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Low Back Pain is one of the leading causes of disability that often requires long-term medical rehabilitation. However, the frequency of rehabilitation visits among Low Back Pain patients enrolled in the National Health Insurance (JKN) program remains suboptimal. This study aims to describe the visit frequency and analyze the factors associated with the frequency of medical rehabilitation visits among JKN participants with Low Back Pain at referral health facilities (FKRTL). This is a non-experimental quantitative study with a cross-sectional design conducted from February to June 2025, using secondary data from the 2024 BPJS Kesehatan Sample Data. The results showed that the majority of LBP patients (65,1%) had a low frequency of rehabilitation visits, indicating poor adherence to therapy. Variables such as age, gender, marital status, residential region and area type, class of care entitlement, participant segmentation, type of FKRTL, and ownership status of FKRTL were significantly associated with the frequency of rehabilitation visits (p < 0.05). These findings highlight the need to strengthen monitoring systems for the utilization of medical rehabilitation services, both to address non-adherence and to identify potential overutilization in specific facilities or patient segments.
Dental health is an integral part of overall body health, and dental health problems contribute significantly to the burden of disease. This study aims to analyze the influence of various variables on the utilization of dental health services at the Primary Health Care (FKTP) based on BPJS sample data in 2023. The research design used the Kruskal-Wallis and Mann-Whitney tests with a total sample of 8,694 participants who utilized dental health services at FKTP in West Java Province. The results showed that the variables of age 15-64 years, female gender, residence in the city, marital status, location of city primary health care facilities, type of primary health care facilities, and PPU membership segment all had a significant relationship with the utilization of dental health services at primary health care facilities (p-value <0.001). The conclusion of this study is that all variables are significantly associated with the utilization of dental health services at primary health care facilities in West Java Province
Latar Belakang: Skizofrenia merupakan gangguan mental kronis yang menimbulkan beban signifikan terhadap sistem pembiayaan kesehatan, terutama dalam program Jaminan Kesehatan Nasional (JKN). Penyakit ini memerlukan perawatan jangka panjang dan rawan kekambuhan, sehingga berkontribusi terhadap tingginya angka kunjungan dan pembiayaan di fasilitas kesehatan, khususnya pada layanan rujukan. Tujuan: Mengetahui besarnya biaya pelayanan kesehatan peserta JKN dengan skizofrenia dan faktor-faktor yang berhubungan dengan biaya tersebut. Metode: Penelitian kuantitatif dengan desain cross-sectional menggunakan data sekunder BPJS Kesehatan tahun 2024. Sampel terdiri dari 1.597 peserta aktif JKN dengan diagnosis skizofrenia selama satu tahun. Analisis dilakukan secara univariat dan bivariat menggunakan SPSS versi 25. Hasil: Total biaya pelayanan mencapai Rp16.896.391.354. Rata-rata biaya rawat jalan Rp314.929 dan rawat inap Rp5.050.107. Biaya signifikan dipengaruhi oleh usia, hubungan keluarga, kelas hak rawat, segmentasi peserta, wilayah kepesertaan, jenis dan kepemilikan FKTP/FKRTL, kunjungan ke FKTP, dan tipe FKRTL. Kesimpulan: Skizofrenia memberikan beban biaya tinggi pada JKN. Diperlukan pembiayaan berbasis kebutuhan serta penguatan layanan jiwa di tingkat primer dan komunitas untuk efisiensi sistem.
Background: Schizophrenia is a chronic mental disorder that poses a significant burden on the healthcare financing system, particularly within Indonesia’s National Health Insurance (JKN) program. The condition requires longterm care and is prone to relapse, contributing to high healthcare utilization and costs, especially at referral level facilities. Objective: To determine the total healthcare costs for JKN participants diagnosed with schizophrenia and to identify factors associated with those costs. Methods: This quantitative study employed a crosssectional design using secondary data from BPJS Kesehatan (Indonesia’s Social Health Insurance) for the year 2024. The sample consisted of 1.597 active JKN participants diagnosed with schizophrenia over a 12 month period. Data were analyzed using univariate and bivariate techniques in SPSS version 25. Results: The total healthcare cost amounted to IDR 16.896.391.354. The average outpatient cost was IDR 314.929, while the average inpatient cost was IDR 5.050.107. Factors significantly associated with higher costs included age, family relationship status, treatment class, participant segmentation, region of enrollment, type and ownership of primary and referral healthcare facilities (FKTP/FKRTL), number of visits to primary care, and type of referral facility. Conclusion: Schizophrenia places a substantial financial burden on the JKN system. A need-based financing approach and strengthened mental health services at the primary and community levels are essential to improving efficiency and sustainability.
