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All Journal JPKMI (Jurnal Publikasi Kesehatan Masyarakat Indonesia) Jurnal Jaminan Kesehatan Nasional
Nugraha, Erfan Chandra
Unknown Affiliation
Humanities Decision Sciences, Operations Research & Management Dentistry Environmental Science Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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Utilisation of Hospital Outpatient Services by Diabetes Mellitus Sufferers, Analysis of BPJS Kesehatan Sample Data Nugraha, Erfan Chandra; Pujiyanto, Pujiyanto; Permanasari, Vetty Yulianty
Jurnal Jaminan Kesehatan Nasional Vol. 4 No. 2 (2024): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v4i2.258

Abstract

Diabetes mellitus is a catastrophic disease that burdens the financing of the National Health Insurance or Jaminan Kesehatan Nasional Program, and sufferers continue to increase. Specific participant segments still widely use access for participants with diabetes mellitus to utilise health services at advanced-level referral health facilities. Various factors also influence access to health services at advanced-level referral health facilities. This research aims to analyse utilisation based on membership type and examine the factors that affect the utilisation of advanced outpatient services by JKN participants with DM. This research uses secondary data from the 2022 DM contextual BPJS Health sample data. The data was analysed univariately, bivariately, and multivariately with the Zero Inflated Negative Binomial regression model. The results of statistical tests showed that in outpatient care, age, type of participant, gender, treatment class, and province of participants were significantly different in terms of health service utilisation. The influence of the type of participation in the JKN program significantly affects the utilisation of services in outpatient care; the utilisation of non-recipients of contribution assistance participants is 1.16 times greater than that of the recipient of contribution assistance participants in outpatient care.
Hemophilia in Indonesia: A Cost of Illness Analysis Using National Health Insurance Data (2022–2023) Zahra, Adelia Pramesti; Permanasari, Vetty Yulianty; Nadjib, Mardiati; Nugraha, Erfan Chandra
Jurnal Publikasi Kesehatan Masyarakat Indonesia Vol 13, No 1 (2026): Jurnal Publikasi Kesehatan Masyarakat Indonesia
Publisher : Lambung Mangkurat University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/jpkmi.v13i1.25233

Abstract

Hemophilia is one of the highest contributors to catastrophic costs in the National Health Insurance (NHI) program. This study aims to estimate the Cost of Illness (COI) of NHI participants with hemophilia from a payer and partial productivity loss perspective, using secondary data from BPJS Kesehatan to examine direct medical costs from the perspective of a third-party payer, and average hourly wages by province in Indonesia to assess patient productivity loss. The research method is a cross-sectional study using a quantitative design. The findings indicate that the average COI per participant was IDR 728,832,232. After applying sampling weights to estimate the national population, the total COI for hemophilia during 2022–2023 was IDR 3.02 trillion, with 99% attributable to direct medical costs. These findings indicate that although hemophilia affects a relatively small number of participants, it imposes a substantial financial burden on the NHI system. Significant differences in COI medians were observed across age, gender, length of stay, special drug usage, membership segmentation, ward class, hospital region, hospital type, treatment type, and severity. Hemophilia, as a high-cost, low-frequency condition, requires careful management to avoid further strain on NHI funding.
Co-Authors Nadjib, Mardiati Permanasari, Vetty Yulianty Pujiyanto Pujiyanto Zahra, Adelia Pramesti