Analysis of Financing Trends and Payment Sources Among Obstetric Inpatients Based on Type of Insurance

Abstract

Introduction The National Health Insurance (JKN) program serves as a key mechanism to expand healthcare access in Indonesia. However, heavy reliance on a single financing source may contribute to imbalances within the healthcare system, particularly in high-utilization services such as obstetric inpatient care.

Methods This study applied a quantitative approach using an analytical observational design with a retrospective method. Secondary data were collected from 1,282 obstetric inpatients at RSUD R.T. Notopuro Sidoarjo in 2024. Data analysis included descriptive statistics, time series analysis, simple linear regression, and comparative testing across payer groups.

Results The findings revealed that the majority of healthcare financing was covered by JKN/BPJS (64.3%), followed by PBI/APBN (23.9%) and out-of-pocket payments (11.8%). Linear regression analysis demonstrated a significant upward trend in JKN/BPJS utilization (β = 2.15; p = 0.031; R² = 0.384), indicating a consistent monthly increase in patient numbers. In contrast, no statistically significant trends were observed for PBI/APBN (p = 0.378) and general patients (p = 0.556). Additionally, comparative analysis confirmed significant differences among payer groups (p < 0.001).

Discussion and Conclusion JKN is proven to be the dominant financing source with an increasing trend in service utilization. Nevertheless, disparities across payment sources persist. Therefore, policy strengthening and increased healthcare capacity are necessary to create a more equitable and sustainable system.