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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

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.

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

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.

Application of Decision Analytic Model in Health Economic Evaluation: Smoking Cessation Cases septiara putri
Jurnal Ekonomi Kesehatan Indonesia Vol 1, No 1 (2016)
Publisher : Fakultas Kesehatan Masyarakat

Health economic evaluation that encompasses decision analytic model is a beneficial approach for assisting decision maker to choose the best health intervention for patients. Decision analytic model has been increasingly applied in health economic evaluation. This mathematical approach is mostly used for conducting cost-effectiveness of healthcare interventions.Decision tree and Markov model has been widely applied in the past 20 years. Decision tree is the simplest form of decision model that drawn by the series of branches and clear pathways. Meanwhile, Markov model is one of the powerful approaches that employ stochastic process in health economic evaluation. This paper describes the applications of those two models in tobacco cessations, specifically for pharmacological interventions.First, decision tree for cost-effectiveness of smoking cessation program with pharmacist and therapies interventions compared to no program or self-aid cessation. Second, the application of Markov model estimates cost-effectiveness of veranicline, in comparison to bupropion. Markov model is constructed with morbidity and mortality states that consists of: well/no morbidities, lung cancer, COPD, stroke, myocardial infarction, and dead. This paper provides step by step of populating and constructing the model-with some modification of data. Several sections discuss the understanding of transition probabilities, costs data, cohort simulation, and the role of sensitivity analysis. Other models, despite deterministic approach, probabilistic approach are also reviewed.Both of models had both advantages and limitation that analysts should be aware of. Translating the ‘real world’ to mathematical model yields beneficial and insightful information for analysts. In addition, it could fulfill the need of evidence-based policy by decision maker. From simulation, the model may easy to be replicated-with appropriate context to generate evidence related health and costs.

Biaya dan Outcome Hemodialisis di Rumah Sakit Kelas B dan C firda tania; Hasbullah Thabrany
Jurnal Ekonomi Kesehatan Indonesia Vol 1, No 1 (2016)
Publisher : Fakultas Kesehatan Masyarakat

Gagal Ginjal Kronis (GGK) merupakan kondisi yang semakin meningkat kejadiannya di Indonesia, menghabiskan banyak dana publik Jaminan Kesehatan Nasional (JKN). Dalam program JKN, hemodialisis (HD) untuk penanganan GGK dijamin tetapi perleu keseimbangan antara biaya dan outcome. Sejak 2014, BPJS menanggung hampir seluruh biaya HD di Indonesia dengan besaran tarif Casemix Base Group (CBG) yang berbeda menurut kelas Rumah Sakit (RS). Tujaun dari penelitian ini adalah untuk mengetahui perbedaan biaya Hemodialisis pada Rumah Sakit Kelas B dan Kelas C.Studi evaluasi ekonomi ini dilakukan di dua RS dengan kelas berbeda: kelas B (RS B) dan kelas C (RS C) dengan perbedaan kepemilikan. Kepemilikan RS B adalah pemerintah daerah sedangkan RS C dimiliki oleh yayasan swasta. Outcome HD diukur dengan suatu survey ke pasien HD. Analisis outcome dilakukan dengan penilaian kualitas hidup (instrumen EQ-5D) dengan Indeks EQ, EQ VAS, intermediate outcome berupa rerata Intra Dialytic Weight Loss (IDWL), dan rerata Hb. Perbedaan rerata nilai hasil diuji dengan Student’s t-test. Responden dipilih dari pasien GGK yang menjalani HD di kedua RS selama Februari-April 2016. Analisis biaya menurut perspektif pasien, meliputi biaya langsung medis, biaya langsung non medis, dan biaya tidak langsung. Biaya sebenarnya yang dikeluarkan oleh RS dikumpulkan dari dokumen RS. Studi kualitatif tambahan dilakukan dengan wawancara mendalam kepada informan kunci di RS yang bertanggung jawab atas unit HD. Pada penelitian ini, total responden sebanyak adalah 100 orang (di RS B 76 orang & di RS C 24 orang). Menurut perspektif pasien, biaya langsung medis HD selama sebulan di RS B Rp 5.215.331 dan di RS C Rp 7.781.744. Besaran tarif CBG untuk RS kelas B adalah Rp 962.800 dan kelas C adalah Rp 893.300. Menurut perspektif RS, tidak terdapat perbedaan biaya operasional HD antar kelas RS. Biaya langsung non medis HD selama sebulan di RS B Rp 566.260 dan di RS C Rp 334.500. Biaya tidak langsung HD selama sebulan di RS B Rp 165.530 dan di RS C Rp 45.830. Rerata total biaya HD selama sebulan di RS B Rp 6.149.285 dan di RS C Rp 8.162.077. Pada intermediate outcome didapatkan bahwa rerata Hb pada RS B sebesar 10,26 g% berbeda secara signifikan dengan RS C (8,21 g%), p= 0,000. Rerata IDWL pada RS B (0,0403) tidak berbeda secara signifikan dengan RS C (0,0438), p= 0.188. Rerata EQ Indeks sebesar 0,7178 dan EQ VAS sebesar 64,74 di RS B tidak berbeda secara signifikan dengan rerata EQ Indeks sebesar 0,7208 dan EQ VAS sebesar 64,79 di RS C, dengan p value secara berurutan p=0,94 dan p= 0,986

Analisis Estimasi Biaya Langsung Medis Penderita Rawat Jalan Diabetes Mellitus Tipe 2 di RSUD Dr. Abdul Aziz Singkawang Tahun 2013 Mursalin Mursalin; Prastuti Soewondo
Jurnal Ekonomi Kesehatan Indonesia Vol 1, No 2 (2016)
Publisher : Fakultas Kesehatan Masyarakat

AbstrakDiabetes Mellitus merupakan penyakit epidemik yang menjadi ancaman global. Selain tingkat morbiditas dan mortalitas yang tinggi, juga menyebabkan sebagian besar negara di dunia mengeluarkan anggaran kesehatan yang besar. Penelitian ini bertujuan untuk menghitung besarnya biaya langsung medis dan faktor-faktor yang mempengaruhinya pada penderita rawat jalan diabetes mellitus tipe 2. Penelitian dilaksanakan pada bulan Januari – Februari 2015 di RSUD dr. Abdul Aziz Singkawang, Kalimantan Barat. Jenis penelitian ini adalah kuantitatif analitik dengan menggunakan data sekunder yang dikumpulkan secara retrospektif berdasarkan data tahun 2013 dengan jumlah sampel sebanyak 200. Hasil analisis multivariat, terdapat perbedaan yang signifikan biaya langsung medis pada setiap tipe penatalaksanaan, lama sakit dan komplikasi yang dialami penderita. Upaya promotif dan preventif perlu ditingkatkan untuk mencapai efektivitas dan efisiensi pengobatan dan meningkatkan kualitas hidup penderita. AbstractDiabetes mellitus has epidemic diseases that seriously global threated. Except, hight level of morbidity and mortality, its also caused most countries in the world spend a lot of money for health care. This study purpose to count direct medical costs and factors of influence on type 2 diabetes mellitus outpatient care. This study conduct on January to February 2015 in RSUD dr. Abdul Aziz Singkawang at West Kalimantan. Design study used cuantitative analysis by secondary data that retrospectively collected on 2013 data and number of samples are 200. Result of multivariate analysis, there were significant difference means of direct medical costs of type 2 diabetes mellitus outpatient care on type of care, diseases duration, and complication. Health promotion and prevention on type 2 diabetes mellitus intervention must be increasingly to achieve effective and efficient cost of care and to increase patient’s quality of life.

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

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.

Analisis Pembiayaan Kesehatan Daerah Bersumber Publik: Studi Kasus di Dinas Kesehatan Kabupaten Bogor Tahun 2012, 2013 dan 2014 Tuti Handayani; Mardiati Nadjib
Jurnal Ekonomi Kesehatan Indonesia Vol 1, No 2 (2016)
Publisher : Fakultas Kesehatan Masyarakat

AbstrakPenelitian ini bertujuan untuk melihat gambaran realisasi belanja kesehatan di Dinas Kesehatan Kabupaten Bogor dengan melihat peruntukannya menurut empat dimensi DHA di tahun 2014 dengan melihat trend 2012 dan 2013. Penelitian ini mengambil data sekunder realisasi belanja kesehatan yang kemudian diolah dan disajikan menurut sumber biaya, pengelola anggaran, penyedia pelayanan, dan program. Studi ini menggunakan desain penelitian deskriptif dengan pendekatan evaluatif, dilakukan di Dinas Kesehatan Kabupaten Bogor. Analisis menunjukkan bahwa total pembiayaan kesehatan di Dinas Kesehatan Kabupaten Bogor bersumber publik tahun 2012 berjumlah Rp289.069.378.168,- tahun 2013 jumlahnya meningkat menjadi Rp 338.469.794.825,- dan di tahun 2014 yang jumlahnya menurun menjadi Rp 337.451.928.421,-. Dilihat dari peruntukkannya, program kegiatan yang belanjanya paling dominan, di tahun 2012, adalah program pembiayaan kesehatan yaitu sebesar 36,29% yang juga masih terlihat masih dominan di tahun 2013 di mana porsinya mencapai 39,48%, namun di tahun 2014, belanja pembiayaan kesehatan porsinya menurun secara signifikan menjadi hanya 23,69%, Adapun belanja terbesar belanja kesehatan tahun 2014 ini adalah untuk program administrasi dan manajemen yaitu sebesar 30,92%.AbstractThis study aimeds to look at the picture of health expenditures in Bogor District Health Office to see the allotment according to the four dimensions of District Health Accounts (DHA) in 2014 to see the trend in 2012 and 2013. This study took data from a secondary data source realization of health spending that was then processed and presented according to the funding source, budget managers, service providers, and programs. The study used a descriptive research design with evaluative approach and conducted in Bogor District Health Office. Analysis showed that the total health financing in Bogor District Health Department public sources in 2012 amounted to Rp 289.069.378.168 , - in 2013 the number increased to Rp 338 469 794 825 , - and in 2014 that number was dropped to Rp337.451.928.421 , - . The funding in 2012 and 2013 came from the state budget, district budget and provincial budget, whereas in 2014 from the state budget , district budget , provincial budget and other public funds . Judging from its designation, The most dominant spending, in 2012 , is health financing programs spent of 36.29 % , in 2013 also still dominant health financing program , its share reached 40.09 % , and in 2014 expenditure on health financing portion significantly decreased to only 23.69 %, with the largest health spending in 2014 was for program administration and management , that was 30.92 %.

Analisis Minimisasi Biaya Amlodipin Generik dan Bermerk pada Pengobatan Hipertensi di RS X Pekanbaru Tahun 2015 Hanny Merliana
Jurnal Ekonomi Kesehatan Indonesia Vol 1, No 3 (2017)
Publisher : Fakultas Kesehatan Masyarakat

Abstrak Hipertensi merupakan tantangan besar di Indonesia, berdasarkan data Riskesdas 2013 prevalensi kejadian sebesar 25% serta kondisi yang sering ditemukan pada pelayanan kesehatan primer. Disamping itu, pengontrolan hipertensi belum adekuat meskipun obat-obatan yang efektif banyak tersedia. Amlodipine adalah salah satu obat hipertensi yang paling sering diresepkan di RS X Pekanbaru. Untuk itu,dipandang perlumelakukan analisis minimisasi biaya dari pengggunaan amlodipine generik dan bermerek sebagai bentuk kendali mutu dan kendali biaya.Penelitian ini merupakan studi retrospektif yangmenggunakan data pasien hipertensi ringan sampai sedang dan periode pengobatan selama 1 bulan dari bulan Januari sampai Desember tahun 2015. Analisa CMA berdasarkan perspektif provider (rumah sakit sebagai pemberi pelayanan).Hasil analisis data ditemukan bahwa penggunaan amlodipin generik lebih banyak dibandingkan penggunaan obat bermerk di Poli Jantung dan Penyakit Dalam RS. X.Rerata biaya pengobatan dengan amlodipin generik Rp 68.660,- per bulan sedangkan dengan amlodipin bermerk sebesar Rp. 374.844.- atau sekitar 5,4 kali lebih tinggi dari amlodipin generik. Penggunaan amlodipin generik maupun bermerk menurukan tekanan darah secara bermakna, namun tidak terdapat perbedaan bermakna antas penurunan tekanan darah yang dicapai dengan pemberian amlodipin generik maupun amlodipin bermerk. Disimpulkan bahwa amlodipin generik merupakan pilihan yang efisien dalam menurunkan tekanan darah dan memiliki biaya yang lebih efisien dibandingkan dengan amlodipin bermerk.Abstract Hypertension in a big challenge in Indonesia, proven by its prevalence that reached 25% in 2013 and conditions that mostly found in primary health care. In addition, hypertension management is considered to be suboptimal despite the availability of effective drugs. Amlodipine is one of anti-hypertensive that is commonly prescribed by X Hospital, Pekan Baru. Therefore, it is important to do cost minimization analysis to compare both generic and branded Amlodipine as an implementation of cost and quality control. This retrospective study involved early and medium stage of hypertensive patients that have at least a month period of treatment from January to December 2015 using provider’s perspectives of CMA (Cost Minimization Analysis). The result showed that generic form of Amlodipine is the most common anti-hypertensive drugs prescribed in Cardiology and Internal Medicine Clinic, X Hospital. It was suggested that average cost of generic form of Amlodipine was IDR 68.660 while branded one was IDR 374.844 or approximately 5.4 times higher. Both generic and branded Amlodipine significantly reduced blood pressure, but there was not any distinguish effect between them. It was concluded that generic form of Amlodipine was a less expensive and efficient choice in reducing blood pressure.

Cost Effectiveness Analysis Between Hemodialysis and Peritoneal Dialysis Elsa Novelia; Ryan Rachmad Nugraha; Hasbullah Thabrany
Jurnal Ekonomi Kesehatan Indonesia Vol 1, No 3 (2017)
Publisher : Fakultas Kesehatan Masyarakat

Abstract The number of patients with End Stage Renal Disease (ESRD) in Indonesia is growing. Increasing prevalence of hypertension and diabetes mellitus contributes to higher prevalence of ESRD. The majority of patients (94%) with ESRD are undertaking hemodialysis (HD) at public and private hospitals. However, continuous ambulatory Peritoneal Dialysis (PD) has been prescribed to small portion of patients with ESRD. The aim of this study was to examine the cost effectiveness between HD and PD on ESRD patients. This study compared 78 HD patients at Hospital X in Bogor and 10 PD patients at Hospital Y in Jakarta. Patient’s quality of life (QoL) was measured using SF 36 questionnaires. The costs were measured by direct medical costs using CBGs prices, direct non-medical costs (transportation, food for patient and family), and indirect medical costs (opportunity costs). The study found that the HD cost per year per patient was IDR 133.4 million and the comparative cost for PD was IDR 81.7 million. The study found lower QoL of HD patients (46.2%) compared to QoL of PD patients (90%). In addition, PD patients had significant better quality of physical activities, emotional states, social function, and sanity. The study found the incremental costs for to HD to reach similar emotional states was IDR 2.0 million compared to PD and IDR 1.8 million for extra physical role gained. It is concluded that PD was more cost-effective than HD in achieving a certain level of quality of life among patients with ESRD in two hospitals in Indonesia. Abstrak Jumlah pasien Gagal Ginjal Stadium Akhir (GGSA) di Indonesia terus meningkat. Meningkatnya prevalensi hipertensi dan diabetes mellitus (DM) berkontribusi terhadap prevalensi kasus GGSA. Mayoritas pasien (94%) dengan GGSA menjalani terapi hemodialisis (HD) baik pada Rumah Sakit (RS) swasta ataupun pemerintah. Bagaimanapun, dialisis peritoneal ambulatori berkelanjutan (continuous ambulatory peritoneal dialysis/CAPD) telah diberlakukan pada sebagian kecil pasien dengan GGSA. Tujuan dari studi ini adalah untuk mengukur efektivitas harga dari HD dan CAPD pada pasien GGSA. Studi membandingkan 78 pasien HD di RS X Bogor dan 10 pasien CAPD pada RS Y Jakarta. Kualitas hidup pasien diukur menggunakan kuesioner 36. Biaya diukur dengan biaya langsung medis (menggunakan harga CBGs), biaya langsung non-medis (transportasi dan biaya makan), serta biaya medis tidak langsung (biaya kesempatan). Studi menunjukkan bahwa HD membutuhkan biaya Rp 133,4 juta per orang per tahunnya, dibandingkan dengan CAPD sebanyak Rp 81,7 juta. Studi menemukan kualitas hidup yang lebih rendah pada pasien HD (46,2%) dibanding CAPD (90%). Selain itu, pasien CAPD memiliki kualitas yang lebih baik dari segi aktivitas fisik, status emosi, fungsi sosial, dan kejiwaan. Studi menemukan bahwa harga inkremental HD, untuk mencapai status emosional yang sama, dibanding CAPD yakni sebanyak 2 juta rupiah; dan 1,8 juta rupiah untuk mencapai peran fisik bila HD dibanding dengan CAPD. Dapat disimpulkan bahwa CAPD lebih efektif dari segi biaya dibanding HD dalam mencapai tingkatan kualitas hidup yang lebih baik pada pasien-pasien GGSA di dua RS di Indonesia.

Analisis Biaya Akibat Sakit serta Kualitas Hidup Pasien Diabetes Mellitus Tipe 2 dengan Penyakit Jantung Lusiani Septika Sari
Jurnal Ekonomi Kesehatan Indonesia Vol 1, No 3 (2017)
Publisher : Fakultas Kesehatan Masyarakat

Abstrak Indonesia merupakan negara terbanyak keempat kematian akibat diabetes Mellitus dan penyakit jantung diantara negara-negara Asia Tenggara. Biaya akibat sakit diabetes mellitus dan jantung membutuhkan biaya tertinggi jika dibandingkan dengan kombinasi penyakit diabetes mellitus dengan penyakit kronik lainnya. Penelitian ini bertujuan untuk mengetahui gambaran biaya akibat sakit serta kualitas hidup pasien diabetes mellitus tipe 2 dengan penyakit jantung dengan sampel 110 orang di RSUD X Bengkulu. Desain studi penelitian cross sectional, data primer dikumpulkan dengan teknik survei menggunakan kuesioner yang terstruktur dan data sekunder diperoleh melalui telaah dokumen rekam medik pasien serta dokumen penunjang lainnya. Penelitian dilaksanakan dari bulan Maret sampai dengan Mei 2014. Populasi adalah seluruh pasien diabetes mellitus tipe 2 dengan penyakit jantung yang melakukan kunjungan rawat jalan di RSUD X Bengkulu, jumlah sampel 110 pasien. Rata-rata biaya pasien akibat sakit diabetes mellitus tipe 2 dengan penyakit jantung selama setahun adalah Rp. 6.081.572 dimana komposisi biaya langsung adalah (81,54%) dan biaya tidak langsung (18,46%). Proporsi terbesar adalah biaya obat (37,05%). Faktor-faktor yang mempengaruhi biaya akibat penyakit tersebut adalah Lama Hari Rawat (LHR) dan jenis pekerjaan sedangkan faktor yang mempengaruhi kualitas hidup pasien adalah Lama/durasi sakit. Disarankan agar RSUD. X Bengkulu menyusun clinical pathway dan formularium rumah sakit. Pemerintah perlu merevisi formularium nasional dengan memperhatikan kondisi lokal dan mengembangkan program peningkatan kualitas hidupAbstract Indonesia is the fourth most deaths due diabetes mellitus and heart disease among south Asia countries. Cost of illness from diabetes mellitus with heart disease is the highest cost if it is compared with combination of diabetes mellitus with other chronic disease. This study with 110 patients as samples is aiming to describing the cost of illness and quality of life of patients with type 2 diabetes mellitus with heart disease in X public hospital. With cross sectional research design, primary data is collected with survey technique that uses structured questionnaire and secondary data is obtained through medical record document review along with another supporting document. This research has been done from March until May in 2014. The population is all type 2 diabetes mellitus patient with heart disease who was doing in-patient visit in X Bengkulu, the number of sample was 110 patients. The annual cost of illness due to type 2 diabetes mellitus with heart disease per patient was Rp. 6,081,572, with direct cost is reached (81.54%) and indirect cost (18.46%). The largest proportion of the cost was drug (37.05%). Factors that affect COI were Length of Stay (LOS) and the type of work, and factor affect quality of life was duration of illness. It is recommended that X Public Hospital Bengkulu should prepare clinical pathways and hospital formulary. The central government needs to revise national formulary with considering variability of country situation and develop program to improve quality of DM patient.

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Nico Kurnia Pratama

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Editorial Address
Fakultas Kesehatan Masyarakat, Universitas Indonesia Kampus Baru UI Depok 16424

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Kota depok,

Jawa barat

INDONESIA

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Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Nico Kurnia Pratama

Contact Email nkpratama23@yahoo.com

Phone -

Journal Mail Official jurnal.eki@cheps.or.id

Editorial Address Fakultas Kesehatan Masyarakat, Universitas Indonesia Kampus Baru UI Depok 16424

Location Kota depok, Jawa barat INDONESIA

Abstract

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Contact Name
Nico Kurnia Pratama

Contact Email
nkpratama23@yahoo.com

Phone
-

Journal Mail Official
jurnal.eki@cheps.or.id

Editorial Address
Fakultas Kesehatan Masyarakat, Universitas Indonesia Kampus Baru UI Depok 16424

Location
Kota depok,

Jawa barat

INDONESIA