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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 7 Documents
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Search results for , issue "Vol. 9, No. 2" : 7 Documents clear
Dampak Faktor Ekonomi dan Non Ekonomi Terhadap Jumlah Anak di Indonesia: Analisis Data Demographic Health Survey 2017 Munthe, MaySarah Qonita; Salsabila, Nasywa Nayifa; Kautsar, Achmad
Jurnal Ekonomi Kesehatan Indonesia Vol. 9, No. 2
Publisher : UI Scholars Hub

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Abstract

Indonesia has a large population, with a declining annual growth trend. Economic and non-economic factors contribute to the desired number of children. This study uses the latest data from the 2017 Demographic and Health Survey (DHS) to analyze the relationship between these factors and the desired number of children. A logit model is employed to evaluate the probability of having more than two children.The findings indicate that higher economic status is associated with a lower likelihood of having more than two children. Women in the middle economic group are 7.1% less likely to have more than two children compared to women in the low-income group. Additionally, non-economic factors, such as education level, show significant associations. Women with higher education are 21.1% less likely to have more than two children compared to women with lower education levels. This highlights the importance of women's education as a key non-economic factor in managing population growth. The government could consider expanding access to education, such as providing scholarships specifically for women, to help them achieve higher education levels. This, in turn, could indirectly contribute to population control in Indonesia.
Evaluasi Ekonomi Total Hip Arthroplasty Protokol Enhance Recovery After Surgery Dibandingkan Konvensional di RSUP Fatmawati Jakarta Lumbangaol, Hanna Elisabet; Nadjib, Mardiati
Jurnal Ekonomi Kesehatan Indonesia Vol. 9, No. 2
Publisher : UI Scholars Hub

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Abstract

Total hip arthroplasty (THA) is a common orthopedic procedure performed to replace damaged hip joints with prostheses. The demand for this procedure is expected to rise in the future. Enhanced Recovery After Surgery (ERAS) has been introduced as an evidence-based, multidisciplinary approach aimed at optimizing postoperative recovery and reducing hospital length of stay. This study aims to evaluate the costs and effectiveness, including hospital stay duration and surgical success rates, of THA using the ERAS protocol compared to conventional approaches. This cross-sectional study involved data collection from healthcare providers between January 2020 and May 2023. The analysis showed that both protocols achieved a 100% success rate in surgery, while a length of stay of ≤5 days was recorded in 88% of ERAS cases and 75% of conventional cases. The average costs were IDR 41,525,202 for the ERAS protocol and IDR 40,845,242 for the conventional protocol. Although no statistically significant differences were found in the direct medical costs or effectiveness between the two approaches, the primary cost differences were attributed to physician consultation and diagnostic examinations. This study was limited to cost and effectiveness analyses, without a comprehensive cost-effectiveness evaluation, such as calculating cost-effectiveness ratios. These findings provide initial insights into the economic implications of the ERAS protocol in Indonesian hospital settings.
Faktor yang Memengaruhi Kinerja Verifikasi Dokter Verifikator Internal Medis dalam Proses Klaim Pasien Jaminan Kesehatan Nasional di Rumah Sakit Cipto Mangunkusumo Tarigan, Immanuel Natanael; Oktamianti, Puput; Darmawan, Ede Surya
Jurnal Ekonomi Kesehatan Indonesia Vol. 9, No. 2
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Since the implementation of the National Health Insurance, hospitals must be able to manage JKN claims properly. One way to properly manage the situation is by employing a medical internal verification doctor. This study aims to determine the factors that influence the performance of medical internal verification doctor based on the percentage of claim eligibility that has been verified. The research was conducted using a case study method with a qualitative and quantitative approach. The study was conducted on 16 medical internal verification doctors using questionnaires and in-depth interviews. The results of the study found that the performance of medical internal verification doctors in January-June 2022 was 81.45%, lower than other hospital owned by the ministry of health (85-94%). This study also found that the factors related to the verification performance of medical internal verification doctors were demographic in the form of years of service as medical internal verification doctors and other workloads, knowledge, job satisfaction in general, satisfaction with salary, benefits and rewards for work, satisfaction with the nature of work, as well as satisfaction with the operational situation of work and colleagues. Other factors in medical internal verification doctors verification performance is organizational support, such as standard operating procedures, training and education opportunities and opportunities for communication with external parties. Other factors related to the verification performance of VIM doctors are the passion as a medical internal verification doctor, tasks assignment, feedback on performance and criteria or standards for becoming a medical internal verification doctors.
Efisiensi Biaya dalam Perawatan Stroke Non-Hemoragik: Studi Kasus di Rumah Sakit Islam Sunan Kudus Mubarok, Chusnul; Suryawati, Chriswardani; Harto, Puji
Jurnal Ekonomi Kesehatan Indonesia Vol. 9, No. 2
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Abstract

Stroke is one of the leading causes of morbidity and mortality globally, with over 12 million new cases each year. In Indonesia, the prevalence of stroke increased from 8.3% in 2007 to 12.1% in 2013, with the age group of 55-64 years recording the highest prevalence. This study aims to analyse the actual costs of non-hemorrhagic stroke care for patients under the National Health Insurance (JKN) at the Islamic Hospital of Sunan Kudus using the Activity-Based Costing (ABC) method. A descriptive quantitative method was applied, collecting data from hospitalised non-hemorrhagic stroke patients during 2023. The results showed a discrepancy between actual costs and INA-CBGs tariffs, with the average actual cost reaching Rp3.146.184, which is lower than the hospital tariff of Rp5.762.965 and the INA-CBGs tariff of class iii Rp4.036.200. CRR1 reaching 183.13% indicates that the hospital tariff includes unit costs with a significant surplus. Meanwhile, CRR2 at 128.30% shows that the INA-CBGs tariff also covers actual costs, but with a smaller margin. This discrepancy financially burdens the hospital, especially for class 3 patients. This study recommends evaluating the hospital's tariff structure and improving compliance with clinical pathways to enhance cost efficiency and service quality. Thus, applying the ABC method is expected to provide more accurate cost information and support more effective management of BPJS claims.
Analisis Klaim Pending, Verifikasi dan Audit Pascaklaim Jaminan Kesehatan Nasional Ulil Amri, Anugrah Aulia; Nurwahyuni, Atik
Jurnal Ekonomi Kesehatan Indonesia Vol. 9, No. 2
Publisher : UI Scholars Hub

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Abstract

The implementation of Indonesia’s National Health Insurance (JKN) poses new challenges for hospitals as service providers. Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan, the program’s administrator, now routinely conducts post-claim verifications and audits after claims have been paid. This often results in claim adjustments or even full reversals of previously reimbursed amounts. This case study examines JKN claim management at a Type D General Hospital in 2022, focusing on pending claims, verification, and post-claim audits, using a systems theory framework. Key issues in pending claims include incomplete medical records (29%), insufficient supporting documents (24%), and coding errors (21%). Post-claim problems primarily stem from problematic service episodes (39%), coding errors (31%), and incomplete medical records (22%). These challenges arise from systemic issues in the hospital's JKN claim management, necessitating improvement. Recommendations emphasize internal hospital reforms, including enhanced training programs, improved communication with leaders, accurate ICD-based diagnoses and procedures, redesigned medical record formats, and the development of electronic medical records. The study also suggests appointing functional medical staff, training for Medical Committee Chairs, and advocating for budget allocation. Furthermore, the study recommends that the Health Office improve inter-agency coordination and provide constructive input to the government regarding BPJS Kesehatan’s post-claim audit practices, which often deviate from regulations. Enhancing the BPJS Kesehatan application is also necessary to establish a more effective feedback mechanism for addressing JKN claim issues.
Faktor Pemicu dan Penghambat Fraud dalam Program Jaminan Kesehatan Nasional dan Strategi Pencegahannya: Sebuah Scoping Review Sam Tito, Julius; Siregar, Kemal Nazaruddin
Jurnal Ekonomi Kesehatan Indonesia Vol. 9, No. 2
Publisher : UI Scholars Hub

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Abstract

Fraud in the National Health Insurance program (JKN) has become one of the challenges faced by the government because it can harm the state finances and negatively impact the decline in the quality of health services. This research aims to identify triggering factors, inhibiting factors, and also strategies in preventing fraud in the JKN program. The study was conducted using the scoping review method according to the Arksey & O'Malley guidelines by searching 5 electronic databases and finding 2,622 articles. The literature search results were performed according to PRISMA-Scr, and 20 articles were analyzed in this study. The study results identified the triggering factors for fraud in the JKN program, namely the lack of understanding of the diagnosis system established by BPJS Kesehatan, dissatisfaction with the INA-CBGs system, insufficient internal supervision and control, limited resources and training for coding, financial factors, and behavioral and social factors. Meanwhile, the inhibiting factors for fraud in the JKN program include internal control, education and socialization, the implementation of SOPs and clinical pathways, as well as work culture and code of ethics. Fraud prevention strategies that can be implemented include strengthening internal controls, enhancing competencies and resources, formulating fraud prevention policies and guidelines, optimizing information technology in detecting fraud through the use of AI and machine learning, as well as reinforcing organizational culture and ethics.
The Role of Social Health Insurance in Achieving Universal Health Coverage in Asia: A Systematic Review Jauhar, Afaf; Nadjib, Mardiati
Jurnal Ekonomi Kesehatan Indonesia Vol. 9, No. 2
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Abstract

Universal Health Coverage (UHC) aims to ensure that all individuals have access to essential health services without financial hardship. Social Health Insurance (SHI) is critical in achieving this goal, especially in low- and middle-income countries. This systematic review explores the role of SHI systems in advancing UHC across 14 Asian countries, focusing on healthcare access, financial protection, and equity. A comprehensive search across PubMed, Scopus, and ScienceDirect identified 768 articles, and 37 studies were selected after screening, following the PRISMA guidelines. The chosen studies cover countries with varying SHI models across Asia. The findings reveal that high-income countries such as Japan, South Korea, and Singapore have made notable progress toward UHC. However, they face challenges related to aging populations and financial sustainability. In Thailand, the Universal Coverage Scheme (UCS) has achieved near-universal coverage, while Malaysia and Indonesia struggle with rural healthcare access and specialized care. In lower-middle-income countries like India, Vietnam, and Bangladesh, progress in financial protection is evident, but gaps persist in outpatient care and equitable access. Nepal and Cambodia face significant barriers due to economic and geographical constraints. This review underscores the critical role of SHI in advancing UHC. It highlights the need for policy reforms, innovative financing, and targeted interventions to strengthen SHI systems and improve equitable healthcare access across all Asian populations.

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