This study aims to identify adverse selection on independent participants non PBI of National Health Insurance (JKN) in RS Rajawali Citra Bantul, Yogyakarta. This research is quantitative descriptive with cross-sectional design.The results of the study show that in April 2014 the patients were hospitalized in the hospital Rajawali Citra has a of 100% month on the card printed with the date SEP BPJS is for 0-3 months. After BPJS applying for 7 days waiting period, it was found that in December 2014 to 9 peoples who have monthly difference of 0-3 months. In August 2015, after BPJS applying 14-days waiting period for patients who have a difference a month for 0-3 months between the date of the card printed with the date SEP BPJS it dropped to 3 people. This shows there is an indication of adverse selection on independent participants non PBI National Health Insurance (JKN) in RS Rajawali Citra Bantul. In addition, the application waiting period conducted by Health BPJS can suppress the occurrence of adverse selection on independent participants non PBI.Keywords: adverse selection, independent participants non PBI

  • The National Health Insurance Program was organized with the aim that each participant obtain maintenance and protection in fulfilling the basic needs of health, including family planning services. The purpose of this study is to describe the implementation of family planning services in The National Health Insurance Program. This study used cross sectional design. The respondents of this study are from family, institutions and family planning service providers in the Province of Lampung (Bandar Lampung and Pesawaran), West Java (Bandung and Purwakarta), Central Kalimantan (Palangkaraya and Pulang Pisau), and East Nusa Tenggara (Kupang city and Kupang district). Respondent of familiy involve 240 women of couples of childbearing age (PUS); which is involved 30 people in each study site. Generally, the result showed that the readiness of institutions in implementation of the family planning services in the national health insurance were not maximized, health facility information system between BKKBN and BPJS Kesehatan (Healthcare and Social Security Agency) had not been integrated, and the community's knowledge about The National Health Insurance Program was relative high, but BPJS Kesehatan (Healthcare and Social Security Agency) card ownership was still low.

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  • Adverse selection and the purchase of Medigap insurance by the elderly

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  • Empirical Evidence of Social Health Insurance Policy: Analysis Of Indonesian Family Life Survey (IFLS) Data. Jurnal Manajemen Pelayanan Kesehatan

    INDIKASI ADVERSE SELECTION PADA PESERTA NON PBI MANDIRI JAMINAN KESEHATAN NASIONAL (JKN) DI RS RAJAWALI CITRA BANTUL YOGYAKARTA | Sri Sularsih Endartiwi

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  • Modelling The Demand For Health Care Given Insurance: Notes For Researcher

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  • Compared to men, women report greater morbidity and make greater use of health-care services. This study examines potential determinants of seks differences in the utilization of health-care services among the elderly. Cross-sectional study covering 3030 subjects, representative of the non-institutionalized Spanish population aged 60 years and over. Potential determinants of seks differences in the utilization of health services were classified into predisposing factors (age and head-of-family status), need factors (lifestyles, chronic diseases, functional status, cognitive deficit and health-related quality of life (HRQL)) and enabling factors (educational level, marital status, head-of-family employment kedudukan and social network). Relative differences in the use of each service between women and men were summarized using odds ratios (OR), obtained from logistic regression. The contribution of the variables of interest to the seks differences in the use of such services was evaluated by comparing the OR before and after adjustment for such variables. As compared to men, a higher percentage of women visited a medical practitioner (OR: 1.24; 95% confidence limits (CL): 1.07-1.44), received home medical visits (OR: 1.67; 95% CL: 1.34-2.10) and took > or = 3 medications (OR: 1.54; 95% CL: 1.34-1.79), but there were no seks differences in hospital admission or selesma vaccination. Adjustment for need or enabling factors led to a reduction in the OR of women compared to men for utilization of a number of services studied. On adjusting for the number of chronic diseases, the OR (95% CL) of women versus men for ingestion of > or = 3 medications was 1.24 (1.06-1.45). After adjustment for HRQL, the OR was 1.03 (0.89-1.21) for visits to medical practitioners, 1.24 (0.98-1.58) for home medical visits, 0.71 (0.58-0.87) for hospitalization, and 1.14 (0.97-1.33) for intake of > or = 3 medications. After adjustment for the number of chronic diseases and HRQL, the OR of hospitalization among women versus men was 0.68 (0.56-0.84). The factors that best explain the greater utilization of health-care services by elderly women versus men are the number of chronic diseases and HRQL. For equal need, certain inequality was observed in hospital admission, in that it proved less frequent among women.

  • For most Social Security Disability Insurance (SSDI) beneficiaries, Medicare entitlement begins 24 months after the date of SSDI entitlement. Many may experience poor access to health care during the 24-month waiting period because of a lack of insurance. National Health Interview Survey bukti for the period 1994-1996 were linked to Social Security and Medicare administrative records to examine health insurance kedudukan and access to care during the Medicare waiting period. Twenty-six percent of SSDI beneficiaries reported having no health insurance, with the uninsured reporting many more problems with access to care than insured individuals. Access to health insurance is especially important for people during the waiting period because of their low incomes, poor health, and weak ties to the workforce.

  • This paper examines the role of social health insurance in four European countries: Germany, Switzerland, France and the Netherlands. It attempts to elucidate the organisational structure, regulation and management of the social insurance schemes, gandar well gandar the relationships between the insurers, providers and consumers in the various countries with the aim of uncovering some of the inherent strengths, weaknesses and tradeoffs hich exist within social insurance systems.