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HEALTH STATUS AND HEALTH SERVICE UTILIZATION IN RETIREMENT Cahya Edi Prastyo; Ascobat Gani
Muhammadiyah International Public Health and Medicine Proceeding Vol. 4 No. 1 (2024): PROCEEDING MUHAMMADIYAH INTERNATIONAL PUBLIC HEALTH AND MEDICINE CONFERENCE - F
Publisher : Fakultas Kesehatan Masyarakat Universitas Muhammadiyah Jakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61811/miphmp.v4i1.621

Abstract

Demographic Transition leads to changes in disease patterns, affecting retired workers and their spouses in the mining industry as they transition into retirement. This study examines the health status of retirees and their spouses and its impact on health service utilization. This descriptive cross-sectional study gathered data from 1644 retirees and their spouses receiving Employer Sponsored retiree health services in Indonesia in 2023. The study revealed that 65.9% of respondents had a history of chronic diseases, with 35.02% having more than one chronic disease. Most respondents of retired workers were men (90.93%), and most spouses were women (78.4%). Chronic diseases were higher among women. Health service utilization increased with age and was higher among those with a history of chronic diseases. Those with chronic diseases utilized health services more frequently than those without, indicating a 3.4 times increase in utilization. Retirees are susceptible to chronic diseases and multimorbidity, with female spouses being particularly vulnerable. Multimorbidity adversely impacts the frequency of health service utilization.
Evaluasi Formatif Penyerapan Anggaran Bantuan Operasional Kesehatan (BOK) Puskesmas Salur Langsung di Kota Depok Tahun 2023 Noviani, Ika Herayana; Gani, Ascobat
Journal of Mandalika Literature Vol. 6 No. 1 (2025)
Publisher : Institut Penelitian dan Pengembangan Mandalika (IP2MI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36312/jml.v6i1.3926

Abstract

Penelitian ini bertujuan untuk mengevaluasi secara formatif penyerapan anggaran Bantuan Operasional Kesehatan (BOK) Puskesmas Salur Langsung di Kota Depok pada tahun 2023. Dengan menggunakan metode evaluasi formatif, penelitian ini menganalisis efektivitas penyaluran BOK Salur dalam mendukung Upaya Kesehatan Masyarakat (UKM). Data dikumpulkan melalui wawancara mendalam dan analisis dokumen terkait alokasi anggaran, waktu penyaluran, insentif UKM, serta hambatan yang dihadapi oleh Puskesmas dalam melaksanakan program ini. Hasil penelitian menunjukkan bahwa penyerapan anggaran BOK Puskesmas di Kota Depok mencapai 87,84%, meningkat dibandingkan tahun sebelumnya yang sebesar 81,92%. Namun, masih terdapat beberapa Puskesmas yang mengalami penurunan penyerapan anggaran secara signifikan. Faktor-faktor yang mempengaruhi penyerapan termasuk ketepatan alokasi dana, waktu pencairan, serta pemahaman tentang petunjuk teknis (juknis) BOK. Selain itu, insentif untuk UKM belum sepenuhnya diserap oleh semua Puskesmas. Kesimpulan dari penelitian ini menegaskan perlunya perbaikan dalam mekanisme penyaluran BOK serta peningkatan kapasitas sumber daya manusia di Puskesmas agar dapat memaksimalkan pemanfaatan dana. Rekomendasi untuk penelitian selanjutnya adalah melakukan studi lebih mendalam tentang faktor-faktor yang menghambat penyerapan anggaran dan mengeksplorasi dampak dari kebijakan insentif UKM terhadap kinerja Puskesmas.
Analisis Efektivitas Biaya Vaksin HPV (Human Papilomavirus) Lupi Trijayanti; Ascobat Gani
Jurnal Penelitian Kesehatan SUARA FORIKES 2022
Publisher : FORIKES

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/sf13nk410

Abstract

Cervical cancer can reduce survival which affects productivity, also requires large health insurance payments. Preventive efforts in the form of administering the Human papilloma virus (HPV) vaccine are a long-term investment in preventing new cases of cervical cancer. This study aims to review the literature on the cost-effectiveness of the HPV vaccine in school-age girls. The method used to search for literature is the PICOS framework from national and international journals published from 2021 to 2022 through the Pubmed and ScienceDirect databases. Based on the 3 articles analyzed, the HPV vaccine evaluated by several countries described a significant reduction in the incidence and death from cervical cancer. In addition, HPV vaccination also provides protection against financial risks, namely household expenses caused by this case. From a health standpoint, vaccination can reduce DALYs and improve quality of life in a healthy and perfect condition. HPV vaccination is a preventive program which is a long-term and cost-effective investment for handling new cases if the coverage of vaccination is high enough.Keywords: cervical cancer; Human papilloma virus; vaccine; cost effectiveness ABSTRAK Kanker serviks dapat menurunkan ketahanan hidup yang mempengaruhi produktifitas, juga membutuhkan pembayaran jaminan kesehatan yang besar. Upaya preventif berupa pemberian vaksin Human papiloma virus (HPV) merupakan investasi jangka panjang dalam mencegah kasus baru kanker serviks. Studi ini bertujuan untuk mereview literature tentang efektifitas biaya vaksin HPV pada anak perempuan usia sekolah. Metode yang digunakan untuk mencari literatur adalah PICOS framework dari jurnal nasional dan internasional yang diterbitkan tahun 2021 sampai 2022 melalui database Pubmed dan ScienceDirect. Berdasarkan 3 artikel yang dianalisis, vaksin HPV yang dievaluasi oleh beberapa negara menggambarkan adanya penurunan insiden dan kematian akibat kanker serviks secara signifikan. Selain itu, vaksinasi HPV juga memberikan perlindungan terhadap risiko keuangan yaitu pengeluaran rumah tangga yang disebabkan oleh kasus ini. Dari sisi kesehatan, vaksinasi dapat menurunkan DALYs dan meningkatkan kualitas hidup dalam kondisi sehat dan sempurna. Vaksinasi HPV merupakan program preventif yang merupakan investasi hemat jangka panjang dan efektif dari segi biaya untuk penanganan kasus baru bila jangkauan dari vaksinasi cukup tinggi. Kata kunci: kanker serviks; Human papiloma virus; vaksin; efektivitas biaya
Integration of Indonesian National Trauma Guideline into the Emergency Room System (Cipto Code Trauma System) Mulyana, Radi Muharris; Gani, Ascobat
Journal of Epidemiology and Public Health Vol. 10 No. 2 (2025)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2025.10.02.02

Abstract

Background: Indonesia has enacted the national trauma guideline since 2017 and Cipto Mangun-kusumo Hospital (CMH) has applied it since 2019 through the establishment of Cipto Code Trauma. This study aimed to describe the compliance, system adherence, performance and outcome associated with the Cipto Code Trauma system.Subjects and Method: This cross-sectional study was conducted at CMH Emergency Room (ER) using direct observations and data from electronic health records (EHRs). Observations were performed on 106 trauma cases by convenience sampling to map clinical and non-clinical components using a checklist. We compared the implemented ER components against the 2017 national trauma guidelines, assessing the system compliance. Total sampling from EHRs was performed on 4,317 trauma patients to assess performance and outcome of Cipto Code Trauma system. The data were analyzed descriptively.Results: Observations from 106 trauma cases indicate that the Cipto Code Trauma meets all criteria from the national trauma guidelines. Performance indicators from 840 patients were achieved, including trauma team activation (87.6%), on-site multidisciplinary consultation (87.6%), time to physician assessment within five minutes (84.4%), except for length of stay under 4 hours (18.5%) and time to operating theatre within two hours (45.5%). Among the 4,317 trauma cases, the mortality rate for patients in the resuscitation category was 0.4%, while 39% of these patients were discharged directly from the ER.Conclusion: The Cipto Code Trauma at CMH has successfully integrated the Indonesian national trauma guidelines, meeting all required standards. However, further improvements are needed to enhance system adherence and performance.
EVALUASI PELAYANAN ANTENATAL CARE DI PUSKESMAS X KOTA PEMATANGSIANTAR Limbong, Ita Riyana; Gani, Ascobat
Jurnal Kesehatan Tambusai Vol. 6 No. 2 (2025): JUNI 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jkt.v6i2.47123

Abstract

Terjadi peningkatan jumlah kematian ibu di Indonesia. Pada tahun 2023 hanya terdapat 57,8% ibu hamil yang menerima ANC sesuai standar. Tahun 2022 terdapat 5 kematian ibu di Kota Pematangsiantar. Cakupan ANC K6 di Kota Pematangsiantar pada tahun 2022 mencapai 81,6% akan tetapi masih terdapat 230 kasus komplikasi dalam kehamilan dan beberapa puskesmas yang cakupannya masih dibawah target. Salah satunya adalah Puskesmas X yang memiliki cakupan K6 sebesar 53,6%. Penelitian berikut bertujuan untuk mengevaluasi pelayanan antenatal care di Puskesmas X Kota Pematangsiantar. Penelitian ini menggunakan desain non-eksperimental dengan studi deskriptif. Informan penelitian diseleksi dengan teknik purposive sampling juga exit poll. Informan penelitian terdiri dari kepala puskesmas, bidan, dokter serta ibu hamil. Variabel penelitian adalah struktur (sumber daya manusia, sarana dan prasarana, bahan medis habis pakai, pendanaan, pedoman ANC), proses (perencanaan, pengorganisasian, pelaksanaan dan pengawasan ANC) dan output (cakupan ANC). Pengumpulan data dengan wawancara mendalam, observasi serta telaah dokumen. Hasil dari penelitian ini menunjukkan bahwa SDM, sarana dan prasarana, dan BMHP di Puskesmas X Kota Pematangsiantar sudah sesuai dengan standar yang ada di Permenkes RI nomor 43 tahun 2019. Pendanaan ANC tidak memiliki hambatan dalam pemanfaatan dana JKN dan BOK. Tenaga kesehatan mengetahui adanya pedoman ANC dan melakukan pelayanan ANC sesuai dengan pedoman. Perencanaan ANC mengalami hambatan dalam pelaksanaannya. Pengorganisasian ANC dilakukan oleh bidan koordinator. Pelaksanaan ANC masih belum sesuai standar kuantitas K6. Pengawasan ANC dilakukan oleh secara internal dan eksternal. Cakupan ANC di Puskesmas X Kota Pematangsiantar masih rendah.
Hubungan Pemanfaatan Telemedicine dengan Peningkatan Kepuasan Pasien, Kepatuhan Pasien berobat dan Loyalitas Pasien di Rumah Sakit Damayanti, Febrini; Gani, Ascobat; Silistiadi, Wahyu
Jurnal Dunia Kesmas Vol 13, No 1 (2024): Volume 13 Nomor 1
Publisher : Persatuan Dosen Kesehatan Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jdk.v13i1.13490

Abstract

ABSTRAKTelemedicine telah banyak terbukti membantu dalam pelayanan kesehatan. Telemedicine juga dapat menjadi solusi permasalahan kesulitan dalam akses kesehatan, keterbatasan SDM dan Membuat biaya kesehatan menjadi efisien.  Penelitian yang dilakukan sebelumnya menyatakan bahwa penggunaan telemedicine sangat berperan dalam meningkatkan kepuasan pasien, kepatuhan pasien dalam pengobatan dan loyalitas pasien. Sayangya penelitian megenai telemedicine di Indonesia masih sangat terbatas. Penelitian ini bertujuan untuk korelasi penggunaan telemedicine dengan kepuasan pasien, kepatuhan pasien dan loyalitas pasien, Metode penelitian ini adalah systematic literature review mnggunakan prisma dan data diperoleh dengan cara online melalui google scholar, dan pubmed. Hasil studi membuktikan bahwa penggunaan telemedicine dapat  meningkatkan kepuasan pasien, kepatuhan pasien dan loyalitas pasien.Kata kunci: Telemedicine, Kepuasan pasien, kepatuhan pasien, loyalitas pasien
Medical cost inflation and its drivers in Indonesian employer-sponsored health insurance for retiree families Prastyo, Cahya E.; Gani, Ascobat
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.2528

Abstract

Rising life expectancy and changes in disease patterns have led to an increase in retiree medical costs. Understanding these trends is essential for ensuring the financial sustainability of retiree healthcare programs. The aim of this study was to analyze medical cost inflation and its drivers in Indonesia's employer-sponsored retiree health insurance program from 2020 to 2023. A retrospective cohort study using total sampling included 29,695 retirees, analyzing medical records and insurance claims to examine demographic transition, cost analysis and relative risk of cost drivers. The study found that the retiree population is aging, characterized by longer life expectancy and a growing proportion of individuals aged above 71 years. Medical cost inflation among retirees is higher compared to the general population, driven by aging, high-cost diseases, increased healthcare utilization, and rising treatment costs. Cardiovascular diseases, diabetes, and chronic kidney disease are major drivers of high medical costs. Inpatient care is the most significant cost component, with a cost risk 14.39 times higher than clinic visits. Medicine and medical treatment are leading cost contributors in the retired population. The rising cost of retiree healthcare necessitates sustainable financing strategies. The study highlights that medical cost inflation in retirees was higher than in the general population, driven by aging, high-cost diseases, increased utilization, and rising treatment costs. Strengthening preventive care, optimizing primary care, and diversifying funding sources are recommended to ensure long-term financial stability.
Towards The Four-Hour Rule: Impact of Observation Units and Emergency Medicine Specialists in an Indonesian Tertiary Hospital Sulistio, Septo; Gani, Ascobat
Jurnal ARSI : Administrasi Rumah Sakit Indonesia Vol. 11, No. 3
Publisher : UI Scholars Hub

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

Abstract

Emergency Department (ED) overcrowding is a global challenge. In response, the government of Indonesia mandates an ED Length of Stay (LOS) of ≤4 hours. This study aims to evaluate the impact of implementing an Emergency Department Observation Unit (EDOU) combined with an Emergency Medicine (EM) specialist-led disposition process on ED LOS at a national referral hospital in Indonesia. This was a retrospective, pre-post analysis comparing all ED visits in 2023 (pre-intervention, n = 26,282) with all visits in 2024 (post-intervention, n = 31,483). The primary outcome was the proportion of patients with an ED LOS ≤4 hours. Secondary outcomes included median ED LOS and the odds ratios (OR) for yellow zone patients achieving the ≤4-hour target based on the intervention period and the deciding physician's specialty. Following the intervention, the median ED LOS decreased from 16.4 hours to 8.0 hours (p-value = <0.05). Yellow zone patients in the post-intervention period had 6.37 times the odds of achieving a ≤4-hour LOS compared to the pre-intervention period (95% CI [5.72–7.09]). When the decision to admit to the EDOU was made by an EM specialist, the odds of achieving the target were 1.86 times higher than for other specialists (95% CI [1.43–2.42]). The combined implementation of an EDOU and EM specialists-led disposition significantly reduced ED LOS and dramatically increased the odds of meeting national performance targets. The success was driven by both increased downstream bed capacity and streamlined, specialist-led disposition processes.
PELAYANAN KESEHATAN YANG EFISIEN DAN TERJANGKAU MELALUI TRANSFORMASI KESEHATAN DIGITAL VIA TELEMEDICINE DI INDONESIA Memo Lukito; Ascobat Gani
Jurnal Kesehatan : Jurnal Ilmiah Multi Sciences Vol 14 No 2 (2024): JURNAL KESEHATAN : JURNAL ILMIAH MULTI SCIENCES
Publisher : STIK SITI KHADIJAH

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52395/jkjims.v14i2.452

Abstract

Indonesia menghadapi tantangan signifikan dalam menyediakan layanan kesehatan yang setara, terutama di daerah terpencil, dengan ketidaksetaraan yang semakin diperburuk oleh pandemi COVID19. Telemedicine muncul sebagai alternatif yang memungkinkan penyedia layanan untuk terhubung dengan pasien tanpa batasan lokasi. Penelitian ini bertujuan mengeksplorasi potensi Telemedicine dan digitalisasi dalam mentransformasi sistem kesehatan Indonesia serta menjembatani kesenjangan dalam penyampaian layanan bagi populasi yang kurang terlayani. Untuk mencapai tujuan tersebut, dilakukan tinjauan literatur menggunakan basis data seperti Google Scholar, PubMed, ResearchGate, dan Scopus dengan kata kunci Telemedicine, digitalisasi, transformasi kesehatan, pelayanan kesehatan, dan Indonesia. Kriteria inklusi mencakup studi yang diterbitkan dalam sepuluh tahun terakhir, baik di Indonesia maupun di seluruh dunia, sementara studi yang tidak relevan dan publikasi lebih dari sepuluh tahun dihapus. Tinjauan ini mengidentifikasi literatur yang menunjukkan efisiensi Telemedicine dalam meningkatkan akses layanan. Telemedicine dan digitalisasi berperan penting dalam mentransformasi sistem kesehatan, namun keberhasilan inisiatif ini memerlukan kebijakan komprehensif untuk mengatasi masalah infrastruktur, pelatihan, dan regulasi, serta penelitian lebih lanjut untuk mengevaluasi dampak jangka panjang terhadap layanan kesehatan dan kepuasan pasien, guna memastikan akses yang setara di seluruh demografi di Indonesia.
The Correlation of Age with Thrombocytes and D-Dimer Values in COVID-19 Patients at Hospital X in Jakarta, Indonesia Prasetyoningsih, Nanik; Gani, Ascobat
Kesmas Vol. 19, No. 5
Publisher : UI Scholars Hub

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

Abstract

Coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus, spread globally, with research indicating that prognosis severity can be assessed by thrombocyte and D-dimer levels; while, patient age serves as a mortality predictor. This study aimed to analyze the relationship between age with thrombocytes and D-dimer in COVID-19 patients. This cross-sectional study used laboratory testing samples from 667 COVID-19 patients at Hospital X in Jakarta, Indonesia, collected from August 2020 until May 2021. The data was collected using cluster random sampling and analyzed using descriptive statistics and the Chi square test (95% CI). The results showed that age and thrombocytes positively correlated with the D-dimer levels in COVID-19 patients (p-value