The Impact of Indonesia’s National Health Insurance Implementation
on the Prevalence of Cases of Diabetes Mellitus Among Children: A
Literature Study
Nur Af’idah
Public Health Faculty, Universitas Airlangga, Mulyorejo, Surabaya, Indonesia
Keywords: Indonesia National Health Insurance, Prevalence, Diabetes Mellitus, Children.
Abstract: Indonesia is 4
th
in the world ranking of countries with the highest prevalence of Diabetes Mellitus. Diabetes
Mellitus has become a serious problem because its pathophysiology can chronically and progressively
develop into acute and chronic complications. Therefore there needs to be comprehensive and integrative
treatment. Since January 1
st
, 2014 Indonesia has been implementing International Health Insurance or
Jaminan Kesehatan Nasional (JKN). 33% of JKN’s expenses are for Diabetes Mellitus and its
complications. By using a literature study and secondary data from BPJS, the result is that the number of
children which have Diabetes Mellitus has increased by 500 percent over five years. In 2014, the number of
children with Diabetes Mellitus reached 1.100 since JKN was been implemented, and this keeps on
increasing.
1 INTRODUCTION
Diabetes Mellitus is a non-communicable disease.
Its pathophysiology can chronically and
progressively develop into acute and chronic
complications. According to the IDF’s (International
Diabetes Federation) estimations, in 2035 the
number of people around the world with diabetes
will rise beyond 592 million. Indonesia is 4th in the
world ranking of countries with the highest
prevalence of Diabetes Mellitus. Diabetes Mellitus
itself is the third largest cause of death by non-
communicable disease in Indonesia after
cardiovascular diseases and cancer. In 2014, the
deaths from Diabetes Mellitus were 6%, cancer
13%, and cardiovascular diseases 37% of the total.
Diabetes Mellitus can occur in adults, adolescents
and children.
IDF estimated that 46% of cases went
undiagnosed in 2014. This can lead to a serious
problem because people are not aware of their
children’s increased risk for developing diabetes-
related complications. Factor which cause Diabetes
Mellitus in undiagnosed cases in Indonesia are due
to factors such as the records of Diabetes Mellitus
data from many hospital in Indonesia not being well-
organised and not all had been reported to a central
service. There is also high price of health care
services for Diabetes Mellitus to consider. However,
since January 1
st
2014, Indonesia’s government has
been implementing National Health Insurance or
Jaminan Kesehatan Nasional (JKN). 33% of JKN’s
expenses are for Diabetes Mellitus and its
complications. JKN also provides a systematic
method of recording since it has been applied
nationally.
2 METHODS
The author has used a literature study method to
analyse the impact of JKN implementation in
prevalence cases of diabetes mellitus among
children. The author has reviewed the evidence and
summarised the available data which relates to JKN
and prevalence cases of Diabetes Mellitus.
3 RESULT
Since 2007 until 2013, the number of Diabetes
Mellitus cases decreased from 6,9% into 5,7%, but
there was a contrast on the undiagnosed respondents.
Af’idah, N.
The Impact of Indonesia’s National Health Insurance Implementation on the Prevalence of Cases of Diabetes Mellitus Among Children: A Literature Study.
In Proceedings of the 4th Annual Meeting of the Indonesian Health Economics Association (INAHEA 2017), pages 199-200
ISBN: 978-989-758-335-3
Copyright © 2018 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
199

According to the result of blood sugar level’s
examination and interview which has been done by
Riskesdas 2007 and Riskesdas 2013, there are 69,
6% and 73,7% ammount of respondents from
Diabetes Melllitus patient which was a undiagnosed
sufferer before. It shows that, the number of
undiagnosed suffeerer increased. The ammount of
undiagnosed children with Diabetes Mellitus
increased can be caused by many factor. One of the
main factor is financially incapable to access health
services.
Since the first implementation of JKN, the
prevalence of children with Diabetes Melitus
increased. it is related to the JKN’s funds which its
33% of the funds allocated to Diabetes Mellitus and
its complication, so that it decreasing Indonesia’s
citizen burden related to financial factor to get acces
to the health services.
Based on the data from a journal titled ‘National
Health Insurance Effects on Inpatient Utilisation in
Indonesia,’ the participation in JKN since its first
implementation in 2014 until 2015 has reached
155,4 million people. This has kept rising to 171
million people in 2016. Meanwhile, JKN’s total
target participation is 254 million people to be
achieved by 2019. It has been shown that Indonesian
citizens prefer to use JKN as their health insurance
to cover their health needs more than any another
health insurance.
Based on a journal titled unsatisfied Patient in
Healthy Industrial in Indonesia’, the number of
people incl uded in Indonesia increases every year.
The prevalence of 5.7% in 2007 and 6.9% means
that this has reached as many as 12.2 million people
in 2014. According to the official internal media of
BPJS (Badan Penyelenggara Jaminan Sosial), the
amount of children was suffering from Diabetes
Mellitus increased by 500% over the course of five
years. Every week, there will always be new
children suffering from Diabetes Mellitus. In 2014,
the number of children which suffer from Diabetes
Mellitus reached 1.100 since JKN had been
implemented and it keeps on increasing.
4 DISCUSSION
Based on the results of the literature study, the
increase in the prevalence of cases of children
suffering from Diabetes Mellitus can be detected
with the implementation of the JKN reporting
system. The increase of JKN and the increasing
number of children with Diabetes Mellitus has
shown that the JKN expenses for Diabetes Mellitus
can attract Indonesian citizen’s attention. By way of
the increasing number of JKN participants, it has
also helped the government to make a centralised
recording system. This will also help them to find
new cases of undiagnosed Diabetes Mellitus.
5 CONCLUSIONS
Based on the results of several literature reviews in
this literature study, the impact of Indonesia’s
national health insurance is that it can increase
awareness of the prevalence of cases of children
suffering from Diabetes Mellitus with the centralised
reporting system.
REFERENCES
BPJS. 2014. Info BPJS Kesehatan Edisi IX. Jakarta Pusat:
BPJS Kesehatan.
Guariguata, L., Seuring, T., Zhang, P., Makaroff, L. 2016.
IDF Diabetes Atlas Estimates of 2014 Global Health
Expenditures on Diabetes. Diabetes Research and
Clinical Practice.
Pulungan Aman. 2013. Increasing Incidence Of DM Type
1 In Indonesia. International Journal of Pediatric
Endocrinology.
Pusat Data Dan Informasi Kementrian Kesehatan RI. ___.
InfoDATIN: Situasi dan Analisis Diabetes. Available
from URL: http://www.depkes.go.id.
Shahib, A. N., Armyn, N., Kadir, A., Thabrany, H., &
Paturus, I. 2017. National Health Insurance Effect on
Inpatient Utilization in Indonesia. International
Journal of Health Science And Research, 7(11).
Soewondo, P., Ferrario, A., Tahapany, D. L., Challenges
in Diabetes Management in Indonesia: a literature
review. Available from URL:
http://www.globalizationandhealth.com/content/9/1/63
[accessed on September 2017]
Tayibnapis, A. Z., Wuryaningsih, L. E. 2016.
Unsatisfaction Patient In Healthy Industrial In
Indonesia. International Journal of Humanities and
Social Science Invention, 5(9).
WHO. 2016. World Health Organization – Diabetes
country profiles.
WHO. 2014. World Health Organization - Non
communicable Diseases (NCD) Country Profiles.
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