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All Journal Jurnal Kebijakan Kesehatan Indonesia ROTOR: JURNAL ILMIAH TEKNIK MESIN Journal of Community Empowerment for Health Jurnal Jaminan Kesehatan Nasional Berita Kedokteran Masyarakat Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management) Journal of Indonesian Health Policy and Administration Media Penelitian dan Pengembangan Kesehatan Jurnal Ekonomi Kesehatan Indonesia
Firdaus Hafidz As Shidieq
Departemen Kebijakan Dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, Dan Keperawatan, Universitas Gadjah Mada
Automotive Engineering Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Education Energy Environmental Science Health Professions Industrial & Manufacturing Engineering Materials Science & Nanotechnology Mechanical Engineering Medicine & Pharmacology Nursing Public Health

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The Relationship Between Health Insurance Ownership and Health Service Utilization, Out-of-Pocket Expenses, and Catastrophic Health Expenditure in the Special Region of Yogyakarta in 2023 Arviana, Mestika Elok; Hafidz, Firdaus
BKM Public Health and Community Medicine The 12th UGM Public Health Symposium
Publisher : Universitas Gadjah Mada

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Abstract

Purpose: Mengetahui hubungan kepemilikan asuransi kesehatan pada rumah tangga di Provinsi Daerah Istimewa Yogyakarta terhadap utilisasi layanan kesehatan, beban biaya out of pocket dan pengeluaran kesehatan katastropik. Method: Penelitian kuantitatif menggunakan rancangan penelitian cross-sectional dengan model secondary data analysis menggunakan data sekunder Survei Sosial Ekonomi Nasional (KOR) dan Survei Sosial Ekonomi Nasional (Modul Konsumsi dan Pengeluaran) pada Maret 2023. Analisis statistik menggunakan distribusi frekuensi, uji chi-square, dan regresi logistik untuk mengidentifikasi hubungan antar variabel. Results: Kepemilikan asuransi kesehatan tidak berhubungan dengan peningkatan utilisasi layanan kesehatan rawat jalan dibandingkan dengan anggota rumah tangga yang tidak memiliki asuransi kesehatan (OR) 1,04 (95% CI 0,93 1,1). Kepemilikan Asuransi Kesehatan juga berhubungan dengan kemungkinan lebih kecil mengalami pengeluaran kesehatan katastropik di seluruh threshold yang digunakan yaitu 10% total pengeluaran (OR) 0,69 (95% CI 0,58 0,82), 25% total pengeluaran (OR) 0,47 (95% CI 0,37 0,59), dan 40% pengeluaran non food rumah tangga (OR) 0,55 (95% CI 0,44 0,68). Variabel lain yang mempengaruhi kejadian pengeluaran kesehatan katastropik adalah usia, pendidikan, pekerjaan, tingkat ekonomi, keluhan kesehatan dan adanya gangguan aktivitas. Conclusion: Kepemilikan Asuransi Kesehatan terbukti berpengaruh bagi anggota rumah tangga di Provinsi Daerah Istimewa Yogyakarta terhadap peningkatan utilisasi rawat inap maupun rawat jalan. Kepemilikan Asuransi Kesehatan memberikan perlindungan finansial berupa dengan mencegah terjadinya pengeluaran kesehatan katastropik. Penting mengoptimalisasikan dan melakukan perluasan program Jaminan Kesehatan Nasional (JKN) agar tercapai Universal Health Coverage untuk memberikan perlindungan finansial dan mengurangi beban keuangan bagi rumah tangga di Indonesia akibat belanja kesehatan katastropik.
Financing the Contact Investigation – TB Patients (Case Study in Mimika District, Papua, Indonesia) Setiawan, Ery; Hafidz, Firdaus; Lestari, Trisasi
BKM Public Health and Community Medicine The 12th UGM Public Health Symposium
Publisher : Universitas Gadjah Mada

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Purpose: This study aims to estimate the unit costs and budget impact of implementing a tuberculosis (TB) contact investigation program in Mimika District, Papua, Indonesia. Method: The study used a microcosting approach to calculate the unit costs of contact investigation activities. Data were collected from six community health centers (Puskesmas) over two months (July-August 2023). Cost components included human resources, medical and non-medical supplies, equipment, and transportation. Combining unit cost data with epidemiological information on TB cases in Mimika allowed for an estimate of the budget impact. Results: The average cost of a home visit for contact investigation was Rp. 53,913, with significant variations across different health centers. For example, the cost ranged from Rp. 39,214 at PKM Limau Asri to Rp. 66,494 at PKM Timika Jaya. On average, the costs were broken down into human resources (Rp. 15,946), supplies (Rp. 25,767), equipment (Rp. 2,833), and transportation (Rp. 16,000). For high-risk individuals requiring further examination, the costs varied based on the diagnostic method used. Microscopic examination cost approximately Rp. 44,482, while rapid molecular testing (TCM) was significantly higher at Rp. 541,472. Overall, the total budget impact to cover all indexed cases in Mimika District was estimated at Rp. 146,969,364. The economic analysis indicated a benefit-cost ratio of 2.62, suggesting that each rupiah invested could yield a return of 2.62 rupiah. Conclusion: Funding the TB contact investigation program in Mimika District is economically beneficial. The program's implementation would require detailed budgeting but promises substantial returns in terms of both economic and health benefits.
Assessment of health status, utilization, and out-of-pocket expenditure among the elderly in Ngestiharjo, Bantul, Yogyakarta Hafidz, Firdaus; Monanda, Adelia Pramudita; Hariyanti, Tatik; Jamiah, Erni
Journal of Community Empowerment for Health Vol 7, No 1 (2024)
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jcoemph.86497

Abstract

Background: As the population ages, it is increasingly crucial to develop community-centered health interventions. This study aims to describe and assess sociodemographic information, health characteristics, health utilization, and out-of-pocket expenses among older people in Ngestiharjo Village, Bantul, Yogyakarta. It was part of an initiative to empower community health workers to understand and address the health needs of older people. Methods: A cross-sectional survey was conducted from April to July 2023 involving 330 participants, with a targeted sample size of 356 elderly individuals. Data on sociodemographics, health status, health utilization, and expenditure were collected through interviews with older people or their companions. Results: Preliminary data showed that most participants were female (58.77%), married (64.91%), and primarily received health information from health workers (47.37%). Hypertension and joint and bone diseases were prevalent, with 16.67% likely experiencing depression. 11.4% of the respondents were hospitalized in the past year, with an average of 2.15 hospitalizations. Private hospitals (69.23%) were the most common healthcare facilities used for hospitalization, and 76.92% consistently utilized health insurance. The average out-of-pocket expenditure for hospitalization was 437,500 IDR. Community health centers (36.36%) and private hospitals (45.45%) were predominantly used for outpatient care, and 77.27% always used health insurance. The average out-of-pocket expenditure for outpatient care was 126,200 IDR. Conclusions: The study underscores the importance of empowering community health workers to effectively disseminate health information, fortify integrated health posts, manage common health issues, and tackle barriers to healthcare utilization and expenditures among older people.
Estimated cost of diabetic wound care in primary healthcare facilities using the time-driven activity-based costing method Budiarto, Arif; Oktafitria, Rita; Hafidz, Firdaus; Aristianti, Vini; Ekawati, Fitriana Murriya; Siregar, Dedy Revalino; Ilyasa; Budiman, Arif; Hendrawan, Donni; Ruby, Mahlil
Berita Kedokteran Masyarakat Vol 41 No 11 (2025)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.v41i11.23797

Abstract

Purpose: This study aimed to estimate the unit cost of diabetic wound care services in primary healthcare facilities (FKTPs) using the Time-Driven Activity-Based Costing (TDABC) method and to quantify the potential cost savings from reallocating cases from secondary (FKRTL) to primary care facilities. Methods: A micro-costing analysis was conducted across 40 FKTPs in Indonesia using a standardized five-step TDABC framework, covering personnel, facility, medical supplies, and overhead costs. Descriptive and nonparametric statistical methods, including the trimmed mean, geometric mean, and interquartile range, were applied to derive cost estimates, and simulations with 15% and 35% case shifting from FKRTL to FKTP were performed. Non-parametric methods (Kruskal–Wallis and Mann–Whitney U) were applied because the cost data were not normally distributed. Results: The estimated unit cost per diabetic wound-care visit ranged from IDR 67,121 (best-case scenario) to IDR 77,189 (realistic scenario). Cost-shifting simulations projected potential savings of up to IDR 28.15 billion in the 35% scenario. Conclusion: Strengthening diabetic wound-care services at the primary care level may enhance system-wide efficiency and reduce avoidable expenditures within the National Health Insurance (JKN) scheme, supporting the adoption of more cost-effective service delivery models in Indonesia.
Co-Authors Agnes Bhakti Pratiwi Amalia, Silviatul Anedya Niedar Anggi Lukman Wicaksana Anisah Ramadhani Annisa Ryan Susilaningrum Arif Budiarto Arif Budiman Arviana, Mestika Elok Ayunda Oktavia Baros, Wan Aisyah Beby Antika Putri Benyamin Saut Citra Jaya Daniel Dary, Sry Wulan Dedet Triwahyudi Dedy Revelino Devi Hartati Dewi Ratnawati Dewi Ratnawati Dewi, Christa Dhanalvin, Erzhan Dibyo Pramono Dibyo Pramono Donald Pardede Endang Suparniati Endra Dwi Mulyanto Ery setiawan Erzan Dhanalvin Fitriana Murriya Ekawati Fitriani, Dewi Caesaria Gilbert Renardi Kusila Hariyanti, Tatik Hendrawan, Donni Hermawati Setiyaningsih Hort, Krishna Ilyasa Imron Rosyadi Jamiah , Erni Jamiah, Erni Jannah, Bayti Julita Hendrartini Jusrawati Krishna Hort Kusila, Gilbert Renardi Labitta Pachira Aquaira Laksono Trisnantoro Maria Sekartaji Monanda, Adelia Pramudita Muhammad Adnan Muhammad Irsan Muhammad Syukran Muliyani, Navantri Nadhira, Farrasila Nafisah, Khilda Durrotun Niedar, Anedya nisa, ananda fadila Oktafitria, Rita Oktavia, Ayunda Pasaribu, Karl Frizts Putri T Rosha Putri, Beby Antika Putri, Rachma Octarinaprawastya Resty Puspita Sari Revelino, Dedy Riris Andono Ahmad Rizaldy Pinzon Rizki Mahardya Ruby, Mahlil Sartika, Dea Ayu Saut, Benjamin Septiani, Trisna Shabrina Rifka Farahiya Sinaga, Sri Putriani Siregar, Dedy Revalino Sulasdi, Nur Ain Desta Sulistyaningsih Sulistyaningsih Sulistyaningsih Sutejo, Mianti Nurrizky Tonang Dwi Ardyanto Trisasi Lestari, Trisasi Utomo, Siti Syamsiyyah Nurmalisa Vini Aristianti, Vini Wan Aisyiah Baros Yasmin Yasmin Yosalli Yulita Hendrartini Yusvardi Yusuf