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All Journal Jurnal Jaminan Kesehatan Nasional Jurnal Ekonomi Kesehatan Indonesia
Novelia, Elsa
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Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Health Professions Medicine & Pharmacology Public Health

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Cost Effectiveness Analysis Between Hemodialysis and Peritoneal Dialysis Novelia, Elsa; Nugraha, Ryan Rachmad; Thabrany, Hasbullah
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 3
Publisher : UI Scholars Hub

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Abstract

The number of patients with End Stage Renal Disease (ESRD) in Indonesia is growing. Increasing prevalence of hypertension and diabetes mellitus contributes to higher prevalence of ESRD. The majority of patients (94%) with ESRD are undertaking hemodialysis (HD) at public and private hospitals. However, continuous ambulatory Peritoneal Dialysis (PD) has been prescribed to small portion of patients with ESRD. The aim of this study was to examine the cost effectiveness between HD and PD on ESRD patients. This study compared 78 HD patients at Hospital X in Bogor and 10 PD patients at Hospital Y in Jakarta. Patient’s quality of life (QoL) was measured using SF 36 questionnaires. The costs were measured by direct medical costs using CBGs prices, direct non-medical costs (transportation, food for patient and family), and indirect medical costs (opportunity costs). The study found that the HD cost per year per patient was IDR 133.4 million and the comparative cost for PD was IDR 81.7 million. The study found lower QoL of HD patients (46.2%) compared to QoL of PD patients (90%). In addition, PD patients had significant better quality of physical activities, emotional states, social function, and sanity. The study found the incremental costs for to HD to reach similar emotional states was IDR 2.0 million compared to PD and IDR 1.8 million for extra physical role gained. It is concluded that PD was more cost-effective than HD in achieving a certain level of quality of life among patients with ESRD in two hospitals in Indonesia.
Enhancing Clinical Coding Expertise in Indonesia’s National Health Insurance Program Gultom, Novianti Br.; Saputra, Arisandy; Surini, Dwi; Erwinsyah; Novelia, Elsa; Johana; Dosiema, Vernanda; Corina, Intan; Ratnafuri, Miranti; Adi Wijayanti, Fallah; Setyawan, Dedy; Januar Prakarsa, Egar; Pali'padang, Sarman; Wardanu, Gilang Yoga; Surosa, Lia Yulianti; Langenbrunner, Jack; Blake, John
Jurnal Jaminan Kesehatan Nasional Vol. 5 No. 2 (2025): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v5i2.408

Abstract

Coding medical records using classification systems can cause inconsistencies, sometimes leading to claim disputes. In January 2021, 440,749 disputed cases were reported, with a total disputed cost amounting to Rp873,111,325,287 for referral healthcare facility claims under the National Health Insurance (JKN). In May 2021, BPJS Kesehatan established the Clinical Coding Expert/Tim Ahli Pengodean Klinis (TAPK) for enhancing clinical coding expertise. The objective of this study was to examine the impact of establishing TAPK. We hypothesize that TAPK affects the decrease in disputed cases in 12 regions of Indonesia. We used data from the JKN Program prior to the establishment of TAPK in January 2021 as controls. We followed up on 86,272 cases for two years after its implementation (as of April 2023). Paired data from 12 regions were compared using descriptive statistics, inferential statistics (paired sample t-test), and boxplot visualization. We also described the knowledge management of clinical coding through Knowledge Spiral of Nonaka and Takeuchi. The finding showed a decrease in the number of claim dispute cases in April 2023 compared to January 2021 (by 80.43%). The average claim cases decreased from 36,729.08 (Before TAPK) to 7,189.33 (After TAPK; t = 2.620, p = 0.0238). TAPK has contributed to standardized coding practices in hospitals across regions. This study reinforces the importance of action to improve competence and organizational learning in TAPK through Knowledge Spiral Model and recommends that TAPK be more widely known to all JKN’s healthcare facilities. Future research should optimize AI-driven clinical coding while ensuring human oversight.
Co-Authors Adi Wijayanti, Fallah Blake, John Corina, Intan Dosiema, Vernanda Erwinsyah Gultom, Novianti Br. Hasbullah Thabrany Januar Prakarsa, Egar johana Langenbrunner, Jack Nugraha, Ryan Rachmad Pali'padang, Sarman Ratnafuri, Miranti Saputra, Arisandy Surini, Dwi Surosa, Lia Yulianti Wardanu, Gilang Yoga