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Comparison of Hemodialysis Service Cost Effectiveness Using Activity-Based Cost Approach with Hospital Cost and Cost Recovery Rate in Regional Public Hospital IA Moeis Samarinda Hasan, Hismawati; Ratno Adrianto; Ike Anggraeni
Window of Health : Jurnal Kesehatan Vol 8 No 4 (October 2025)
Publisher : Fakultas Kesehatan Masyarakat Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33096/woh.vi.1485

Abstract

The determination of service rates in hospitals is often not based on unit cost calculations, but rather on fixed rates used by other hospitals for practicality and ease of implementation. This leads to the problem of differences between INA-CBGs rates and hospital rates in the era of the National Health Insurance (JKN). The study aimed to determine the unit cost of Hemodialysis services using the Activity-Based Costing method, and compare with hospital rates and INA CBGs, and calculate the recovery rate cost. This is a descriptive research study employing a case study approach. This research was conducted to describe the current condition of the hospital costing system, revealing the cost structure and calculation of service unit costs using the Activity-Based Costing method. The Hospital's financial transaction reports of 2023 were used as a data source. Data is grouped based on fixed costs, semi-variable costs, and variable costs, and then translated into direct costs and overhead costs to calculate the unit costs of hemodialysis. The results of the Hemodialysis unit cost calculation were compared with hospital rates and INA CBGs. The cost recovery rate was then calculated. The study results showed that the unit cost of Hemodialysis, calculated using the Activity-Based Costing method, was Rp1,364,257. The comparison result was that the unit cost was higher than the hospital rate (86%) and also than the INA CBGs rate (61%). The results of the cost recovery rate (CRR) calculation are still below 100%. Influencing factors include direct costs, overhead costs, and the number of actions.
Determinan Kebutuhan Pelayanan Kesehatan pada Lansia: Sebuah Studi di Samarinda, Indonesia Masithah, Masithah; Gunawan, Ike Anggraeni; Susanti, Rahmi; Ariyanti, Rea; AB, Ismail
Jurnal Kesehatan Masyarakat Mulawarman (JKMM) Vol.7 No.2 (2025) : Jurnal Kesehatan Masyarakat Mulawarman (JKMM)
Publisher : Mulawarman University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30872/jkmm.v7i2.22723

Abstract

Meningkatnya kebutuhan perawatan lansia di Indonesia menunjukkan tantangan dalam memenuhi tuntutan kesehatan fisik, mental, dan sosial individu lanjut usia. Penelitian ini bertujuan untuk mengidentifikasi determinan utama yang memengaruhi kebutuhan dan preferensi layanan kesehatan pada lansia. Menggunakan desain observasional potong lintang, data dikumpulkan dari 61 lansia berusia 54 hingga 82 tahun di 14 Posyandu Lansia di Samarinda. Kuesioner terstruktur yang diadaptasi dari alat yang telah divalidasi, termasuk SF-36 dan UCLA Loneliness Scale, digunakan untuk menilai karakteristik demografi, tingkat kelemahan, aktivitas harian, kesehatan kognitif, dan kesejahteraan mental. Hasil penelitian menunjukkan bahwa 32,8% responden membutuhkan bantuan untuk memenuhi kebutuhan kesehatannya, dengan kelemahan fisik (p=0,021), kemandirian aktivitas harian (p=0,039), dan penurunan kognitif (p=0,036) secara signifikan memengaruhi kebutuhan tersebut. Sebagian besar responden menilai kondisi kesehatan fisik (78,7%) dan mentalnya (75,4%) baik, meskipun 39,3% melaporkan gejala depresi. Dukungan sosial cukup umum, dengan 75,4% memiliki pendamping dari keluarga atau pengasuh, namun hal ini tidak secara signifikan memengaruhi kebutuhan kesehatan (p=0,186). Temuan ini menegaskan sifat multidimensi kebutuhan kesehatan lansia, dengan kelemahan fisik, penurunan kognitif, dan kemandirian aktivitas harian sebagai determinan utama. Intervensi yang berfokus pada area ini, disertai dengan peningkatan sistem dukungan, dapat meningkatkan akses dan hasil layanan kesehatan untuk populasi lansia. Studi ini menemukan pentingnya model layanan kesehatan terpadu yang mencakup dimensi fisik, kognitif, dan sosial untuk memberikan perawatan yang komprehensif bagi lansia.
Analisis Faktor Risiko Penyakit Tidak Menular di Kelurahan Prapatan, Kota Balikpapan, Kalimantan Timur Tahun 2023 Tien Fatimatuzzahra; Ratih Wirapuspita Wisnuwardani; Ike Anggraeni Gunawan
Jurnal Ners Vol. 9 No. 3 (2025): JULI 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v9i3.47919

Abstract

Non-Communicable Diseases (NCDs) are a major public health challenge. The incidence of NCDs is influenced by modifiable and non-modifiable risk factors. This study aimed to evaluate the prevalence and associations of NCD risk factors in the Prapatan area through the PRAPATAN POSTER innovation. A retrospective cross-sectional study was conducted using data from 363 screenings; the prevalence of hypertension was 19.3%, diabetes 7.7%, with 51.2% being overweight or obese, 48.25% reporting physical inactivity, and 8.5% identified as smokers. Chi- square tests revealed significant associations between age and hypertension (p=0.000), age and type 2 diabetes (p=0.000), obesity and hypertension (p=0.000), as well as obesity and physical inactivity (p=0.000). Strengthening health promotion, early detection, and community- based interventions are recommended for NCD prevention and control. Keywords: Non Communicable Diseases, hypertension, diabetes, risk factors
Performance Evaluation of Tim Pendamping Keluarga (TPK) in theAccelerated Stunting Reduction Programme within Kutai KartanegaraRegency in 2024 Dewi Endah Ramadhani; Ike Anggraeni G Anggraeny; Ratno Adrianto
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Abstract

Background : Stunting is a condition of impaired growth in children under five (toddlers) resulting from chronic malnutrition and recurrent infections. This condition adversely affects the development of cognitive and physical abilities. Stunting prevention necessitates a multisectoral approach, including improvement in nutrition, hygiene and sanitation, maternal and child health, and socioeconomic factors. The main challenge of controlling stunting is the complexity of its determinants, including direct factors such as inadequate nutritional intake and indirect factors such as poverty and low education (Black et al., 2013; UNICEF, 2019). Objective : The objective of this study is to assess the efficacy of Tim Pendamping Keluarga (TPK) in executing the accelerated stunting reduction program in Kutai Kartanegara Regency in 2024 Research Methods/ Implementation : a quantitative descriptive approach, utilizing monitoring data, TPK output achievements, and verification across districts and sub-districts ResultsThe analysis revealed the highest accompaniment rate for children under two at 86.84%, followed by at-risk prospective spouses at 81.45%, postpartum women at 71.62%, and the lowest for pregnant women at 25.32%. The Pearson correlation between the target numbers and those who were affected is quite strong for children under two (R=0.99), spouses (R=0.98), and postpartum women (R=0.95), and lower for pregnant women (R=0.76), indicating implementation gaps in accompaniment for pregnant women. The synergy of KRS (At-Risk Families) data collection and verification through Elsimil, together with cross-sector collaboration, contributed to a reduction in the stunting prevalence in Kutai Kartanegara (from 27.1% in 2022 to 14.3% in 2024), although increasing accompaniment coverage for pregnant women remains a priority for improvement, with Kutai Kartanegara serving as a leading example in East Kalimantan. Conclusion/Lesson Learned : Nevertheless, optimizing TPK resources remains a major concern. Accompaniment coverage for pregnant women must be strengthened in parallel with other targets, supported by TPK training or capacity building, supervision, and improvements in data integration systems so that the Kutai Kartanegara accompaniment model can be adopted as a national best practice for stunting reduction.
Maternal Mortality Analysis Through AMP-SR Review in East  Kalimantan Province, Indonesia, 2023–2024 Ari Utari; Ratno Adrianto; Ike Anggraeni Gunawan
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Abstract

Background : Maternal mortality remains a major public health challenge in East Kalimantan Province, despite a decline in reported cases from 83 deaths in 2023 to 74 deaths in 2024. Objective : This study aimed to describe the pattern of maternal deaths based on maternal characteristics, timing and place of death, and to analyze preventable factors through the Audit Maternal Perinatal Surveillance and Response (AMP-SR) approach. Research Methods/ Implementation Methods : A descriptive-analytic case series design was applied using secondary data from the East Kalimantan Maternal Perinatal Death Notification (MPDN) database for 2023–2024. Results : The results revealed that more than 51% of deaths occurred during the postpartum period and 77% took place in hospitals, indicating the predominance of Delay 3 (delays in receiving adequate care). Analysis of modifiable factors showed that most deaths were preventable through improvements in the quality of obstetric services, increased antenatal care (ANC) compliance, and strengthened referral and postnatal follow-up systems. The major risk factors included delays in family decision-making, weak interfacility referral coordination, and inadequate case management at referral hospitals. Conclusion/Lesson Learned : These findings highlight that reducing the Maternal Mortality Ratio in East Kalimantan requires the completion of 100% AMP-SR case reviews, the strengthening of Postnatal Care (PNC) implementation, and the enhancement of Emergency Obstetric and Neonatal Care (EmONC) capacity across all levels of healthcare facilities.
The Effectiveness of Video Education and Small-Group Discussions in Increasing Adolescent Awareness of Tuberculosis (TB) Prevention: A Literature Review Andi Nursafa; Ike Anggraeni
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Abstract

Background : Tuberkulosis (TBC) merupakan salah satu penyakit menular yang masih menjadi masalah kesehatan masyarakat di Indonesia. Remaja termasuk kelompok rentan yang memiliki peran penting dalam upaya pencegahan penularan TBC di lingkungan sekolah maupun masyarakat. Edukasi kesehatan yang menarik dan interaktif dibutuhkan untuk meningkatkan kesadaran mereka terhadap pencegahan penyakit ini. Objective : literatur ini bertujuan untuk menganalisis efektivitas edukasi kesehatan melalui media video dan metode diskusi kelompok kecil dalam meningkatkan kesadaran remaja terhadap pencegahan TBC. Research Methods/ Implementation Methods : Metode penelusuran literatur dilakukan melalui database seperti Google Scholar, PubMed, dan ScienceDirect berdasarkan publikasi tahun 2017–2025 dengan kata kunci “edukasi kesehatan”, “media video”, “diskusi kelompok kecil”, dan “tuberkulosis pada remaja” dengan menggunakan PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) sebagai protokol penelitian. Results : Hasil dari berbagai penelitian menunjukkan bahwa penggunaan media video mampu meningkatkan pemahaman dan daya tarik peserta, sedangkan diskusi kelompok kecil mendorong partisipasi aktif serta perubahan sikap yang lebih bermakna. Kombinasi kedua metode ini dinilai efektif dalam meningkatkan kesadaran dan perilaku pencegahan TBC di kalangan remaja. Oleh karena itu, strategi edukasi berbasis media audiovisual dan interaksi kelompok kecil dapat dijadikan alternatif inovatif dalam program promosi kesehatan di sekolah. Conclusion/Lesson Learned : Oleh karena itu, strategi edukasi berbasis media audiovisual dan interaksi kelompok kecil dapat dijadikan alternatif inovatif dalam program promosi kesehatan di sekolah.
Time series analysis of outpatient visits at RSUD X In Samarinda using the ARIMA model Deby Indah Saputri; Ike Anggraeni; Ronny Isnuwardana
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Abstract

Background : Efficient hospital resource planning, including staff allocation and pharmaceutical logistics, heavily relies on accurate patient visit volume forecasting. Daily outpatient visit data at Regional Hospital from January 2023 to February 2025 shows high volatility and a strong weekly pattern (5-day work cycle). Therefore, a forecasting method is needed that can describe the patterns and trends of patient visits based on historical data. Methods commonly used for time series forecasting is ARIMA (Autoregressive Integrated Moving Average). This model is capable of capturing seasonal patterns and trends within the data, making it useful for predicting the number of future visits with a high level of accuracy. Objective : This study aims to identify the most optimal time series forecasting model using internal seasonal SARIMA and external regression SARIMAX analysis. Research Methods/ Implementation Methods : This study design is repeated cross-sectional. Outpatient visit data was divided into training (2023-2024) and testing (January-February 2025) sets for accuracy validation, measured by Root Mean Squared Error (RMSE). Results : In the first stage, the seasonal ARIMA model without explanatory variables, namely ARIMA(0,0,1)(2,1,0)[5], passed the Ljung-Box diagnostic test (p>0.05) but showed low predictive accuracy (RMSE 281.01). The second stage involved using explanatory (exogenous) variables such as Monday, Friday, and Public Holidays. A regression model with ARIMA(0,1,1) errors was identified as the superior model with an RMSE of 194.39. Regression coefficients showed a significant impact from specific days: Monday (+50 visits, 95% CI 32, 68), Friday (-91 visits, 95% CI -73, -109), and Public Holidays (-489 visits, 95% CI -463, -516). ConclusioAlthough the Ljung-Box test resulted in p<0.05, indicating that there are still residuals not fully explained by the model, it still provides important insights for hospital operational planning.n/Lesson Learned :
Analysis of Health Service Performance at Loa Bakung Health CenterAfter Implementation The e-Puskesmas System La Debi Atthoba; Ike Anggraeni; Ratno Adrianto
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Abstract

Background : Digital transformation is a key strategy in modernizing the health sector globally and nationally. In Indonesia, the implementation of health information systems such as E-Puskesmas aims to improve work efficiency, clinical data accuracy, service effectiveness at First-Level Health Facilities. Objective : This study analyzes the performance indicators of health services at UPTD Puskesmas Loa Bakung after the implementation of the E-Puskesmas system, focusing on service time efficiency, curative workload, and the achievement of promotive–preventive programs. Research Methods/ Implementation Methods : A descriptive approach was used based on secondary data from E-Puskesmas operational reports from January to September 2025. Data were obtained from individual service unit (UKP) reports, monthly BPJS Health reports, and public health program records. The analysis focused on operational efficiency, disease burden profiles, and priority program achievements. Results : Findings reveal a gap between digitalization goals and operational reality. Only 50.1% of patients were served within less than 10 minutes, indicating workflow bottlenecks. Essential Hypertension (2,985 cases), Acute Respiratory Infections (1,300 cases) dominated curative services, while screening achievements for Hypertension (16.43%) and Diabetes (4.10%) remained below targets. This reflects a reactive service orientation with limited promotive and preventive efforts. Conclusion/Lesson Learned : : E-Puskesmas has improved data recording accuracy but has not fully enhanced systemic performance. Optimization is needed through better network infrastructure, improved digital competence among health workers, and data-driven decision-making. Strategic focus should emphasize strengthening promotive and preventive programs as the core of primary health digital transformation.
Health Impacts Quality of Life in Communities Affected by Coal Mining in Kutai Kartanegara Rahmat Barkati; Ike Anggraeni; Annnisa Nurrachmawati
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Abstract

Background : The impacts of coal mining activities on the quality of life in surrounding communities, specifically focusing on employment opportunities, income perceptions, health security, and infrastructure. Objective : The primary goal is to understand how these factors influence the overall well-being of residents in mining-affected areas, providing valuable insights for sustainable community development and policy-making Research Methods/ Implementation Methods : A cross-sectional survey was conducted with 300 respondents from three villages near mining operations in Kutai Kartanegara, East Kalimantan, using structured questionnaires. Data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) to explore the relationships between various social determinants and health outcomes. The study also examined environmental factors, such as air and water quality, through laboratory testing Results : The findings highlight significant variations in the perceptions of the local community regarding the benefits and challenges posed by mining activities. Employment opportunities and income were generally viewed positively, while concerns about environmental pollution and housing affordability were prevalent. These results underscore the need for targeted interventions to improve health security and infrastructure in mining communities. Conclusion/Lesson Learned : While coal mining has contributed to economic opportunities for some, it has also introduced challenges related to environmental health and living conditions. The study highlights the need for improved environmental management, better health services, and policies that address housing affordability. These findings emphasize the importance of balancing economic development with community health and well-being in mining regions.
Knowledge of Public Health Students Regarding HIV/AIDS and PLHIV: Do They Have Stigma? Sendila Ernesy Asari; Ike Anggraeni Gunawan; Masithah
KESMAS UWIGAMA: Jurnal Kesehatan Masyarakat Vol 10 No 1 (2024): January-June
Publisher : Universitas Widya Gama Mahakam Samarinda

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24903/kujkm.v10i1.2641

Abstract

Latar Belakang: Human immunodeficiency virus (HIV) merupakan infeksi yang menyerang sistem kekebalan tubuh. HIV/AIDS merupakan penyakit seumur hidup. Jika terus dibiarkan, virus tersebut dapat menular pada orang lain karena penderita HIV/AIDS dapat tampak sehat dan tanpa gejala. HIV/AIDS dapat menyebabkan masalah fisik berupa infeksi oportunistik. Selain itu, terdapat masalah psikologis dan sosial bagi ODHA karena adanya stigma. Stigma masyarakat terhadap HIV/AIDS dan ODHA dipengaruhi oleh pengetahuan. Tujuan: Dilakukan penelitian mengenai hubungan pengetahuan terkait HIV/AIDS dan ODHA dengan stigma mahasiswa FKM UNMUL terhadap ODHA karena mahasiswa merupakan agent of change sehingga perlu memiliki pengetahuan terkait masalah kesehatan, salah satunya mengenai HIV/AIDS Metode Penelitian: Penelitian ini menggunakan desain cross sectional dengan instrumen berupa kuesioner. Sampel pada penelitian ini adalah 199 mahasiswa FKM UNMUL angkatan 2020 – 2022 yang diperoleh dengan metode stratified sampling. Data dianalisis menggunakan uji chi-square Hasil: Hasil penelitian menunjukkan bahwa mahasiswa FKM UNMUL memiliki stigma terhadap ODHA. Berdasarkan uji chi-square menunjukkan p-value < 0,001 yang verarti terdapat hubungan antara pengetahuan dengan stigma terhadap HIV/AIDS dan ODHA Kesimpulan: Terdapat hubungan antara pengetahuan dengan stigma terhadap HIV/AIDS dan ODHA
Co-Authors Adiyatsa, Reza Jales Mahesa Adrianto, Ratno Agus Hardito Akbarini, Oon Fatonah Akhmad Dzikri Alfina Rahma Adila Andi Anwar, Andi Andi Baso, Ismail Andi Nursafa Andi Nursafa Andriana Ratna Ningrum Annisa Nurrachmawati Annisa Nurrachmawati Annnisa Nurrachmawati Ardhiputri, Titania Ari Utari Ariyanti, Rea Asari, Sendila Ernesy Auliya, Jumi Ayulia Dwi Sandi, Dita Camara Indriani, Dilla Deby Indah Saputri Dewi Endah Ramadhani Dewi Endah Ramadhani Eko Prasetya Budi Elma Hafizatun Nisa Endah Wahyutri Erwina, Brigita Win Fitriana, Risma Hafizatun Nisa, Elma Hani Adriani, Retno Hasan, Hismawati Hasmawati Hasmawati Hasmawati Hasmawati Heri Gunawan Hilda Marfu'ah Rozkiah Ida Ayu Indira Dwika Lestari Ifroh, Riza Hayati Ifroh, Riza Hayati Ika Wulan Sari Irfansyah Baharuddin Pakki Iriyani Iriyani Iriyani Kamaruddin, Iriyani Ismail AB, Ismail Izma, Hayatun Jasmawati, Jasmawati Jumi Auliya Kiswanto Kiswanto Kristiandi, Kiki La Debi Atthoba Lies Permana Made Darawati Mardiany Masithah Masithah Masruroh1,2, Ah Yusuf3 , Nikmatur Rohmah4, Irfansyah Baharudin Pakki5 , Anita Dewi Prahastuti Prasojo6 , Qurnia Andayani1 , *Agung Dwi Laksono7 Mifthahul Jannah Muftadiin, Fatimatul Muhammad Arifin Muhidin, Muh. Azmi Nahara Isnani Nur Asma Nur Rohmah Nur Rohmah Nur Rohmah Nursafa, Andi Nurul Afiah Nurul Afiah Oktaviani, Raeza Noorinda Pasambuna, Muksin Pramono, Dwi Agung PUTRI, TIARA Raden Mohammad Pradendi Nikita Sangaji Rahma Adila, Alfina Rahmat Bakhtiar Rahmat Barkati Rahmi Susanti Rahmi Susanti Rahmi Susanti Ramadhani, Alfina Suci Ratih Wirapuspita Wisnuwardani Ratih Wirapuspita Wisnuwardani Ratih Wirapuspita Wisnuwardani Ratna Wati Ratna Wati Reny Noviasty Reza Jales Mahesa Adiyatsa Reza Nur Fahmi Rika Yunita Sari Risma Fitriana Ronny Isnuwardana S Siswanto Sendila Ernesy Asari Sendila Ernesy Asari Setiawan, Muhammad Irwan Silaban, Vandy Siti Nurjannah Siti Raihanah Sitorus, Rame Swandari Paramita Tetty Herta Doloksaribu Tien Fatimatuzzahra Triani Putri, Irda W Wisnuwardani, Ratih Wahyu Ramadhani, Reza Widiya Rolantika Widyasasi, Dyah Winardi Winardi Yunianto Setiawan, Yunianto Yunianto, Andi Eka Yuniar, Dewi