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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.
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.
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.
This study analyzes the utilization of mental health services for depression at healthcare facilities among JKN participants in 2023. The research design is non-experimental with a cross-sectional approach. The results show that the majority of participants utilized mental health services for depression with a low frequency of visits, ranging from 1 to 3 visits per year, totaling 70,351 (88.3%) participants. Factors that showed significant associations include age, gender, marital status, participant segmentation, type of healthcare facility, ownership of healthcare facility, and facility location. The main determinant is age, with participants aged 45-54 having the highest likelihood of being in the high-frequency visit category (OR: 2.583; 95% CI: 2.042-3.268). These findings indicate the need for education, interventions, improvement in service quality and healthcare providers, as well as the equitable distribution of healthcare facilities and workforce.
This study analyzes the utilization of mental health services for depression at healthcare facilities among JKN participants in 2023. The research design is non-experimental with a cross-sectional approach. The results show that the majority of participants utilized mental health services for depression with a low frequency of visits, ranging from 1 to 3 visits per year, totaling 70,351 (88.3%) participants. Factors that showed significant associations include age, gender, marital status, participant segmentation, type of healthcare facility, ownership of healthcare facility, and facility location. The main determinant is age, with participants aged 45-54 having the highest likelihood of being in the high-frequency visit category (OR: 2.583; 95% CI: 2.042-3.268). These findings indicate the need for education, interventions, improvement in service quality and healthcare providers, as well as the equitable distribution of healthcare facilities and workforce.
