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All Journal Journal Health & Science : Gorontalo Journal Health and Science Community International Journal of Health and Pharmaceutical (IJHP)
Oktaviani Yustedjo, Dika
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Health Professions Nursing Public Health

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Insurance Utilities in Indonesia: A Study for Future Opportunities Green Nego, Ingrid; Oktaviani Yustedjo, Dika; Parlindungan, Hotmada; Puspitaloka Mahadewi, Erlina
International Journal of Health and Pharmaceutical (IJHP) Vol. 5 No. 2 (2025): May 2025 ( Indonesia - Iraq - Malaysia)
Publisher : CV. Inara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51601/ijhp.v5i2.370

Abstract

This study analyzes Indonesia's path toward universal health coverage (UHC), which has been marked by the introduction of targeted schemes such as Askeskin and Jamkesmas, culminating in the comprehensive National Health Insurance (JKN) program. This literature review systematically synthesizes peer-reviewed empirical studies published between 2005 and March 2025, examining the impact of government-managed health insurance on healthcare utilization, financial protection, and equity across different population groups. The study conducted a structured narrative synthesis of studies retrieved from PubMed, Scopus, Web of Science, and Google Scholar, focusing on inpatient and outpatient services, maternal and dental care, and out-of-pocket expenditures. The findings indicate that insured individuals consistently demonstrate higher utilization rates and significant reductions in out-of-pocket spending, with notable benefits in maternal health and primary care in rural areas; however, geographic and socioeconomic disparities persist, particularly among the urban poor and remote communities. Secondary analysis revealed moral hazard effects and shifting private market dynamics, highlighting the need for cost-sharing mechanisms and regulatory oversight. Propose policy strategies to expand enrollment, adjust premium subsidies, integrate fragmented schemes, strengthen the community health center (Puskesmas) infrastructure, and enhance preventive care and health literacy. An integrated approach aligning financial, clinical, and regulatory reforms is essential to optimize equity, efficiency, and sustainability in Indonesia’s UHC journey.
KONSEP DASAR EKONOMI KESEHATAN DAN APLIKASINYA DALAM SISTEM PELAYANAN KESEHATAN : TINJUAUAN LITERATUR Green Nego, Ingrid; Oktaviani Yustedjo, Dika; Parlindungan, Hotmada; Hartono, Budi; Ghutsa Daud, Alfani
Journal Health & Science : Gorontalo Journal Health and Science Community Vol 9, No 4 (2025): OKTOBER: JOURNAL HEALTH AND SCIENCE : GORONTALO JOURNAL HEALTH AND SCIENCE COMMU
Publisher : Gorontalo State University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35971/gojhes.v9i4.34207

Abstract

Kenaikan biaya layanan kesehatan global serta tuntutan pencapaian Cakupan Kesehatan Semesta (UHC) menuntut strategi alokasi sumber daya yang efisien dan adil. Ekonomi kesehatan menjadi kerangka analitis untuk menilai intervensi, efektivitas biaya, dan distribusi manfaat kesehatan. Studi ini merupakan narrative integrative review terhadap 20 artikel peer-reviewed (2020–2025) yang diperoleh melalui PubMed Central, DOAJ, dan repositori institusi menggunakan kata kunci “health economics” “cost-effectiveness” “resource allocation” “efficiency” dan “health system management”. Hasil menunjukkan bahwa evaluasi ekonomi—cost-effectiveness, cost-utility, cost-benefit, dan cost-minimization—menjadi instrumen utama prioritisasi intervensi; teknik manajerial seperti Just-In-Time dan Total Quality Control efektif mengurangi pemborosan; metode lanjut seperti probabilistic sensitivity analysis dan distributional cost-effectiveness analysis mengintegrasikan aspek keadilan; sementara kerangka Health Technology Assessment (HTA) adaptif diterapkan mulai dari QALY threshold di Inggris hingga causal loop diagrams di Thailand. Hambatan utama meliputi keterbatasan data dan kurangnya tenaga terlatih, sedangkan manfaatnya mencakup efisiensi biaya, perluasan akses, dan keberlanjutan pembiayaan. Kesimpulannya, ekonomi kesehatan memberikan kerangka komprehensif untuk meningkatkan mutu, aksesibilitas, dan keberlanjutan sistem pelayanan kesehatan, serta dapat menjadi dasar pengambilan keputusan berbasis bukti. Kebaruan penelitian ini terletak pada sintesis komprehensif yang tidak hanya menekankan efisiensi biaya, tetapi juga integrasi prinsip keadilan (equity) melalui pendekatan distribusional dan prosedur fairness, sehingga ekonomi kesehatan diposisikan bukan semata alat penghematan, melainkan instrumen strategis dalam pemerataan akses dan penguatan kebijakan kesehatan berkelanjutan 
Co-Authors Budi Hartono Ghutsa Daud, Alfani Green Nego, Ingrid Parlindungan, Hotmada Puspitaloka Mahadewi, Erlina