Does the implementation of national health insurance affect the workload of a doctor and have an impact on service quality? A systematic literature review

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Tri A. Sugiyatmi *
Usman Hadi
Djazuli Chalidyanto
Firdauz Hafidz
Muhammad Miftahussurur
(*) Corresponding Author:
Tri A. Sugiyatmi |


National Health Insurance (NHI) was originally a health financing reform that eventually became a ‘driver’ for changes in all health care sectors. The burden on doctors in health facilities is likely to increase due to its changes in standard fees for medical services. This study aimed to describe NHI system changes that will affect doctor’s professionalism. This is a systematic review taken from MEDLINE complete of EBSCOhost research database. The search period range covered between 1983 to October 19 2018. The results revealed 853 unique citations which globally stated about the potential impact of NHI implementation on doctors. The majority studies indicate that there is a relationship of the implementation of NHI, workload of doctors and quality of health care service. It can be concluded that NHI implementation requires a large quantity of human resources, especially doctors. Therefore, doctors are advised to adapt to their role and function in this era of NHI.

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