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Kata Kunci : Evaluasi, Stock Out, Obat, Program Rujuk Balik
This study aims to explore the determinants relating the availability of drugs in Back Referral Program (PRB) in BPJS Kesehatan KC Depok area. This case study was using qualitative approach, data collection through in-depth interviews, observation, and document review to explore the reliability of input and process variables related to stock out. Input incule internal and external stakeholders, comprised of HR and policy as well as policy and evaluation). The process described supply chain management of drugs including planning, budgeting,provider payment, purchasing and distribution of PRB drug. The refealed that the stock out was resulted from of this study indicate the problem stock out included the the dimensions in the process of input and process. In terms of inputs, the role of human resources , policy implementation, resources and stakeholder commitments were among the identified factor related to challenge on PRB drug. While problems that occurred in the process that contributed to the stock out of PRB drug included drug supply chain management, planning, payment scheme, and distribution of drugs. This problem potentially affected mismatch of RKO (plan on number drugs required to provide service) with requirement on regional level, irrational HPS (National reference on price) and policy. This study suggested to undertake comprehensive monitoring and evaluaton including input, process and output as well as solution of the problem.
Keywords: evaluation, stock out, back referral program (PRB)
Chronic Kidney Disease (CKD) is a progressive and irreversible catastrophic illness with a high financial burden in the National Health Insurance (JKN) program. This study aims to describe the cost and identify factors affecting healthcare costs for CKD services among JKN participants in DKI Jakarta Province in 2023. This research employed a non-experimental quantitative design using secondary data from the 2024 BPJS Kesehatan sample dataset. Data were analyzed using univariate and non-parametric bivariate tests, including Spearman, Mann-Whitney, and Kruskal-Wallis tests, with a total sample of 22,619 participants. The results showed that the total healthcare expenditure for CKD in DKI Jakarta in 2023 was IDR 555,265,832,525, with an average cost per participant of IDR 3,250,400. The variables of male gender, age 15–59 years, unmarried status, PBI APBN membership segment, class II inpatient rights, frequency of outpatient and inpatient visits, and length of stay were significantly associated with differences in healthcare costs (p-value < 0.001). In conclusion, all studied variables showed a statistically significant relationship or difference in median costs for CKD healthcare services among JKN participants in DKI Jakarta in 2023.
Chronic Kidney Disease (CKD) is a progressive and irreversible catastrophic illness with a high financial burden in the National Health Insurance (JKN) program. This study aims to describe the cost and identify factors affecting healthcare costs for CKD services among JKN participants in DKI Jakarta Province in 2023. This research employed a non-experimental quantitative design using secondary data from the 2024 BPJS Kesehatan sample dataset. Data were analyzed using univariate and non-parametric bivariate tests, including Spearman, Mann-Whitney, and Kruskal-Wallis tests, with a total sample of 22,619 participants. The results showed that the total healthcare expenditure for CKD in DKI Jakarta in 2023 was IDR 555,265,832,525, with an average cost per participant of IDR 3,250,400. The variables of male gender, age 15–59 years, unmarried status, PBI APBN membership segment, class II inpatient rights, frequency of outpatient and inpatient visits, and length of stay were significantly associated with differences in healthcare costs (p-value < 0.001). In conclusion, all studied variables showed a statistically significant relationship or difference in median costs for CKD healthcare services among JKN participants in DKI Jakarta in 2023.
Penelitian ini menganalisis Cost of Illness (COI) peserta JKN dengan penyakit kanker serviks di Indonesia dan faktor-faktor yang mempengaruhinya. Desain penelitian yang digunakan adalah studi observasional deskriptif dengan pendekatan cross sectional. Data yang digunakan dalam penelitian ini adalah Data Sampel BPJS Kesehatan dan Data Upah Rata-Rata per Jam menurut Provinsi Tahun 2022-2023. Teknik pengambilan sampel menggunakan total sampling sehingga sampel merupakan seluruh peserta JKN dengan penyakit kanker serviks di Indonesia sesuai dengan kriteria inklusi dan eksklusi yang ditetapkan. Hasil penelitian ini menunjukkan bahwa total Cost of Illness peserta JKN dengan penyakit kanker serviks adalah sebesar Rp105.507.876.365 dengan rata-rata COI per peserta adalah sebesar Rp4.582.340. Nilai COI tersebut belum termasuk dengan klaim obat terpisah yang dibayarkan BPJS Kesehatan diluar paket INA-CBG. Faktor usia, status perkawinan, segmentasi kepesertaan, hak kelas rawat, jumlah kunjungan RJTL, jumlah kunjungan RITL, lama hari perawatan, dan tingkat keparahan berpengaruh signifikan secara statistik terhadap Cost of Illness. Hasil penelitian ini menggambarkan beban ekonomi yang disebabkan oleh penyakit kanker serviks sehingga program deteksi dini sangat penting untuk dilakukan demi tercapainya efisiensi biaya kesehatan.
This study analyzed the Cost of Illness (COI) of JKN participants with cervical cancer in Indonesia and the factors that influence it. The research design used was a descriptive observational study with a cross sectional approach. The data used in this study are BPJS Kesehatan Sample Data and Average Hourly Wage Data by Province in 2022-2023. The sampling technique used total sampling so that the sample was all JKN participants with cervical cancer in Indonesia according to the specified inclusion and exclusion criteria. The result of this study indicates that the total Cost of Illness of JKN participants with cervical cancer is Rp105.507.876.365 with an average COI per participant of Rp4.582.340. The COI value doesn’t include separate drug claims paid by BPJS Kesehatan outside the INA-CBG package. The factors of age, marital status, membership segmentation, class of care, number of RJTL visits, number of RITL visits, length of treatment days, and severity have a statistically significant effect on the Cost of Illness. The results of this study illustrate the economic burden caused by cervical cancer so that early detection programs are very important to do in order to achieve health cost efficiency.
Background: Mental health disorders present a significant global economic burden, with projected losses reaching USD 6 trillion by 2030. In Indonesia, the estimated annual direct cost may reach IDR 87.5 trillion if all individuals with mental disorders undergo routine treatment. Objective: To identify the total cost and factors associated with mental health service expenditures in outpatient care at advanced referral health facilities (FKRTL) for JKN participants. Methods: This study uses cross-sectional design using the 2024 BPJS Kesehatan Sample Data. Univariate and bivariate analyses were conducted on 785,150 active mental health service users. Results: BPJS Kesehatan covered a total of IDR 3.4 trillion in mental health outpatient services within one year. There was a significant relationship between service costs and age, participant segmentation, number of diagnoses, outpatient visits frequency, advanced health facilities regional, advanced referral health facilities ownership, and chronic disease conditions. Conclusions: The highest costs were observed among the elderly and in Regional 1, reflecting a concentration of services and better access. These findings highlight the importance of equitable distribution and need-based approaches in mental health service financing.
