Health insurance service model on the basis of patient-centered care: a scoping review

Moh Ali Imron; Andari Wuri Astuti; Hilmi Zadah Faidullah; Wantonoro; Siti Fatimah; Khaterina Kristina Manurung; Maya Febriyanti; Dedy Revelino Siregar; Wan Aisyah Baros

doi:10.31101/jhtam.3607

Authors

Moh Ali Imron Faculty of Health Sciences, Universitas Aisyiyah Yogyakarta, Indonesia
Andari Wuri Astuti Universitas Aisyiyah Yogyakarta, Indonesia https://orcid.org/0000-0003-3643-4022
Hilmi Zadah Faidullah Faculty of Health Sciences, Universitas Aisyiyah Yogyakarta, Indonesia
Wantonoro Faculty of Health Sciences, Universitas Aisyiyah Yogyakarta, Indonesia
Siti Fatimah Universitas Muhammadiyah Banjarmasin, Indonesia
Khaterina Kristina Manurung BPJS Kesehatan, Indonesia
Maya Febriyanti BPJS Kesehatan, Indonesia
Dedy Revelino Siregar BPJS Kesehatan, Indonesia
Wan Aisyah Baros BPJS Kesehatan, Indonesia

DOI:

https://doi.org/10.31101/jhtam.3607

Keywords:

patient-centered care;

Abstract

Health insurance provides access to every color of the country to get access to health services in the form of promotive, preventive, curative, and rehabilitative efforts at affordable costs. Integrated health services that focus on patient needs (patient-centered care) will increase the active role of families and communities in making decisions related to health services to be provided and are often associated with health financing and insurance used. This Scoping review aims to explore and map the scientific evidence related to the health insurance model in patient-centered care-based health services. This study uses Arkshey & O'Malley Framework and PRISMA-ScR Checklist. In the identification of articles used using PubMed, EBSCO, ProQuest, Wiley Online Library, and Grey supporting literature such as Google Scholar and appropriate databases. The article inclusion criteria used in the search are primary articles in 2012-2022, articles from relevant Gray literature and databases, scientific articles in English and/ or Indonesian, and scientific articles that focus on the health care insurance model and patient-centered care-based health services. While the exclusion criteria used are articles in the form of guidelines, standard operating procedures, opinion papers, reviews, commentaries, research articles that do not use English and Indonesian, and research articles that focus on medicine-centered care are not included in this review. The keywords used are patient-centered care and health insurance. Assessment of Article quality using the Critical Appraisal Skills Program (CASP) and Joanna Bridge Institute Tools (JBI). A total of 6,388 articles were selected and 14 articles were reviewed. Research articles were reviewed from 8 countries with 12 articles using quantitative research design and 2 articles using qualitative research design. From the review article, the author identified 2 main themes, namely the use of health insurance and the application of patient-centered care. Patient satisfaction among Health Insurance users is higher than patients who do not use health insurance because health insurance provides financial protection for health services. The use of health insurance based on patient-centered care is expected to provide positive benefits to health services such as improving patient healing, reducing unnecessary actions/ care, and reducing the length of hospital treatment so that it is expected to reduce the financing made by patients and health insurance used.

Author Biography

Andari Wuri Astuti, Universitas Aisyiyah Yogyakarta

Google Scholar URL Scopus ID 57211968612

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