Evaluation of the National Health Insurance Policy in Improving Public Access to Healthcare Services: A Literature Review
Keywords:
National Health Insurance; Health Policy Evaluation; Healthcare Access; Universal Health Coverage; Healthcare Services.Abstract
Objective: This literature review aimed to evaluate the National Health Insurance (Jaminan Kesehatan Nasional/JKN) policy in improving public access to healthcare services and to identify the supporting factors and barriers affecting its implementation. Methods: A literature search was conducted across several electronic databases using keywords related to the National Health Insurance, access to healthcare services, universal health coverage, insurance enrollment, healthcare utilization, and equity in healthcare services. Articles were selected according to predetermined inclusion and exclusion criteria and subsequently analyzed using a descriptive narrative approach. Results: The review findings indicate that the JKN policy has contributed to expanding population coverage, increasing the utilization of healthcare facilities, and reducing financial barriers to accessing healthcare services. However, its effectiveness continues to be influenced by the unequal distribution of healthcare facilities and personnel, limited geographical accessibility, inadequate participant understanding, inactive membership status, administrative procedures, the referral system, and disparities in service quality across regions. Low-income populations, residents of remote areas, informal-sector workers, and individuals experiencing social disadvantage continue to face barriers to obtaining timely and high-quality healthcare services. Implications: Strengthening the JKN policy should focus on ensuring a more equitable distribution of healthcare facilities and personnel, simplifying administrative procedures, improving participants’ health insurance literacy, strengthening primary healthcare services, improving the referral system, and continuously monitoring disparities in access. Policy evaluation based on service availability, affordability, accessibility, acceptability, and quality is essential to enable JKN to achieve more equitable and inclusive access to healthcare services.
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