the decision-making process. In order to improve the quality of services and the efficiency of the management of the health system, proper and effective decision-making is essential. The data-based approach, also known as evidence-based practice (EBP), emphasizes the use of strong scientific evidence, such as research results and health data, in the decision-making process in the health system. This research is a literature review. This literature survey data source is obtained from PubMed and Google Scholar. The research data is from the years 2019-2024. Based on the literature review that has been carried out, it shows that the Indonesian health system is improving the accessibility and quality of its services, even though there are challenges such as limited facilities, limited resources, and inadequate data collection and analysis capabilities. Keywords: Analysis, Evaluation, Evidence-based decision making, Health information systems, Strategies to improve data use
Co-Authors 'Aisy, Afifah Rohadatul Abdillah, Ratu Puanurani Anggitya Adelia Putri, Maritza Adinda Kurnia Herlambang Adjrina Dawina Putri Adjrina Dawina Putri Adzkia Avisena Maghfiroh Adzroo Atiiqoh Nur Nabiila Afifah Thaliah Putri Priyono Aghniya Choirunnisa Aguilera, Solita Claudya Aisy, Afifah Rohadatul Aisyah Putri Amanda Alba, Alinda Mahardika Aldera Almeria Annisa Putri Almeria Annisa Putri Alvianty, Rizka Ayu Amanda Nurjanah Amanda Safitri Amanda, Aisyah Putri Andi Paluseri Andriana, Bunga Angelina, Gabriela Anggraeni Dian Ciptaningrum Anggraeni Dian Ciptaningrum Anggraini, Mela Ratri Anggreini, Anis Lusiana Angraeni, Fitri Anis Lusiana Anggreini, Anis Lusiana Anggreini Annisya Putri Salsabila Apriliyani, Mutia Apriningsih, Apriningsih Apriningsih Arbitera, Cahya Arimbi Prashintya Simawang Arvian, Shenia Rully Assyifa Ramadhani Astuti, Winda Dwi AULIA RAHMA, FADILAH Ayu Alvianty, Rizka Azahra, Sabrina Azizah, Nazhifa Nurul Azizah, Siti Nurul Azzahra, Fitria Bustan Nurfianty Azzahra, Raisya Shafa Bahiizza Shadrina Zhafarin Bunga Andriana Cahya Arbitera Cahya Arbitera Cahya Arbitera Chandrayani Simanjorang Ciptaningrum, Anggraeni Dian Cordellia, Nadhira Nasywa Della Dwi Ayu Dewayani Hidayat, Dayinta Diva Latifah Rochmah, Diva Latifah Rochmah Dwi Rani Oktapiani Dwinova, Keira Editha Lesmana, Aurelia El-Tsana, Ashfiya Vi'aqila Eva Nur Agustin Evita Mutiara Faridz, Hasbi Miftah Fatima Tudzahro Fitri, Tasya Ariani Fitriani, Mutiara Aisyah Fitrianto, Rasyad Hakim, Jiddan Azizan Hera, Agnes Gonxa Mulia Huwaydi Azzam Yusuf Istanti, Novita Dwi Jaya, Liranti Jacinta Kiswanto, Melda Julianti Kulsum, Annisa Ummu Kurnia, Inara Perdana Kusuma, Putri Naira Laily Hanifah Lesmana, Aurelia Editha Lintang Tyas Pramesti Lumbantobing, Saula Bellatrix Lusyta Puri Ardhiyanti Maharani, Ghania Danisha Mahardieka, Clarissa Marina Ery Setyawati Melani, Alif Indah Meutya Zahra Eriansyah Meutya Zahra Eriansyah Meutya Zahra Saphira Mugi Rahayu Lestari Mujriah Nabiila, Adzroo Atiiqoh Nur Nabiilah Salsa Zain Nabilah, Hanifah Nadia Hafrisa Nadia Putri Untiami Nadiyatul Ulya Nadya Nur Syafina Putri Nafisah, Dewi Syaidah Naradhipa, Rasyid Araghani Nashiroh, Alya Devia Nasywa Athiyah Zahra Natasya Nazla Prasetyo Nazhifa Nurul Azizah Nazwa Fadya Nur Shaumi Nikita Alia Rajebta Novita Dwi Istanti Novita Dwi Istanti Novita Dwi Istanti Nurani, Firda Syafitri Nurmaliza, Mazaya Raini Nurul Rizqi Azizah Octaviani, Putri Panggayuh, Prananta Hadi Pasaribu, Christiani Priyono, Afifah Thaliah Putri Projokusuma, Rachmad Purba , Shofiyyah Salma Purba, Shofiyyah Salma Putri Aulia Rosmayani Putri Naira Kusuma Putri Priyono, Afifah Thaliah Putri, Almeria Annisa Putri, Nadya Nur Syafina Rahayu Lestari, Mugi Rahmadanti, Mutia Devani Raisha Syahida Raisha Syahidah Rajebta, Nikita Alia Raudina Izzah Reynanda Sabrina Risma Pertiwi Robby Firmansyah Rochmah, Diva Latifah Rully Arvian, Shenia Sabrina Putri Salsabila Firdausi Salsabila, Annisya Putri Salsabila, Meuthya Putri Salsabilah, Alya Saphira, Meutya Zahra Saula Bellatrix Lumbantobing Sekar Ayu Putri Sekarningrum, Rizda Maharani Septiana, Wulan Sihole, Putri Oktamaria Siregar, Salwa Febriana Ekasari Siti Aisyah Siti Nurul Azizah Siti Rahima Kiram Solita Claudya Aguilera Sudarningayuti Lintang Wahyu Azahra Syafira, Seftiani Syahidah, Raisha Syalisa Syabil Tsabitah, Humairah Fahma Ummi Rahma Utami, Elisa Tri Widya Andini, Widya Widyastuty, Theresia Miranda Wirdatul Jannah Wulan Septiana Wulan Septiana Zahra Septina Zahra Septina Zahra, Nasywa Athiyah