Factors associated with antenatal care utilization among national health insurance participants in North Maluku: An analysis of BPJS Kesehatan sample data

Vollständiger Abstract

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Background: Maternal mortality remains a public health concern in North Maluku. Antenatal care (ANC) is essential for early risk detection, but the utilization recorded in health insurance claims may vary according to participant and healthcare-system characteristics. Objective: To analyze factors associated with recorded ANC utilization among National Health Insurance (JKN) participants in North Maluku using BPJS Kesehatan Sample Data. Methods: This cross-sectional secondary-data study used the 2025 BPJS Kesehatan Sample Data, with healthcare claims from 2021–2024. Total sampling included 179 eligible JKN participant–delivery episodes. Recorded ANC utilization was defined as the number of unique primary healthcare facility service dates coded Z32–Z36 within 280 days before an indexed delivery coded O80–O84 and was categorized as