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All Journal Proceedings of the International Conference on Applied Science and Health Jurnal Respirologi Indonesia Aspirasi : Jurnal Masalah-masalah Sosial Journal of Indonesian Health Policy and Administration Jurnal Ekonomi Kesehatan Indonesia Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Hasbullah Thabrany
Departemen Administrasi Kebijakan Kesehatan Fakultas Kesehatan Masyarakat Universitas Indonesia
Religion Humanities Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Health Professions Medicine & Pharmacology Nursing Public Health Social Sciences

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DELAYED CLAIM PAYMENT AND THE THREAT TO HOSPITAL CASH FLOW UNDER THE NATIONAL HEALTH INSURANCE SCHEME IN INDONESIA Yuliyanti, Citra; Thabrany, Hasbullah
Proceedings of the International Conference on Applied Science and Health No 3 (2018)
Publisher : Proceedings of the International Conference on Applied Science and Health

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Abstract

Background: Indonesia commits to ensure health care access for all population through the National Health Insurance (JKN) managed by the BPJS Health. By February 2018, the JKN covered 193 million people (73% of the total population). To ensure health delivery, 2,104 public and private hospitals are contracted by the BPJS and prospective payment using Case-mix Based Group (CBG) that changes hospital managements. Hospitals become more dependent on payments by BPJS. Delay in claim payment will have serious impact on hospital managements. This study aims to identify current practices in timely payment to hospitals and finding factors correlate with delay in payments. Methods: This study used trend analysis of the secondary claim data of BPJS with the total sample of 57,475 bundles of claims. Total claim population was used in this study. In addition, qualitative study via in-depth interview with six informants consisting of members of National Social Security Council, hospital director of three different classes, and BPJS. Results: This study found 60% of claims were paid within one month (N-1) of claim submission, below the target of 100%. There were tendencies of delays in claim settlements since November 2017. Informants believed that late payments were correlated with non-compliance of doctor to complete medical records, incompetence coders, inadequate management information system, and financial condition of BPJS. There were three main problems faced by hospitals as a result of delay in payments: 1) disturbed drug availability, 2) decreased performance of doctors, 3) poorer maintenance of medical equipment. Conclusion: Delayed in claim payments were occurred and led to a threat of decreasing quality of care to patients. The study suggests the government should fix the problems to protect patients from decreasing quality of care. Hospitals should provide reserve funds to protect them from financial hardship when delays occur. 
The Role of Health System to Support PMTCT Program Implementation in Jayawijaya Regency Trisnawati, Lea Meirina; Thabrany, Hasbullah
Journal of Indonesian Health Policy and Administration Vol. 1, No. 1
Publisher : UI Scholars Hub

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Abstract

The incidence of HIV and AIDS in Indonesia continues to increase. The possibility of mother to child transmission will be greater if intervention is not performed. The purpose of this study is to assess the role of health systems in health and non-health sector affecting the implementation of PMTCT. This qualitative research took place in Jayawijaya. Primary data collection was conducted through in-depth interviews, and observation. Secondary data was derived from the survey of health facilities conducted in Papua. We interviewed eleven (11) informants. The results of this study confirmed that the implementation of PMTCT was still inadequate, only 64% of the health services in Jayawijaya provide PMTCT services. Considering the vast area and the difficulty of access to health services, local government should undertake expansion of comprehensive PMTCT services, provide antiretroviral drugs for pregnant women, and reagents, as well as psychosocial support to PLHIV.
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.
People’s Support on Sin Tax to Finance UHC in Indonesia, 2016 Thabrany, Hasbullah; Laborahima, Zahrina
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 1
Publisher : UI Scholars Hub

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Abstract

Indonesia has the highest prevalence of smokers with 67% of adult males were smokers. Smoking prevalence among all adults increased sharply from 27% in 1995 to 36.3% in 2013. High consumption of cigarettes has been correlated with low price and excise of cigarettes. Experiences from other countries showed that one of the most effective way to reduce cigarette consumption is by increasing cigarette price and excise. Burden of tobacco related diseases has increased. The health burden will increase claims of JKN or Universal Health Coverage which currently has claim ratio of 115% and the quality of care remain low. The difficulties in collecting contribution from non salaried workers are blamed to contribute the deficit. Many countries have earmarked cigarette excise to supplement financing of (UHC) both in tax-funded system or in social health insurance system. The question is do people support? This study explored the possibility the people’s support to increase cigarette prices and excise to meet financial shortage of the JKN.
A Comparative Budget Requirements for TB program based on Minimum standard of Services (SPM) and Budget Realization: an Exit Strategy Before Termination of GF ATM Setiawan, Ery; Sucahya, Purwa K; Thabrany, Hasbullah
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 1
Publisher : UI Scholars Hub

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It has become a common issue that the Global Fund (GF) as one of the largest international donors to AIDS, Tuberculosis, and Malaria Program will immediately stop the funding. Data shows that in 2009 GF ATM support reached 88,8% while APBN funding just cover 11,2% of the total budget needed. However, APBN budget for ATM programs was significantly increased in 2012 which covered almost 30% of the total budget. Eventhough the increasing trend of ATM budget seemed at the central government level, how ever the local governments will hold the key to the sustainability of the post- termination GF ATM Funding
Evaluasi Pengadaan Obat Publik Pada JKN Berdasarkan Data e-Catalogue Tahun 2014-2015 Dwiaji, Ary; Sarnianto, Prih; Thabrany, Hasbullah
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 1
Publisher : UI Scholars Hub

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Abstract

Since National Health Insurance (JKN) has been implemented, drug procurement in public health care facilities use e-Purchasing via e-Catalogue. Based on the RKO and HPS, drafting e-Catalogue have gone through a tender process and price negotiations. The process chain will effect the type (molecules) and the amount of drug through the e-Catalogue as well as the number and volume of demand by public health care facilities (e-Order).
Biaya dan Outcome Hemodialisis di Rumah Sakit Kelas B dan C Tania, Firda; Thabrany, Hasbullah
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 1
Publisher : UI Scholars Hub

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Abstract

Chronic Kidney Disease (CKD) is a condition that is increasing in incidence in Indonesia, consuming a lot of National Health Insurance (JKN) public funds. In the JKN program, hemodialysis (HD) for treating CKD is guaranteed but requires a balance between costs and outcomes. Since 2014, BPJS has covered almost all HD costs in Indonesia with different Casemix Base Group (CBG) rates according to hospital class.
Increasing Cigarette Excise Tax Prevents Smoking Initiation in Children and Finances National Health Insurance in Indonesia Purnamasari, Ayu Tyas; Pujiyanto, Pujiyanto; Thabrany, Hasbullah; Nurhasana, Renny; Satrya, Aryana; Dartanto, Teguh
Jurnal Ekonomi Kesehatan Indonesia Vol. 3, No. 2
Publisher : UI Scholars Hub

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Indonesia has ranked third among countries with the highest number of smokers in Asia because the price of cigarettes in those countries is still affordable. The strategy to make the price of cigarettes is not affordable is increasing cigarette excise tax. This instrument is considered the most effective way to control cigarette consumption. The purpose of this study was to find out how the public perceive the increase of the cigarette excise tax to cover the National Health Insurance (NHI) deficit and to identify the factors which affect such perception. This study used mobile phone survey and the sample were 1000 respondents. The list of potential respondent’s mobile phone numbers was selected using the systematic random sampling method with an interval of 100,000 to 200,000. The result showed that 87.9% respondents agree to increase cigarette price so that the children do not start to smoke. The majority of respondents (86.2%) also agree to increase the price of cigarettes to finance the JKN deficit. Perceptions of respondents who agreed to increase the price of cigarettes to prevent smoking initiation in children also tended to accede the increase in cigarette prices for financing the JKN deficit.
Efektivitas Biaya Strategi DOTS Program Tuberkulosis antara Puskesmas dan Rumah Sakit Swasta Kota Depok Ulya, Fikrotul; Thabrany, Hasbullah
Jurnal Ekonomi Kesehatan Indonesia Vol. 3, No. 1
Publisher : UI Scholars Hub

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Abstract

Global TB notification rate at 2016 was 77% and 46.5% in Southeast Asia. Indonesia last 5 years still remain at 32-33% where Depok City reached 58%. In Depok City, private sector contributed 18.7% of the notified TB case in 2016 although only 40% of private hospitals were involved. The aims of this study is to determine cost-effectiveness of DOTS strategy implementation at private hospital and Public Health Centre (PHC). Comparative study carried out for six months with cohort retrospective between PHC, DOTS and Non DOTS hospitals using 36 samples per group. The calculation of the societal perspective with microcosting based on tariffs, market prices and budget value. Output is Success Rate, where at PHC 86.1%, DOTS hospital 77.78% and Non DOTS hospital 63.89%. The addition cost providers especially person in charge at PHC and DOTS hospital increase success rate. The cost of TB treatment in PHC 42% of private hospital. ACER (Average Cost Effectiveness Ratio) is obtained that the hospital which carry out the DOTS strategy is cost effective. To increase 1% success rate of TB treatment costs Rp 10,084,572 with intervention DOTS programs into a private hospital. An Independen t test stated that cost-effectiveness societal perspectives on TB treatment has a significant difference between PHC, DOTS hospital and Non DOTS hospital .
Perbandingan Klaim Penyakit Katastropik Peserta Jaminan Kesehatan Nasional di Provinsi DKI Jakarta dan Nusa Tenggara Timur Heniwati, Heniwati; Thabrany, Hasbullah
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 2
Publisher : UI Scholars Hub

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Abstract

Several diseases that become catastrophic at the household level include end-stage renal disease, cardiovascular diseases, cancer, thalassemia, and hemophilia. Patients with these diseases benefit significantly from the National Health Insurance (JKN), and these conditions absorb high claim costs from JKN. Special attention is needed to manage these diseases effectively. Disparities in healthcare facilities, specialists, and variations in Case Mix Group (CMG) payment are suspected to be important contributing factors to the variation in JKN fund absorption across provinces. This study uses 2014 claim data from BPJS Kesehatan in Jakarta and East Nusa Tenggara (NTT) provinces to explore the extent of these differences. The total number of claims analyzed was 309,301. The results show statistically significant differences in claim payments per case, per admission, and per hospital day. These differences are primarily due to variations in CMG prices, which do not provide adequate incentives for specialists to work in smaller hospitals of classes B, C, and D in lower-income provinces. This study does not prove the transfer of JKN funds from NTT to Jakarta.
Co-Authors Aryana Satrya Budi Hidayat Dumilah Ayuningtyas Dwiaji, Ary Elisna Syahruddin Ery setiawan Faizin, Ruli E Al Fitriah Fitriah Hartono, Risky Kusuma Heniwati, Heniwati Komaryani, Kalsum Laborahima, Zahrina Lucya Agung Susilawati Maulana, Andhika Nurwin Michael Ong Novelia, Elsa Nugraha, Ryan Rachmad Nurmadani, Labbaika Pujianto Pujianto Pujiyanto Pujiyanto Purnamasari, Ayu Tyas Purwaningrum, Farah Ramadhan, Ben Fauzi Renny Nurhasana Sarnianto, Prih Sayekti, Mutia A. Situmorang, Chazali Sucahya, Purwa K tania, firda Teguh Dartanto Trisnawati, Lea Meirina Ulya, Fikrotul Wahyu Pudji Nugraheni Yuliyanti, Citra Yuliyanti, Sayekti