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INDONESIA
Jurnal Ekonomi Kesehatan Indonesia
Published by Universitas Indonesia
ISSN : 25278878     EISSN : 25983849     DOI : https://doi.org/10.7454/eki
Core Subject : Economy, Health, Science,
Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Health Professions Medicine & Pharmacology Public Health
This journal encompasses original research articles, case studies, conceptual fields, review-based studies (very limited, it will be strictly selected), and protocols. The journal publishes research from various topics in health economics, including but is not limited to the following topics: Economic Evaluation Health Financing Health Policy Health Insurance Pharmacoeconomics Health Technology Assessment (HTA) Tobacco Control Jaminan Kesehatan Nasional (JKN) Health and Econometric Article published in Jurnal Ekonomi Kesehatan Indonesia are determined through the blind review process conducted by the editor and reviewers. They provide evaluation and constructive suggestions for the authors. Prior to be accepted, they considers several factors such as whether the manuscript format is in accordance with the manuscript template and writing guidelines for authors, the relevance of the article with scopes, and its contribution to the development of health economics evaluation and accounting practices as well as the health policy.
Arjuna Subject : Ilmu Sosial - Kesehatan (Ilmu Sosial)
Articles 130 Documents
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People’s Support on Sin Tax to Finance UHC in Indonesia, 2016 Thabrany, Hasbullah; Laborahima, Zahrina
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 1
Publisher : UI Scholars Hub

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Abstract

Indonesia has the highest prevalence of smokers with 67% of adult males were smokers. Smoking prevalence among all adults increased sharply from 27% in 1995 to 36.3% in 2013. High consumption of cigarettes has been correlated with low price and excise of cigarettes. Experiences from other countries showed that one of the most effective way to reduce cigarette consumption is by increasing cigarette price and excise. Burden of tobacco related diseases has increased. The health burden will increase claims of JKN or Universal Health Coverage which currently has claim ratio of 115% and the quality of care remain low. The difficulties in collecting contribution from non salaried workers are blamed to contribute the deficit. Many countries have earmarked cigarette excise to supplement financing of (UHC) both in tax-funded system or in social health insurance system. The question is do people support? This study explored the possibility the people’s support to increase cigarette prices and excise to meet financial shortage of the JKN.
A Comparative Budget Requirements for TB program based on Minimum standard of Services (SPM) and Budget Realization: an Exit Strategy Before Termination of GF ATM Setiawan, Ery; Sucahya, Purwa K; Thabrany, Hasbullah
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 1
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Abstract

It has become a common issue that the Global Fund (GF) as one of the largest international donors to AIDS, Tuberculosis, and Malaria Program will immediately stop the funding. Data shows that in 2009 GF ATM support reached 88,8% while APBN funding just cover 11,2% of the total budget needed. However, APBN budget for ATM programs was significantly increased in 2012 which covered almost 30% of the total budget. Eventhough the increasing trend of ATM budget seemed at the central government level, how ever the local governments will hold the key to the sustainability of the post- termination GF ATM Funding
Application of Decision Analytic Model in Health Economic Evaluation: Smoking Cessation Cases Putri, Septiara
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 1
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Abstract

Health economic evaluation that encompasses decision analytic model is a beneficial approach for assisting decision maker to choose the best health intervention for patients. Decision analytic model has been increasingly applied in health economic evaluation. This mathematical approach is mostly used for conducting cost-effectiveness of healthcare interventions. Decision tree and Markov model has been widely applied in the past 20 years. Decision tree is the simplest form of decision model that drawn by the series of branches and clear pathways. Meanwhile, Markov model is one of the powerful approaches that employ stochastic process in health economic evaluation. This paper describes the applications of those two models in tobacco cessations, specifically for pharmacological interventions. First, decision tree for cost-effectiveness of smoking cessation program with pharmacist and therapies interventions compared to no program or self-aid cessation. Second, the application of Markov model estimates cost-effectiveness of veranicline, in comparison to bupropion. Markov model is constructed with morbidity and mortality states that consists of: well/no morbidities, lung cancer, COPD, stroke, myocardial infarction, and dead. This paper provides step by step of populating and constructing the model-with some modification of data. Several sections discuss the understanding of transition probabilities, costs data cohort simulation, and the role of sensitivity analysis. Other models, despite deterministic approach, probabilistic approach are also reviewed. Both of models had both advantages and limitation that analysts should be aware of. Translating the ‘real world’ to mathematical model yields beneficial and insightful information for analysts. In addition, it could fulfill the need of evidence-based policy by decision maker. From simulation, the model may easy to be replicated-with appropriate context to generate evidence related health and costs.
Evaluasi Pengadaan Obat Publik Pada JKN Berdasarkan Data e-Catalogue Tahun 2014-2015 Dwiaji, Ary; Sarnianto, Prih; Thabrany, Hasbullah
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 1
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Abstract

Since National Health Insurance (JKN) has been implemented, drug procurement in public health care facilities use e-Purchasing via e-Catalogue. Based on the RKO and HPS, drafting e-Catalogue have gone through a tender process and price negotiations. The process chain will effect the type (molecules) and the amount of drug through the e-Catalogue as well as the number and volume of demand by public health care facilities (e-Order).
Biaya dan Outcome Hemodialisis di Rumah Sakit Kelas B dan C Tania, Firda; Thabrany, Hasbullah
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 1
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Abstract

Chronic Kidney Disease (CKD) is a condition that is increasing in incidence in Indonesia, consuming a lot of National Health Insurance (JKN) public funds. In the JKN program, hemodialysis (HD) for treating CKD is guaranteed but requires a balance between costs and outcomes. Since 2014, BPJS has covered almost all HD costs in Indonesia with different Casemix Base Group (CBG) rates according to hospital class.
Terapi Sistemik Defisit JKN: Bahan Refleksi Bagi Semua Pihak Hidayat, Budi
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 1
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Abstract

The deficit deserves to be considered a chronic JKN disease. Indications of the deficit are revealed from the claims ratio figures. In 2014 and 2015, the claims ratio was consistently above 100%. This figure results from dividing claim costs (or participant health costs) by contribution income. Thus, the claims ratio describes the absorption of contribution funds for health costs only. However, contribution income must also be allocated for operational expenses and reserves. The JKN deficit will continue to grow if systemic therapy is nil. For 2016, the author's estimation results by referring to the assumed contribution amounts by Presidential Regulation No. 28/2016 (Cabinet Secretariat, 2016) and service rates in Minister of Health Regulation 59/2014 (Minister of Law and Human Rights, 2014) found a claim ratio of 101%. This means that contribution income still needs to be increased, even if only to fund health services. Where do the funds come from to fund operational costs? Does JKN only rely on government funding injections? The label of chronic deficit disease deserves to be carried by JKN. What is the cure?
Estimasi Biaya dan Evaluasi Program Intervensi Pemberian Pangan Olahan untuk Keperluan Medis Khusus (PKMK) untuk Perbaikan Status Gizi di Banyumas, Jawa Tengah Hasnur, Hanifah; Presilawati, Febyolla
Jurnal Ekonomi Kesehatan Indonesia Vol. 6, No. 2
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Abstract

The Government of Banyumas has implemented an intervention in the Provision of Processed Food for Special Medical Purposes (FSMP) with nutritional supplementation of 1.5 kcal/mL in 2019. However, there is no evaluation has been carried out, both of outcome and the cost of the intervention. So that, it is necessary to provide an initial picture of the resources needed for the formulation of future intervention plans. This study aims to determine the estimated cost required for FSMP intervention and to determine the outcome of the intervention. The economic evaluation was carried out partially by calculating costs from the perspective of the program implementing institution and the outcome of the intervention in the form of increasing weight and height. The research sample was 40 toddlers who had been selected based on nutritional screening of toddlers who were unable to consume existing foods and had inadequate nutritional intake. The results of the study showed that the total intervention cost was Rp.219.817.000 for 40 children (Rp.5.495.438 per child) where for nutritional supplementation of 1.5 kcal/mL per child was Rp.1.395.850. There was an increase in the average weight and height of children by 0.64-kilogram and 0.47-centimeter in 28 days after the program was completed. The estimated cost from the results of this study could be lower in subsequent interventions if the equipment is reused. This study can be used as a reference for FSMP interventions with the same subject coverage/criteria or on a wider scale.
Analisis Efisiensi Relatif di Unit Pelaksana Teknis Badan Pengawas Obat dan Makanan Tahun 2019 Widyastuti, Pantri; Nurwahyuni, Atik
Jurnal Ekonomi Kesehatan Indonesia Vol. 6, No. 2
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Abstract

The challenge of drug and food supervision requires the BPOM Technical Implementation Unit (UPT) to work optimally in the midst of limited resources. The analysis of the relative efficiency of the BPOM Technical Implementation Unit in 2019 was carried out with the aim of improving BPOM's planning, budgeting, and strategic policies in an effort to improve performance at each UPT. Calculation of relative efficiency using the DEA (Data Envelopment Analysis) method. This study uses a mixed method with a cross sectional research design. The research sample was 31 UPT BPOM that met the requirements as DMU (Decision Making Unit), 10 informants in the deepening of the process to determine the factors that affect the efficiency of UPT with DEA. There are 3 inputs and 4 outputs analyzed by DEA. The results of the analysis there are 15 efficient UPT and 16 inefficient UPT. The results of the deepening of the process revealed that the efficient and inefficient UPT had implemented the internal efficiency strategy well. DEA is a relative efficiency analysis with the concept of maximizing the ratio of output and input. The use of the VRS (Variable Return to Scale) model that considers the process, is expected to eliminate the shortcomings contained in the calculation with DEA. DEA calculation is done mechanically, so it is necessary to deepen the process to explore efficiency factors that are not obtained from DEA calculations, especially for organizations that involve large external factors in the process.
Physicians’ Behavior in Referring National Health Insurance Patients to Hospital Natalia, Natalia
Jurnal Ekonomi Kesehatan Indonesia Vol. 6, No. 2
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Abstract

Physicians’ decision to refer patients in primary health care is vital in supporting the referral system. The increase of referral cases impacted the claims cost and hospital workload. This study aimed to analyze the physicians’ behavior in referring National Health Insurance (NHI) patients to hospitals. This study employed a qualitative method; 18 informants were selected using purposive sampling and analyzed using content analysis. The data were validated by triangulating method, source, and data. Physicians referred patients when the cases could not be handled; there were indications of severe disease and required further examination. The obstacles in the referral system were pressure from NHI patients that wanted to be referred and diagnosed differently from ICD 10. In referring NHI patients, physicians had followed referral procedures and criteria. High referrals were caused by patients being forced to be referred, coming with complaints of severe disease, having examined in a hospital, and some cases should not be referred to but still referred by entering a similar diagnosis into the ICD 10. It is expected that public health centers will educate NHI patients related to tiered referral procedures in health services.
Evaluasi Capaian Peta Jalan JKN di Provinsi Bengkulu Studi Kasus Sectio Caesarea Tahun 2014 Sampai 2019 Wulan, Susilo
Jurnal Ekonomi Kesehatan Indonesia Vol. 6, No. 2
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Abstract

Bengkulu is one of the provinces in Indonesia where SC rate has increased significantly over the last five years after the implementation of JKN. Previous studies into SC trend in Indonesia indicate that both overutilization and underutilization of SC exist reflected inequality. SC is a public health concern since it absorbs a huge amount of JKN funds and is indicated to contribute to the BPJS deficit. This study evaluates the achievement of the SC case equity target in Bengkulu Province based on the 2014- 2019 JKN roadmap. Combining qualitative and quantitative approaches, analyzing secondary data from the BPJS routine data and government survey (SUSENAS) as well as interview with Local government and BPJS staff. This study found that despite the increase in coverage of JKN memberships, gap exists in the provision of health professionals, doctors and obstetrician distribution likely affected the utilization of SC. Currently, SC is enjoyed mostly by women residing in Bengkulu city and dominated by PPU and PBPU segment, which are 39 and 45% respectively. Improved monitoring and realization of compensation policy to provide equal distribution of doctors and obstetricians either by BPJS or local government.

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