Standard Inpatient Class Financing from the Perspective of Equity and Financial Sustainability
DOI:
https://doi.org/10.59261/jlsp.v4i4.284Keywords:
Standard Inpatient Class (KRIS), Equity, Financial Sustainability, National Health Insurance, Single Standard Inpatient Financing ModelAbstract
Background: The implementation of the Standard Inpatient Class (Kelas Rawat Inap Standar/KRIS) under Presidential Regulation No. 59 of 2024 represents a major reform of Indonesia’s National Health Insurance (JKN) system aimed at improving equity in inpatient healthcare services. However, challenges remain, including disparities in hospital readiness, persistent variations in service delivery, and concerns regarding the long-term financial sustainability of the health financing system.
Objective: This study aims to examine KRIS financing from the perspectives of equity and financial sustainability and to propose a financing model that balances these two principles.
Methods: This normative legal study employed statutory, conceptual, and comparative approaches. The analysis was supported by policy evidence, including data on National Health Insurance Fund performance, hospital readiness, and compliance with KRIS service standards. A functional comparison was conducted with Germany’s social health insurance system and tax-funded financing models, focusing on risk pooling, entitlement, strategic purchasing, and fiscal responsibility.
Results: The findings indicate that KRIS has not yet fully achieved substantive equity because access to standardized inpatient services remains influenced by differences in hospital capacity and readiness. Moreover, the infrastructure requirements associated with KRIS place additional financial pressure on the sustainability of health financing. This study proposes the Single Standard Inpatient Financing Model, which integrates ability-to-pay principles, need-based benefits, national risk pooling, strategic purchasing, and shared fiscal responsibility.
Conclusion: The proposed model positions the Single Standard Inpatient Class as the foundation for equitable inpatient healthcare delivery by improving access, financing efficiency, and the long-term sustainability of Indonesia’s National Health Insurance system.
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