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Journal of Health Policy and Management
Published by Universitas Sebelas Maret
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Medicine & Pharmacology Public Health
Journal of Health Policy and Management (JHPM) is an electronic, open-access, double-blind and peer-reviewed international multidisciplinary and integrative journal, focusing on health policy, health system, and healthcare management. It began its publication on October 21, 2015. The journal is published twice yearly. It aims to improve the design and implementation of health policies, health systems, and healthcare management, primarily in low- and middle-income countries. JHPM analyzes policy initiatives and healthcare systems and provides evidence-based research to guide policymaking and management decision-making.
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Articles 253 Documents
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Unit Cost Analysis of National Health Insurance in Inpatients during COVID-19 Pandemic at Pelengkap Medical Center Hospital, Jombang, East Java Galuh Ayu Dyah Prameswari; Didik Gunawan Tamtomo; Bhisma Murti
Journal of Health Policy and Management Vol. 7 No. 3 (2022)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: In the era of Universal Health Coverage (UHC) as it is now, it is no longer a strange thing. The Indonesian government is preparing for the fulfillment of Universal Health Coverage (UHC) through the National Health Insurance program. The challenge that occurs is that hospitals that work together with BPJS Health are required to be able to carry out quality and cost control. The purpose of this study was to analyze the factors that influence the gap between the BPJS Health Inpatient unit cost rates and the INA CBGs package rates at complementary medical center hospitals in the pandemic era.Subjects and Method: The study was conducted with an analytical observational study design using a crosssectional approach carried out at the Complementary Medical Center Hospital in February March 2022. In a one year period, 204 billing for inpatients using BPJS Kesehatan were selected using a random sampling method. The dependent variable is the difference between the INA CBG package rates and the unit cost. The independent variables were readmission patients, surgery, extra doctors, intensive care, and special drugs. Data were collected by taking billing unit cost of patients at the hospital and analyzed using logistic regression. Results: The results showed that readmission, surgery, and intensive action had an effect on reducing the difference between INA CBG payments and unit cost and was statistically significant. INA CBG payments for patients with readmission were on average Rp 1,142,409 lower than the unit cost (b= 1,142,409; 95% CI= 1,864,753 to 420,066; p= 0.002), while the average surgical procedure was Rp 343,067 lower than the unit cost (b=343,067; 95% CI= 727,550 to 41,414; p = 0.80) and the average intensive action was Rp 1,226,861 lower than the unit cost and the effect was statistically significant (b= 1,226,861; 95% CI= 1,904,739 up to 538,984; p<0.001). Meanwhile, special drugs and extra doctors did not have a statistically significant effect, special drugs (b= 450,282; 95% CI= 1,662,453 to 761,889; p= 0.645) and extra doctors (b=159,838; 95% CI= 537,507 to 253,507; p = 0.447).Conclusion: Patient readmission and surgical procedures affect the difference in INACBGs package rates and unit costs. Keywords: inpatient unit cost, health bpjs.Correspondence: Galuh Ayu Dyah Prameswari. Masters Program in Public Healrh, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: galuh.mahesa@gmail.com. Mobile: 0895358233743.Journal of Health Policy and Management (2022), 07(03): 210-217 https://doi.org/10.26911/thejhpm.2022.07.03.05
Analysis of the Solid Medical Waste Management System Personal Protective Equipment (PPE) at the Special Covid-19 Isolation Facility in Suryah Khairudin Regional General Hospital Syarifah Aini; Hutwan Syarifuddin; Ilham Ilham
Journal of Health Policy and Management Vol. 7 No. 2 (2022)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: The generation of solid medical waste Personal Protective Equipment (PPE) generated in special facilities for Covid19 isolation is increasing and is an infectious waste that poses a risk of transmitting Covid19 to the environment. The occupancy rate (BOR) in the Covid19 special isolation room at Suryah Khairudin Hospital in 2020 was 14.75% of 51 beds, with an average number of inpatients 13 people/month, the total amount of solid medical waste PPE produced reached 60.69 kg/month. Subjects and Method: This was a descriptive qualitative study. The study informants were waste management officers. The data were obtained from interviews and observation. The data were extracted and analyzed using SWOT analysis.Results: The PPE solid medical waste management system at the Suryah Khairudin Hospital as a special Covid19 facility in West Tanjung Jabung Regency is quite good in terms of sorting, transportation is carried out less than 24 hours after being collected, and processing is carried out using incinerator. This is in accordance with KMK No. HK 01.07/MENKES/537/2020. Meanwhile, what has not been fulfilled is the labeling of plastic bags containing PPE waste because the use of black bags is still found but it is not labeled "biohazard" or a description of COVID19 waste, there are no TPS that meet the requirements in accordance with PermenLHK No. 56 of 2015 for storing Covid19 medical waste before processing it using an incinerator and the lack of awareness of waste transport officers in the use of PPE in carrying out their duties.Conclusion: The importance of providing biohazard symbols or information on Covid19 waste, socializing officers on the importance of using PPE, accelerating the implementation of making TPS that meet standards and building collaboration with surrounding companies to get support in the form of assistance for activities related to the management of PPE solid medical waste in special Covid19 facilities. 19 can be done well.Keywords: Covid19, PPE solid medical waste, waste management systemCorrespondence: Syarifah Aini. Study Program of Environmental Sciences, Postgraduate School, Universitas Jambi. Jl. Raden Mattaher 21 Pasar Jambi, Kota Jambi, Indonesia. Email: syarifah.22aini@gmail.com. Mobile: +6285266079299.Journal of Health Policy and Management, (2022), 07(02): 125-138https://doi.org/10.26911/thejhpm.2022.07.02.04
Meta-Analysis: Effects of Unsafe Action and Work Experience on Occupational Exposure to Needlestick Injury among Health Workers in the Hospital Nurul Dwi Andriani; Sumardiyono Sumardiyono; Bhisma Murti
Journal of Health Policy and Management Vol. 7 No. 1 (2022)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: Needlestick injury is a dangerous work accident that causes blood contact with pa-tients and is at risk of being infected with blood borne diseases such as hepatitis B virus (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). The purpose of this study was to analyze the influence of unsafe behavior factors on the incidence of accidents due to needlestick injury to health workers in hospitals. Subjects and Method: This research was conducted using a systematic review and meta-analysis study design using PICO, population: health workers, intervention: unsafe action and lack of work experience. Comparison: safe action and good work experience, Outcome: Needlestick Injury (NSI) incident. The articles used in this study came from 4 databases, namely Pubmed, ScienceDirect, ProQuest and Google scholar. The keywords of the article are ("Needle Stick Injury" or "Sharp Injury") AND aOR. The articles included in this study are full paper articles, observational study designs, 2011-2021 and the size of the relationship between Adj Odds Ratio Results: A total of 19 observational studies (case-control and cross-sectional) with 28,487 health workers from the African Continent (Egypt and Ethiopia), the Asian Continent (Thailand, Taiwan, Malaysia and Indonesia) and the European Continent (Bosnia and Herzegovina) were analyzed. From data processing, it was found that unsafe action increased the incidence of Needlestick Injury (NSI) in health workers in hospitals by 2.79 times higher than health workers who behaved safely (safe action) and statistically significant (aOR= 2.79; 95% CI= 2.18 to 3.67; p<0.001). Work Experience increases the incidence of Needlestick Injury (NSI) in health workers in hospitals by 1.97 times higher than health workers who have good work experience and is statistically significant (aOR= 1.97; 95% CI= 1.16 to 3.34; p = 0.010) . Conclusion: The influence of human factors, especially unsafe action, in increasing the incidence of needlestick injuries in health workers.Keywords: needlestick injury, sharp injury, unsafe actionCorrespondence:Nurul Dwi Andriani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: nurul.d.andriani@gmail.com. Mobile: +6282137279586.Journal of Health Policy and Management, 07(01): 58-71https://doi.org/10.26911/thejhpm.2022.07.01.06.
Organizational Effect on the Implementation of “SIMRS” (Hospital Management Information Systems) in Hospital: A Systematic Review Adhani Windari; Kismartini Kismartini; Yanuar Luqman; Bagoes Wijanarko
Journal of Health Policy and Management Vol. 8 No. 1 (2023)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: Utilization of information and communication technology has penetrated the field of health services. The form of health service innovation by utilizing information technology is the Hospital Management Information System (SIMRS). SIMRS is needed by Hospitals to ensure fast, accurate and reliable information needs in decision making, as well as the need for systematic data processing for strategic decision making. This study aimed to systematically review the influence of the organization on the implementation of “SIMRS”.Subjects and Method: A systematic review were conducted by searching articles from three databases, namely Google Scholar, Pubmed, and Science Direct. Keywords to search for articles are “Organization” OR “group” AND “Hospital Management Information Systems” OR “SIMRS” or “Management” AND “Hospital” or “Healthcare”. Articles included are full-text English from 2014 to 2019. Articles were selected using a PRISMA flow diagram method.Results: Organizational factors which include organizational structure and organizational environment are the main determining factors in the implementation of information systems. The successful implementation of SIMRS from the aspect of organizational structure, namely the role of leaders in providing support, motivation to users, a supportive work culture and work environment, a clear division of tasks and authority, regular monitoring and evaluation activities, fulfillment of infrastructure needs that support the implementation of SIMRS, availability of budget allocations for training and competency development for system users. While the organizational environment aspect, namely the role of Hospital management, has established policies as guidelines for the implementation of SIMRS.Conclusion: Organizational factors from the aspect of organizational structure and organi-zational environment can increase the success of the implementation of "SIMRS" in Hospitals.Keywords: SIMRS, organizational structure, organizational environment.Correspondence: Adhani Windari. Doctoral Program in Public Administration Science, Universitas Diponegoro. Jl. Pleburan, South Semarang, 50241 Central Java. Email: adhaniwindari@student.-undip.ac.id. Mobile: +62 8170582584.Journal of Health Policy and Management (2023), 08(01): 13-22https://doi.org/10.26911/thejhpm.2023.08.01.02
Health Service Quality Management at dr. Siswanto Air Force Hospital, Colomadu, Karanganyar, Central Java Dwi Marwanto; Bhisma Murti; Didik Gunawan Tamtomo
Journal of Health Policy and Management Vol. 6 No. 3 (2021)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: Patient satisfaction is an important indicator of health care success. Patients assess the quality of service received based on their satisfaction with the services provided. The purpose of this study was to describe the quality management of health services at dr. Siswanto Air Force Hospital (RSAU) Colomadu, Karanganyar.Subject and Method: This study is a qualita­tive study with a descriptive approach. The study was conducted from March to May 2021. The data for this study were taken from two sources, namely internal hospitals as health service providers and the community as users of health services. Informants in this study were the director of the dr. Siswanto Air Force Hospital, staff of dr. Siswanto Air Force Hos­pital, and 7 patients who used health services at dr. Siswanto Air Force Hospital. Data was collected by means of in-depth inter­views, observations, documents and focused group discussions. The data analysis techniques carried out were data reduction, data display and conclusion and also verification.Results: The quality of health services from the side of health service users (patients) showed that dr. Siswanto Air Force Hospital has good quality health services based on the following aspects: (1) reliability: patient regis­tration services, admi­nistrative management, provision of treatment rooms that are fast and easily accessible to patients, (2) assurance: health personnel have a polite, friendly, and res­pectful attitude towards patients, (3) tangible: the hospital room is comfortable, the staff is neat and clean, and medical equipment is complete, clean, and ready to use, (4) empathy: the officer gives special attention to patients and patient complaints, and there is no diffe­rence in atti­tude and treatment in general patient care and insurance, and (5) responsi­veness: there is good communication from hospital staff to patients and quick action if the patient needs immediate help.Conclusion: The quality of health service management at dr. Siswanto air force hospital fulfills the criteriaof reliability, assurance, tangible, empathy and responsiveness.Keywords: Management of health services, quality of health servicesCorrespondence: Dwi Marwanto. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: dwiantox74@gmail.com. Mobile: 082138064130.Journal of Health Policy and Management (2021), 06(03): 182-189 https://doi.org/10.26911/thejhpm.2021.06.03.03
The Affecting of Demographic Factors on Utilization of Postpartum Health Service Kusmirawati Kusmirawati; Fadila Alfiasari; Amanda Via Maulinda; Melinda Febianca Gaurinindi; Afifah Noer; Shofia Nur Fadhila; Salwa Annisaa; Putri Hapsari; Septyandi Ramadhan; Rendi Adiansa
Journal of Health Policy and Management Vol. 7 No. 3 (2022)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: Based on research states that the prevalence rate of complete postpartum visits (KF) in Indonesia is 37%, where this figure has increased from 2013 of 32.1%. The problem with the achievement of postpartum visits in Indonesia is that the underdeveloped areas mentioned in Presidential Decree Number 63 of 2020, namely North Sumatra, Central Sulawesi, Maluku, Papua and West Papua, occupy the bottom 6 provinces in the complete postnatal visit. The province of West Papua is the region with the lowest KF coverage rate in Indonesia. Subjects and Method: Metaanalysis conducted using the PRISMA systematic guidelines. Population= puerperium mother, Intervention= Urban, Comparison= Rural, Outcome= Utility of postnatal health service. The process of searching for articles was carried out between 2005 and 2021 using a database search engine consisting of; PubMed, Science Direct, Springer Link, and Google Scholar. Based on the database search, there were ten articles that met the criteria with a crosssectional design and observational studies and research that discussed demographic factors (urban & rural) on health care facilities. Results: The results of the analysis had high heterogeneity between studies I2= 94%, so that the Random Effect Model was used. Postnatal mothers living in urban areas increased by 1.48 times in utilizing postnatal care health services compared to postnatal mothers living in rural areas. however it was not statistically significant (SMD= 1.48; 95% CI= 0.90 to 2.44; p= 0.012). Conclusion: Postpartum women who live in urban areas use postpartum health services more than postpartum women who live in rural areas. Keywords: postpartum, postnatal visit, demographic factorsCorrespondence: Kusmirawati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: rendiadiansa@student.uns.ac.id Mobile Number: 08816008735.Journal of Health Policy and Management (2022), 07(03): 176-184https://doi.org/10.26911/thejhpm.2022.07.03.01
The Effect of Health Insurance Membership on Self-Medicine: An Analysis using Indonesian Family Life Survey 5 Rahmi Syuadzah; Hari Wahyu Nugroho; Safitri Tia Tampy; Dwiana Kartikawati
Journal of Health Policy and Management Vol. 6 No. 1 (2021)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: The prevalence of selfmedication in Indonesia is still quite large. The result of a survey conducted by the National SocioEconomic Survey (Susenas) showed that the percentage of the population who had selfmedicated health complaints was 61.05%. The negative impact of selfmedication is the side effects of drugs, the resistance to antibiotics, and the wrong choice of drugs. This study aimed to analyze the correlation between insurance ownership and selfmedication using IFLS data analysis.Subjects and Method: This was a crosssectional study. This study involved 31,411 sample obtained from IFLS 5 data. The dependent variable was selfmedication. The independent variables were age, sex, residence, marital status, and insurance ownership. The data were analyzed by multiple logistic regression. Results: The individuals who had insurance increased the initiative to seek selfmedication (OR=1.08; 95%CI=1.04 to 1.13; p<0.001). Male (OR=0.92; 95%CI=0.88 to 0.96; p<0.001), who lived in the city (OR=0.94; 95%CI=0.90 to 0.99; p=0.009), in the working reproductive age (1564 years) (OR=0.80; 95%CI=0.73 to 0.89; p<0.001), and married (OR = 0.82; 95% CI = 0.78 to 0.86; p <0.001) had a tendency not to take selfmedication.Conclusion: Based on the result of the study, the subjects of the study who have insurance have a greater risk of selfmedication.Keywords: Selfmedication, insuranceCorrespondence: Rahmi Syuadzah. Pediatric Research Center (PRC) Department of Child Health, Dr. Moewardi Hospital, Surakarta. Jl. Kolonel Sutarto, Jebres, Surakarta, Central Java 57126. Rahmi_syuadzah@yahoo.com.Journal of Health Policy and Management (2021), 06(01): 67-73https://doi.org/10.26911/thejhpm.2021.06.01.07
Analysis of Perception, Attitude, and Quality of Service on Patient Satisfaction at the Registration Place of the Kesambenkulon Health Center, Kediri Menik Tri Kumalasari; Katmini Katmini
Journal of Health Policy and Management Vol. 8 No. 1 (2023)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: Understanding the patient's needs and wants is an important thing that affects patient satisfaction. The purpose of this study is to analyzethe influence of perceptions, attitudes and quality of service on patient satisfaction at the registration of the Kesambenkulon Health Center. Subjects and Method: A cross sectional study conducted at Kesambenkulon Health Center, from August 19 to September 4, 2022. A sample of 105 respondents was taken by a simple random sampling. The dependent variable was patient satisfaction. The independent variables are perceptions, attitudes and service quality. Data were analyzed using a multiple linear regression.Results: Perception (b= 0.23; 95% CI= 6.12 to 8.13; p<0.001), attitude (b= 0.43; 95% CI= 5.65 to 7.84; p= 0.002), quality service (b= 0.15; 95% CI= 4.84 to 7.59; p= 0.002) were significantly associated with patient satisfaction at the Kesambenkulon health center registration (adj. R2= 81.2%). Conclusion: The researcher believes that understanding the patient's needs and desires is an important thing that affects patient satisfaction. Satisfied patients are very valuable assets because if patients are satisfied they will continue to use the services of their choice.Keywords: satisfaction, service quality, perception & attitudeCorrespondence: Menik Tri Kumalasari. Masters Program in Public Health, Strada Indonesian Institute of Health Sciences. Jl. Manila 37, Sumberece. Pesantren, Kediri, East Java 64133, Indonesia. Email: meniktrikumalasari@gmail.com. Mobile: +6281235500034.Journal of Health Policy and Management (2023)https://doi.org/10.26911/thejhpm.2023.08.01.07 
Meta-Analysis: Intervention Using Midfulness Training to Reduce Burnout in Medical Doctors Maika Ratri; Bhisma Murti; Didik Gunawan Tamtomo
Journal of Health Policy and Management Vol. 7 No. 1 (2022)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: Burnout is one of the mental health problems caused by a high workload that causes excessive stress characterized by symptoms such as anxiety and even depression, because of the seriousness of this burnout problem, the WHO classifies burnout as a disease. Burnout is a very serious problem in many countries, so efforts are needed to prevent and/or reduce the negative consequences and impacts of burnout syndrome. One of the interventions that can be done to achieve this is using the mindfulness method. This study aims to examine the effectiveness of mindfulness in reducing burnout levels in doctors.Subjects and Method: This meta-analysis study was conducted using PICO as follows: The population is doctors (general and specialist) who work in hospitals. Intervention is mindfulness. Comparison in the form of mindfulness therapy. The outcome is a low level of burnout. Sources of meta-analysis studies were accessed using: Clinical Key, Google Scholar, MEDLINE/PubMed, Science Direct. The articles used in this study are full-text articles with a Randomized Controlled Trial (RCT) study design. This meta-analysis used 10 articles with a total sample of 539 doctors who were divided into two groups (mindfulness group and no mindfulness group). Analysis of the data using the application Review Manager 5.4.1. The purpose of this study was to determine the Standardized Mean difference (SMD) and heterogeneity in the study sample.Results: The results showed that this study was homogeneous (I2=47%; P<0.001) so the Fixed Effect Model (FEM) was used. Mindfulness intervention was effective in reducing burnout levels in doctors 0.20 units lower than without using mindfulness and the results were statistically significant (SMD -0.20; 95% CI -0.37 to -0.03; p=0.020).Conclusion: Mindfulness is effective in reducing burnout levels in doctors 0.20 units lower than without using mindfulness and the results are statistically significant. Keywords: mindfulness, burnout, doctor.Correspondence: Maika Ratri. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java. Email: ratrim.mr@gmail.com.Mobile: +6285702081870.Journal of Health Policy and Management (2022), 07(01): 24-33https://doi.org/10.26911/thejhpm.2022.07.01.03
Modified-TAM Analysis of the Implementation of the e-Hospital System on Polyclinic Service Devina Gracia Pratama; Ignatius Wiseto Prasetyo Agung; Purwadhi Purwadhi
Journal of Health Policy and Management Vol. 7 No. 3 (2022)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: Technology in the field of health services allows an individual to get a productive life and a longer life expectancy. The purpose of this study was to provide describe of obstacles in the implementation of the e-Hospital system, especially EMR services at the Dermatology & Venereology (DV) Polyclinic "X" Hospital from the perspective of service providers.Subjects and Method: This qualitative descriptive research was done with natural observation and using electronic questionnaire based on Modified-TAM Analyses. It was conducted since February-June 2022. The study participants were determined based on the Non-Random Purposive Sampling technique which included all of DV Polyclinic staff at “X” Hospital (3 doctors, 2 nurses, and 2 administrative staff).Results According to the results, it was found that the implementation of the e-Hospital system at the DV Polyclinic was still not running optimally. The most commonly encountered barrier factors based on the Perceived Usefulness (PU), Perceived Ease of Use (PEOU), and Behavioural Intetion (BEI) components was the perception that “e-Hospital cannot replace the conventional system” (50%); and for the PTH & SI components was “the hospitals are not ready to run e-Hospital system” (60%).Conclusion: The hospital management needed to re-evaluate which constraint factors cause these perspectives, which could be an obstacle in implementing the e-Hospital system. In addition, it was necessary to re-emphasize the e-Hospital system and its benefits through periodically training, affirm the vision and mission related to the system, and do periodic feedback evaluations from service providers so that the hospital management could comprehend which obstacles were found and were able to make changes and increase the motivation of service providers to use the e-Hospital system.Keywords: e-Hospital System, Polyclinic Services, Service Provider, TAMCorrespondence: Devina Gracia Pratama. Master of Management Postgraduate Program, Adhirajasa Reswara Sanjaya University. Terusan Sekolah st. No.1-2, Cicaheum, Kec. Kiaracondong, Kota Bandung 40282, West Java. Email: devinagracia07@gmail.com. Mobile: +6281220811014.Journal of Health Policy and Management (2022), 07(03): 218-226https://doi.org/10.26911/thejhpm.2022.07.03.06

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