Title: A system dynamic to reforming of the healthcare sector in the Indonesian National Health Insurance System Program

Authors: Diva Kurnianingtyas; Budi Santosa; Nurhadi Siswanto

Addresses: Department of Industrial and Systems Engineering, Faculty of Industrial Technology and Systems Engineering, Institut Teknologi Sepuluh Nopember, Kampus ITS Sukolilo, Surabaya, 60111, Indonesia ' Department of Industrial and Systems Engineering, Faculty of Industrial Technology and Systems Engineering, Institut Teknologi Sepuluh Nopember, Kampus ITS Sukolilo, Surabaya, 60111, Indonesia ' Department of Industrial and Systems Engineering, Faculty of Industrial Technology and Systems Engineering, Institut Teknologi Sepuluh Nopember, Kampus ITS Sukolilo, Surabaya, 60111, Indonesia

Abstract: National Health Insurance System (NHIS) was established by the Indonesian Government to ensure the health needs of its people. However, the programme encountered many obstacles due to inefficiencies caused by changes in people's behaviour. The aim is to identify key factors, evaluate and plan further policies using Indonesian data from 2014 to 2018. The system's dynamics approach is used to build a model for determining policy alternatives that only focuses on referral reform and limiting health service coverage. The proposed model was proven correct and then implemented in 2019 to plan a policy solution. The result was limiting healthcare coverage as a short-term strategy, whereas changing tiered referrals to combined referrals could be considered a long-term strategy. However, the success of this strategy will only occur if there is good collaboration between health services and regulations. In addition, it is necessary to improve the structure of healthcare.

Keywords: system dynamics; simulation; National Health Insurance System; NHIS; patient referral mechanism; financial strategy.

DOI: 10.1504/IJISE.2022.127423

International Journal of Industrial and Systems Engineering, 2022 Vol.42 No.4, pp.452 - 477

Received: 06 Feb 2020
Accepted: 17 Feb 2021
Published online: 05 Dec 2022 *

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