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p-Index From 2021 - 2026
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All Journal KESANS : International Journal of Health and Science
Ummi Kalsum
Universitas Jabmbi, Indonesia
Chemistry Health Professions Medicine & Pharmacology Physics Public Health

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A Systematic Review of Reimbursement Mechanisms: Effectiveness, Efficiency, and Patient Satisfaction in Insurance-Based Health Financing Systems Neliyana Neliyana; Ummi Kalsum; Asparian Asparian; Dwi Noerjoedianto; Wilia Novita Eka Rini; Muldiasman Muldiasman
Jurnal KESANS : Kesehatan dan Sains Vol 5 No 9 (2026): KESANS: International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v5i9.646

Abstract

Introduction: The reimbursement mechanism is a fundamental component in an insurance-based financing system that affects service effectiveness, operational efficiency, and patient satisfaction. Objective: This study aims to conduct a systematic review of the literature that discusses reimbursement mechanisms with a focus on these three main dimensions. Method: Using the Systematic Literature Review approach following the PRISMA 2020 guidelines, a comprehensive search was conducted through four electronic databases to identify peer-reviewed articles for the 2021-2025 period. Of the 30 articles initially identified, six studies met the inclusion criteria and were analyzed in depth. Results and Discussion: Results show that the Diagnosis Related Groups system is effective in reducing costs but has the potential to negatively impact the quality of service. Differential reimbursement and cost-sharing mechanisms have been shown to be able to direct healthcare seeking behavior, although their effectiveness is highly contextual dependent on geographic and socio-economic factors. Patient satisfaction shows significant variation by service class with disparities in the dimensions of effectiveness, accessibility, patient-centeredness, and equity. The utilization rate of health services in Indonesia's National Health Insurance system is still relatively low, indicating the need for a comprehensive evaluation of the design of reimbursement mechanisms. Conclusion: This study emphasizes that optimizing the reimbursement system requires a holistic approach that balances cost efficiency, service quality, and patient satisfaction as interrelated outcomes in the health financing ecosystem
Systematic Review: Factors Associated with the Incidence of Colorectal Cancer Tassya Alfiola; Ummi Kalsum; Fairuz Quzwain
Jurnal KESANS : Kesehatan dan Sains Vol 5 No 9 (2026): KESANS: International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v5i9.655

Abstract

Introduction: Colorectal carcinoma (CRC) ranks third in global cancer incidence with an estimated 1.93 million new cases in 2020 and constitutes the second leading cause of cancer-related mortality worldwide. Indonesia documented 34,189 new cases, predominantly diagnosed at advanced stages, underscoring the critical need for comprehensive identification of CRC risk determinants. Objective: To systematically synthesize factors associated with CRC occurrence and analyze the magnitude of their associations to formulate evidence-based prevention recommendations. Methods: A systematic literature review following PRISMA 2020 guidelines was conducted across PubMed, Google Scholar, and ScienceDirect (2015–2024), yielding 30 selected articles from 309 initial records. Results and Discussion: Non-modifiable factors demonstrated the highest associations, including first-degree family history (OR 17.78), precancerous lesions (OR 8.57), and inflammatory bowel disease (OR 7.07). Modifiable factors encompassed physical inactivity (OR 5.69), excessive red meat consumption (OR 4.97), alcohol (OR 4.92), central obesity causally confirmed via Mendelian randomization (OR 1.38), diabetes (HR 2.20), and hypertension (HR 1.99). Gut microbiota dysbiosis actively contributed to carcinogenesis through genotoxicity and chronic inflammation mechanisms. Conclusion: CRC is multifactorial in nature; while non-modifiable factors carry larger absolute effect sizes, modifiable factors offer more strategically actionable intervention targets
Co-Authors Asparian Asparian Dwi Noerjoedianto Fairuz Quzwain Muldiasman Muldiasman Neliyana Neliyana Tassya Alfiola Wilia Novita Eka Rini