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All Journal Journal of Community Empowerment for Health Berita Kedokteran Masyarakat Jurnal Ekonomi Kesehatan Indonesia
Hariyanti, Tatik
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Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Health Professions Medicine & Pharmacology Nursing Public Health

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Navigating older adults care: insights from caregivers and community health workers in Ngestiharjo, Bantul, Yogyakarta Hafidz, Firdaus; Monanda, Adelia Pramudita; Fitriani, Dewi Caesaria; Hariyanti, Tatik; Jamiah , Erni
BKM Public Health and Community Medicine Vol 40 No 09 (2024)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.v40i09.10389

Abstract

Purpose: This study aimed to elucidate the knowledge, attitudes, and practices of older adult caregivers in Ngestiharjo, Bantul, Yogyakarta, Indonesia, towards older adult care and to discern the role of Community Health Workers (CHWs). Methods: A mixed-methods approach was employed between April and June 2023, encompassing quantitative data collection with a cross-sectional approach from 253 older adult caregivers via a pretested questionnaire and qualitative insights with a descriptive approach from focus group discussions with seven CHWs. The data were analyzed using descriptive analysis and thematic analysis. Results: The caregivers were predominantly female (67.2%) and over the age of 50 (46.6%), with the most common occupation being housekeeping (34.8%). Knowledge deficits were noted in several areas, with mean scores of 0.53 for depression signs, 0.56 for physical exercise, 0.73 for sleep quality, and 0.79 for fall risk. Caregivers' sleep quality and fall risk knowledge were better than depression and physical exercise. Attitude scores averaged 82.42 ± 20.42 (out of 125), showing moderate confidence in caregiving activities. Practices related to older adult care showed promising results, especially in maintaining a clean living environment (mean Score: 4.08 ± 0.86). The pivotal role of CHWs in bridging this knowledge gap and facilitating healthcare access was underscored. Conclusion: The study highlights the need for targeted educational programs to improve the knowledge and practices of caregivers, particularly in physical exercise and mental health areas. Strengthening the role of CHWs is essential to enhancing caregiving outcomes.
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

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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.
Pendekatan Time-Driven Activity-Based Costing dan Theoretical Framework of Acceptability untuk Estimasi Anggaran Layanan Home-Based Palliative Care di Yogyakarta Hariyanti, Tatik; Hafidz, Firdaus; Budiarto, Arif
Jurnal Ekonomi Kesehatan Indonesia Vol. 11, No. 1
Publisher : UI Scholars Hub

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Abstract

Palliative care services delivered through a home care scheme in Indonesia are not yet included in the National Health Insurance (JKN) benefit package. Through a bridging guarantee scheme, since 2020 the Regional Government of the Special Region of Yogyakarta (DIY) has provided this service to the local population in accordance with applicable regulations. Therefore, a basis for budget allocation that considers the regional conditions of DIY is required. This study employed a mixed-methods approach with an explanatory sequential design, beginning with a quantitative study to estimate the prevalence of the population requiring palliative care services as well as the unit cost using a time-driven activity-based costing (TDABC) approach. The qualitative study was conducted using purposive sampling of 14 respondents through in-depth interviews with healthcare workers, patients and their families, and policymakers, applying the Theoretical Framework of Acceptability (TFA). The estimated prevalence over five years (2025–2029) showed 145, 148, 151, 155, and 158 cases, respectively. The unit cost of palliative care services using the TDABC approach was IDR 3,396,787. The estimated budget for services over five years, after being multiplied by the number of cases, amounted to IDR 492,534,115; IDR 502,724,476; IDR 512,914,837; IDR 526,501,985; and IDR 536,692,346, respectively. Palliative care is a necessary service that provides significant benefits, particularly for poor and underprivileged populations. However, broader dissemination is needed, including clearer service standards and regulatory frameworks governing its implementation. Based on the financial capacity of the Regional Government of DIY, stakeholders need to prioritize eligible population groups as service beneficiaries, while also restructuring the existing service delivery system. This budget estimation is proposed as a basis for allocating funds to ensure the sustainability of palliative care services for poor and underprivileged populations in DIY.
Co-Authors Arif Budiarto Dewi Caesaria Fitriani Firdaus Hafidz As Shidieq Jamiah , Erni Jamiah, Erni Monanda, Adelia Pramudita