Factors Correlated with Willingness and Compliance to Pay National Health Insurance Premium in Jember Regency
Abstract
Background: Fulfillment of premium collectivity is related to willingness and compliance to pay BPJS Kesehatan premiums. Increasing participation in the informal sector is not in line with compliance in paying BPJS Health premiums. This study aims to analyze the influence of factors of willingness and compliance to pay premiums for BPJS Kesehatan independent participants in Jember Regency.
Subjects and Method: This was a cross sectional study conducted in 31 sub-districts in Jember Regency, East Java, in July-September 2020. Sampling of 200 BPJS Kesehatan Mandiri participants was conducted using random sampling. The dependent variable is willingness to pay and compliance to pay the BPJS Health premium. The independent variables include education, income, willingness to pay, imitation of the referral group and number of family members. Data were collected using a questionnaire. Data were analyzed using multiple linear regression, multiple logistic regression and path analysis with Stata 16.
Results: Factors that affect the willingness to pay are education (b= 45531.18; 95% CI= 35335.1 to 55727.26; p <0.001) and (b= 2.13 units; 95% CI= 1.41 to 2.86; p <0.001), income (b= 17469; 95% CI= 7171.90 to 27766.09; p <0.001), and (b= 1.19; 95% CI= 0.46 to 1.92; p <0.001). Compliance to pay is influenced by the willingness to pay factor (b= 4.19; 95% CI = 2.19 to 8.04; p <0.001) and (b= 0.64; 95% CI= 0.02 to 1.27; p= 0.044) with an average willingness to pay Rp 44,792, imitation of the reference group (b= 2.59; 95% CI = 1.39 to 4.85; p= 0.003) and (b = 0.95; 95% CI = 0.33 to 1.58; p= 0.003) and the number of family members (b= 1.90; 95% CI= 1.02 to 3.56; p= 0.044).
Conclusion: Willingness to pay premiums is directly affected by education and income. Compliance with premium payments is directly affected by willingness to pay, imitation of the referral group, and the number of family members.
Keywords: willingness to pay, paying compliance, social cognitive theory
Correspondence: Nazilla Ade Nurlia.Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: nazillaade29@gmail.com. Mobile: +6281230004195.
Journal of Health Policy and Management (2021), 06(01): 35-47
https://doi.org/10.26911/thejhpm.2021.06.01.04
References
Adebayo EF, Uthman OA, Wiysonge CS, Stern EA, Lamont KT, Ataguba JE (2015). A systematic review of factors that affect uptake of community-based health insurance in low-income and middle- income countries. BioMed Central. 15(543). doi: 10.1186/-s12913-015-1179-3.
Ashari MR, Nurhayani (2013). Permintaan (demand) masyarakat terhadap pemanfaatan asuransi kesehatan di PT (Public demand for the use of health insurance at PT). Asuransi Jiwa In Health Makassar. Jurnal MKMI. 53–59. Available at: https://media.ne-liti.com/media/publications/212592-none.pdf.
Azhar A, Rahman MM, Arif MT (2018). Willingness to pay for health insurance in Sarawak, Malaysia: A contingent valuation method. Bangladesh Journal of Medical Science. 17(2): 230–237. doi: 10.3329/bjms.v17i2.35876.
Barida M (2016). Pengembangan perilaku anak melalui imitasi (Development of children's behavior through imitation). Jurnal CARE Edisi Khusus Temu Ilmiah. 03(3): 13–20. Retrieved fromhttp://e-journal.unipma.ac.id/index.php/JPAUD/article/view/594
BPJS Kesehatan (2019). Data peserta progam JKN (JKN program participant data). Retrieved from https://bpjskesehatan.go.id/.../b39df9ae7a30a5c7d4bd0f54d763b447.pdf
Fadlallah R, El-jardali F, Hemadi N, Morsi RZ, Samra CAA, Ahmad A, Arif K, Hishi L, Honein-abouhaidar G, Akl EA (2018). Barriers and facilitators to implementation, uptake and sustainability of community- based health insurance schemes in low- and middle-income countries: a systematic review. Int J Equity Health. 17(13): 1–18. doi: 10.1186/s12939-018-0721-4.
Mas’udin (2017). Identifikasi permasalahan finansial pada jaminan sosial kesehatan nasional (Identification of financial problems in national health social security). Jurnal Info Artha. 1(2): 111–119. doi: 10.31092/jia.v1i2.142.
Nguyen LH, Hoang ATD (2017). Willingness to pay for social health insurance in central Vietnam. Front public health. 5(APR): 1–7. doi: 10.3389/FPUBH.2017.00089.
Noormalasari W, Sandra C (2015). Kemampuan membayar iuran jaminan kesehatan nasional bagi nelayan di kabupaten Jember (Ability to pay national health insurance contributions for fishermen in Jember district). e-Jurnal Pustaka Kesehatan.3(1): 147–154.
Prakoso AD (2020). Analisis jalur determinan partisipasi pekerja informal pada progam jaminan kesehatan di Kabupaten Kudus (Analysis of the determinant pathway for the participation of informal workers in the health insurance program in Kudus Regency). Program Ilmu Kesehatan Masyarakat, Program Pascasarjana, Universitas Sebelas Maret.
Rosmanely S (2018). Studi ketidakpatuhan membayar iuran bpjs kesehatan peserta non pbi bukan penerima upah di kelurahan parang tambung kec. Tamalate (The study of non-compliance with paying bpjs health fees for non-pbi participants who did not receive
wages in the Parang Tambung district). Administrasi Kebijakan Kesehatan. Universitas Hasanuddin. Retrieved from http://digilib.unhas.ac.id/uploaded_files/temporary/Digi-talCollection/MGNjYTEyN2ZiYjI4YzljNWE2ZGM0ODZkMTdhNjNlNDM4YjQ3MDg4ZA==.pdf.
Sunjaya DK, Herawati DMD, Siregar AY (2020). Factors affecting independent participants of Indonesia’s national health insurance in paying premium compliance: a qualitative study. (38): 1–32. doi: 10.21203/rs.3.rs-26637/v1.
Thi N, Nga T, Fitzgerald G, Dunne M (2018). Family-based health insurance for informal sector workers in Vietnam: why does enrolment remain low?. Asiapac J public health. 1–9. doi: 10.1177/1010539518807601.
Widyanti N (2018). Faktor yang berhubungan dengan kepatuhan membayar iuran BPJS Kesehatan mandiri pada pasien di rsud labuang baji kota Makassar. Hasanuddin Makassar. Retrieved from http://digilib.unhas.ac.id/uploaded_files/temporary/Di-gitalCollection/NTVkYzIxMDYzM2I0YTViYTgzOGZlYzgwNjI3OWQ1OTE-0N2M2ZTRkMw==.pdf.
Witati, Putri PI (2020). Determinant of willingness to pay health insurance contribution to informal workers. Economics Development Analysis Journal, 9(2): 144–158. Retrieved from: https://journal.unnes.ac.id/sju/index.php/edaj/article/view/38440
Workneh SG, Biks GA, Woreta SA (2017). Community-based health insurance and communities scheme requirement compliance in Thehuldere district, northeast Ethiopia: cross-sectional community-based study. Dove Med Journal. 353–359. doi: 10.2147/CEOR.S136508.
Zhai S, Wang P, Dong Q, Ren X, Cai J, Coyte PC (2017). A study on the equality and benefit of China’ s national health care system. Int J Equity Health. 16 (155): 1–11. https://doi.-org/10.1186/s12939017-0653-4
