Predictors of Indonesian National Health Insurance Knowledge: A Cross-Sectional Study Among Public Health Students in Palembang
Abstract
Students, as agents of change, are expected to assist in reaching the success of the Indonesian National Health Insurance/Jaminan Kesehatan Nasional (JKN) program. Therefore, this study aimed to analyze the JKN knowledge among public health students and the associated factors in Palembang City, Indonesia. A cross-sectional online survey was conducted to collect data from 279 students at Universitas Sriwijaya in Palembang City, Indonesia. The analyzed variables included gender, age, marital status, residence, family size, income, study level and period, as well as source of JKN information. Additionally, statistical analysis using binary logistic regression, presenting odds ratio and 95% CI, was conducted to identify the determinants of JKN knowledge with significance set at a p-value <0.05. The results showed that 92.47% of respondents had low JKN knowledge with the following characteristics; female (93.83%), aged >20 years (92.93%), not married (93.75%), living in urban areas (90.24%), having family members >4 people (91.39%), income ≤UMR (93.38%), undergraduate level (93.70%), study period ≤2 years (93.89%), and receiving information from the Social Security Administration Agency for Health/Badan Penyelenggara Jaminan Sosial Kesehatan (BPJSK) (94.32%). The most associated variable with JKN knowledge was residence after being controlled by gender, study period, and information source variables. Specifically, respondents residing in urban areas (aOR = 10.73; 95% CI: 1.32–86.89) showed a higher likelihood of having good JKN knowledge than those in rural areas.
References
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33. Myint CY, Pavlova M, Groot W. Health Insurance in Myanmar: Knowledge, Perceptions, and Preferences of Social Security Scheme Members and General Adult Population. The International Journal of Health Planning and Management. 2019;34(1):346–469. https://doi.org/10.1002/hpm.2643
2. Yagi BF, Luster JE, Scherer AM, Farron MR, Smith JE, Tipirneni R. Association of Health Insurance Literacy with Health Care Utilization : a Systematic Review. Journal of General Internal Medicine. 2021;37(2):375–389. https://doi.org/10.1007%2Fs11606-021-06819-0
3. Mao W, Tang Y, Tran T, Pender M, Khanh PN, Tang S. Advancing Universal Health Coverage in China and Vietnam: Lessons for Other Countries. BMC Public Health. 2020;1–9. https://doi.org/10.1186/s12889-020-09925-6
4. Chaleunvong K, Phoummalaysith B, Phonvixay B, Sychareun V, Durham J, Essink DR. Factors Affecting Knowledge of National Health Insurance Policy Among Out-Patients in Lao PDR: An Exit Interview Study. Global Health Action. 2020;13(2):124-128. https://doi.org/10.1080%2F16549716.2020.1791414
5. Parisi D, Srivastava S, Parmar D, Strupat C, Brenner S, Walsh C, et al. Awareness of India’s National Health Insurance Scheme (PM-JAY): A Cross-Sectional Study Across Six States. Health Policy and Planning. 2023;38(3):289–300. https://doi.org/10.1093/heapol/czac106
6. James TG, Sullivan MK, Dumeny L, Lindsey K, Cheong J, Nicolette G. Health Insurance Literacy and Health Service Utilization Among College Students. Journal of American College Health. 2020;68(2):200–206. https://doi.org/10.1080/07448481.2018.1538151
7. Id SB, Bhusal S, Paudel R, Gaihre M, Paudel K, Adhikari TB, Pradhan PMS. Health Literacy and Associated Factors among Undergraduates: A University-Based Cross-Sectional Study in Nepal. PLOS Global Public Health. 2021;1(11):e0000016.
https://doi.org/10.1371/journal.pgph.0000016
8. Albejaidi FM, Pasha SA, Jehan M. Awareness, Knowledge and Perception of the Cooperative Health Insurance among the College of Health Sciences Students. International Journal of Science and Research (IJSR). 2019;8(4):1769–1772. https://www.ijsr.net/archive/v8i4/ART20197367.pdf
9. Adegboyega A, Nkwonta CA, Edward J. Health Insurance Literacy among International College Students: A Qualitative Analysis. Journal of International Students. 2020;10(1):50–68. https://doi.org/10.32674/jis.v10i1.1097
10. Upadhyay SSN, Merrell LK, Temple A, Henry DS. Exploring the Impact of Instruction on College Students’ Health Insurance Literacy. Journal of Community Health. 2022;47(4):697–703. https://doi.org/10.1007/s10900-022-01096-2
11. Feleke BT, Wale MZ, Yirsaw MT. Knowledge, Attitude and Preventive Practice Towards COVID-19 and Associated Factors Among Outpatient Service Visitors at Debre Markos Compressive Specialized Hospital, North-West Ethiopia, 2020. PLoS One. 2021;16(7):1–15. https://doi.org/10.1371/journal.pone.0251708
12. Elegbede O, Durowade K, Sanni T, Ipinnimo T, Alabi A. Knowledge of Community-Based Health Insurance and Associated Factors Among Artisans in a Selected Community of Ekiti State. Nigerian Journal of Medicine. 2022;31(5):509–514. https://www.ajol.info/index.php/njm/article/view/237648
13. Rababah JA, Al-Hammouri MM, Drew BL, Aldalaykeh M. Health Literacy: Exploring Disparities Among College Students. BMC Public Health. 2019;19(1):1–11. https://doi.org/10.1186/s12889-019-7781-2
14. Kaklottar SA, Sarate S. A Study to Assess Knowledge and Attitude Regarding Selected Government Health Insurance Schemes among Staff Nurse in Selected Hospitals of Ahmedabad District: A Main Study. Open Access Library Journal. 2019;6(1):1–5. https://doi.org/10.4236/oalib.1105128
15. Suleiman YS, Mukhtar M, Nasir L, Yahaya RJ. Knowledge of Community Based Health Insurance Among Residence of Katsina State, Nigeria; A Comparative Cross-Sectional Study State Contributory Health Management Agency, Katsina State, Nigeria. Texila International Journal. 2022;1–10. https://doi.org/10.21522/TIJAR.2014.SE.22.02.Art006
16. Merrell LK, Henry DS, Blackstone SR, Howley T. Predictors of Health Insurance Literacy Among University Employees. American Journal of Health Studies. 2021;36(2):103–114. https://doi.org/10.47779/ajhs.2021.650
17. Yunizar, A., & Nasution NH. Faktor-Faktor Yang Berhubungan dengan Pemanfaatan BPJS di Desa Pargarutan Tonga Kecamatan Angkola Timur Tahun 2019. Jurnal Kesehatan Ilmiah Indonesia (Indonesia Health Scientific Journal). 2020;5(1):61–70. http://dx.doi.org/10.51933/health.v5i1.238
18. Charles KA, Horioka Y. Determinants of Health Insurance Enrollment and Health Expenditure in Ghana: An Empirical Analysis. NBER: National Bureau of Economic Research 2023;1269–1288. https://doi.org/10.3386/w30175
19. Fitriana EN, Probandari AN, Pamungkasari EP, Ardyanto TD, Puspitaningrum RA. The Importance of Socialization in Achieving Universal Health Coverage: Case Study of Jaminan Kesehatan Nasional (JKN) Implementation in Two Different Region in Central Java Province. JKKI: Jurnal Kedokteran dan Kesehatan Indonesia. 2019;10(2):110–120. https://doi.org/10.20885/JKKI.Vol10.Iss2.art3
20. Tang C, Wu X, Chen X, Pan B, Yang X. Examining Income-Related Inequality in Health Literacy and Health-Information Seeking Among Urban Population in China. 2019;(19)1–9. https://doi.org/10.1186/s12889-019-6538-2
21. Kanchan S, Gaidhane A. Social Media Role and Its Impact on Public Health: A Narrative Review. Cureus. 2023;15(1):1–10. https://doi.org/10.7759%2Fcureus.33737
22. Hegde R, Kiran KG, S NK. Knowledge, Coverage and Usage Patterns of Health Insurance in Rural South India. Indian Journal of Public Health Research & Development. 2020;11(3):282–286. https://doi.org/10.37506/ijphrd.v11i3.834
23. Ghimire S, Ghimire S, Khanal P, Sagtani RA, Paudel S. Factors Affecting Health Insurance Utilization Among Insured Population: Evidence from Health Insurance Program of Bhaktapur District of Nepal. BMC Health Service Research. 2023;23(1):1–8. https://doi.org/10.1186/s12913-023-09145-9
24. Diaz GA, Crowe J, Hopkin J. Health Insurance Literacy and Health Services Access Barriers in Niemann–Pick Disease: The Patient and Caregiver Voice. Orphanet Journal of Rare Diseases. 2022;17(1):1–13. https://doi.org/10.1186/s13023-022-02490-8
25. Bhusal UP, Sapkota VP. Predictors of Health Insurance Related Inequality Enrolment And Wealth in Nepal : Evidence From Multiple Indicator Cluster Survey (MICS) 2019. BMJ Open. 2021;11(11):1–12. http://dx.doi.org/10.1136/bmjopen-2021-050922
26. Apriani M, Zulkarnain M, Idris H. Analysis of Willingness to Pay Contributions In The Membership of The National Health Insurance on Regency of Banyuasin. PREPOTIF Jurnal Kesehatan Masyarakat. 2021;5(2):484–495. https://doi.org/10.31004/prepotif.v5i2.1733
27. Raghupathi V, Raghupathi W. The Influence of Education on Health: An Empirical Assessment of OECD Countries for the Period 1995-2015. Archives of Public Health. 2020;78(1):1–18. https://doi.org/10.1186/s13690-020-00402-5
28. Murugesu L, Heijmans M, Rademakers J, Fransen MP. Challenges and Solutions in Communication with Patients with Low Health Literacy: Perspectives of Healthcare Providers. PLoS One. 2022;17(5):1–16. https://doi.org/10.1371/journal.pone.0267782
29. Abiola AO, Ladi-Akinyemi TW, Oyeleye OA, Oyeleke GK, Olowoselu OI, Abdulkareem AT. Knowledge and Utilisation of National Health Insurance Scheme Among Adult Patients Attending a Tertiary Health Facility in Lagos State, South-Western Nigeria. African Journal of Primary Health Care & Family Medicine. 2019;11(1):1–7. https://doi.org/10.1186/s12913-023-09145-9
30. Nisa’ C, Sari IN. Social Health Insurance Literacy: Lesson Learned from Social Insurance for Maternity Care by National Health Insurance Programme. Jurnal Administrasi Kesehatan Indonesia. 2019;7(1):25-32. https://doi.org/10.20473/jaki.v7i1.2019.25-32
31. Sivakumar A, Jayasingh S. Social Media Influence on Students’ Knowledge Sharing and Learning: An Empirical Study. Educations Sciences. 2023;13(7):1-16 https://doi.org/10.3390/educsci13070745
32. Huang C, Yan D, Liang S. The Relationship between Information Dissemination Channels, Health Belief, and COVID-19 Vaccination Intention: Evidence from China. Hindawi. 2023;6915125:1-11 https://doi.org/10.1155/2023/6915125
33. Myint CY, Pavlova M, Groot W. Health Insurance in Myanmar: Knowledge, Perceptions, and Preferences of Social Security Scheme Members and General Adult Population. The International Journal of Health Planning and Management. 2019;34(1):346–469. https://doi.org/10.1002/hpm.2643
Authors
Ainy, A., & Pujiyanto, P. (2023). Predictors of Indonesian National Health Insurance Knowledge: A Cross-Sectional Study Among Public Health Students in Palembang. Media Kesehatan Masyarakat Indonesia, 19(3), 120-129. https://doi.org/10.30597/mkmi.v19i3.26340
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