Barriers to the Implementation of Dental Insurance in Indonesia as Perceived by Primary Dentists

  • Iwan Dewanto Department of Public Health Dentistry, Faculty of Medicine and Health Science, Muhammadiyah University of Yogyakarta
  • Sitichai Koontongkaew Department of Oral Biology, Faculty of Dentistry, Thammasat University
  • Niken Widyastuti Department of Public Health Dentistry, Faculty of Medicine and Health Science, Muhammadiyah University of Yogyakarta

Abstract

 
Introduction: In 2014, the government of Indonesia launched the National Health Insurance (NHI) system. The system faced challenges in terms of its implementation because it changed the funding scheme within the pre-established health services structure. Under the new NHI system, the funding scheme for primary care providers is a capitation system; in the field of dental care, this means primary dentists received payment based on the amount number of participants enrolled within their geographical area.
 
Objectives: The aim of this study is to describe primary dentists’ perceived constraints toward the implementation of the NHI system and their level of knowledge about managed care in Yogyakarta, Indonesia.
 
Methods: To determine dentists’ perceptions about the implementation of NHI and their knowledge about managed care, we surveyed dentists in a descriptive study. Two types of questionnaire were administered to 91 dentists who work at community health centers (CHCs) in Yogyakarta, using the total population sampling technique.
 
Result: Through the surveys, we determined that 78 dentists (71%) perceived constraints related to capitation, 65 dentists (72%) perceived constraints related to benefits packages, 59 dentists (65%) perceived constraints related to workload, and 23 dentists (25%) perceived constraints related to dental health facilities. In terms of their knowledge of managed care, 46 respondents (50.5%) demonstrated a good knowledge of managed care, 43 respondents (47.3%) had moderate knowledge, and 2 respondents (2.2%) had poor knowledge.
 
Conclusion: The constraints to managed care, as perceived by primary dentists, should be taken into account when implementing the NHI system in Yogyakarta, as these perceptions could affect the system’s success.

References

Thabrany H. Rasional pembayaran kapitasi. Ikatan Dokter Indonesia (IDI). 2000. Jakarta.
Boland P. The capitation sourcebook: a practical guide to managing at risk arrangements. California: Boland Health Care Inc. 1996.
Johansson V, Axtelius B, Söderfeldt B, Sampogna F, Lannerud M, Sondell K.. Financial systems’ impact on dental care: a review of fee for service and capitation systems. Community Dent Health. 2007;24(1):12-20.
Dewanto I, Lestari NI. Panduan pelaksanaan pelayanan kesehatan gigi dan mulut dalam sistem jaminan kesehatan nasional (guide to the implementation of oral health service in a national health insurance system. 1st ed. Jakarta: PB PDGI; 2014.
Heywood P, Choi Y. Health system performance at the district level in Indonesia after decentralization. BMC Int Health and Human Rights. 2010;10(3):1-12.
Satinder WS, Anup N, Amaninder K, Kamaldeep K. 2014. Type of patients, disease pattern, felt needs and serves provided to patients attending Community Dental Camps in Amritsar District. Indian J Compr Dent Care. 2014;4(2):448-51.
Maharani DA. Do the Indonesians receive the dental care treatment they need? a secondary analysis on self-perceived dental care need. ISRN Dent. 2012;2012:1-5.
Hartley D. Rural health disparities, population health, and rural culture. Am J Public Health. 2004;94(10):1675–8.
Kletke PR, Marder WD, Willke RJ. A projection of the primary care physician population in metropolitan and nonmetropolitan areas; Primary care research: theory and methods: AHCPR conference proceedings; Washington DC: Agency for Health Care Policy and Research; 1991. p. 261-9.
Van Nostrand JF, editor. Common beliefs about the rural elderly: what do national data tell us? Vital and health statistics 3.
Hartley D, Quam L, Lurie N. Urban and rural differences in health insurance and access to care. Journal of Rural Health. 1994;10(2):98-108.
Phillips CD, McLeroy KR. Health in rural America: remembering the importance of place. Editorial. Am J Public Health. 2004;94(10):1661-3.
BPS-Statistics of D.I. Yogyakarta Province. Daerah Istimewa Yogyakarta in figures 2007/2008. Yogyakarta: BPS-statistics of D.I. Yogyakarta Province; 2008.
BPS-Statistics of Indonesia. Trends of selected socioeconomic indicators of Indonesia. Jakarta: BPS-Statistics Indonesia; 2010.
Pattussi MP, Marcenes W, Croucher R, Sheiham A. Social deprivation, income inequality, social cohesion and dental caries in Brazilian school children. Soc Sci Med. 2001;53(7):915-25.
Tatiana D, Anca C. Professional judgment and reticence to apply sampling techniques. Procedia Economics and Finance. 2014;15:1253–8.
Singarimbun M, Sofian E. Survey research methods (Metode penelitian survei). Jakarta, Indonesia: Pustaka LP3ES Indonesia; 1989.
Sturm R. Effect of managed care and financing on pactice constraints and career satisfaction in primary care. J Am Board Fam Pract. 2002;15(5):367-77.
Published
2018-10-19
How to Cite
DEWANTO, Iwan; KOONTONGKAEW, Sitichai; WIDYASTUTI, Niken. Barriers to the Implementation of Dental Insurance in Indonesia as Perceived by Primary Dentists. Journal of Indonesian Dental Association, [S.l.], v. 1, n. 1, oct. 2018. ISSN 2621-6175. Available at: <http://jurnal.pdgi.or.id/index.php/jida/article/view/281>. Date accessed: 24 apr. 2019. doi: https://doi.org/10.32793/jida.v1i1.281.
Section
Research Article