Email this article Comparison Of Health Service Utilization by BPJS Participation Status In Brebes
Abstract
ABSTRACT
Health service utilization is an indicator in assessing the success of the healthcare system and equitable access to healthcare services in a country. Differences in socioeconomic status between Contribution Assistance Recipients (PBI) and Non-PBI participants are assumed to influence healthcare utilization patterns. This study aimed to analyze differences in health service utilization based on BPJS participation status at primary healthcare facilities in Brebes Regency, Central Java. This study used a cross-sectional quantitative study conducted at primary healthcare facilities in Brebes Regency, Central Java, Indonesia. The cross-sectional study was conducted from January to February 2026. The sample was selected using a disproportionate stratified random sampling approach supported by Slovin's method. A total of 100 respondents were selected, divided into 50 PBI participants and 50 non-PBI participants. Data were analyzed using univariate analysis and the Mann–Whitney U test.The majority of respondents demonstrated high health service utilization, accounting for 81.0% of the total respondents. The mean rank of health service utilization among PBI participants was 51.51, while among Non-PBI participants it was 49.49. The Mann–Whitney U test showed that there was no statistically significant difference in health service utilization between PBI and Non-PBI participants (U=1199.500; Z=-0.349; p=0.727).There was no significant difference in health service utilization based on BPJS participation status at primary healthcare facilities in Brebes Regency. Implementation of the BPJS Health program has relatively supported equitable access to primary healthcare services among PBI and Non-PBI participants
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?Yusoff MM. Improving the quality of life for sustainable development. In: IOP Conference Series: Earth and Environmental Science. IOP Publishing Ltd; 2020.
?Subiakso A, Juliarto TS, Darmawan D, Sisminarnohadi S, Romli RA. Legal Rights in Access to Health Services for Persons with Disabilities. Technol Soc. 2023;2(3):15–20.
?Nunes R, Nunes SB, Rego G. Health care as a universal right. J Public Heal. 2017 Feb 1;25(1):1–9.
?Wendimagegn NF, Bezuidenhout MC. Integrating promotive, preventive, and curative health care services at hospitals and health centers in Addis Ababa, Ethiopia. J Multidiscip Healthc. 2019;12:243–55.
?Manita R, Afrita I. Aksesbilitas Pembiayaan dalam Program Jaminan Kesehatan Nasional. Innov J Soc Sci Res. 2024;4(1):12874–86.
?Hamidah T, Putera AP, Pramono B. Government Authority and Responsibility in the Universal Health Coverage Program from the Aspect of Participation and Financing. RechtIdee. 2024;19(2):285–303.
?Izzah N, Majid M, Rusman ADPR, Sari RW. Exploration Of BPJS Health Patients’ Experiences In Accessing Primary Health Services. Indones J Heal Sci. 2026;10(1):74–83.
?BPJS. Data JKN. BPJS Kesehatan. 2026.
?Nurani H, Akbar IZ, Shadiqi MA. Influencing Healthcare Utilization: Exploring the Interplay of Education, Attitudes, and Distance in Access to Health Services. River Stud Adv Knowl Steward world’s rivers. 2023;1(2):83–92.
??enol V, Elmali F, Çetinkaya F, Naçar M, Yalap R. Change in Utilization of Health Services and its Affecting Factors in Kayseri City Center: A Comparative Population-Based Cross-Sectional Study in 2004 and 2017. Turkiye Klin J Med Sci. 2023;43(1):49–63.
?Malangalila SM, Laison AM. Levels of Health Care Services Utilization and its Determinants among Household: Cross Sectional Study in Iringa Tanzania. Int J Innov Sci Res Technol [Internet]. 2025;10(1):287–93. Available from: www.ijisrt.com
?Neugebauer J. Economic Barriers as a Large Part of the Problem with Access to Healthcare. 3rd Proc Open Sci Conf 2024. 2024 Aug 7;41–50.
?Prasad S, Patro KS, Bhandari S, Gulecha V. Bridging the Gap: Healthcare Access and Quality Disparities Between Urban and Rural Area. J Innov Teach Learn. 2025 Mar 26;4(1 march 2025):44–50.
?Maulia H, Yunita J, Renaldi R, Jepisah D, Ermanto. Analisis Implementasi Penerapan Pola Pengelolaan Keuangan Badan Layanan Umum Daerah (PPK-BLUD) Puskesmas di Kabupaten Bengkalis Tahun 2024. Med Nutr J Ilmu Kesehat. 2025;20(1).
?Saputra F. Pengaruh Faktor Manajemen Internal terhadap Ketercapaian Indikator Mutu Pelayanan Kesehatan di Fasilitas Kesehatan Pratama (Klinik X). J Ilmu Kesehat Masy. 2025 Feb 19;14(01):1–8.
?BPS. Banyaknya Peserta BPJS Kesehatan Menurut Kabupaten/Kota di Provinsi Jawa Tengah (Orang), 2025. Badan Pusat Statistik Provinsi Jawa Tengah. 2026.
?Wulandari RD, Laksono AD, Rohmah N, Ashar H. Regional differences in primary healthcare utilization in Java Region—Indonesia. PLoS One. 2023 Mar 1;18(3 March).
?Kurniawanto H, Anggriawan MA, Tejaarief B, Kenedi. The Role of Health Insurance in Facilitating Access to Healthcare Utilization: A Case Study of BPJS Kesehatan Users in Banten Province. J Penelit Pendidik IPA [Internet]. 2025 Feb 25;11(2):729–41. Available from: https://jppipa.unram.ac.id/index.php/jppipa/article/view/9319
?Mitani AA, Mercaldo ND, Haneuse S, Schildcrout JS. Survey design and analysis considerations when utilizing misclassified sampling strata. BMC Med Res Methodol. 2021 Dec 1;21(1).
?Farhansyah J, Suardy NF. Perbedaan BPJS PBI dan Non PBI: Peserta, Iuran, & Fasilitasnya. mekari talenta. 2026.
?Sari NN, Idris H, Syakurah RA. Analisis Pemanfaatan Pelayanan Kesehatan pada Peserta Jaminan Kesehatan Nasional: Studi Literatur. Heal Inf J Penelit. 2023;15(3):1–10.
?Chicco D, Sichenze A, Jurman G. A simple guide to the use of Student’s t-test, Mann-Whitney U test, Chi-squared test, and Kruskal-Wallis test in biostatistics. BioData Min. 2025 Dec 1;18(1).
?Susilo D, Wulandari LPL, Sukmayeti E, Asante A, Jan S, Thabrany H, et al. Can Indonesia achieve universal health coverage? Organisational and financing challenges in implementing the national health insurance system. SSM - Heal Syst. 2025 Dec;5:100138.
?Cheng Q, Fattah RA, Susilo D, Satrya A, Haemmerli M, Kosen S, et al. Determinants of healthcare utilization under the Indonesian national health insurance system – a cross-sectional study. BMC Health Serv Res. 2025 Dec 1;25(1).
?Hasibuan SR. Behavioral determinants of retention in Indonesia’s national health insurance: a retrospective cohort study of informal workers. Ber Kedokt Masy [Internet]. 2026 Mar 31;e28542. Available from: https://journal.ugm.ac.id/v3/BKM/article/view/28542
?Wulandari RD, Laksono AD, Mubasyiroh R, Rachmalina R, Ipa M, Rohmah N. Hospital utilization among urban poor in Indonesia in 2018: is government-run insurance effective? BMC Public Health. 2023 Dec 1;23(1).
DOI: https://doi.org/10.32502/sm.v17i1.11138
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Syifa Medika: Jurnal Kedokteran dan Kesehatan
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