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INDONESIA
Jurnal Ekonomi Kesehatan Indonesia
Published by Universitas Indonesia
ISSN : 25278878     EISSN : 25983849     DOI : 10.7454
Jurnal Ekonomi Kesehatan Indonesia, Jurnal EKI, presents scientific writings on information and updates of health economic in collaboration with Centre for Health Economic and Policy Studies (CHEPS) Universitas Indonesia and INAHEA (indonesian Health Economic Association). Jurnal EKI is published four times (four number) annually (per volume) in two languages (Bahasa Indonesia and English) electronically and printed. It includes research findings, case studies, and conceptual fields, namely: health economic, health insurance, health administration/policy, pharmaco-economic, and Health Technology Assessment (HTA).
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Articles 103 Documents
Biaya Satuan dan Pemulihan Biaya (Cost Recovery Rate) Layanan Pasien Acute Coronary Syndrome dengan Rawat Inap di Rumah Sakit X Tahun 2015 Anna Aurelia; Eka Pujiyanti
Jurnal Ekonomi Kesehatan Indonesia Vol 1, No 3 (2017)
Publisher : Fakultas Kesehatan Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (345.242 KB) | DOI: 10.7454/eki.v1i3.1778

Abstract

Abstrak Rumah Sakit X merupakan salah satu rumah sakit kelas C di Jakarta Selatan yang mengalami lonjakan pasien sejak diber­lakukannya rujukan berjenjang oleh BPJS. Pasien Acute Coronary Syndrome (ACS) merupakan pasien dengan kegawatdaru­ratan medis yang membutuhkan penanganan intensif di ICU. Tujuan penelitian ini adalah menganalisis biaya pelayanan pasien ACS dengan rawat inap di RS X pada tahun 2015 menggunakan metode Activity Based Costing. Hasil penelitian menyatakan bahwa biaya satuan untuk menyelenggarakan pelayanan pasien ACS dengan rawat inap di RS X pada tahun 2015 adalah Rp 6.083.444,-. Diperoleh hasil analisis Cost Recovery Rate untuk pasien umum adalah 227.98 % dan pasien BPJS adalah 71.38 %. Disarankan agar Rumah Sakit X mengembangkan clinical pathway untuk penyakit ACS sebagai panduan tindakan dan hari rawat pasien, dan merekrut dokter tetap untuk pengendalian biaya operasional.Abstract X Hospital is a Class C Hospital in South Jakarta, which experiencing a substantial increased number of patients since the BPJS has implemented the referral system. Acute Coronary Syndrome (ACS) patient is a patient with a medical emergency require intensive treatment in the ICU. The purpose of this study was to analyze the cost for hospitalized ACS patients at X Hospital in 2015 using activity based costing. The study revealed that the unit cost of hospitalized ACS patients at X Hospital in 2015 was Rp 6.083.444,-. The Cost Recovery Rate for patients with fee-for-service was 227.98% and for BPJS patient was 71.38%. This study suggested the hospital to develop clinical pathway for ACS guidance, as well as recruiting full time doctors.
People’s Support on Sin Tax to Finance UHC in Indonesia, 2016 Hasbullah Thabrany; Zahrina Laborahima
Jurnal Ekonomi Kesehatan Indonesia Vol 1, No 1 (2016)
Publisher : Fakultas Kesehatan Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (275.547 KB) | DOI: 10.7454/eki.v1i1.1759

Abstract

AbstractIndonesia has the highest prevalence of smokers with 67% of adult males were smokers. Smoking prevalence among all adults increased sharply from 27% in 1995 to 36.3% in 2013. High consumption of cigarettes has been correlated with low price and excise of cigarettes. Experiences from other countries showed that one of the most effective way to reduce cigarette consumption is by increasing cigarette price and excise. Burden of tobacco related diseases has increased. The health burden will increase claims of JKN or Universal Health Coverage which currently has claim ratio of 115% and the quality of care remain low. The difficulties in collecting contribution from non salaried workers are blamed to contribute the deficit. Many countries have earmarked cigarette excise to supplement financing of (UHC) both in tax-funded system or in social health insurance system. The question is do people support? This study explored the possibility the people’s support to increase cigarette prices and excise to meet financial shortage of the JKN.ObjectivesThis polling conducted to explore cigarette consumption and supports of price increase to finance JKN or UHC.MethodsThis study used telephone polling conducted form December 2015 to January 2016. The sample (n=1,000) was randomly selected using systematic random by the interval of 20,000 of mobile phones numbers. Analysis is focused on how various groups support incrasing cigarette prices and excise. The final analysis is logistic regression to assess any difference in supporting the excise increase.Results and DiscussionThe polling (65.9% males and 3.3% females) showed 41.3% respondents consume 1-2 pack cig­arette per day with spending of IDR 450 – 600 thousands per month. In total, 80.3% respondents support increasing cigarette price and exice to supplement health financing of JKN. The proportion of non smokers who supported the earmarking was higher (83.4% ) compared to smokers (75.9%), but the difference is not significance in the final model. The proportion of smokers who know that cigarette is harmful reached 96.8% but the large majority of them had difficulties to quit smoking. There are plenty of room to mobilize money through increasing price and excise of cigrettes since more than 72.3% of smokers said that they would stop smoking if the price of cigarette is above IDR 50,000 per pack; far above current prices. If the prices of cigarettes are double and the excise level reaching maximum allowable levels, there is potential to increase revenue up to IDR 70 Trillion that is almost equivalent to estimate all claim of JKN in 2016. In the logistic model, all groups of respondents unanimously support increasing prices and excise of cigarettes to finance JKN.ConclusionThe prevalence of cigarette smoking is high because of prices of cigarette is relatively cheap and the excise levels have not reduced consumption. This study found that large majority (80%) of non smokers and 76% smokers supported increasing cigarette prices and excise to supplement financing for the JKN. The potential money to supplement JKN is double of the current revenue of JKN.
Determinan Variasi Klaim Penyakit Stroke Peserta Jaminan Kesehatan Nasional Rumah Sakit X Sumatera Utara Joan Xaveria Mahulae; Jaslis Ilyas
Jurnal Ekonomi Kesehatan Indonesia Vol 2, No 2 (2017)
Publisher : Fakultas Kesehatan Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (303.374 KB) | DOI: 10.7454/eki.v2i2.2147

Abstract

Abstrak Penelitian yang dilakukan oleh IHME pada tahun 2010 terkait Global Burden of Disease menunjukkan bahwa stroke merupakan penyebab kematian terbesar di Indonesia. Pembiayaan penyakit stroke oleh BPJS Kesehatan menduduki peringkat kedua terbesar setelah penyakit jantung. Penelitian ini ditujukan untuk mengetahui karakteristik dominan yang memicu variasi klaim pasien stroke rawat inap peserta JKN di RS X Sumatera Utara Penelitian ini merupakan penelitian kuantitatif dengan rancangan cross sectional dan analisis multivariat dengan uji regresi linear. Karakteristik yang dominan berhubungan dengan total klaim pasien stroke adalah kelas perawatan (p-value=0,0005), jenis kepesertaan (p-value=0,0005), lama hari rawat (p-value= 0,004), dan tingkat keparahan ( p-value = 0,0005). Abstract Refers to IHME study in 2010 about Global Burden of Disease shows that stroke is one of the highest cause of mortality in Indonesia. While the expenditure by BPJS Health for stroke is the 2nd highest after heart disease. This study aims to determine the most dominant characteristics associated with the total claims of stroke patients covered by JKN for inpatient service at X Hospital by doing multivar­iate analysis with variable linear regression method. The most significant characteristics are type of health care, type of membership, length of stay age, and level of severity. The finding shows that X Hospital is still not optimal in providing services for stroke. Some feasible efforts that can be considered are increasing the neurovascular experts and providing better diagnostic equipments in order to deliver the necessary treatment. 
Analisis Pembiayaan Program Promotif dan Preventif Pemberantasan Demam Berdarah Dengue (DBD) Bersumber Pemerintah di Kota Semarang Tahun 2013-2015 Nisa Kamila
Jurnal Ekonomi Kesehatan Indonesia Vol 2, No 1 (2017)
Publisher : Fakultas Kesehatan Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1862.677 KB) | DOI: 10.7454/eki.v2i1.1953

Abstract

AbstrakSelama tahun 2010-2014, Kota Semarang selalu termasuk dalam peringkat tiga besar Incidence Rate Deman Berdarah Dengue (DBD) di Provinsi Jawa Tengah. Penelitian ini bertujuan menganalisis pembiayaan program pemberantasan DBD bersumber pemerintah pada tahun 2013-2015 dan kesenjangan sumberdaya. Pendekatan akun biaya kesehatan (health account) digunakan untuk menelusuri pembiayaan menurut sumber, fungsi, dan penyedia layanan. Hasil studi menunjukkan bahwa total belanja program DBD bersumber APBD tahun 2013 adalah Rp. 4.018.927.020,- meningkat sebesar 101% pada tahun 2014 dan meningkat sebesar 218% pada tahun 2015. Belanja terbesar pada program pemberantasan DBD adalah untuk kegiatan surveilans epidemiologi dan pengendalian penyakit menular. Tidak terdapat kesenjangan antara ketersediaan sumber daya (berdasarkan belanja kesehatan program pemberantasan DBD) dengan kebutuhan program (berdasarkan perhitungan kebutuhan metode SPM). Disarankan agar perencanaan program lebih berfokus pada kegiatan promotif dan preventif. AbstractIn 2010–2014, Semarang was involved as the big three city with high incidence rate of dengue in Central Java province. This study aimed to analyze the financing by the local government for Dengue preventive program in 2013-2015, as well as the resources gap.The health account approach was used to analyze spending by source, function, and provider. Total local government spending for dengue in 2013 were IDR 4.018.927.020,- increased by 101% in 2014 and increased by 218% in 2015. The largest expenditure for Dengue Preventive program is epidemiological surveillance and infectious disease control. There was no gap between available resources and requires program according to SPM. The study suggested to improve planning by focusing on the direct activities such as promotive and preventive.
Analisis Upaya Rumah Sakit dalam Menutupi Kekurangan Biaya Klaim Indonesia Case Base Group (INA-CBGs) Yang Dihitung dengan Metode Activities Base Costing pada Rumah Sakit Swasta Kelas C di Kota Medan Tahun 2017 Destanul Aulia; Sri Fajar Ayu; Nur Hidayah Nasution
Jurnal Ekonomi Kesehatan Indonesia Vol 1, No 4 (2017)
Publisher : Fakultas Kesehatan Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (352.869 KB) | DOI: 10.7454/eki.v1i4.1783

Abstract

AbstrakIndonesia telah mengembangkan Sistem Jaminan Sosial Nasional (SJSN) dengan dibentuknya program Jaminan Kesehatan Nasional (JKN) yang diselenggarakan oleh Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan. Salah satu cara pembayaran pelayanan kesehatan untuk rumah sakit di era JKN adalah dengan sistem pembayaran Indonesia Case Base Groups (INACBGs), yaitu besaran pembayaran klaim oleh BPJS Kesehatan kepada rumah sakit atas paket layanan yang didasarkan kepada pengelompokan diagnosis penyakit dan prosedur. Penelitian ini bertujuan untuk menganalasis upaya-upaya yang dilakukan rumah sakit swasta untuk menutupi kekurangan biaya klaim INA-CBGs. Jenis penelitian ini deskriptif dengan pendekatan kualitatif dan kuantitatif. Kualitatif dilakukan dengan wawancara mendalam, dan kuantitatif dilakukan dengan menghitung biaya riil menggunakan metode ABC dan membandingkan dengan biaya klaim INA-CBGs, Hasil penelitian menunjukkan bahwa upaya-upaya yang dilakukan rumah sakit swasta untuk menutupi kekurangan biaya klaim INA-CBGs di antaranya memanfaatkan tenaga kesehatan dari mahasiswa yang berasal dari sekolah milik rumah sakit swasta, lamanya pemberian pelayanan, menetapkan paket pelayanan untuk pasien umum, dan menyediakan fasilitas. Disarankan kepada rumah sakit swasta untuk mengevaluasi risiko keuangan yang diterima rumah sakit dari pelayanan fisioterapi, dan mengevaluasi distribusi biaya klaim INA-CBGs untuk pelayanan fisioterapi yang sesuai dengan standar. AbstractIndonesia has developed the National Social Insurance System with the establishment of the National Health Insurance program and organized by BPJS Kesehatan. One of payment way of health services for the hospital in the era of JKN is Indonesian Case Base Group (INA-CBG’s), that is the payment of claims from BPJS to hospital on a package of services based on the packet of disease diagnosis and procedure.This study aims to analyze efforts by hospitals to cover the cost deficiency of INA CBG’s claims in Privat Hospital in Medan. This research type is descriptive with qualitative and quantitative. Qualitative is done by in-depth interview, and quantitative is done by calculating real cost and cost of INA-CBG’s claim and by Activity Based Cost method. The counting result with ABC system, The results showed that the efforts made by hospitals to cover INA-CBG’s claim cost deficits are utilizing the help of health professionals from students from private hospital schools / academies, length of service delivery, setting out service packages for general patients, and providing patient pickup facilities. Suggested to to the Hospital to evaluate the financial risks the hospital receives from services, practice student performance, and distribute the cost of INA CBG’s claims well in order to improve the quality of health services in accordance with the standards.
Perbandingan Klaim Penyakit Katastropik Peserta Jaminan Kesehatan Nasional di Provinsi DKI Jakarta dan Nusa Tenggara Timur Tahun 2014 heni wati; Hasbullah Thabrany
Jurnal Ekonomi Kesehatan Indonesia Vol 1, No 2 (2016)
Publisher : Fakultas Kesehatan Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (370.474 KB) | DOI: 10.7454/eki.v1i2.1771

Abstract

AbstrakBeberapa penyakit yang pada tingkat rumah tangga tergolong katastropik adalah gagal ginjal, kardiovaskular, kanker, thalassemia dan hemophilia. Penderita penyakit tersebut merupakan kelompok yang paling menikmati Jaminan Kesehatan Nasional (JKN) dan penyakit-penyakit tersebut menyerap klaim besar dalam JKN yang perlu mendapat perhatian serius. Karena sebaran fasilitas kesehatan dan kompetensi tenaga medis yang berbeda serta bayaran CBG yang tidak adil, disinyalir terjadi serapan dana yang tidak seimbang antara propinsi. Penelitian bertujuan untuk menganalisis besaran klaim penyakit tersebut di dua proponsi Jakarta dengan pendapatan per kapita tinggi dan NTT dengan pendapatan per kapita rendah. Penelitian ini menggunakan data klaim di BPJS Kesehatan tahun 2014 yang berjumlah 309.301 klaim di kedua propinsi tersebut untuk mengekplorasi sejauh mana perbedaan klaim klaim. Hasil analisis menunjukkan ada perbedaan bermakna rata-rata klaim klaim per CBG, per perawatan, per hari rawat . Faktor terbesar perbedaan tersebut adalah besaran CBG yang tidak member insentif pemerataan dokter spesialis ke RS kelas B, C, dan D di daerah dengan pendapatan per kapita rendah. Penelitian ini tidak membuktikan bahwa dana dari provinsi NTT terserap di provinsi DKI.AbstractSeveral diseases that at the household level become catastrophic are end stage renal diseases, cardiovascular, cancer, thalasemia, and haemphilia. Patients of those diseases are benefitted the most of the National Health Insruacen (JKN) and those diseases absorbed high claim costs of the JKN. Special attentions are needed to manage those diseases. Disparity of health care facilities, specialists, and differentials of Casemix Base Group (CBG) payment are susptected to be important contributing factors that create absosrbtion of JKN fund across provinces. This study use 2014 claim data of BPJS Kesehatan in Jakarta and East Nusa Tengga (NTT) provinces to explore the size of differences. The total number of claims analyzed was 309,301 claims. The results show statistically difference of claim payment per case, per admission, and per hospital day. The differences are atributable mostly by differentials of CBG prices that are not providing incentives for specialists to be deployed in smaller hospitals of class B, C, and D in low income provinces.This study does not prove transfer of JKN fund from NTT to Jakarta.
Pemanfaatan Dana Kapitasi oleh Puskesmas di Kota Lubuklinggau Tahun 2014-2016 Muhammad Yulianto; Mardiati Nadjib
Jurnal Ekonomi Kesehatan Indonesia Vol 2, No 1 (2017)
Publisher : Fakultas Kesehatan Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1928.364 KB) | DOI: 10.7454/eki.v2i1.1963

Abstract

Sejak implementasiJaminan Kesehatan Nasional (JKN), Puskesmas mendapat pembayaran dari Badan Penyelenggaran Jaminan Sosial (BPJS) Kesehatan berupa dana kapitasi. Di Kota Lubuklinggau terdapat masalah mengenai sisa lebih perhitungan anggaran (SiLPA) di puskesmas yang rata-rata pertahunnya sebesar 23%. Penelitian ini bertujuan menganalisis pemanfaatan dana kapitasi Puskesmas di Kota Lubuklinggau tahun 2014-2016. Penelitian kualitatif ini dilakukan di Puskesmas Simpang Periuk, Taba, Citra Medika dan Swasti Saba berdasarkan realisasi SiLPA terendah dan tertinggi denganpengumpulan data secara retrospektif. Hasil penelitian menunjukkan bahwa penggunaan dana kapitasi untuk jasa pelayanan telah sesuai target (69,5%) sedangkan untuk kegiatan operasional penyerapan masih kecil (12,4 %). Puskesmas belum melaksanakan perencanaan sistematis dengan tahapan Planning, Organizing, Actuating, Controlling dalam pemanfaatan dana kapitasi. Aturan pemanfaatan yang dianggap rumit menyebabkan puskesmas tidak menyerap dana kapitasi tersebut. Pengawasan dan bimbingan diperlukan agar penyerapan dana kapitasi dapat ditingkatkan.
Terapi Sistemik Defisit JKN: Bahan Refleksi Bagi Semua Pihak Budi Hidayat
Jurnal Ekonomi Kesehatan Indonesia Vol 1, No 1 (2016)
Publisher : Fakultas Kesehatan Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (260.545 KB) | DOI: 10.7454/eki.v1i1.1869

Abstract

Defisit layak disandang sebagai penyakit kronis JKN. Indikasi defisit terungkap dari angka rasioklaim. Pada tahun 2014 dan 2015 angka rasio klaim selalu berada diatas 100%. Angka ini merupakan hasil pembagian biaya klaim (atau biaya kesehatan peserta) dengan pendapatan iuran. Dengan demikian rasio klaim menggambarkan penyerapan dana iuran untuk biaya kesehatan saja. Padahal pendapatan iuran juga harus dialokasikan untuk biaya operasional dan cadangan. Defisit JKN akan terus bergulir jika terapi sistemik nihil. Untuk tahun 2016, hasil estimasi penulis dengan merujuk pada asumsi besaran iuran sesuai Peraturan Presiden No 28/2016 (Sekretariat Kabinet, 2016) dan tarif pelayanan Permenkes 59/2014 (Menteri Hukum dan Hak Asasi Manusia, 2014) menemukan angka rasio klaim 101%. Artinya, pendapatan iuran masih kurang meski hanya untuk mendanai pelayanan kesehatan. Dari mana sumber dana untuk mendanai biaya operasional? Apakah JKN hanya mengandalkan suntikan dana pemerintah? Label penyakit kronis defisit layak disandang oleh JKN. Apa obatnya?
Strategi Pemasaran Pelayanan Continuous Ambulatory Peritoneal Dialysis di Klinik Khusus Ginjal X Batam Tahun 2016 Bertha Toha; Vetty Yulianty Permanasari
Jurnal Ekonomi Kesehatan Indonesia Vol 1, No 3 (2017)
Publisher : Fakultas Kesehatan Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (360.493 KB) | DOI: 10.7454/eki.v1i3.1779

Abstract

Abstrak Saat ini hanya 53% pasien Gagal Ginjal Terminal (GGT) yang dapat mengakses dialisis dan sebagian besar menjalani HD, pada­hal biaya untuk melaksanakan CAPD lebih murah dibandingkan HD (P2JK, 2016). Pelayanan CAPD di Klinik Khusus Ginjal X Batam sudah dimulai sejak tahun 2010, namun jumlah pasien CAPD hanya 3% dari total pasien GGT di klinik tersebut. Tujuan penelitian ini untuk menganalisis Strategi Pemasaran Pelayanan Continuous Ambulatory Peritoneal Dialysis di Klinik Khusus Ginjal X Batam Tahun 2016. Desain penelitian yang digunakan adalah analitik deskriptif dengan pendekatan kuantitatif dan kualitatif. Instrument dan Tahapan analisis yang digunakan adalah strategi Fred R. David yang kemudian dilanjutkan dengan Segmenting, Targeting dan Positioning, lalu menentukan bauran pemasaran (Product, Promotion, Price, Place, People, Physical evidence, Process, Customer Service). Klinik telah menetapkan tarif pelayanan yang disesuaikan dengan tarif paket INA-CBG’s, namun belum melakukan perhitungan biaya satuan. Strategi Pemasaran yang layak dan sesuai dengan analisis situasi adalah: Market Penetration dan Product Development. Pemasaran produk pelayanan di Klinik Khusus Ginjal X Batam dapat berupa periklanan melalui berbagai media seperti talk show di radio, talk show di stasiun televisi di kota Batam, dan leaflet; penyeba­ran leaflet di ruangan pelayanan Ilmu Penyakit Dalam; promosi penjualan, dan pembinaan dokter puskesmas. Selain itu bisa dilakukan promosi secara online. Untuk menghindari terjadinya asimetric information, maka dokter penanggungjawab mem­berikan edukasi yang komprehensif terhadap terapi CAPD. Abstract Currently only 53% of patients with end-stage renal disease that can access dialysis and mostly get Hemodialysis (HD), whereas the cost to Continous Ambulatory Peritoneal Dialysis (CAPD) cheaper than HD (Ministry of Health, 2016). Services of CAPD in Clinic for Kidney Disease X. Batam began since 2010, but the number of CAPD patients only 3% of the end stage renal disease patients there. The purpose of this study to analyze the Marketing Strategy of Continuous Ambulatory Peritoneal Dialysis Services at the Clinic for Kidney Disease X Batam Year 2016. The design of the study is an analytic descriptive with quantitative and qualitative approaches. Stages of analysis used Fred R. David strategies and followed by Segmenting, Targeting and Positioning, and then determine the mar­keting mix (Product, Promotion, Price, Place, People, Physical Evidence, Process, Customer Service). The Clinic has set tariffs adjusted rates INA-CBG’s package but has not calculated the cost of the unit. A Marketing strategy that good and proper with the analysis of the situation are: Market Penetration and Product Development. Product marketing services in Clinic for Kidney Disease X Batam can be advertised through various media such as radio talk shows, Local Batam station of television talk shows and leaflets; distribute leaflets in the service room of Medicine; sales promotion, and training for doctors in health primary care. In addition, promotion of CAPD can use online or social media. In order to avoid asimetric information, the doctors have responsible for giving a comprehensive education on CAPD therapy.
A Comparative Budget Requirements for TB program based on Minimum standard of Services (SPM) and Budget Realization: an Exit Strategy Before Termination of GF ATM Ery Setiawan; Purwa K Sucahya; Hasbullah Thabrany; Kalsum Komaryani
Jurnal Ekonomi Kesehatan Indonesia Vol 1, No 1 (2016)
Publisher : Fakultas Kesehatan Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (273.53 KB) | DOI: 10.7454/eki.v1i1.1761

Abstract

AbstractIt has become a common issue that the Global Fund (GF) as one of the largest international donors to AIDS, Tuberculosis, and Malaria Program will immediately stop the funding. Data shows that in 2009 GF ATM support reached 88,8% while APBN funding just cover 11,2% of the total budget needed. Howev­er, APBN budget for ATM programs was significantly increased in 2012 which covered almost 30% of the total budget. Eventhough the increasing trend of ATM budget seemed at the central government level, how­ever the local governments will hold the key to the sustainability of the post- termination GF ATM FundingObjectivesThis study aimed to get a picture of the local government’s commitment as an implementing insti­tution to respond the financing needs specifically for TB programs.MethodsThis economic evaluation compared the amount of the existing budget of local governments and the amount needed based on the Minimum Standards of Services (MSS) of TB Programs. We sampled two district in west java that were Cirebon and Garut. The cost component calculated in these evaluation were: medicines, medical supplies, case findings, and administrative cost.Results and DiscussionTotal budget needed in Garut according to MSS amounted 2,5 Billion Rupiahs, whereas the total budget which has been alocated approximately 2 Billion Rupiahs. For those budget allocated in Garut, 90% of the total was supported by the Government then the rest of that was supported by GF. A similar trend showed in Cirebon, which was found a budget shortage amounted 700 Million Rupiahs from approximate­ly 1,6 Billion Rupiahs budget needed and 80% of those was sourced by The Government. The particular finding showed that prevention and case detection program in Garut still dominated by GF support which slightly above 65%. Otherwise, budget allocated for those Activity in Cirebon has been dominated by the government approximately 80%.ConclusionIn general, both Garut and Cirebon faced two common challenges in terms of financing the TB program. First, the high shortage between needs and budget alocated of the program becomes an important concern for addressing TB cases reduction in related district. The second is program’s sustainibility after termination of Global Fund, particularly for prevention and case detection programs. Therefore, it might be need a support from NGO or other related institution to advocate the local government and DPRD to allocate more budget for reducing TB cases.  

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