Dinamika model kepesertaan BPJS Kesehatan dan perhitungan premi terhadap segmen kepesertaan = A dynamic model of BPJS kesehatan participation and premium calculation for participation types

Isabel, Laurencia (2020) Dinamika model kepesertaan BPJS Kesehatan dan perhitungan premi terhadap segmen kepesertaan = A dynamic model of BPJS kesehatan participation and premium calculation for participation types. Bachelor thesis, Universitas Pelita Harapan.

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Abstract

BPJS Kesehatan merupakan jaminan sosial kesehatan dari pemerintah bagi masyarakat Indonesia yang terbagi menjadi tiga segmen kepesertaan. Penelitian ini bertujuan untuk membangun dinamika model kepesertaan BPJS Kesehatan dan besaran premi yang sesuai berdasarkan data sampel klaim. Parameter model diestimasi dari data populasi peserta tahun 2014-2018 dengan menggunakan R-package Flexible Modelling Environment (FME) dan solusi model dihitung dengan metode Runge Kutta. Hasil yang diperoleh berupa estimasi populasi jumlah peserta BPJS Kesehatan setiap segmen tahun 2014-2044 yang digunakan untuk menghitung besaran premi yang dibutuhkan. Perhitungan premi setiap segmen peserta dihitung secara parametrik dengan model risiko agregat dan prinsip standar deviasi Buhlmann. Dengan data sampel BPJS Kesehatan, frekuensi klaim dalam periode bulan memiliki model terbaik negatif binomial dan lognormal untuk besaran klaim per kunjungan setiap segmen. Perhitungan premi dilakukan dengan dua skenario yang berbeda yaitu dengan asumsi nol-klaim dan tanpa nol-klaim. Hasil yang didapatkan dari dua skenario tersebut dapat menggambarkan besaran premi yang sesuai untuk data sampel dalam berbagai proporsi peserta. Hasil dari penelitian ini didapatkan jumlah populasi peserta BPJS Kesehatan naik secara signifikan hingga tahun 2044 dan jumlah peserta tersebut berpengaruh terhadap besaran premi yang tepat untuk setiap periode. Secara keseluruhan, hasil prediksi premi yang didapatkan hanya dapat menggambarkan estimasi yang dapat terjadi berdasarkan data sampel. / Indonesian National Health Insurance (JKN) is a social health insurance prepared by the government for the Indonesian people. JKN participation number is divided into 3 segments namely PBI, PPU, and Mandiri and they are an important aspect in the implementation of JKN. This thesis will discuss the dynamic model of JKN or BPJS Kesehatan participation number and the estimated premium based on the number of participation and data claim. The parameters of the model are estimated from the population data of each segment from 2014-2018 using R-package Flexible Modelling Environment and the solution is calculated using Runge Kutta method. As a result, the estimated number of JKN participation for each segment until 2044 is obtained. The number of participation is used to calculate the exact premium amount based on the sample data from BPJS Kesehatan. To model the data claims, parametric model is utilized to calculate the premium of each segment with aggregate risk model and Buhlmann standard deviation principle. From the sample data, negative binomial is the best model for frequency or number of claims for each month and lognormal for severity claims, the amounts of claims per visit. There are two scenarios for the premium calculation, with zero claim and without zero claim. As a result, the lower and upper limit for premium needed every period is obtained. In conclusion, from the dynamic model solution, the number of BPJS Kesehatan participants increased significantly and it affect the amount of the right premium each period based on data. The conclusions obtained in this thesis for the dynamic model can be justified for the Indonesian population. However, for the premium prediction of each segments can only be justified for the sample data from BPJS Kesehatan.

Item Type: Thesis (Bachelor)
Creators:
CreatorsNIMEmail
Isabel, LaurenciaNIM00000026134isabelsuwanda@yahoo.co.id
Contributors:
ContributionContributorsNIDN/NIDKEmail
Thesis advisorSaputra, Kie Van IvankyNIDN0401038203kie.saputra@uph.edu
Thesis advisorMargaretha, HelenaNIDN0312057504helena.margaretha@uph.edu
Uncontrolled Keywords: BPJS Kesehatan; persamaan diferensial biasa; markov chain monte carlo; runge kutta; model risiko agregat; prinsip standar deviasi Buhlmann
Subjects: Q Science > QA Mathematics
Divisions: University Subject > Current > Faculty/School - UPH Karawaci > Faculty of Science and Technology > Mathematics
Current > Faculty/School - UPH Karawaci > Faculty of Science and Technology > Mathematics
Depositing User: Users 5961 not found.
Date Deposited: 16 Jul 2020 06:27
Last Modified: 16 Jul 2020 06:27
URI: http://repository.uph.edu/id/eprint/9298

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