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Background: Tuberculosis and diabetes mellitus are major health problems in Indonesia. The correlation between these two diseases leads to an increased risk of treatment failure, relapse, which affects the duration of treatment and high financial burden. Objective: To identify factors associated with the incidence and cost of treating tuberculosis and diabetes mellitus among JKN participants in 2019. Methods: This study used a quantitative approach with a cross-sectional study using BPJS Health Sample Data in 2019. The samples of this study were patients with a diagnosis of tuberculosis and diabetes mellitus at FKRTL services in 2019. Results: Patients with TBDM comorbidities in Indonesia were 21,105 participants. BPJS Kesehatan spent a budget of Rp. 120,563,754,830.00 for the treatment of patients with TBDM comorbidities for one year. Factors associated with TBDM comorbidities and treatment costs were gender, age, entitlement to treatment class, membership segment, type of primary care provider, population density, smoking percentage, and environmental quality (p-value <0.05). Conclusion: The variables of case severity and primary care visit rate did not influence the high cost of care for patients with TBDM comorbidities
This study aims to analyze the use of caesarean section deliveries in advanced referral health facilities in DKI Jakarta Province in 2023, using an non-experimental analytical cross-sectional design based on BPJS Health sample data from 2024. Results showed that 77.6% of participants gave birth via caesarean section. Several factors were significantly associated with caesarean delivery, including age over 35 years (OR: 1.93; 95% CI: 1.68–2.21), residence in East Jakarta (OR: 4.68; 95% CI: 4.18–5.25), PBPU insurance status (OR: 2.50; 95% CI: 2.23–2.79), Class I inpatient entitlement, private hospital ownership (OR: 3.19; 95% CI: 3.08–3.32), Class C hospital type (OR: 1.50; 95% CI: 1.47–1.75), and facility location in East Jakarta (OR: 3.75; 95% CI: 3.53–3.98). History of caesarean section was the strongest predictor (OR: 77.2; 95% CI: 61.42–97.2), indicating a high likelihood of reccuring procedures. These findings highlight the importance of careful medical decision-making during the first delivery, as it can significantly influence subsequent delivery patterns. Comprehensive interventions are needed, both on the maternal side through preventive measures and strengthened readiness starting at the primary care level, and on the service side through medical audits and strict implementation of clinical guidelines.
Latar belakang: Penyakit menular, khususnya Tuberkulosis (TB), masih menjadi tantangan besar di Indonesia, dengan prevalensi yang tinggi dan dampak signifikan terhadap sistem kesehatan. Komorbiditas seperti Diabetes Mellitus (DM) dan koinfeksi HIV memperburuk pengobatan TB, memperpanjang durasi terapi, serta meningkatkan beban biaya. Penelitian ini bertujuan untuk menganalisis perbandingan biaya rawat inap pada pasien TB dengan komorbid DM dan koinfeksi HIV di fasilitas kesehatan Indonesia, khususnya yang terdaftar dalam program Jaminan Kesehatan Nasional (JKN). Tujuan: Mengetahui perbandingan biaya rawat inap pada layanan FKRTL peserta JKN penderita TB/DM dan TB/HIV di Indonesia selama satu tahun. Metode: Penelitian ini menggunakan pendekatan kuantitatif dengan studi cross-sectional menggunakan data sampel BPJS Kesehatan tahun 2023. Sampel penelitian ini adalah peserta dengan diagnosis primer TB yang memiliki diagnosis sekunder DM dan HIV pada pelayanan FKRTL. Hasil: Terdapat sebanyak 4.753 peserta RITL JKN tahun 2022. Dari total kunjungan, sebanyak 4.531 merupakan peserta komorbid TB/DM dan 232 peserta koinfeksi TB/HIV. Pada tahun 2022, BPJS Kesehatan membayarkan sebesar Rp28,8 miliar untuk peserta RITL komorbid TB/DM dan Rp3,1 miliar untuk peserta RITL koinfeksi TB/HIV. Kesimpulan: Faktor-faktor yang berhubungan dengan biaya komorbid TB/DM pada kunjungan RITL peserta JKN 2022 adalah umur, hak kelas rawat, segmen kepesertaan, dan rujukan FKTP. Sedangkan, faktor-faktor yang beruhubungan dengan biaya koinfeksi pada kunjungan RITL pada kunjungan peserta JKN 2022 adalah jenis kelamin, umur, hak kelas rawat, dan segmen kepesertaan.
Background: Infectious diseases, particularly Tuberculosis (TB), remain a major challenge in Indonesia, with high prevalence and significant impact on the healthcare system. Comorbidities such as Diabetes Mellitus (DM) and HIV coinfection worsen TB treatment, prolong therapy duration, and increase healthcare costs. This study aims to analyze the comparison of inpatient costs for TB patients with comorbid DM and HIV coinfection in Indonesian healthcare facilities, specifically those enrolled in the National Health Insurance (JKN) program. Objective: To determine the comparison of inpatient costs for JKN FKRTL services for TB/DM and TB/HIV patients in Indonesia over the course of one year. Method: This study employs a quantitative approach with a cross-sectional design using BPJS Health sample data from 2023. The research sample includes participants with a primary TB diagnosis and secondary diagnoses of DM and HIV in FKRTL services. Results: There were 4,753 JKN inpatient participants in 2022. Of these, 4,531 were TB/DM comorbid patients, and 232 were TB/HIV coinfected patients. In 2022, BPJS Health paid Rp28.8 billion for TB/DM comorbid patients and Rp3.1 billion for TB/HIV coinfected patients. Conclusion: Factors related to the cost of TB/DM comorbidity for JKN inpatient visits in 2022 include age, inpatient class entitlement, membership segment, and FKTP referral. Meanwhile, factors related to the cost of coinfection for JKN inpatient visits in 2022 include gender, age, inpatient class entitlement, and membership segment.
