Need and Demand of Primary Health Care on Public Health’s
Undergraduate Students, Airlangga University, Surabaya
Widya Nur Azizah
Faculty of Public Health, Airlangga University, Mulyorejo, Surabaya, Indonesia
{Widya Nur Azizah} wid
y
a.nur.azizah-2014
@f
km.unair.ac.id
Keywords: Primary Health Care, Need, Demand, Undergraduate student, Public health.
Abstract: Health is important to everyone. Health is needed for doing daily activities. Everyone would like to be
healthy through various ways such as investment or in consuming goods and health services. Therefore,
everyone wants to go to health services. Need and demand depend on need and ability to fulfill their needs.
Public Health’s undergraduate students should know the importance of primary healthcare. The aim of this
research is to analyze the need and demand for primary healthcare in public health undergraduate students
and the gap between need and demand. This research uses primary data from questionnaire on the need and
demand for primary health care for public health undergraduate students. This research emphasizes the gap
in the analysis of need and demand in primary healthcare. Population of this research is 924 students of
public health. Meanwhile, the sample of population is 276 students. The result from this research is that a
gap between need and demands of primary healthcare still exists. According to respondents, the need for
primary healthcare has not yet been fulfilled with the demand of primary healthcare. This problem can be
solved by improving the quality of primary healthcare with considering the needs of customers.
1 INTRODUCTION
Primary healthcare is the first health service of the
basic needs of the community when they have health
problems or accidents. Primary healthcare is given
by Puskesmas (Pusat Kesehatan Masyarakat) or
community health services, health centers and
clinics. Primary healthcare is Fasilitas Kesehatan
Tingkat Pertama (FKTP), which relates directly to
the public. Thus, access to primary healthcare
services needs to be considered. Access here can be
at a reasonable distance and at an affordable price.
This is supported by the implementation of the
Jaminan Kesehatan Nasional (JKN) system as the
National Health Insurance in Indonesia. In the era of
JKN, patients in need of healthcare should go to
Fasilitas Kesehatan Tingkat Pertama (FKTP) in
advance, except in emergency conditions. FKTP
destination is faskes who have cooperated with BPJS
(Badan Pengelola Jaminan Sosial).
The JKN program owned by the government
depends on the supply and demand of health
services. The need and demand for health services
could be used as a tool for the evaluation of the JKN
program, particularly in Fasilitas Kesehatan Tingkat
Pertama (FKTP). Demand for health services is the
realization of the use of health services by
consumers or patients. Demand consists of need and
want. Need is the best goods or services by
healthcare providers. Meanwhile, want is the goods
or services desired by the patient. In the Strategic
Plan 2015-2019, the Health Department revealed the
data did not meet the need for health services by 7%.
The data indicate the problematic need for health
services in Indonesia.
Students of public health should have more
knowledge about health, especially the health
service in Indonesia. Need and demand of their
preferences could be drawn as the situation in the
population. The demand of primary health care
could be used as a tool to evaluate insurance’s
utilization in Airlangga University and primary
health care on Airlangga University. The aim of this
research is to analyze the need and demand of
primary health care in public health undergraduate
students and the gap between the need and demand.
From some of the above explanation, the researcher
adopted the issue of the need and demand for
primary healthcare on public health
undergraduatestudents. The results of this study can
Azizah, W.
Need and Demand of Primary Health Care on Public Health’s Undergraduate Students, Airlangga University, Surabaya.
In Proceedings of the 4th Annual Meeting of the Indonesian Health Economics Association (INAHEA 2017), pages 25-28
ISBN: 978-989-758-335-3
Copyright © 2018 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
25

be used as a recommendation to primary healthcare
to meet the needs of customers or patients
2 METHODS
This research uses descriptive analysis to analyze the
need and demand of primary healthcare in public
health undergraduate students from primary data.
The instrument of this research is using online
questionnaire regarding the need and demand of
primary healthcare. The questionnaire was held on
September 3
rd
– 4
th
, 2017. Respondents of this
research are public health undergraduate students for
the academic years of 2017/2018, which include the
years of 2014, 2015, 2016 and 2017. The method for
determining the sample of this research is simple
random sampling. Population of this research is 924
undergraduate students of public health in Airlangga
University. Meanwhile, the sample for this research
is 276 students.
3 RESULT
The sampling method uses simple random sampling,
which is a sampling design in which n distinct units
are selected from the N units in the population in
such a way that every possible combination of n
units is equally likely to be the sample selected. (2)
The results of this research compare the need
and demand of primary healthcare. Need and
demand of primary healthcare can be seen by the
number of expectancy and realization seeking health
services for treatment.
Characteristic respondents of this research are
dominated by females. In the population of public
health undergraduate students, the number of female
students is greater than male students. Respondents
of this research are divided into four categories of
academic years, 2014, 2015, 2016 and 2017. The
distribution by academic years can be seen from
Table 2, which is dominated by students of the 2014
academic year. The student’s allowance per month is
dominated by students with IDR 750.000 –
1.000.000, and the result is that 31.9% students
choose that.
Table 1:.Number of respondents by gender
Gende
r
Total Percenta
g
e
Male 34 12.3%
Female 242 87.7%
Total 276 100%
Table 2: Number of respondents by academic year
Years Total Percenta
g
e
2014 102 37.0%
2015 65 23.6%
2016 57 20.7%
2017 52 18.8%
Total 276 100.0%
Table 3: Number of respondents by allowance per month
Allowance
(
IDR
)
Total Percenta
g
e
<500.000 52 18.8%
500.000
–
750.000 74 26.8%
750.000
–
1.000.000 88 31.9%
> R
p
1.000.000 62 22.5%
Total 276 100.0%
Most of the respondents have health insurance.
The result is 84.8% of all respondents or 234
students have health insurance. The type of health
insurance that they have is dominated by social
insurance from governance, such as JKN (Jaminan
Kesehatan Nasional), KIS (Kartu Indonesia Sehat),
ASKES (Asuransi Kesehatan), etc. A total of 214
students have social insurance while the others have
private insurance. From this condition, public health
students can be seen to be aware of their health
condition.
Table 4: .Number of respondents by having health
insurance
Have Health insurance Total Percenta
g
e
Yes 234 84.8%
No 42 15.2%
Total 276 100.0%
Table 5: Number of respondents by type of health
insurance.
Type of Health Insurance Total Percentage
Social Insurance 214 91.5%
Private Insurance 20 8.5%
Total 234 100.0%
Table 6: Number of respondents who have been sick the
last six months.
Sic
k
Total Percentage
Yes 181 65.6%
No 95 34.4%
Total 276 100.0%
The type of health services that respondents want
to visit when they are sick is dominated by
INAHEA 2017 - 4th Annual Meeting of the Indonesian Health Economics Association
26

Puskesmas (Pusat Kesehatan Masyarakat) or
clinics. 35,1% of respondents want to go to a
Puskesmas or clinic when they feel sick. The finding
is that when respondents feel sick, 27. 8% of
respondents choose Puskesmas or clinics. From the
data, we can know that need and demand has not yet
been met. This can be caused by various reasons.
From this research, the unmet demand of primary
healthcare can be caused by a misperception
between health providers and customers (patients).
Respondents think that distance, facility and quality
of health providers and health services can boost
primary healthcare visits. Health services that are
accessible is also important according to
respondents. Respondents will choose health
services that are accessible in terms of distance and
cost.
Table 7: Health Services that respondents want to visit
Type of Health Services Total Percentage
Governance Hos
p
ital 37 13.4%
Private hos
p
ital 46 16.7%
Medical S
p
ecialist 19 6.9%
Doctor/Midwife 69 25.0%
Puskesmas/Clinic 97 35.1%
PLK (Pusat Layanan
K
esehatan
)
UNAIR
8 2.9%
Total 276 100.0%
Table 8: Respondents go to health services when they are
sick
Respondents are sick and go
to health services
Total Percentage
Yes 144 52.2%
No 132 47.8%
Total 276 100,0%
Table 9: Type of health services that are chosen
Type of Health Services Total Percentage
Governance Hospital 26 18.1%
Private hospital 30 20.8%
Medical S
p
ecialist 6 4.2%
Doctor/Midwife 28 19.4%
Puskesmas/Clinic 40 27.8%
PLK (Pusat Layanan
K
esehatan
)
UNAIR
14 9.7%
Total 144 100.0%
From the result, most of respondents want to go
to Puskesmas when they were sick. They have
chosen to go to puskesmas or clinic when they are
sick. But the number has not met yet. So, the need
and demand of primary health care has not met yet.
4 DISCUSSION
Health system financing in Indonesia these days is
through JKN (Jaminan Kesehatan Nasional).
According to Peraturan Menteri Kesehatan RI
Nomor 71 Tahun 2013 Tentang Pelayanan
Kesehatan Pada Jaminan Kesehatan Nasional, JKN
is a health insurance system in Indonesia which
protect participants’ health, so that they will get the
benefit of healthcare and protection to fullfil their
basic health needs. The participants will get the
benefit of health insurance when they have paid the
premium or have been paid by the governance.
JKN depends on the supply and demand of
health services. The need and demand of health
services can be used as a tool to evaluate this
program, especially for primary healthcare or FKTP
(Fasilitas Kesehatan Tingkat Pertama). Demand of
health services is defined as the realization of using
health services by consumers or patients. Demand
consists of need and want. Need is the best goods or
services according to health providers, while want is
goods or services that patients wish to buy.
Need is generally defined as the number of
medical services, which, in the opinion of medical
professionals, should be consumed by members of a
community if they are to become or remain as
healthy as possible given existing medical
knowledge.
Demand refers to the number of medical services
community members want to consume at certain
prices as reflected by their tastes and preferences for
all goods and services available to them.
Most of the respondents already have national
health insurance, JKN, which is required by the
governance. As public health students, they are
already aware of health issues, especially about
health system financing in Indonesia. From the
result of this research, the need and demand of
primary healthcare in public health undergraduate
students shows some difference. The degree of need
of primary healthcare is higher than its demand.
Besides the primary healthcare, respondents also
choose doctor and hospital as health services that
they use when they feel sick. From the data, the
students will also go to a private hospital aside from
primary healthcare such as puskesmas or clinics.
Unmet need can be caused by various reasons
according to respondents. Most said that
accessibility will determine the choice of health
services. Accessible means health services that can
be reached by public transportation and at affordable
prices. Another reason that supports health services
is the quality of health services. The quality of
Need and Demand of Primary Health Care on Public Health’s Undergraduate Students, Airlangga University, Surabaya
27

health services can be determined by qualified health
providers and complete facility.
There are some intervention to reduce demand
barriers, information on health care, education,
costs, household preferences, community and
cultural preferences, attitude, norms, price and
availability. (Ensor & Cooper, 2004)
A demand curve can be used in evaluating the
program with need and demand analysis. However,
in this research a demand curve cannot be created
because of the time limitation. The researcher cannot
measure the change of quantity and prices in order to
form a demand curve
5 CONCLUSION
The conclusion of the need and demand analysis of
primary healthcare in public health undergraduate
students is that there is a gap between the need and
demand of primary healthcare. There is unmet need
in primary healthcare because of the quality of
health providers and access to health services.
Future research can be carried out over a longer
period, so that there will be change of prices and
quantity and, from those variables, a demand curve
can be drawn. The demand curve can then be used as
a tool to evaluate the JKN (Jaminan Kesehatan
Nasional) Program.
REFERENCES
Boivin, J., Bunting, L., Collins, J. A. & Nygren, K. G.,
2007. International Estimates of Infertility Prevalence
and Treatment Seeking: Potential Need and Demand
for Infertility Medical Care. Human Reproduction,
22(6), pp. 1506-1512.
Ensor, T. & Cooper, S., 2004. Overcoming Barriers to
Health Service Access: Influencing The Demand Side.
Health Policy and Planning, 19(2), pp. 69-79.
Huda, L. N., 2007. Hubungan Status Reproduksi, Status
Kesehatan, Akses Pelayanan Kesehatan dengan
Komplikasi Obstetri di Banda Sakti Lhokseumawe
Tahun 2005. Jurnal Kesehatan Masyarakat Nasional,
1(6), pp. 275-281.
Janis N. (2014). Supply dan Demand terhadap Layanan
Kesehatan. Depkeu. BPJS Kesehatan. 1–8.
Kementerian Kesehatan (2015). Rencana Strategis
Kementerian Kesehatan 2015-2019. Jakarta:
Kementeri Kesehatan Republik Indonesia.
Murti, B., 2006. Contracting Out Pelayanan Kesehatan:
Sebuah Alternatif Solusi Keterbatasan Kapasitas
Sektor Publik. Manajemen Pelayanan Kesehatan,
9(3), pp. 109-117.
R. S., K. & Wardani, Y., 2013. Faktor-faktor yang
Berhubungan dengan Pola Pencarian Pengobatan ke
Pelayanan Kesehatan Alternatif Pasien Suspek
Tuberculosis di Komunitas. Jurnal Kesehatan
Masyarakat Nasional, 7(2), pp. 55-112.
Rahma, A., Arso, S. P. & Suparwati, A., 2015.
Implementasi Fungsi Pokok Pelayanan Primer
Puskesmas Sebagai Gatekeeper dalam Program JKN
(Studi di Puskesmas Juwana Kabupaten Pati). Jurnal
Kesehatan Masyarakat, 3(3), pp. 1-11.
Tanser, F., Gijsbertsen, B. & Herbst, K., 2006. Modelling
and Understanding Primary Healthcare Accessibility
and Utilization in Rural South Africa: An Exploration
Using A Geographical Information System. Social
Science & Medicine, 63(3), pp. 691-705.
Thompson S. K. (2012). Sampling, 3rd ed. New Jersey:
John Wiley & Sons, Inc.
INAHEA 2017 - 4th Annual Meeting of the Indonesian Health Economics Association
28