Revenue and financing of patients with national health insurance by the social security organizing agency to improve health services

Abstract

Objective

This study was aimed to analyze the comparison of income claims by social security organizing agency or Badan Penyelenggara Jaminan Sosial (BPJS) and non-BPJS and analyze the cost of health services.

Method

It was a descriptive analytic approach, this study analyzed the acceptance of BPJS and non-BPJS claim revenue with quantitative data, then the study analyzes the financing for BPJS patients in regional public hospital Andi Makkasau Parepare.

Result

BPJS claims revenue has increased very significantly, reached IDR 56.60 billion (86%), while for non-BPJS, it was IDR 7.98 billion (14%). BPJS patient visits hospital has reached 3793 people and absorbed around 1.8 billion funds per third quarter, and BPJS Health patient spending expenses are dominated by handling non-communicable diseases as high-cost diseases namely cataracts IDR 376 million (21.26%), cancer IDR 371 million (20.98%) and heart disease IDR 219 million (13.53%) are seen as a burden that dominates the absorption of national health insurance funds, but health services are already being felt by the community, and users are getting bigger as the participants increase BPJS.

Conclusion

BPJS claims revenue increased very significantly, reaching 86%, as BPJS patient visits at regional hospital Andi Makkasau Parepare continued to increase and absorb funds of around 7.5 billion per year along with patient financing dominated by handling non-communicable diseases (PTM).