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All Journal International Journal of Public Health Science (IJPHS) Disease Prevention and Public Health Journal Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education Journal of Health (JoH) Syntax Literate: Jurnal Ilmiah Indonesia Jurnal Pemberdayaan: Publikasi Hasil Pengabdian Kepada Masyarakat Jurnal Formil (Forum Ilmiah) Kesmas Respati Jurnal Kajian Ilmiah Kesehatan Dan Teknologi (JKIKT) Medical Technology and Public Health Journal Jurnal Pelayanan dan Pengabdian Masyarakat (Pamas) PREPOTIF : Jurnal Kesehatan Masyarakat JUMANTIK: Jurnal Mahasiswa dan Peneliti Kesehatan Jurnal Aisyah : Jurnal Ilmu Kesehatan Science Midwifery Indonesian Journal of Global Health research Indonesian Journal of Hospital Administration Jurnal Promotif Preventif Epidemiology and Society Health Review (ESHR) Indonesian Journal of Engagement, Community Services, Empowerment and Development (IJECSED) INDRA: Jurnal Pengabdian kepada Masyarakat Media Publikasi Promosi Kesehatan Indonesia (MPPKI) Healthy Tadulako Journal (Jurnal Kesehatan Tadulako) JUMANTIK (Jurnal Ilmiah Penelitian Kesehatan) Jurnal Vokasi Kesehatan International Journal of Healthcare Research Promotor: Jurnal Mahasiswa Kesehatan Masyarakat Jurnal Pengabdian Sosial Academic Hospital Journal Mohuyula : Jurnal Pengabdian Kepada Masyarakat
Hidayat, Muhammad Syamsu
Universitas Ahmad Dahlan
Religion Arts Humanities Biochemistry, Genetics & Molecular Biology Chemistry Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary Other

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Journal : Science Midwifery

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Comparative study of UHC implementation in Indonesia and Malaysia: Literature review Rahim, Mohammad Afiff Bin; Rosyidah, Rosyidah; Hidayat, Muhammad Syamsu
Science Midwifery Vol 13 No 4 (2025): October: Health Sciences and related fields
Publisher : Institute of Computer Science (IOCS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35335/midwifery.v13i4.2106

Abstract

Universal Health Coverage Universal Health Coverage (UHC) is a key principle of an equitable health system, ensuring access to healthcare services without financial burden. Indonesia, with its National Health Insurance (JKN), and Malaysia, with its tax-based public healthcare system, have different approaches to implementation. This study compares the implementation of UHC in Indonesia and Malaysia, including the financing system, resource distribution, service coverage, and service quality. The study used a literature review with the PRISMA approach. From the total number of articles found in various databases, titles, abstracts, and inclusion-exclusion criteria were screened, leaving 15 relevant articles for analysis. Indonesia, through JKN, has covered a large portion of the population, but faces disparities in access, unequal distribution of healthcare workers, and high out-of-pocket costs for specialist services. Malaysia has near-universal coverage with subsidized public services and financial protection for poor households, although there is inequality between the public and private sectors. Indonesia needs to improve infrastructure, equitable distribution of healthcare workers, public education regarding active participation, and strengthened program management. Malaysia is advised to strengthen the integration of the public and private sectors and maintain progressive financing to reduce financial risks for poor households.
Analysis of hospital costs and insurance reimbursement systems for pneumonia patients: A literature review Pujokusuma, Nopriyan; Hidayat, Muhammad Syamsu; Ruliyandari , Rochana
Science Midwifery Vol 13 No 6 (2026): February: Health Sciences and related fields
Publisher : Institute of Computer Science (IOCS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35335/midwifery.v13i6.2225

Abstract

Pneumonia has remained one of the leading causes of global morbidity and mortality and has imposed a substantial clinical and financial burden on healthcare systems. The high cost of pneumonia care was influenced by disease severity, comorbidities, length of hospital stay, and the use of therapeutic and diagnostic interventions. The implementation of prospective payment systems, such as Diagnosis Related Groups (DRGs) and INA-CBG’s, aimed to improve cost efficiency; however, it often resulted in gaps between actual hospital costs and reimbursement tariffs. This literature review aimed to analyze hospital costs and insurance reimbursement systems for pneumonia patients. A Systematic Literature Review was conducted following PRISMA guidelines through searches of PubMed and Google Scholar for publications from 2020 to 2025. Eleven articles met the inclusion criteria and were analyzed narratively. The findings indicated that length of stay, clinical complexity, and the use of broad-spectrum antibiotics were the main determinants of high costs. Package-based payment systems improved efficiency but continued to face underfunding challenges. This study concluded that optimizing pneumonia cost management required clinical efficiency, accurate claims coding, and technological support to ensure hospital financial sustainability.
Co-Authors Abiyusa, Annisaa Yuniarti Adnan, Muhammad Luthfi Afthina, Rifka Ellya Agra Nabilfavian Evandinnartha Agung Kristanto Anggi Triya Septiani Anggita, Dila Astia Putri, Dela Baehaqi Bariya, Umi Khoirul Dodik Prakoso Eko Hery Suwandojo Dwi Yulianti Fatma Nuraisyah, Fatma Fatwa Tentama Fitriana Putri Utami Fitro Adilla Fitroh Adhilla Fitroh Adila Handayani, Lina Handayani, Tika Sri Helfi Agustin Ianto, Sadam Alfian Galang Ichsan Priyotomo Ifada Rahmayanti Khoiriyah, Salsabila Laila, Linda Lina Handayani Lina Handayani Mahmood, Afzal Marwati, Tri Ani Mentes Hartanti Moss, John Muhammad Ihsan Pratama Muhammad Syapril Nabila Fanda Syafitri Neni Ramayani Nuramelia, Yulianti Nurhafisah Nurhafisah Nurmaningsih Nurmaningsih Pangastuti, Palupi Melati PUJOKUSUMA, NOPRIYAN Rahim, Mohammad Afiff Bin Rifka Ellya Afthina Rochana Ruliyandari Rokhmayanti Rokhmayanti Rosyidah Rosyidah Rosyidah Rosyidah Rosyidah, Rosyidah rubaida, ida Ruliyandari , Rochana Ruwanto, Ruwanto Safrotul Laely Selegani, Ferdinan Septian Emma Dwi Jatmika, Septian Emma Dwi Siti Kurnia Widi Hastuti Sitti Nur Djannah Siwi Pramatama Mars Wijayanti Solikhah, Dina Putri Sri Wahyunita Mohamad Sulistyawati Sulistyawati Sulistyawati Sulistyawati Sumadi, Andrias Feri Sumiyati Sumiyati Surahma Asti Mulasari Teti Sukmawati Tri Ani Marwati Tri Ani Marwati Tri Ani Marwati Tri Wahyuni Sukesi Trismadani Erlina Putri Ulinnuha Yudiansa Putra Wardiyanta Wardiyanta Wardiyanta, Wardiyanta Widodo Hariyono Widodo Hariyono Wiji Astuti Wiji Astuti Yanasta Yudo Pratama Zahra, Aini