| Abstrak/Abstract |
Background: To improve healthcare access to remote areas, telemedicine services were introduced a few years ago in
Indonesia. Although the services have been introduced in many areas, they were not part of the national health insurance
program. In 2019, there has been an initiative to integrate those services with the national health insurance scheme. The
objectives of this study are to integrate telemedicine services under the national health insurance scheme and to
evaluate the potential efficiency.
Methods: A mixed-method design with quantitative and qualitative approaches was used in this study. Primary data
were collected using questionnaires and focus group discussions with respondents from multiple stakeholders. Secondary data was collected from hospital claims from 2016 to 2018 in 11 areas of national health insurance regions.
Results: The survey showed that 63.0% (n=346) respondents had ever used telemedicine applications and were
perceived to save time and improve access; 80.0% perceived that telemedicine is an adequate substitution for faceto-face visits, and 72.0% agreed that telemedicine is as good as face-to-face visits. Between 19.0% and 21.0% of
telemedicine consultations still require referral to higher-level health facilities for further examination and treatment. This
finding suggests that telemedicine -without proper quality and cost control- may cause additional expenses from a
payer’s point of view. Furthermore, the data analysis showed a potential reduction in health care costs if
telemedicine is used, even after adjusting for potential 20.0% supply-induced demand.
Conclusion: Telemedicine has an opportunity to become one of the benefits of the national health insurance
program. |
