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Congenital hypothyroidism (CH) is a congenital disorder that can have an impact inthe form of permanent mental retardation. Giving the right dose of levothyroxine atthe earliest possible age, can prevent the disruption of growth and development.Newborns do not show symptoms of CH, and unfortunately the symptoms appear inthe late period and in many cases it shows growth disorders. The congenitalhypothyroidism screening (CHS) program has been implemented to find infant caseswith CH, and followed up with treatment.Although it has been made since 2006, Minister of Health just issued the regulationin 2014 on the implementation of CHS in Indonesia. This economic evaluation of theCHS program in 2014-2015 was done using cost analysis, while outcome obtainedfrom the systematic review (SR). The assumptions used in the analysis weredeveloped based on real data from a CHS screening program in two referrallaboratories in Jakarta and Bandung. Out of 56.186 screened babies, 24 babies werefound as CH positive cases.The result of the SR revealed that the earlier onset of initiation therapy, the moreadequate dose and the more continuous therapy given to the patient, the better resultwill be achieved. It will prevent the patients from severe complications of CH andwill improve the quality of thegrowth and development..The study found that the economic benefit is achieved in the second year of CHtreatment, since the pathological symptoms generally appear at the age of 3-6 monthand parents seek care in the second year. Consequently, cost to treat patients willincrease. The cost of screening and early treatment was found worthy as compared toeconomic loss resulting from growth disorders.Key words:Congenital Hypothyroid screening, cost, outcome
Penelitian ini bertujuan untuk mengetahui keberlangsungan program pengelolaan sarana air bersih dan sanitasi dengan pendekatan pemberdayaan masyarakat di Desa Karangsuko Tahun 2012. Penelitian ini menggunakan pendekatan kualitatif menggunakan analisis isi melalui wawancara mendalam, telaah dokumen dan observasi. Keberlangsungan program pengelolaan sarana air bersih dan sanitasi dapat dilihat dengan terpeliharanya manfaat sarana air bersih dan sanitasi sampai dengan penelitian ini berlangsung, terlembaganya Badan Pengelola Sarana Air Bersih dan Sanitasi "Sumber Maron" menjadi organisasi yang berbadan hukum dengan bukti Akte pendirian Badan Pengelola Sarana Air Bersih dan Sanitasi Sumber Maron Nomor AHU-0462.AH.02.01 Tahun 2010 tanggal 28 Januari 2010, dan meningkatnya cakupan layanan dan akses sarana air bersih menjadi 4 Desa yaitu Desa Karangsuko, Desa Sukosari, Desa Panggungrejo dan Desa Gondanglegi Kulon dengan total layanan 1.225 Kepala Keluarga (KK). Munculnya dorongan menjaga kesinambungan sarana air bersih dan sanitasi disebakan rasa memiliki terhadap program WSLIC-2 yang sepenuhnya melibatkan partisipasi masyarakat dalam tahapan pembangunannya.
This research aims to determine the sustainability of the program management of water supply and sanitation trough community empowerment approach in Karangsuko 2012. This research used a qualitative approach through content analysis through in-depth interviews, document review and observation. Sustainability of management program of water supply and sanitation can be seen within the maintenance of the benefits of water supply until now, organization Badan Pengelola Sarana Air Bersih dan Sanitasi "Sumber Maron" into an organization with legal status in fact of establishment of the Certificate No: AHU-0462.AH.02.01 Tahun 2010 tanggal 28 Januari 2010 and increased service coverage and access to clean water became four villages, Desa Karangsuko, Desa Sukosari, Desa Panggungrejo dan Desa Gondanglegi Kulon with total service 1.225 families. Encouragement to maintain continuity of management of water supply and sanitation was caused by sense of belonging to WSLIC-2 is fully involves community participation in its development stages.
Analisis penerapan Penganggaran berbasis Kinerja untuk Standar Pelayanan Minimal (SPM) Orang dengan Gangguan Jiwa (ODGJ) Berat di Dinas Kesehatan Kota Depok Tahun 2025, Penelitian ini menganalisis pelaksanaan penganggaran berbasis kinerja (PBK) terhadap Standar Pelayanan Minimal (SPM) ODGJ Berat di Dinas Kesehatan Kota Depok telah mencerminkan kebutuhan riil di lapangan. Meskipun capaian SPM tercatat mencapai 100% pada tahun 2023 dan 2024, alokasi anggaran justru mengalami penurunan signifikan: dari (0,06%) pada 2023 menjadi hanya (0,02%) pada 2024 dari total anggaran Dinas Kesehatan. Kontradiksi ini mencolok, terutama ketika prevalensi gangguan jiwa di Kota Depok masih sangat tinggi 9,1% di kalangan pegawai pemerintah dan 15,3% di masyarakat umum, angka provinsi (4,4%) dan nasional (2%). Kondisi ini menunjukkan adanya tantangan serius dalam penerapan PBK yang seharusnya mengedepankan prinsip efektivitas, efisiensi, dan evidence-based. Penelitian ini menggunakan pendekatan komprehensif terhadap komponen struktur, proses, dan komitmen daerah, untuk menilai apakah kebijakan penganggaran yang diterapkan sudah mendukung keberlanjutan layanan kesehatan jiwa secara substantif, bukan sekadar administratif.
Analysis of the Implementation of Performance-Based Budgeting for Minimum Service Standards (SPM) for People with Severe Mental Disorders (ODGJ) at the Depok City Health Office in 2025,This study analyzes whether the implementation of performance-based budgeting (PBB) for the Minimum Service Standards (SPM) for People with Severe Mental Disorders (ODGJ) at the Depok City Health Office reflects the actual needs in the field. Although SPM achievements reached 100% in 2023 and 2024, the allocated budget experienced a significant decline—from 0.06% in 2023 to only 0.02% in 2024 of the total Health Office budget. This contradiction is striking, especially considering the high prevalence of mental disorders in Depok: 9.1% among government employees and 15.3% in the general population, far exceeding the provincial average (4.4%) and the national rate (2%). This situation highlights serious challenges in the application of PBB, which should prioritize effectiveness, efficiency, and evidence-based principles. This study adopts a comprehensive approach by examining structural components, processes, and regional commitment to assess whether the current budgeting policy supports the sustainability of mental health services in a substantive, rather than merely administrative, manner.
ABSTRAK Nama : Wirda Syari Program Studi : Magister Ilmu Kesehatan Masyarakat Judul : Evaluasi Ekonomi Parsial Antara Pemberian Terapi Rivaroxaban dan Terapi Kombinasi (UFH + Warfarin) untuk Pengobatan Trombosis Vena Dalam (Deep Vein Thrombosis) pada Pasien Kanker di Rumah Sakit Kanker Dharmais Tahun 2016 – 2018 Pembimbing : Dr. drg. Mardiati Nadjib, MS Berdasarkan penelitian-penelitian sebelumnya, diketahui bahwa terapi rivaroxaban memiliki beberapa kelebihan dibandingkan dengan terapi kombinasi (UFH + warfarin) untuk pengobatan trombosis vena dalam (deep vein thrombosis/DVT). Akan tetapi, masih sedikit dokter di RS Kanker Dharmais yang memberikan terapi rivaroxaban untuk pengobatan DVT. Penelitian evaluasi ekonomi parsial ini bertujuan untuk menganalisis efektivitas/outcome dan besarnya biaya yang dibutuhkan dari perspektif rumah sakit antara pemberian terapi rivaroxaban dan terapi kombinasi (UFH + warfarin) untuk pengobatan DVT pada pasien kanker di Rumah Sakit Kanker Dharmais tahun 2016 – 2018. Karena keterbatasan jumlah pasien yang mendapatkan terapi rivaroxaban selama 3 – 6 bulan, studi ini menganalisis biaya dan efektivitas/outcome dari pasien yang mendapatkan terapi selama 1 bulan. Efektivitas/outcome yang diukur adalah intermediate outcome, yang meliputi lama hari rawat, kesembuhan, dan kejadian perdarahan. Biaya dihitung berdasarkan biaya yang dibebankan kepada pasien (charge), yang meliputi biaya obat, pemeriksaan penunjang, tindakan, serta administrasi dan akomodasi. Hasil penelitian menunjukan bahwa untuk efektivitas/outcome terapi rivaroxaban, sebagian besar pasien tidak mendapatkan perawatan rawat inap, 40% pasien dinyatakan sembuh dari DVT, dan tidak ada pasien yang mengalami kejadian perdarahan. Rata-rata biaya terapi rivaroxaban hingga mencapai outcome yang diharapkan adalah Rp 8.824.791,00. Untuk efektivitas/outcome terapi kombinasi (UFH + warfarin), sebagian besar pasien memiliki lama hari rawat antara 8 – 14 hari, 46% pasien dinyatakan sembuh dari DVT, dan tidak ada pasien yang mengalami kejadian perdarahan. Rata-rata biaya terapi kombinasi (UFH + warfarin) hingga mencapai outcome yang diharapkan adalah Rp 13.201.698,00. Kata Kunci: Evaluasi ekonomi; kanker; rivaroxaban; trombosis vena dalam; warfarin
ABSTRACT Name : Wirda Syari Study Program : Magister of Public Health Title : Partial Economic Evaluation Between Rivaroxaban Therapy and Combination Therapy (UFH + Warfarin) for the Treatment of Deep Vein Thrombosis in Cancer Patients at Dharmais Cancer Hospital during 2016 - 2018 Counsellor : Dr. drg. Mardiati Nadjib, MS Based on previous studies, rivaroxaban therapy has several advantages compared to combination therapy (UFH + warfarin) for the treatment of deep vein thrombosis (DVT). However, the use of rivaroxaban in Dharmais Cancer Hospital is still low. This partial economic evaluation study aims to analyze cost and consequence of rivaroxaban therapy and combination therapy (UFH + warfarin) for DVT treatment in cancer patients at the Dharmais Cancer Hospital during 2016 – 2018. Data collection was done using cohort-retrospective and individual unit of analysis. Due to limited number of patient treated with rivaroxaban therapy within 3-6 months, we estimated the cost and consequence related to patients who were successfully treated in one month. The consequence was the intermediate outcome, i.e length of stay, recovery, and the occurrence of bleeding. The cost was calculated based on hospital perspective including drugs, laboratory tests, procedures, as well as the administrative and accommodation costs. The results showed that patients with rivaroxaban therapy were not admitted to inpatient care, 40% of patients were recovered from DVT, and none of the patients experienced bleeding. The average cost of rivaroxaban therapy to reach the expected outcome was Rp 8,824,791.00. The study also showed that the outcome of combination therapy (UFH + warfarin) were length of stay between 8 to 14 days, 46% of patients were recovered from DVT, and none of the patients experienced bleeding. The average cost of combination therapy (UFH + warfarin) to reach the expected outcome was Rp 13,201,698.00. Key words: Cancer; deep vein thrombosis; economic evaluation; rivaroxaban; warfarin