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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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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
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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.
Cost of Illness pada Pasien Hipertensi Rawat Jalan di Puskesmas Gamping 2 Andriani, Yuni; Wulandari, Sephia; Larasati, Niken
Jurnal Ekonomi Kesehatan Indonesia Vol. 10, No. 1
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Abstract

Hypertension is characterized by increased blood pressure due to various risks that do not function normally in stabilizing blood pressure. According to WHO, the number of hypertension patients worldwide in 2020 reached 972 million (26.4%) and increased in 2021 to 1.2 billion (29.2%). Hypertension treatment must be carried out long, requiring a substantial aggregate treatment cost. Based on BPJS data, in 2014, hypertension accounted for approximately Rp2.8 trillion in healthcare costs, which increased annually until 2016, reaching around Rp4.2 trillion. The purpose of this study is to describe the overall estimated cost of hypertension treatment for outpatients at Puskesmas Gamping 2. This Cost of Illness (COI) study calculates direct and indirect costs from the perspectives of payers and patients. The study was conducted on 65 respondents selected using the convenience sampling technique. The research instruments included the collection of financial administration information and medical records. The study results show that the majority of outpatient hypertension patients at Puskesmas Gamping 2 are female, totaling 41 patients (63%), aged 55-64 years (27 patients, 42%), and working as housewives (27 patients, 42%). The average total cost (COI) of outpatient hypertension treatment at Puskesmas Gamping 2 is Rp1,852,392, with a minimum cost of Rp772,886 and a maximum of Rp3,837,080 per patient per year. These results indicate the need for a more effective and efficient hypertension management strategy, both clinically and economically, to reduce the continuously increasing financial burden on the healthcare system and patients.
Jaminan Kesehatan Nasional pada Ibu Bersalin: Sebuah Studi Cross Sectional di Nusa Tenggara Timur, Indonesia Bahaji, Amanda Firdausya; Muhammad, Faris; Ayu, Putri; Davina, Rizani Alia; Yulianty, Vetty
Jurnal Ekonomi Kesehatan Indonesia Vol. 10, No. 1
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Abstract

Maternal Mortality Rate (MMR) in Indonesia remains high, particularly in East Nusa Tenggara (NTT). This study analyzes the relationship between National Health Insurance (JKN) ownership and mothers choosing childbirth facilities in NTT. This study employs a cross-sectional design with a quantitative approach, utilizing secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS), which was conducted from October to November 2024. The study population includes mothers who gave birth in NTT during the 2017 IDHS period, with a sample of 1,236 respondents selected using a stratified two-stage cluster sampling technique. Data analysis was performed using the chi-square test to assess the relationship between JKN ownership as the independent variable and the choice of childbirth facility as the dependent variable. Additionally, covariate variables such as maternal education level, economic status, maternal age, and residential location were analyzed. The results indicate that maternal education level has a significant relationship with the selection of healthcare facilities (p-value < 0.001). However, maternal age (p-value = 0.447), economic status (p-value = 0.199), residential location (p-value = 0.069), and JKN ownership (p-value = 0.110) do not show significant relationships. This study concludes that health education for pregnant women and optimizing the JKN program are necessary to enhance the utilization of healthcare facilities for childbirth and improve healthcare access, particularly in regions such as NTT.
Kebijakan Cukai Konsumsi Minuman Berpemanis dalam Kemasan (MBDK) dalam Mengendalikan Masalah Kesehatan: Tinjauan Literatur Sistematis dan Meta Analisis Hartono, Risky Kusuma; Aryani Susanti, Fitria
Jurnal Ekonomi Kesehatan Indonesia Vol. 10, No. 1
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Abstract

Globally, the consumption of sugar-sweetened beverages (SSBs) has increased by nearly 16%. The imposition of taxes on sugary drinks is considered one of the strategic measures to control diseases associated with their consumption. This study aims to conduct a meta-analysis of the correlation between SSB taxation and health issues. The systematic review and meta-analysis were carried out following the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) guidelines. Literature from various countries published since January 1, 2014, was collected using databases such as Google Scholar, PubMed, and Science Direct. The meta-analysis process was performed using a funnel plot. A total of 44 articles meeting the criteria and relevance were selected for the meta-analysis. The highest implementation rate of SSB taxation was 60%, while the lowest was 7%, with an average tax rate of 20% across 20 states. The results of the meta-analysis demonstrated a significant positive relationship between SSB taxation and the prevalence of overweight (0.17, 95% CI: 0.09 to 0.25), obesity (0.23, 95% CI: 0.10 to 0.35), diabetes (0.16, 95% CI: 0.01 to 0.31), cancer (0.12, 95% CI: -0.06 to 0.28), heart disease (0.12, 95% CI: -0.03 to 0.26), and dental caries (0.37, 95% CI: -0.05 to 0.68). However, no significant association was found between SSB taxation and stroke prevalence (0.02, 95% CI: 0.01 to 0.04). This study highlights a significant positive association between the imposition of taxes on sugary beverages and the high prevalence of health problems such as overweight, obesity, diabetes, cancer, heart disease, and dental caries, while the relationship with stroke prevalence was insignificant. The study recommends policymakers formulate and enhance the effectiveness of SSB taxation policies.
Status Sosial Ekonomi dan Pengeluaran OOP Kesehatan Penyandang Disabilitas Nainggolan, Maxent RG; Relaksana, Riki
Jurnal Ekonomi Kesehatan Indonesia Vol. 10, No. 1
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Abstract

In 2020, the number of persons with disabilities in Indonesia reached 22.97 million. One of the main challenges this population faces is the high burden of health expenditures, particularly those that are urgent and unpredictable. This study aims to analyze the influence of socioeconomic status on out-of-pocket (OOP) health expenditures among households with persons with disabilities in Indonesia. A quantitative approach was employed using secondary data from the 2022 National Socioeconomic Survey (Susenas), utilizing the core module (KOR) and the household expenditure module (KP). Data were analyzed using the two-part regression model to identify the determinants of OOP health spending. The results indicate that total household expenditure, educational attainment, and age of persons with disabilities are positively and significantly associated with higher OOP health expenditures. Conversely, health insurance ownership negatively and significantly affects OOP spending. These findings highlight the importance of social protection policies and expanded access to health insurance in reducing the economic burden on households with disabled members.
Analisis Ekonomi dan Dampak Pandemi COVID-19 terhadap Kunjungan Pasien Diabetes: Studi Kasus Poliklinik Pusat Diabetes RS Ngoerah, Bali, Indonesia Saraswati, Made Ratna; Ayuningtyas, Dumilah
Jurnal Ekonomi Kesehatan Indonesia Vol. 10, No. 1
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Abstract

The COVID-19 pandemic has significantly impacted community activities, including social and economic aspects, as well as health behavior and healthcare services. Diabetes Mellitus (DM) is a chronic disease that requires continuous management to prevent chronic complications. Ngoerah Hospital (RS Ngoerah), Bali, Indonesia, is a type A hospital where DM patients generally present with complications. This study analyzes the impact of the COVID-19 pandemic on DM patient visits to the Diabetes Center Polyclinic at RS Ngoerah by considering economic aspects. This research is a retrospective study of patient visit data to the Diabetes Center Polyclinic at RS Ngoerah from 2019 to 2024, covering the time before, during, and after the COVID-19 pandemic. A descriptive analysis was carried out to observe changes in patient visits during each period. Furthermore, an aggregate analysis was conducted to examine the correlation between the number of patient visits and the number of detected COVID-19 cases, the COVID-19 pandemic timeline along with government regulations during the pandemic, and the economic condition reflected by the Gross Regional Domestic Product (GRDP) of Bali Province in the same year. The COVID-19 pandemic led to a decrease of up to 58.65% in DM patient visits to the Diabetes Center Polyclinic at Ngoerah Hospital. Directly, there was no significant correlation between the number of reported COVID-19 cases in Bali Province and the number of DM patient visits to the Diabetes Center Polyclinic at RS Ngoerah (r=0.262, p=0.155); however, other factors influencing the number of patient visits included government policies during the COVID-19 pandemic and the GRDP
Determinants of Catastrophic Health Expenditure of Households in Indonesia Afrizal, Rafa Fayza; Hasya, Novira; Harda, Faticha Putri; Alfathin, Wildan Avif; Latifah, Vanissa Nur; Nainggolan, Maxent Rael; Jaelani, Fadillah Rahmah; Sihaloho, Estro Dariatno
Jurnal Ekonomi Kesehatan Indonesia Vol. 10, No. 1
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Abstract

The need for healthcare services due to illness is unpredictable, thus burdening patients economically and posing a risk of catastrophic events. The percentage of households with catastrophic health expenditures is defined as out-of-pocket payments exceeding 10% of the household’s capacity to pay for healthcare. Increasing catastrophic expenditure costs can further deteriorate the household’s financial condition. This study analyzes the determinants of catastrophic health expenditures in Indonesian households. A total of 12,892 household samples from the cross-sectional Indonesian Family Life Survey (IFLS) wave 5 (2014) were used in this study. Using a logistic regression model, this study aims to identify various socioeconomic factors and household members’ health histories that may influence the probability of a household experiencing catastrophic health expenditures. The study results show that socioeconomic factors, including household expenditures (p<0.01), the number of working household members (p<0.01), the number of insured household members (p<0.01), residential area (p<0.1), and the education level of the household head (p<0.01), have a significant influence on catastrophic expenditures. Catastrophic health expenditures are also significantly affected by the health history of household members, including chronic diseases (p<0.01), hospitalization history (p<0.01), and outpatient care (p<0.01). To reduce financial risks, policymakers can design a fair healthcare financing mechanism that addresses socioeconomic vulnerabilities and health risks. Expanding insurance coverage and strengthening financial protection for at-risk households can help alleviate the burden of catastrophic health expenditures.
Correlation Between Drug-Related Problems and the Treatment Cost for Geriatric Ischemic Stroke Patients in Tulungagung nugraha, dhanang prawira; aditya, martanty
Jurnal Ekonomi Kesehatan Indonesia Vol. 10, No. 1
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Abstract

Ischemic stroke was one of the diseases that frequently occurred in geriatric patients, while hemorrhagic stroke had a higher prevalence. Geriatric patients who experienced a stroke were not exempt from drug-related problems (DRP) due to the complexity of treatment and comorbid factors they encountered. This study aimed to determine the correlation between DRP and the cost of care for ischemic stroke patients, particularly in the geriatric population. The study design was cross-sectional, with data collected retrospectively, and the sample comprised 53 geriatric stroke patients who met the inclusion and exclusion criteria. DRP was assessed using the PCNE 6.2 criteria, and the cost data included expenses for medications, medical devices, laboratory tests, visit fees, accommodation, diagnostic electromedical procedures, radiology, nutrition, and insurance. The independent variable in this study was DRP, while the dependent variable was the cost of care. The analysis used in this study was Spearman's correlation and was presented with a correlation coefficient (R). The results showed a significant correlation between DRP and care costs (p-value < 0.05), with a correlation coefficient 0.501. The study concluded with the assertion that an increase in DRP is associated with elevated costs of care for geriatric ischemic stroke patients.
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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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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