The strategic role of the Universal Health Coverage (UHC) to improve national health insurance participants satisfaction, health service provider satisfaction, and quality of primary services in Badung Regency, Indonesia

This study aims to determine the satisfaction of the Indonesian National Health Insurance (JKN) participants before and after Universal Health Coverage (UHC), the effect of UHC on the satisfaction of JKN participants, health service providers, and achievement of JKN primary health service quality in Badung Regency. This study was a survey with a cross-sectional design. The sample of this study were 71 Primary Health Facilities (PHF) and one Hospital and JKN participants from 62 villages. The variables studied included participant satisfaction, JKN Health service provider satisfaction and achievement of primary service quality. Research data were collected from July 2017, January 2018 and January 2019, then analyzed using the Wilcoxon Test. The results of this study indicate that there was an increase in participant satisfaction with PHF from 51.2 to 98.3 before and after the UHC. There was an increase in JKN Participants' satisfaction with BPJS Kesehatan services from 67.6 to 93.2 before and after the UHC. There is a difference in the average satisfaction of the Health Facilities for BPJS Kesehatan services (P = 0.001). There is a difference in the average achievement of Based-Commitment Services (KBK) of PHF in Badung (P = 0,000). In conclusion, UHC has an effect on increasing the satisfaction of JKN participants and health service provider satisfaction and has an effect on increasing quality of primary service quality. The policy implication of this research is to improve the performance of quality health services by PHF, making PHF prosperous, and optimizing participants registered at PHF.