Indonesian National Health Insurance scheme longitudinal sample data 2015-2020: overview and potential uses for...

Area of Science:

• Healthcare policy research
• Health services research
• Public health surveillance

Background:

• The Indonesian National Health Insurance Agency (BPJS-K) operates one of the world's largest single-payer healthcare systems.
• BPJS-K sample data, representing 1% of insured individuals since 2019, remains underutilized in research.
• The dataset covers 95% of Indonesia's population as of December 2023.

Purpose of the Study:

• To provide a comprehensive overview of the BPJS-K sample dataset (2015-2020).
• To highlight the dataset's structure, content, and key variables for research.
• To illustrate the potential applications, strengths, and limitations of the BPJS-K data for health policy analysis.

Main Methods:

• Descriptive statistical analysis of the BPJS-K sample data.
• Examination of key variables including demographics, healthcare utilization, diagnoses, referrals, and tariffs.
• Comparison of dataset representativeness with Indonesian census data.

Main Results:

• BPJS-K sample data broadly represents the Indonesian population, with observed regional disparities in healthcare access.
• Acute respiratory infections were the most frequent diagnosis (6% of visits) in primary healthcare.
• Data includes diagnoses and reimbursement information, showing potential for longitudinal health policy analysis.

Conclusions:

• The BPJS-K sample data is a valuable resource for longitudinal and cross-sectional health policy research.
• Recommendations include enhancing data quality, diagnostic recording, accessibility, and linkage to socio-economic data.
• Optimizing the dataset's utility requires addressing current limitations for broader research application.