Appendix Irma

Health promotion is a critical tool for enhancing community health and ensuring equitable access to quality health services. In Indonesia, the BPJS (Badan Penyelenggara Jaminan Sosial) health insurance system plays a pivotal role in providing healthcare to millions. However, the effective utilization of health services by BPJS participants remains a challenge. Our study seeks to bridge this gap by assessing the impact of health promotion on the utilization of health services among BPJS health participants, with a particular focus on the roles of perception, self-efficacy, and social support. Using a quantitative research design, we conducted a study involving 500 BPJS health participants at RSUD Prof. Dr. Margono Soekarjo Hospital in Purwokerto. Data were collected through comprehensive questionnaires and supplemented by secondary data reflecting the hospital’s history, vision, and mission. We employed Structural Equation Modeling (SEM) using the AMOS application to analyze the relationships among health promotion, perception, self-efficacy, social support, and health service utilization. Our findings indicate that health promotion has a significant direct effect on health service utilization behavior and an indirect effect mediated by perception. Notably, perception directly influences self-efficacy, which subsequently impacts service utilization. Social support emerged as a crucial factor, directly affecting service utilization and shaping outcome expectations through perception, although it did not mediate service utilization through perception or outcome expectations. Interestingly, self-efficacy did not significantly mediate the relationship between outcome expectations and service utilization. These results underscore the importance of designing health promotion strategies that enhance perception and self-efficacy among BPJS participants, while also leveraging social support to optimize health service utilization. Our study contributes valuable insights into the development of more effective health promotion models that can improve healthcare access and outcomes for BPJS participants