Asthma in Indonesia's National Health Insurance (JKN)

Executive summary

This report describes how people with asthma use Indonesia's National Health Insurance scheme (JKN), using the BPJS Kesehatan Sample Data for 2015 to 2024. It covers served disease burden across ages, the trend in preventable exacerbation admissions, hospital setting and inpatient mortality, comorbidity, the cost of care, and the gap between the population served and asthma prevalence in the community.

All population figures are survey-weighted national projections from the household sample and describe the population that is served by JKN, not the true prevalence in the whole population. Asthma is often managed with over-the-counter medicines or outside JKN, so claims under-state the true burden. A community comparison using the 2023 Indonesia Health Survey is provided as context, and cost figures are verified-paid claim values, not official budget realisation.

Questions this report answers

• How many people with asthma are served by JKN, and across which ages does the burden fall?
• How often do preventable asthma exacerbations lead to hospital admission, and is that trend improving?
• What is inpatient mortality from asthma, and how does it rise with age?
• How much does asthma cost the scheme, and how large is the gap between served patients and community prevalence?

Key findings

• In 2024 about 1,209,379 people with asthma were served by JKN, around 435 per 100,000 members, after a dip during the pandemic years and a recovery to the highest level in the period.
• Asthma is a burden across the life course with a heavy weight on children and young adults: about 19 percent of patients are aged 0 to 14 years and most others are young adults aged 15 to 44, a different age profile from chronic obstructive lung disease.
• Preventable exacerbation admissions rose sharply, from 982 sample claims in 2015 to 2,840 in 2024, a national projection of about 252,421 admissions in 2024, pointing to outpatient asthma control that is not yet optimal.
• Inpatient case fatality was about 1.7 percent overall but climbed steeply with age, reaching about 4.5 percent at 65 years and older, with a 30 day readmission rate of about 3.7 percent.
• Atopic and cardiorespiratory conditions accompany asthma: allergic rhinitis, acute respiratory infection, and pneumonia are common, while hypertension and diabetes appear among adults.
• Total asthma cost reached about Rp 7 trillion over 2015 to 2024 (verified-paid claims), and diagnosed asthma in the community was about 1.6 percent of the population in the 2023 Indonesia Health Survey, roughly 5 million people, far above the number served in JKN and indicating a gap in access and management.