Understanding Continuance Intention toward Indonesia’s National Health Insurance Mobile Application (Mobile JKN): Integrating Innovation Resistance and UTAUT Perspectives

Abstract

Digital transformation in public healthcare has accelerated the development of mobile service platforms designed to enhance accessibility, efficiency, and transparency. In Indonesia, Mobile JKN was introduced as a national digital innovation to support the National Health Insurance system. Despite extensive population coverage, active application usage remains substantially lower than total membership, indicating challenges in sustaining digital engagement. This study examines the determinants of continuance intention and its impact on word-of-mouth (WOM) and intention to recommend among Mobile JKN users. Drawing on Innovation Resistance Theory (IRT) and selected UTAUT constructs, this study proposes a hybrid framework incorporating usage barriers, value barriers, traditional barriers, performance expectancy, effort expectancy, social influence, and facilitating conditions as predictors of continuance intention. Continuance intention, the user’s intention to continue using a service or product, is modeled as a mediator that influences word-of-mouth (WOM) and recommendation behavior. Using a quantitative causal-explanatory design and Partial Least Squares Structural Equation Modeling, the findings indicate that value and traditional barriers significantly reduce continuance intention, while enabling factors enhance sustained usage. Continuance intention positively influences WOM and intention to recommend. This study extends IRT into digital public healthcare contexts and provides strategic insights for policymakers seeking to enhance digital service retention and citizen advocacy.