Abstrak:

Sakit merupakan suatu kejadian yang tidal: dapat diduga kapan akan menimpa seseorang. Biaya yang harus dikeluarkan juga cukup bcsar khususnya untulc rawat inap. Untuk rnengurangi beban biaya yang dilimbulkannya, salah satu cara untuk mcntransfer resiko biaya dengan memiliki asuxansi kesehatan. PT. Askes merupakan salah satu asuradur yang wajib dimiliki oleh pcgawai negeri sipil tetapi dalam pelaksanaannya, peserta masih harus mengeluarkan beban biaya sencliri (our ofpocket) karena adanya perbcdaan antara biaya sesuai tarif rumah sakit dengan tarif paket Askes. Beberapa penelitian membuktikan kondisi tersebut, sepeni di RS PMI Bogor, RSUD Kota Cilegon dan RS Persahabatan Jakarta. Sedangkan di RSUD dr. Achmad Diponegoro - Putussibau, Kabupatcn Kapuas Hulu - Kalimantan Barat belum pernah diteliti. Studi ini dilakukan untuk mengetahui gambaran, faktor-faktor apa yang mempengaruhi dan faktor mana yang paling mempengaruhi serta model prcdiksi beban biaya sendiri (our of packcl) pasien rawat inap pegerla Askcs di RSUD dr. Achmad Diponegoro-Putussibau, Kabupatcn Kapuas Hulu, Propinsi Kalimantan Barat, tahun 2005. Rancangan penelitian ini cross sectional dengan sampel sebesar 257 pasien rawat inap di RSUD dr. Achmad Diponegoro - Putussibau, Kabupaten Kapuas I-lulu - Kalimantan Barat tahun 2005. Rata-rata beban biaya sendiri (out of pocket) pasien rawat inap pcserta Askes di RSUD dr. Achmad Diponegoro sebesar Rp. 2l5,472,76 atau 20,84 % dari rata-rata pengeluaran biaya perawatan sesuai tariff RSUD. Bcban minimum sebesar Rp. 25.000,- penyakit penyulit, obat-obatan, pesertal (peserta), peserta3(isteri), pegawail(golongan I), interaksi antara lama hari rawat dengan penyakit penyulit dan interaksi antara penyakit penyulit dengan obat-obatan dimana interaksi antara lama hari rawa dengan penyakit penyulit merupakan faktor yang paling mempengaruhinya (nilai B yang tcrtinggi yakni sebesar 0,624). Setelah dilakukan uji asumsi dan uji interaksi, maka diperoleh model prediksi beban biaya sendiri = 5,743 + 0,3l3*|ama hari rawat - 0,785*tidak ada penyakit penyulit + 0,8l9*obat~obatan (Non DPHO) + 67,39'7*peserta1 + 0,179*peserta3 + l,489*pegawail + 0,26O*Interaksi penyakit penyulit dengan Obat-obatan + 37,353*Imeraksi Iama hari mwat dengan Penyakit Penyulit. Diharapkan pihak manajemen RSUD dapat menghitung tarif RSUD sesuai kondisi riil sehingga dapat digunakan sebagai bahan masukkan ke Pemda Kabupaten Kapuas Hulu untuk menetapkan kebijakan tarif dan pcmberian subsidi ke RSUD khususnya untuk golongan 1, melakukan advokasi pada PT. Askes, menyarankan penggunaau obat-obatan DPI-10 dan diharapkan juga PT. Askes dapat mempenimbangkan untuk menyesuaikan pemberian manfaat kepada. pescrta khususnya untuk pcserta dengan status kepegawaian golongan 1 yaitu bcrupa penyesuaian tarif PT. Askes sesuai dengan situasi dan kondisi rumah sakit.

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No ones could predict when they would get sick. There will be some significant amount of expenses to be paid during the time of being hospitalized. In order to reduce the amount of expenses a patient should pay, to minimalize risk of cost by having health insurance is a way of working it out. PT Askes is one of the health insurance providers which its membership is a mandatory for every public service officers in Indonesia. Yet, in the reality, a patient still have to cover some oi' his or her expenses hom his or her pocket, due to the differences between hospital fare and the expenses that is covered by Askes. Some researches bring forward eveidenoes regarding this issue, in example researched conducted in PMT hospital in Bogor, District Hospital of Cilcgon City, and Persahabatan hospital in Jakarta. While in Kapuas I-lulu District, dr. Achmad Diponegoro Hospital in Putussibau, West Kalimantan Province, such research has not been conducted yet. This researched is to find out the influence factors, the most influence factor, and the prediction model of out of pocket of hospitalized patient with Askcs membership at dr. Achmad Diponegoro Hospital in Putussibau, Kapuas I-lulu District, West Kalimantan Province in 2005. This researched design is cross sectional, using 257 sample of hospitalized patients in dr. Achmad Diponcgoro Hospital in Putusibau, Kapuas Ilulu District, West Kalimantan Province during the year of 2005. The average amount of out of pocket self cost of each patient is Rp 215,472.76 or 20.84 % out of the total expenses in the district hospital. the minimum fare id Rp 25,000.- and the maximum one is Rp 2,784,000.-, depend on the number of days in hospitaL the kind of illness, medications, memberl (the person with the membership), mernber3 (the spouse), level 1 employee, thc interaction between long of stay with the type of illness, and the interaction between the complicated illness and the drugs are the most influence factor( the 6 value are the highest, which is 0,624). The assumption and interaction test, result the model of self expenses prediction model = 5,743 + 0,3 l3*long of stay - 0,785*no complicated illness + 0,8l9*drugs (Non DPHO) + 67,397*memberl + 0,179*member3 + l,489*employeel + 0,260*interaction between complicated illness and drugs + 0,260*Interaction between long of stay and complicated illness. It is necessary for the District Hospital management to calculate the fare according to the real expenses as an advocacy for the Kapuas Hulu District government for the titre and subsidiary to District Hospital policies making especially for the base level oflicer, advocacy to the PT Askes, awareness to use DPHO drugs and it's necessary for PT Askes to consider adjustment in providing the benefits for its members especially for the base level oflicer to be more in line with the current situation of the hospital.

Abstrak: POSTGRADUATE PROGRAM PUBLIC HEALTH SCIENCE STUDIES HEALTH ECONOMIC AND INSURANCE THESIS, August 2005 Roxanna Kuswandhani SELF-EXPENSE (OUT-OF-POCKET) VARIATION DETERMINANT OF IN-PATIENT SERVICES FOR COMPULSORY HEALTH INSURANCE MEMBERS IN CILEGON GENERAL HOSPITAL IN 2004 xv + 77 pages + 12 tables + 1 appendix ABSTRACT Based on the Government Regulation No. 69/91, PT (Persero) Askes is permitted to charge cost sharing to health insurance (Askes) members. The mistake in financing system implemented is that all premiums are carried on by the members. However, in practice, guarantees provided for the members are emphasized more on medical treatment and recovery by charging quite lots of cost sharing, though the services are delivered in Health Service Provider (PPK) net appointed. Consequently, civil servants still have to pay quite lots of self-expense (out-of-pocket). This causes chronic problem for social health insurance in Indonesia, which lead to complaints and blasphemies. Cilegon General Hospital implements health service tariff based on Cilegon Administrative Regulation. The tariff is higher than tariff packet released by PT (Persero) Askes based on a Joint Decree. To avoid more subsidies, compulsory health insurance members who utilize health services in the hospital have to pay by themselves (out-of-pocket) amounting the rest of health service tariff reduced by expense guaranteed by Askes plus Non-DPHO drug cost. This research was carried out in Cilegon General Hospital. The research object is Self-expense (Out-of-Pocket) Variation Determinants of In-Patient Services for Compulsory Health Insurance Members in Cilegon General Hospital in 2004. Data are from the 2004 in-patient register of compulsory health insurance members of Cilegon General Hospital, the 2004 compulsory health insurance member in-patient payment bill, at Cilegon General Hospital finance division, and the 2004 drug usage and prescription report of compulsory health insurance member in-patients of Cilegon General Hospital This research is an analytical survey using quantitative cross sectional approach. Dependent and independent variables are measured simultaneously. The result indicates that of 240 patient populations, self-expense (out-of-packet) variable has an average value of 671,719 rupiahs, with deviation standard 842,414 rupiahs and median 265,143 rupiahs. Meanwhile, the lowest self-expense (out-of-pocket) is 0 rupiahs and the highest is 5,683,925 rupiahs. Using bivariate analysis, variables related to self-expense (out-of-pocket) are age, officialdom level, education level, medical treatment pattern, medical care class choice, and length of care. The last modeling in multivariate analysis using double linear regression analysis yielded self-expense (out-of-pocket) =4.908+0.06*length of care + 0.156*local administration subsidies – 0.683*medical treatment pattern + 0.579*medical care class choice + 0.472*education 2(D3)-0.323 level (officialdom level II). It is recommended that PT Askes evaluate the determination of packet tariff and DHPO drugs periodically, disseminate medical treatment packets and medical care classes appropriate for their level/right and advocate PPK the proportional medical treatment days. It is also recommended for the next research to obtain more complete information on how much the expense for non-DHPO drugs is from respondents. It is hoped that Cilegon General Hospital provide qualified services in spite of different medical service class, upgrade their data so that they can help education, research and development of health. References: 42 (1985—2005)

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Masih tingginya preskripsi obat paten yang telah mempunyai generik di salah satu bagian Rumah Sakit Umum Pusat Hasan Sadikin (RSHS) Bandung telah mendorong dilakukannya penelitian Beban Biaya Yang Timbul Akibat Ketidakpatuhan Pemberian Obat Generik Pada Pasien Rawat Inap di RSHS - Bandung Tahun 2001. Biaya ketidak-patuhan pemberian obat generik adalah biaya masyarakat yang tidak perlu yang menjadi ruang lingkup penelitian ini. Penelitian dilakukan selama bulan April sampai Juni 2002 dengan desain Comparative Non Eksperimental Study secara Ex Post Facto terhadap data sekunder pasien rawat inap di RSHS Tahun 2001. Sampel yang diambil sebanyak 323 buah dengan sumber data terdiri dari resep, kartu status, dan rekam medik tahun 2001. Hasil penelitian menyatakan bahwa beban biaya tambahan yang harus ditanggung pasien/keluarga pasien karena ketidak-patuhan pemberian obat generik secara financial mencapai Rp 10,6 juta atau 55,46% dari belanja obat pasien. Variabel lama kerja dokter dan keparahan penyakit ternyata merupakan variabel yang dominan yang mempengaruhi ketidak-patuhan pemberian obat generik. Estimasi biaya ini pada pasien rawat inap selama tahun 2001 mencapai Rp 13 miliar atau sekitar Rp 600 ribu per pasien rawat inap. Disarankan perlunya tambahan materi pengenalan obat generik bagi dokter maupun calon dokter serta melakukan trial klinik obat generik baik di universitas maupun di rumah sakit dengan melibatkan para dokter maupun calon dokter. Saran berikutnya adalah perlunya memberdayakan Permenkes nomor 085/MEN/KES/PER/I/1989 yaitu dengan memberikan penghargaan pada dokter yang patuh memberikan obat generik dan memberikan pembinaan pada dokter yang tidak patuh memberikan obat generik.

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The heightening of branded medicine prescribing in one department of RSHS - Hasan Sadikin Central Public Hospital motivated the study of Cost Implication of Non-compliance of Generic Medicine Prescribing of Hospital Care Patient in Hasan Sadikin Central Public Hospital - Bandung 2001. The non-compliance cost implication of generic medicine prescribing is a community unnecessary cost that being this study scope. The study was carried out during April -- June 2002 on Comparative Non Experimental with Ex Post Facto Design to the secondary data of hospital care patients in RSHS - Bandung in 2001. The amount of sample is 323 consist of prescriptions, condition state cards of patient, and medical records. The result showed that the cost implication bad to be loaded by the patient or their family caused non-compliance of generic medicine prescription financially are Rp 10,6 million or 55,46% from their medicines cost. Physician length of work and severity of disease are dominant variables in influencing of non-compliance generic medicine prescribing. Estimation of the non-compliance cost on hospital care patient in 2001 reaches Rp 13 billion or about Rp 600 thousand per patient. Suggestion is having addition of genetic medicine introducing to both physicians and their candidates and its clinical trial in universities or hospitals. The further suggestion is law enforcing of Permenkes 085/MEN/KES/PER/I/1989 by giving reward to the doctors compliance generic medicine prescribing and pay attention to the others to establish compliance generic medicines prescribing.

Abstrak:

Diare akut sarnpai saat ini masih merupakan masalah kesehatan, tidak saja di negara berkembang tetapi juga di negara maju. Penyakit diare ini masih sering menimbulkan Kejadian Luar Biasa (KLB) dengan penderita yang banyak dalam waktu yang singkat. Dalam periode tahun 2005-2006, jumlah kasus penyakit diare di Kabupaten Landak mengalami kenaikan yang cukup tajam. Tahun 2005 sebanyak 4.474 kasus (1 meninggal) dan tahun 2006 naik menjadi 6.210 kasus (2 meninggal). Diare menempati urutan ketiga setelah ISPA dan Malaria dalam proporsi sepuluh penyakit terbesar di Kabupaten Landak. Tingginya kejadian penyakit diare ini menimbulkan kerugian sosial ekonomi dan berdampak pada pembiayaan pemerintah dan masyarakat. Penelitian terhadap kerugian yang dialarni oleh diare pemah dilakukan hanya pada satu sisi saja yaitu pada sisi pasien. Sementara sisi provider belum pemah dilakukan. Biaya yang timbul pada sisi provider maupun pasien masing-masing diklasifikasikan sebagai biaya langsung (drect cost) dan biaya tak langsung (indirect cost). Untuk itu penelitian ini bertujuan secara umum rnemperoleh gambaran tentang besaran biaya yang ditimbulkan akibat sakit (cost of illness) rawat jalan diare. Sedangkan Tujuan khusus penelitian ini adalah untuk memperoleh gambaran tentang karakteristik pasien rawat jalan diare, besaran biaya langsung (direct cost) dan biaya tak langsung (indirect cost) pada sisi provider dan pasien yang melakukan kunjungan ke puskesmas dalam satu periode sakit. Penelitian ini menggunakan desain studi cross sectional dengan jumlah responden sebanyak 96 orang yang dilaksanakan di wilayah kerja Puskesrnas Ngabang Kalimantan Barat pada buian Maret s/d Mei 2007. Data yang digunakan dalarn penelitian ini adalah data sekunder yang diperoleh dari lokasi penelitian serta data primer yang diperoleh dari basil interview kepada pasien. Hasil penelitian menunjukkan bahwa kebanyakan pasien ada/ah kelompok umur dewasa 44%, berjenis kelamin laki-laki 54%, tidakibelum bekerja 49%, tidakibelum sekolah 50%, tidak berpenghasilan 56%, jalan kaki ke puskesmas 40%, penanggung biaya puskesrnas berasal dad kantong sendiri 76%, jurnlah hari sembuh 2 hari 54%. Hasil penelitian menunjukkan besar biaya langsung pada provider adalah Rp. 2.292.440,- dengan rata-rata biaya langsung sebesar Rp. 23.879,-. Biaya tidak langsung pada provider sebesar Rp. 75.492,- dengan rata-rata sebesar Rp. 786,-. Total biaya pada provider sebesar Rp. 2.367.933,- dengan rata-rata sebesar Rp. 24.665,-. Biaya langsung pada pasien sebesar Rp. 478.000,- dengan rata-rata sebesar Rp. 4.979,- per pasien. Biaya tidak langsung pada pasien sebesar Rp. 1.090.250,- dengan rata-rata sebesar Rp. 11.356,-. Total biaya pada pasien diare sebesar Rp. 1.568.250,- dengan biaya rata-rata sebesar Rp. 16335,-. Hasil penelitian ini menunjukkan bahwa rata-rata biaya akibat sakit (cost of illness) yang dikeluarkan baik pada sisi provider maupun sisi pasien untuk pelayanan rawat jalan diare per pasien sebesar Rp. 41.001,-(tidak termasuk opportunity cost). Apabila dilakukan simulasi perhitungan kerugian ekonomi yang menjadi beban pemerintah dan masyarakat akibat sakit diare maka diperoleh angka sebesar Rp. 1,6 IniIyar per tahun, atau 0,3% dari APED (Rp. 435.887.753.163,-), 7% dari anggaran kesehatan plus gaji (Rp. 26.126.133.800,-), 9% dari anggaran kesehatan tanpa gaji (Rp. 18.245.385.200,-). Dikaitkan dengan UMR Landak, maka didapatkan angka kerugian sebesar Rp. 2,5 Myst per tahun. Saran yang dapat disampaikan adalah angka kenigian yang dialarni dapat dijadikan aeuan perencanaan, penyusunan anggaran dan intervensi program penanggulangan diare dengan berorientasi path upaya preventif dan promosi, perlunya dilakukan penghematan biaya pada sisi provider dengan menekan penggunaan obat diare yang tidak rasionil, perlu dilakukan perhitungan biaya secara menyeluruh berdasarkan kegiatan, perlu penyuluhan dan perbatian kepada masyarakat tentang penyakit diare, dan terakhir bagi peneliti selanjutnya dapat melihat seeara bersarnaan pada layanan rawat jalan dan map di rurnah sakit dan puskesmas dengan menghitung opportunity cost.

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Acute diarrhea at present still becomes health problem, not only in developing countries but also in developed countries. Diarrhea still leads to endemic (KLB) with very huge sufferer in short time. Between 2004-2005, number of diarrhea case in Landak Regency increase quite sharply. There are 4,474 cases (one died) in 2005 and the cases increase to 6,210 (2 died) in 2006. Diarrhea places the third rank after Upper Respiratory Infection (1SPA) and malaria among ten diseases in Landak Regency. The high of diarrhea incident has caused social economic loss and affected the cost for government and people. Research on loss caused by diarrhea was ever conducted but limited on patient side. Meanwhile, research on provider has never been done. Cost resulted from patient as well as provider was respectively classified as direct cost and indirect cost. Generally, the purpose of this research is to obtain description on the cost of illness for diarrhea outpatients. Meanwhile. particularly, the purpose is to obtain description on characteristics of diarrhea outpatients, direct cost and indirect cost at provider and patient visiting health center in one period of illness. The research conducted in Puskesmas Ngabang West Kalimantan from March to May 2007 uses cross sectional design with 96 respondents. Secondary data employed in this research come from research location, while the primary data come from interviewing the patient. The results show that mostly patients are adult (44%). male (54%). unemployment (49%). uneducated (50%), having no income (56%). going to health center on foot (40%). self-utiarant or (76%), and having two-days recovery day (54%). Direct cost for provider is IDR 2,292,440 with direct cost IDR 23,879 on average. Indirect cost for provider is 1DR 75,492 with [DR. 786 on average. Total cost for provider is IDR 2.367,933 with /DR 24,665 on average. Direct cost on patient is [DR 478,000 with DR 4,979 on average per patient. Indirect cost for patient is [DR 1,090,250 with IDR 11,356 on average. Total cost for diarrhea patienzs is [DR 1.568.250 with 1DR 16,335 on average. The results indicate that thc average cost of illness incurred by both provider and patients for outpatient service of diarrhea per patient is [DR. 41,001 (excluded opportunity cost). If economic loss due to diarrhea borne by government and people was caiculated, the rate is DR 1.6 billion per year or 0.3% of APBD (1DR 435,887,753,163), 7% of health budget phis salary (IDR 26,126,133.800), 9% of health budget without salary (IDR 18,245,385,200) Related to UN1R of Landak. the loss is 1DR 2.5 billion per year. It is recommended that loss can be used as reference in planning, developing budget. and intervening program diarrhea control orienting to prevention and promotion. It is in need to retrench provider cost by reducing irrational use of diarrhea medicines, calculate cost comprehensively based on activities, educate people and keep them focused on diarrhea. Furthermore,, researcher could instantaneously see the service for outpatient and inpatient in hospital and health center by calculating opportunity cost.

Abstrak:

ABSTRAK Obat merupakan salah satu kornponen penting dan memeriukan biaya besar dalarn pelayanan kesehatan. Harganya relatif mahal dan tidak berpihak kepada konsumen, sehingga bisa menyebabkan temjadinya moral hazard pada para pelaku kesehalan. Pasien tidak bisa memilih sesuai dengan kebutuhan dan kemampuan bayarnya karena mempunyai kctcrbatasan kemampuan. Salah satu pengendalian biaya kesehatan yaitu melalui jaminan pelayanan kesehatan sosial yang ditangani oleh PT Askes. Pelayanan yang dibenikan seharusnya bersifat komprehensif, tetapi kenyataannya jaminan ditekankan pada pcnycmbuhan dan pemulihan dengan iur biaya (cost sharing), ini berlaku untuk pelayanan obat. Pengendalian biaya obat askes melalui penggunaan DPHO. Penulisan resep dokter diluar DPI-I0 dapat membcratkan pasicn askes, apalagi pada penderita penyakit kronis seperti hipertensi. Di RSUD Gunung Jati tahun 2006 penyukit hipertensi merupakan peringkat empat kelornpok penyakil di instalasi rawat jalan dcngan kunjungan 470 pasien per bulan. I Pcnclitian ini dilakukan untuk mengetahui pola peresepan dan biaya obat pasien askes sosial penderita hiperlensi Instalasi Rawat Jalan RSUD Gunung J ati dan perbedaan biaya obat gcncrik pcngganti obat bermerk di luar DPI-I0 yang ditulis dokter. Jenis penelitian kuantitatif dengan metode survey, dan dilakukan analisis data dengan Wilcoxon's Signed Rank Test, Mann-Whitney Test, Kruska!-Wallis Test. Hasil pcnelitian diketahui bahwa penderita hipertensi lebih banyak yang mempunyai penyakit lainfpenyerta, dan terbanyak diabetes mellitus (49%). Resep dokter untuk penderita hipertensi pescrta askes sosial semua obatnya masuk DPI-IO.. Obat antihipertensi yang terbanyak ditulis dokter adalah Amlodipin scbanyak SI R/ (2l,34%) dari total obat antihipertensi. Dari hasil analisis diketahui jumlah item obat (R/) rata-rata = 2,8lR/, besar rata-rata biaya obat pada penulisan rescp_dokter Rp 70.167 dan pelayanan apotik Rp 5. 128, dengan nilai p = 0,000 menunjukan adanya perbedaan ra1a~rala besar biaya obat amara keduanya. Hasil perbandingan rata-rata besar biaya obal pada pcnulisan resep doktcr, ada perbedaan (p < 0,05) pada penulisan resep antar dokter, antar poliklinik, antar kelompok umur pasien dan anlar penyakit pcnycrta serta tidak ada perbedaan antar kelompok tempat tinggal dan antar jenis kelamin pasien. Hasil perbandingan rata-rata jumlrtth item obat ada perbedaan (p < 0,05), pada pcnulisan resep amar poliklinik dan antar penyakit penyerta serta tidak ada perbedaan (p > 0,05) untuk penulisan resep antar dokter, antar jenis kelamin , antar umur dan antar kota tempat tinggal pasien. Kesimpulan dari pcnelitian ini adalah tidak ada obat di luar DPHO yang ditulis dokter untuk pasicn askes sosial penderita hipertensi. Rata-rata jumlah item obat pcrlcmbar resepnya 2,81 dan biaya penulisan resepnya sebcsar Rp 70.l67. Sebagai saran kcpada rumah sakit agar terus melakukan pemantauan terhadap para dokter tentang pcnulisan resep dalam DPI-IO untuk pasicn askes. Sedangkan untuk P.T Askes dan Apotik Askes agar selalu rnenyedial-can obat yang diresepkan dokter dan dapat mcmberikan obat kepada pasien sesuai resep dokter dan kctentuan DPI IO (maksimal untuk 30 hari).

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ABSTRACT Medication is one of important component and needs great cost in health service. The prices are relatively expensive and not stand for consumer, so that it could cause moral hazard to health agent. Patient could not choose appropriate with needs and ability to pay because has limited ability. One of the health cost restriction is through social health service guarantee that handled by PT Askcs. Given service should comprehensive, but apparently guarantee stressed to heal and curing with cost sharing, it prevails for medication service. Cost control of medication health assurance through using DPHO. Doctor prescription outside DPHO could against health assurance patient, especially on chronic diseases patient such as hypertension. In RSUD Gunung Jati year 2006 hypertension disease is forth level disease group in outpatient installation with visitation of 470 patients per month. This research conducted to recognize prescription design and medication cost of social health assurance patient with hypertension. RSUD outpatient installation Gunung Jati and difference of genetic medication as substitute of branded medication outside DPHO that written by doctor. Quantitative research type conducted with survey method, and conducted data analysis by Wi1coxon?s Signed Rank Test, Mann- Whitney Test, and Kruskal-Waillis Test. Research result known that more hypertension patient has other disease/participate: and the most is diabetes mellitus (49%). Doctor prescription for hypertension patient of social health assurance participant all of the medication included in DPHO. The most anti-hypertension medication that written by doctor is Amlodipin as much as Sl R/(21 ,34%) from total medication of anti-hypertension. From analysis result known that average medication item (Rf) = 2,8lR/, average medication cost on doctor prescription is Rp 70.167 and pharmacy service is Rp. 5.128, with p value = 0,000 shows a difference of average medication cost between both. Equivalent result of average medication cost on doctor prescription there is difference (p < 0,05) on prescription between doctor, between polyclinic, between patient age group and between disease participator and there is no difference between residence groups and between patient gender. There is a difference of average equivalent result of total medication item (p < 0,05) for prescription between doctor, between gender, between ages and between patient town. Conclusion from this research is not medication outside DPHO that written by doctor for social health assurance hypertension patient. Total average of medication item prescription sheet is 2,81 and prescription cost is Rp. 70. 167. Suggested hospitals constantly do monitoring toward doctor about prescription in DPHO for health assurance patient. While suggested both PT Askes and Askes Pharmacy to give medication for patient appropriate with doctor prescription and DPI-IO regulation (maximally 30 days).