FACTORS INFLUENCING THE UTILIZATION OF HEALTH SERVICES BY NATIONAL HEALTH INSURANCE PARTICIPANTS AT THE BATANG KUIS COMMUNITY HEALTH CENTER
Indonesia Indonesia Indonesia 
Article Sidebar
-
Andersen’s Theory, Health Centers, JKN, Utilization of Health Services
Abstract
Universal Health Coverage in Deli Serdang Regency has reached 98.6%. However, JKN participant activity and primary health care utilization in several areas remain below the national target. At UPT Puskesmas Batang Kuis, JKN utilization by participants has reached only 67.2% of total users. This study modifies Andersen’s theoretical model by incorporating contemporary digitalization indicators (use of the Mobile JKN application and digital queue system) within the knowledge assessment instrument. It aims to analyze factors associated with health service utilization among JKN participants. This quantitative study used a cross-sectional design with 96 respondents selected through simple random sampling. Data were collected using a structured questionnaire tested for validity and reliability, then analyzed using the chi-square test and binary logistic regression. Univariate analysis showed that 51.0% of respondents utilized health services. Individual assessment of the health center was the dominant factor (Exp(B)=13.741). Positive attitudes, family support, and good perceptions of facility quality were the main determinants, while knowledge alone was insufficient. Health centers should improve physical service quality, staff responsiveness, and medicine availability.
Full text article
References
Alkhawaldeh, A., ALBashtawy, M., Rayan, A., Abdalrahim, A., Musa, A., Eshah, N., Khait, A. A., Qaddumi, J., Khraisat, O., & ALBashtawy, S. (2023). Application and Use of Andersen’s Behavioral Model as Theoretical Framework: A Systematic Literature Review from 2012–2021. Iranian Journal of Public Health. https://doi.org/10.18502/ijph.v52i7.13236
Adriyani, R., Widati, S., & Lestari, R. (2023). Collective decision-making in health-seeking behavior among rural communities in Indonesia. *Journal of Public Health Research*, 12(2), 145-154. https://doi.org/10.1177/22799036231174521
Americans, S., & Indians, A. (2005). Societal and Individual Determinants of Medical Care Utilization in the United States . 83 (4), 1–28. https://doi.org/10.1111/j.1468-0009.2005.00428.x
Arimbi, D. (2022). Opportunities and Challenges in National Health Insurance in Indonesia: A Policy Study. Indonesian Journal of Health Policy , 11 (1). https://doi.org/10.22146/jkki.70231
Arruan, A., & Amiruddin, F. (n.d.). Factors Associated with the Utilization of Health Services by JKN-KIS Participants in the Kondodewata Community Health Center Working Area, Tana Toraja Regency . https://doi.org/10.55197/qjmhs.v4i2.140
Azzopardi, P. S., Kennedy, E. C., & Patton, G. C. (2021). Gender, maternal health, and primary care utilization in Southeast Asia: A developmental perspective. *The Lancet Regional Health - Western Pacific*, 15, 100234. https://doi.org/10.1016/j.lanwpc.2021.100234
Bappenas, K. P. (2020). STRATEGI KOMUNIKASI Tujuan Pembangunan Berkelanjutan/Sustainable Development Goals. TPB/SDGs. https://doi.org/10.1093/heapol/czad104
Cheng, L., Zhou, Y., & Wang, X. (2025). Determinants of healthcare utilization under the Indonesian national health insurance system – a cross-sectional study. *BMC Health Services Research*, 25(1), 48-62. https://doi.org/10.1186/s12913-025-12014-4
Dwicaksono, A., Nadjib, M., & Mahendradhata, S. (2022). Financial protection and out-of-pocket expenditure among subsidized national health insurance participants in Indonesia. *International Journal for Equity in Health*, 21(1), 89-101. https://doi.org/10.1186/s12939-022-01691-x
Fatimah, S., & Indrawati, F. (2019a). Factors in Utilizing Health Services at Community Health Centers. HIGEIA JOURNAL OF PUBLIC HEALTH , 3 (1), 121–131. https://doi.org/10.20473/jaki.v7i2.2019.145-152
Fatimah, S., & Indrawati, F. (2019b). Factors in Utilization of Health Services at Community Health Centers . https://doi.org/10.20473/jaki.v7i2.2019.145-152
Handayani, T., & Pratama, R. (2023). Stigma and perceptions of discrimination in national health insurance services in community health centers outside Java. Indonesian Journal of Health Policy, 12(1), 12-21. https://doi.org/10.22146/jkki.v12i1.6710
Irawan, B., & Ainy, A. (2018). Analysis of factors related to the utilization of health services among National Health Insurance participants in the Payakabung Community Health Center working area, Ogan Ilir Regency. Journal of Public Health Sciences, 9(3), 189–197. https://doi.org/10.26553/jikm.2018.9.3.189-197
Ismah, Z., Arrazy, S., Hasibuan, R., Purnama, TB, & Ashar, YK (2024). Health Data Management and Analysis Practicum MODULE Revised Edition 2024. https://doi.org/10.22435/jbk.v8i2.6102
Jauhar, A. (2025). ANALYZING THE FACTORS INFLUENCING PUBLIC VS PRIVATE HELTHCARE UTILIZATION UNDER JKN PROGRAM IN INDONESIA. Quantum Journal of Medical and Health Sciences , 4 (2), 78–85. https://doi.org/10.55197/qjmhs.v4i2.140
Juniasti, HT, Batmanlusi, K., & Zamuli, H. (2025). Optimizing UHC (Universal Health Coverage) Coverage Through JKN (National Health Insurance) Education and the Use of the JKN Mobile Application . 5 (1), 887–893. https://doi.org/10.1002/hpm.3912
Lende, DN, Sirait, RW, & Dodo, DO (2021a). Public Health Media for National Health Insurance Participants in the Work Area of Public Health Media . 3 (1), 19–28. https://doi.org/10.35799/kesmas.v10i4.34190
Lende, DN, Sirait, RW, & Dodo, DO (2021b). Utilization of Individual Health Efforts (UKP) by National Health Insurance Participants in the Tarus Community Health Center Work Area. Public Health Media , 3 (1), 19–28. https://doi.org/10.35799/kesmas.v10i4.34190
Maharani, D., Haeruddin, Ahri, RA, Muchlis, N., & Andayanie, E. (2024). Factors related to the utilization of health services by BPJS participants in Mappedeceng District. Window of Public Health Journal, 5(1), 139–152. https://doi.org/10.32832/pro.v5i3.6165
Mulyadi, A., Setiawan, B., & Harahap, R. (2023). Univariate and multivariate determinants of national health insurance utilization in rural communities in North Sumatra. *Journal of Community Health Epidemiology*, 8(1), 74-83. https://doi.org/10.14710/jekk.v8i1.15611
Nasution, FS, Rahmah, LA, Youlanda, R., & Pramita, F. (2023). LITERATURE REVIEW: ANALYSIS OF FACTORS RELATED TO HEALTH IN NATIONAL HEALTH INSURANCE PARTICIPANTS . 4 (September), 2962–2967. https://doi.org/10.21109/phri.v19i2.6450
Nasution, FS, Rahmah, LA, Youlanda, R., & Pramita, F. (2023). LITERATURE REVIEW: ANALYSIS OF FACTORS RELATED TO HEALTH IN NATIONAL HEALTH INSURANCE PARTICIPANTS . 4 (September), 2962–2967. https://doi.org/10.21109/phri.v19i2.6450
Peruzzo, E., Vainieri, M., & Rosis, S.D. (n.d.). Enhancing Learning Systems in Using Patient Experience Data: An Exploratory Mixed?Method Study in Two Italian Regions . https://doi.org/10.1186/s12875-024-02311-1
Putri, SA, & Asyari, DP (dt). Factors Associated with the Utilization of Health Services in BPJS Patients at the Air Tawar Community Health Center in 2025 . https://doi.org/10.59431/gjik.v4i1.352
Putri, SA, & Asyari, DP (2026). Factors Associated with the Utilization of Health Services in BPJS Patients at the Air Tawar Community Health Center in 2025. Gudang Jurnal Ilmu Kesehatan , 4 , 121–128. https://doi.org/10.59431/gjik.v4i1.352
Rizqi, C., Saputro, A., & Fathiyah, F. (2022). Universal Health Coverage: Internalization of Norms in Indonesia . 2 (2), 204–216. https://doi.org/10.22146/jkki.v11i2.54120
Rumengan, DSS, Umboh, JML, & Kandou, GD (2015). Factors Associated with the Utilization of Health Services among BPJS Kesehatan Participants at the Paniki Bawah Community Health Center, Mapanget District, Manado City . https://doi.org/10.35790/jkkt.v8i1.28911
Salsabila, AZ, Setianingsih, LE, Studi, P., Administrasi, S., Kesehatan, FI, & Suherman, UM (2024). Utilization of health services for national health insurance participants at the Cikarang Community Health Center 1,2 . 01 (01), 9–17. https://doi.org/10.7454/arsi.v10i1.4891
Septiana, W., Azizah, SN, Wasir, R., & Depok, K. (2024). Challenges and Opportunities in Achieving Universal Access to Quality Health Services in Indonesia (Literature Review) . 2 (3). https://doi.org/10.22146/jmpk.v27i3.9103
Singal, HI V, Kandou, GD, & Rumayar, AA (2018). The Relationship Between Knowledge, Attitude, and Income with the Utilization of Community Health Centers by the Kima Bajo Village Community, Wori District. Jurnal Kesmas , 7 (5). https://doi.org/10.35799/kesmas.v7i5.22104
Sinthya Wulandari, LP (2025). Utilization Review of National Health Insurance: Implementation, Challenges, and Essential Components. Indonesian Journal of Health Economics , 10 (2). https://doi.org/10.7454/eki.v10i2.1153
Sumpeno, SJ, Raniah, S., & Gurning, FP (2025). Factors influencing BPJS utilization in health services at Community Health Centers (Literature Review). Collaborative Journal of Science, 8(7), 4706–4712. https://doi.org/10.56338/jks.v8i7.8278
Stiyawan, Y., & Ainy, A. (2023). Utilization of Health Services by National Health Insurance Participants in Jejawi District. Journal of Health Management, Dr. Soetomo Hospital Foundation, 9(1), 163–175. https://doi.org/10.29241/jmk.v9i1.1427
Utami, TN, Arrazy, S., & Wahyudi. (2025). RESEARCH METHODS . https://doi.org/10.17605/OSF.IO/EG42K
Yoharani, M., Noerjoedianto, D., & Wardiah, R. (2022). Determinants of Health Service Utilization for Participants of the National Health Insurance (JKN) PBI Group in Jambi City in 2021. 6 ( 2), 294–301. https://doi.org/10.14710/jekk.v7i2.13901
Authors
Copyright (c) 2026 Riska Ananda, Fitriani Pramita Gurning, Eliska Eliska
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
