| Summary: | Background: Service agency of Sintesa Community Health Care Insurance Kendari was founded as community health insurance agency at Kendari City. At the begining the agency attracts people to become participants of health care insurance but due to some reasons the number of participants decline.
Objective: The study was aims to identify factors leading to opting out and continuation as member of community health care insurance agency.
Methods: The study was a qualitative and quantitative type. The qualitative method was applied to 3 groups (22 people) of focus group discussion, two groups of which consisted of those who opted out from their participation and one group consisted of those who continued their participation in the insurance, followed by indepth interview with 4 respondents who opted out and 2 respondents who were active participants the topics for study are premium issues, perception of being ill, health care packages, health services at health centers and the professionalism of service agency. The discussion and interview were recorded, transcripts were compiled and open coding was conducted.
Results: Most respondents, both who resigned and were active participants, worried about the cost of being ill. Most participants who resigned said that premi was too high and that they were dissatisfied with health care packages. Most participants, either those who opted out or those who were still active said that health service at health centers was unsatisfactory and the professionalism of service agency was low. Active participants had more knowledge about community health care insurance than those who resigned. Factors leading to decision of opting out from participation were the absence of premi collector, temporary cancellation of premi collection, unawareness of the functioning of community health care insurance, and distrust toward service agency. Factors leading to active participation were benefits of having the insurance when participants were ill, satisfaction with health care packages and the fact that participants had no other health insurance.
Conclusion: High premi, unsatisfactory health service at health centers and health care packages, as well as low professionalism of service agency were factors leading to decision of opting out from the insurance. Consequently there was declining number of community health care insurance participants at Sintesa service agency.
Keywords: community health care insurance, resigned an active participant
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