Determinants of compliance with contribution payment of JKN mandiri participants in the bantimurung health center working area

Authors

  • Annisa Department of Public Health, Universitas Tamalatea Makassar, Makassar, Indonesia, Indonesia
  • Darmi Arda Department of Nursing, Politeknik Sandi Karsa, Makassar, South Sulawesi, Indonesia https://orcid.org/0000-0001-8153-153X

DOI:

https://doi.org/10.61099/jakespol.v1i4.543

Keywords:

health insurance, income, knowledge, patient compliance, social security

Abstract

Introduction: Premium payment compliance is essential for maintaining the financial sustainability and continuity of Indonesia’s National Health Insurance (JKN), particularly among self-employed participants who are responsible for paying contributions independently. Non-compliance may lead to inactive membership and disrupted access to healthcare. This study aimed to identify factors associated with premium payment compliance among active independent JKN participants in the working area of Bantimurung Community Health Center.

Methods: An observational analytic study with a cross-sectional design was conducted among 93 Non-Wage Recipient Workers (PBPU) selected from a population of 1,288 participants using purposive sampling. Data were collected using a structured questionnaire. Descriptive analysis was used to summarize participant characteristics, while bivariate associations were examined using the Chi-square test at a significance level of α = 0.05. Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated from the reported 2×2 contingency tables.

Results: Overall, 72 respondents (77.4%) were compliant with JKN premium payments. Participants with good knowledge had higher odds of payment compliance than those with poorer knowledge (OR = 3.76; 95% CI: 1.34–10.52; p = 0.009). High-income participants were more likely to comply with premium payments than low-income participants (OR = 4.75; 95% CI: 1.02–22.10; p = 0.032). Participants with fewer family dependents also had higher odds of compliance compared with those with more dependents (OR = 2.88; 95% CI: 1.05–7.84; p = 0.035).

Conclusion: Knowledge, income, and family dependency burden were significantly associated with JKN premium payment compliance. Strengthening participant education, payment reminders, and socioeconomic-sensitive payment strategies may improve contribution continuity and support JKN sustainability.

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References

1. Adewole OA, Akingbola A, Adegbesan AC, Ndu-Esekea TN, Olalemi SB. Leveraging artificial intelligence to improve health insurance access and address disparities in rural Africa. J Med Surgery, Public Heal. 2025;5:100172. doi:https://doi.org/10.1016/j.glmedi.2024.100172

2. Al-Aqqad N, McCarthy L-J, Roura M. The bidirectional effects of the COVID-19 pandemic on the social determinants of health among refugees and internally displaced persons in low and lower-middle income countries: A systematic review of qualitative studies. J Migr Heal. 2025;12:100369. doi:https://doi.org/10.1016/j.jmh.2025.100369

3. Borawski EA, Goodwin MA, Glenn AC, et al. Study design and protocol for Nourishing Beginnings, an integrated service delivery model addressing food insecurity and social needs of low-income pregnant individuals. Contemp Clin Trials. 2023;133:107310. doi:https://doi.org/10.1016/j.cct.2023.107310

4. Carson B. Reconsidering the normative foundations of public health: market vs. social justice. J Econ Behav Organ. 2025;237:107144. doi:https://doi.org/10.1016/j.jebo.2025.107144

5. Craig A, Lawford H, Miller M, et al. Use of Technology to Support Health Care Providers Delivering Care in Low- and Lower-Middle-Income Countries: Systematic Umbrella Review. J Med Internet Res. 2025;27. doi:https://doi.org/10.2196/66288

6. Dally D, Amith M, Mauldin RL, Thomas L, Dang Y, Tao C. A Semantic Approach to Describe Social and Economic Characteristics That Impact Health Outcomes (Social Determinants of Health): Ontology Development Study. Online J Public Health Inform. 2024;16. doi:https://doi.org/10.2196/52845

7. Dávila RC. The role of available resources to identify and treat low-income women with postpartum depression during Covid-19✰. J Affect Disord Reports. 2024;16:100755. doi:https://doi.org/10.1016/j.jadr.2024.100755

8. Gichoya JW, Mwavu R, Minja F, Kaonga N, Purkayastha S, Newsome J. Leveraging digital technologies to reduce cancer disparities in low-income and middle-income countries. Lancet Digit Heal. 2025;7(10):100937. doi:https://doi.org/10.1016/j.landig.2025.100937

9. Gulak D, Moreira VR, Ferraresi AA. Social performance indicators in Brazilian health cooperatives. Soc Enterp J. 2025;21(4):574-593. doi:https://doi.org/10.1108/SEJ-05-2024-0084

10. Le HT, Vu DVT, Nguyen TNA, et al. Research Electronic Data Capture (REDCap) for Population-Based Data Collection in Low- and Middle-Income Countries: Opportunities, Challenges, and Solutions. J Med Internet Res. 2025;27. doi:https://doi.org/10.2196/65377

11. LeBrun M, Brannagan K, Smart AN. Gaps in Social Determinants of Health History Taking, Clinical Documentation, and Billing/Coding Errors During Women’s Health Patient Encounters. Adv Fam Pract Nurs. 2023;5(1):169-182. doi:https://doi.org/10.1016/j.yfpn.2022.11.009

12. Kwaffo M, Adomah-Afari A. Health-care providers’ knowledge and compliance with patient safety incidents reporting at two specialist hospitals in Ghana. Int J Qual Serv Sci. 2025;17(4):583-612. doi:10.1108/IJQSS-03-2025-0073

13. Mamuye A, Nigatu AM, Chanyalew MA, et al. Facilitators and Barriers to the Sustainability of eHealth Solutions in Low- and Middle-Income Countries: Descriptive Exploratory Study. JMIR Form Res. 2023;7. doi:https://doi.org/10.2196/41487

14. Morelli V. Social Determinants of Health: An Overview for the Primary Care Provider. Prim Care Clin Off Pract. 2023;50(4):507-525. doi:https://doi.org/10.1016/j.pop.2023.04.004

15. Mozaffarian D, Aspry KE, Garfield K, et al. “Food Is Medicine” Strategies for Nutrition Security and Cardiometabolic Health Equity: JACC State-of-the-Art Review. J Am Coll Cardiol. 2024;83(8):843-864. doi:https://doi.org/10.1016/j.jacc.2023.12.023

16. Mustaking Mustaking Suprapto Suprapto TS. Developing an Integrated Bureaucratic Reform Model to Improve Public Healthcare Service Quality in Indonesia: A Sequential Explanatory Mixed-Methods Study. Soc Sci Humanit Open. Published online 2026:21.

17. Nepal G, Yadav JK, Lamsal S, Ojha R. Pragmatic strategies for improving prevention, diagnosis, and treatment of epilepsy in low- and middle-income countries. Epilepsy Res. 2025;215(April 2025):107586. doi:10.1016/j.eplepsyres.2025.107586

18. Nguyen AX, Chow DR, Hébert M, Ing E, Nassrallah G, Nijhawan N. Geospatial analysis of accessibility to oculofacial plastic surgery in the United States: Driving distance and sociodemographic disparities. AJO Int. 2025;2(4):100192. doi:https://doi.org/10.1016/j.ajoint.2025.100192

19. Sohmer J, Lobaina D, Jhumkhawala V, et al. Health disparities and health literacy challenges experienced by individuals with hearing loss: A scoping review. Patient Educ Couns. 2025;131:108549. doi:https://doi.org/10.1016/j.pec.2024.108549

20. Somani R, Muntaner C, Velonis AJ, Smith P, Hillan EM. Factors Contributing to Increased Workplace Violence Against Nurses During COVID-19 in the Healthcare Settings of a Lower Middle-income Country: A Qualitative Study. Asian Nurs Res (Korean Soc Nurs Sci). 2024;18(2):148-158. doi:https://doi.org/10.1016/j.anr.2024.04.008

21. Suprapto S. Policy analysis of national health financing implementation on access and equity of healthcare services in rural communities. J Heal Policy Anal. 2026;1(3):80-89. doi:https://doi.org/10.61099/jakespol.v1i3.402

22. Suprapto S, Djaha YTL. Professional Nursing Competence in Contemporary Healthcare: A Qualitative Study of Knowledge, Skills, and Attitudes Integration. J Curr Heal Sci. 2026;6(3):121-128. doi:https://doi.org/10.47679/jchs.2026169

23. Zhao J, Yang Y, Miao J, Wang X, Qi D, Zang S. Factors Associated With the Level of Trust in Health Information Robots Among the General Population From a Socioecological Model Perspective: Network Analysis. J Med Internet Res. 2025;27. doi:https://doi.org/10.2196/68299

24. Tan AK, Strauss SM. Social Determinants of Health and Newer Diabetes Medications: NHANES Analysis. J Nurse Pract. 2025;21(2):105287. doi:https://doi.org/10.1016/j.nurpra.2024.105287

25. Totok Sundoro. Community Perceptions About National Health Insurance To Participation To Be A BPJS Health . J Ilm Kesehat Sandi Husada. 2023;12(1 SE-Articles):15-24. doi:10.35816/jiksh.v12i1.506

26. Yang L, Liu X, Xu H, Wang G. Identifying social isolation profiles among young and middle-aged patients with cancer in Western China: A latent profile analysis. Asia-Pacific J Oncol Nurs. 2025;12:100794. doi:https://doi.org/10.1016/j.apjon.2025.100794

27. Zhang M, Wang X, Shao M, et al. Financial toxicity of informal caregivers of colorectal cancer patients: A cross-sectional study. Eur J Oncol Nurs. 2024;69:102519. doi:https://doi.org/10.1016/j.ejon.2024.102519

28. Yu S, Wang M, Liang Y. Child education and parental financial outcomes: Evidence from a schooling reform. Financ Res Lett. 2025;83:107659. doi:https://doi.org/10.1016/j.frl.2025.107659

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Published

2026-10-10

How to Cite

Annisa, & Darmi Arda. (2026). Determinants of compliance with contribution payment of JKN mandiri participants in the bantimurung health center working area. JAKESPOL Journal of Health Policy Analysis, 1(4), 152–162. https://doi.org/10.61099/jakespol.v1i4.543

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