MAKASSAR, Indonesia Apr 14 2026/NMHEALTHCARE/ – Having health insurance is often seen as a guarantee of better healthcare. But is access alone enough? A recent study reveals that even insured patients may not always receive the quality of care they deserve.
The article titled “Healthcare Quality Received by Insured Patients in Two Indonesian Regional Public Hospitals”, published in the journal Public Health of Indonesia by Sage in June 2024, explores this important issue . The study analyzed hospital data from 2019 to 2020 to evaluate how well insured patients were treated in two regional public hospitals in Indonesia.
At first glance, the findings seem reassuring. Most patients were discharged with a doctor’s approval, and hospital stays generally followed expected durations. However, a deeper look reveals several hidden problems that affect healthcare quality.
One major concern is the variation in length of hospital stay among patients with the same diagnosis. Some patients stayed longer than necessary, while others were discharged too early. This inconsistency suggests that care is not always standardized. In healthcare, consistency is critical—patients with similar conditions should receive similar treatment plans.
Another important issue is the rate of hospital readmission within 30 days. Ideally, this rate should be very low, indicating that patients were properly treated before discharge. However, the study found that readmission rates in both hospitals exceeded the recommended standard. This means some patients had to return to the hospital shortly after leaving, which may indicate incomplete treatment or poor follow-up care.
The study also highlights that more than 60% of patients were treated in third-class wards. This reflects the reality that most insured patients come from lower-income groups. While Indonesia’s national health insurance system (BPJS) has improved access to healthcare, ensuring equal quality across all patient groups remains a challenge.
These findings are closely connected to SDG 3: Good Health and Well-being, which emphasizes not only access to healthcare but also the quality and safety of services. Providing insurance is an important step, but it must be accompanied by high-quality care that is safe, effective, and consistent.
So, what is the solution? The researchers recommend implementing Integrated Clinical Pathways (ICP). This approach standardizes patient care by outlining clear steps for diagnosis, treatment, and follow-up. By using ICP, hospitals can reduce unnecessary variations in care, shorten hospital stays, and lower readmission rates.
In addition, better coordination among healthcare professionals—especially nurses, doctors, and administrators—is essential. Strong teamwork ensures that patients receive continuous and well-planned care from admission to discharge.
In conclusion, this study reminds us that healthcare is not just about access, but also about quality. Insurance alone cannot guarantee good outcomes if the care provided is inconsistent or incomplete. To truly achieve SDG 3: Good Health and Well-being, Indonesia must focus on improving the quality of healthcare services for all patients, regardless of their economic status.
Reference:
DOI : https://doi.org/10.1177/08980101241229481
Contact:
Prof. Rini Rachmawaty, S.Kep., Ns., MN, PhD
0812 1391 6730
