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All Journal Nurse Media Journal of Nursing Health Science Journal of Indonesia Jurnal Administrasi Kesehatan Indonesia JURNAL KESEHATAN LINGKUNGAN (Journal of Environmental Health) Aspirasi : Jurnal Masalah-masalah Sosial Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Wahyu Pudji Nugraheni
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Religion Humanities Dentistry Education Health Professions Nursing Public Health Social Sciences

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The Implications of The Covid-19 Pandemic on The Utilization and Catastrophic Costs of National Health Insurance Wahyu Pudji Nugraheni; Syarifah Nuraini; Risky Kusuma Hartono
Health Science Journal of Indonesia Vol 13 No 1 (2022): (In Press)
Publisher : Sekretariat Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/hsji.v13i1.6028

Abstract

Background: The COVID-19 pandemic in Indonesia has significantly impacted the health care system and insurance schemes. Social distancing policies during the pandemic have led to changes in utilization in health facilities, especially those related to catastrophic diseases that cost a lot of money. This study aims to analyse the impact of the Covid-19 pandemic on the utilization and financing of catastrophic diseases in the National Health Insurance (NHI) program. Methods: The research design is quantitatively and qualitatively. The quantitative study analysed secondary data obtained from the Social Security Administrator for Health and the nat. This study also has qualitative data from in-depth interviews with government and private hospital informants, health economists, and social health insurance experts. Results: COVID-19 pandemic has impacted decreasing the utilization of National Health Insurance participants to health facilities and significantly affecting the financing of catastrophic diseases. Before pandemic, the disease with the highest claim fee was ischemic heart disease, and after the pandemic, the disease with the highest claim fee was chronic kidney disease. There is also a change in the ranking diseases pattern before and during the covid-19 pandemic. Conclusion: In the future, National Health Insurance financing needs to expand the scope of the benefits of preventive and promotive services, especially the prevention of catastrophic diseases, to reduce the burden of NHI claims. Health facilities provided by National Health Insurance providers need to prepare for better management of health services after the pandemic.
Pengalaman Indonesia dalam Penanganan Dispute Klaim Covid-19 Nugraheni, Wahyu Pudji; Hartono, Risky Kusuma; Situmorang, Chazali; Thabrany, Hasbullah
Jurnal Aspirasi Vol 13, No 1 (2022)
Publisher : Pusat Analisis Keparlemenan Badan Keahlian Sekretariat Jenderal DPR RI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46807/aspirasi.v13i1.2747

Abstract

Dispute claims for Covid-19 patient financing become a problem amidst the pandemic that could impact the sustainability of health service cash flow in several provinces in Indonesia. This research aims to explore the handling and dispute claims of Covid-19 patients in nine provinces in Indonesia. Also, this is qualitative research using a case study approach. Informants came from primary and secondary health services. Data analysis was carried out by means of triangulation of sources between the informants. The results from this research indicate that several provinces still have difficulties using the online application for claim handling based on the experience that has occurred. Other obstacles include claim documents that failed to upload, unreadable documents, and residents without a national identity number or NIK. These are what made most of the dispute claims occur due to the incomplete claim files and the criteria for guaranteed patients who were not eligible. One of the efforts the hospital took was improving the hospital management information system to minimize dispute claims. This research concludes that dispute claims are still vulnerable, so increasing the capacity and information system of health services, commitment, coordination, and regular socialization from the payer side is needed to prevent the dispute claims of Covid-19 patients.Abstrak:Dispute klaim pembiayaan pasien Covid-19 menjadi permasalahan di tengah pandemi yang dapat berdampak pada keberlangsungan arus kas pelayanan kesehatan di beberapa provinsi di Indonesia. Penelitian ini bertujuan untuk mengeksplorasi penanganan dan dispute klaim pasien Covid-19 di sembilan provinsi di Indonesia. Penelitian ini juga merupakan penelitian kualitatif dengan pendekatan studi kasus. Informan berasal dari pelayanan kesehatan primer dan sekunder. Analisis data dilakukan dengan cara triangulasi sumber antarinforman. Hasil dari penelitian ini menunjukkan bahwa beberapa provinsi masih kesulitan menggunakan aplikasi daring untuk penanganan klaim berdasarkan pengalaman yang telah terjadi. Kendala lainnya antara lain dokumen klaim yang gagal diunggah, dokumen yang tidak terbaca, dan penduduk yang tidak memiliki nomor identitas nasional atau Nomor Induk Kependudukan. Hal inilah yang membuat sebagian besar dispute klaim terjadi karena berkas klaim yang tidak lengkap dan kriteria jaminan pasien yang tidak memenuhi syarat. Salah satu upaya yang dilakukan pihak rumah sakit adalah dengan meningkatkan sistem informasi manajemen rumah sakit untuk meminimalisasi dispute klaim. Penelitian ini menyimpulkan bahwa dispute klaim masih terjadi sehingga peningkatan kapasitas dan sistem informasi pelayanan kesehatan, komitmen, koordinasi, dan sosialisasi secara berkala dari pihak pembayar diperlukan untuk mencegah terjadinya dispute klaim pasien Covid-19.
Implementation of Insecticide for Fogging and Larvicidation in Dengue Fever Control and Its Impact on Vector Resistance in Banjarmasin City: A Qualitative Analysis Juhairiyah; Muhammad Rasyid Ridha; Indriyati, Liestiana; Yudhastuti, Ririh; Triwibowo Ambar Garjito; Muhammad Choirul Hidajat; Wahyu Pudji Nugraheni; Nurul Hidayah; Isnawati; Babucarr Jassey
JURNAL KESEHATAN LINGKUNGAN Vol. 17 No. 2 (2025): JURNAL KESEHATAN LINGKUNGAN
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jkl.v17i2.2025.99-109

Abstract

Introduction: Dengue remains a major public health concern in Indonesia, including Banjarmasin. Insecticide-based interventions, such as fogging and larviciding, are key components of dengue vector control. However, improper implementation can lead to insecticide resistance, reducing program effectiveness. Methods: This qualitative study aimed to evaluate the implementation of insecticide use in the dengue control program in Banjarmasin. Data were collected through in-depth interviews, observations, and document reviews at national, provincial, and municipal levels. A total of 60 informants were purposively selected, including stakeholders from the Ministry of Health, provincial and city health offices, pharmaceutical warehouses, community health centers, sub-districts, and urban villages. Data were analyzed using a deductive Input-Process-Output (IPO) model and inductive gap analysis. Triangulation was applied to ensure data validity. Results and Discussion: The study revealed that the absence of national and local insecticide resistance mapping hinders the implementation of insecticide rotation policies. Other challenges include a shortage of trained entomology personnel, limited training, weak intersectoral coordination, and poor dissemination of vector control regulations, particularly regarding fogging procedures. Moreover, unsupervised community-led fogging often deviates from standard operating procedures. Conclusion: Strengthening human resource capacity, improving insecticide distribution planning based on resistance data, and enhancing regulatory enforcement are critical to improving program effectiveness. Promoting community-based approaches is also essential to support sustainable and responsive dengue vector control strategies.
THE HIDDEN ECONOMIC BURDEN OF LEPTOSPIROSIS: HEALTHCARE COSTS AND PATIENT IMPACT Nugraheni, Wahyu Pudji; Lestyoningrum, Sinta Dewi; Pawitaningtyas, Indah; Nuraini, Syarifah; Putri, Linta Meyla; Ristiyanto; Milcent, Carine
Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia) Vol. 13 No. 1 (2025): June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jaki.v13i1.2025.98-109

Abstract

Background: Leptospirosis is a public health issue caused by the Leptospira bacterium, leading to significant economic impacts. The cost of illness due to Leptospirosis encompasses hidden costs that significantly affect individuals and society Aims: This study aimed to assess the hidden economic burden (direct and indirect costs) experienced by patients and their families due to healthcare treatment of leptospirosis. Methods: This descriptive cross-sectional study was conducted in Banyumas Regency from February to June 2024. Data were collected from patients who completed leptospirosis treatment in 2023. The variables of cost were categorized into direct treatment cost, treatment cost, and indirect cost, which were analyzed descriptively.   Results: Most leptospirosis patients were male, aged 26 – 45 years old, and the majority worked as farmers. Our study reveals that uninsured patients incurred higher out-of-pocket expenses during leptospirosis’ treatment. The productivity loss was estimated at USD 44.75, with significant hidden costs being transportation (USD 31.90), caregiver support (USD 86.38), and hospital treatment (USD 231.40). Conclusion: The significant burden of Leptospirosis in Indonesia highlights the economic impact on individuals and the challenges within the healthcare system. This study calls for enhanced public health strategies focused on prevention, early diagnosis, and improved healthcare access to address the leptospirosis burden effectively. Keywords: Cost of illness, economic burden, financial impact, leptospirosis, productivity loss
Socioeconomic Roles in Cesarean Section Delivery in the Philippines: A Secondary Analysis of the 2022 National Demographic and Health Survey Yunitawati, Diah; Laksono, Agung Dwi; Wulandari, Ratna Dwi; Latifah, Leny; Effendi, Diyan Ermawan; Hidayat, Taufiq; Nugraheni, Wahyu Pudji; Batangan, Dennis B.
Nurse Media Journal of Nursing Vol 15, No 2 (2025): (August 2025) [In Progress]
Publisher : Department of Nursing, Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/nmjn.v15i2.70559

Abstract

Background: Cesarean section (CS) delivery should only be performed with medical indications. It is important to analyze the socioeconomic role in CS and determine how to address socioeconomic-related factors in optimizing CS coverage in the Philippines using the latest national data.Purpose: This study analyzed the socioeconomic roles in CS delivery in the Philippines.Methods: This study used secondary data from the 2022 Philippines National Demographic and Health Survey (NDHS). The cross-sectional study included 4,452 women aged 15–49 who had given birth within the previous three years. Seven control factors were examined: employment, antenatal care (ANC), age, education, marital status, residence, and parity. The mode of delivery was considered the outcome variable, while socioeconomic status was the exposure variable. Binary logistic regression was used for the final data analysis.Results: Cesarean section was performed in 18.45% of deliveries in the Philippines. Analysis of socioeconomic status showed that women in the “poorer” group were 1.758 times more likely than the poorest to undergo CS (AOR 1.758; 95% CI 1.757–1.758). Women in the middle-income group were 2.164 times more likely than the poorest to have a CS (AOR 2.164; 95% CI 2.163–2.165). Those in the richer group were 2.718 times more likely (AOR 2.718; 95% CI 2.717–2.719), and the richest were 4.787 times more likely to deliver by CS compared to the poorest (AOR 4.787; 95% CI 4.785–4.789).Conclusion: Socioeconomic disparities are strongly associated with CS delivery in the Philippines. The wealthier the mother, the more likely she is to have a CS. Efforts should focus on reducing unnecessary CS in the rich and richest groups. Optimizing ANC education should include addressing psychological needs, promoting positive values, and providing a sense of security and comfort in normal childbirth. At the same time, equitable access to CS should be ensured for the poorest groups through education and insurance coverage.
Economic Loss of Leptospirosis: Is It Still Appropriate to be Tropical Neglected Zoonosis Disease? Nugraheni, Wahyu Pudji; Lestyoningrum, Sinta Dewi; Ristiyanto, Ristiyanto; Putro, Wahyu Gito; Pawitaningtyas, Indah; Nuraini, Syarifah; Putri, Linta Meyla; Faisal, Debri Rizki; Noveyani, Adhista Eka; Mikrajab, Muhammad Agus
Kesmas Vol. 19, No. 5
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Leptospirosis is a tropical endemic disease that can reduce the productivity of sufferers. However, research on economic and productivity losses due to leptospirosis is rare. This study aimed to determine economic and productivity losses due to leptospirosis in the Banyumas District, Indonesia, as an endemic area. This study used a cross-sectional design and quantitative methods conducted in October 2022. Secondary data of medical records and billing information from 73 inpatients receiving treatment at a Public Hospital in the Banyumas District from February 2021 to September 2022 obtained from the hospital’s archives were used. This study examined the actual costs (direct and indirect costs) of treatment, average length of stay, and patient characteristics. Statistical tools were carried out to check the results. The results showed that over half of leptospirosis patients used insurance with an economic loss of USD 289.64 and a productivity loss value of USD 388,499. Patients infected with leptospirosis vary in age. Leptospirosis results in loss of patient productivity during treatment. Increasing prevention and control to prevent deaths and economic burdens on society and local governments is proposed to local governments.
Co-Authors Agung Dwi Laksono Babucarr Jassey Batangan, Dennis B. Diah Yunitawati Diyan Ermawan Effendi, Diyan Ermawan Faisal, Debri Rizki Hartono, Risky Kusuma Hasbullah Thabrany Indah Pawitaningtyas ISNAWATI Juhairiyah Leny Latifah Lestyoningrum, Sinta Dewi Liestiana Indriyati Milcent, Carine Muhammad Agus Mikrajab Muhammad Choirul Hidajat Muhammad Rasyid Ridha Noveyani, Adhista Eka Nurul Hidayah Ratna Dwi Wulandari Ririh Yudhastuti Ristiyanto Ristiyanto Ristiyanto Situmorang, Chazali Syarifah Nuraini Syarifah Nuraini Taufiq Hidayat Triwibowo Ambar Garjito Wahyu Gito Putro