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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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Timbang Besarnya Manfaat dari Salah Sasar Penerima Bantuan Iuran Jaminan Kesehatan Soewondo, Prastuti
Jurnal Ekonomi Kesehatan Indonesia Vol. 2, No. 2
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Abstract

One of the foremost government policies implemented in achieving Universal Health Coverage for the Indonesian population is the provision of financial assistance through contribution of Social Health Insurance for 92.4 million targeted poor and near poor households. This segment of the population is referred to as Penerima Bantuan Iuran (PBI) and represents about 35% of the total population. This study reveals the government’s progress in protecting the health of this sub-population. The data is derived from the 2016 National Social Economic Survey. The results indicate that, at the national level, the government’s health protection program has reached the majority of poor and near poor household (51%), especially those residing in Eastern part of the country (58%). Together with local government’s support, 59.5% of poor and near poor households (66.4% in Eastern region) have been insured. While improvements in coverage should still be top policy agenda, this achievement of the government deserves more appreciation. We show that misallocation of PBI to wealthy households is only small (3%), yet often broadcasted with much hype to create agitation
Perkembangan Asuransi Kesehatan Swasta di Indonesia Tahun 2012-2016 Sari, Kurnia
Jurnal Ekonomi Kesehatan Indonesia Vol. 2, No. 2
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Abstract

Total private insurance spending in 2015 is about 3.9% of Indonesia’s health expenditures. Although it is not considerably high, the information about private health insurance in Indonesia is still limited. This review is aimed to provide an overview of the private health insurance company growths in Indonesia. The number of private insurance company does not grow significantly, while the number of membership tends to fluctuate in the last 5 years, even it is tend to decrease for non life insurance category. Sums assured tend to rise until 2014, then stagnant for the next period. The amount of premium received by the company and claims to be paid (claim ratio) is considerably increase. It could not be denied that government program for achieving the universal health coverage is a threat to private insurance
Perbandingan Klaim Penyakit Katastropik Peserta Jaminan Kesehatan Nasional di Provinsi DKI Jakarta dan Nusa Tenggara Timur Heniwati, Heniwati; Thabrany, Hasbullah
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 2
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Abstract

Several diseases that become catastrophic at the household level include end-stage renal disease, cardiovascular diseases, cancer, thalassemia, and hemophilia. Patients with these diseases benefit significantly from the National Health Insurance (JKN), and these conditions absorb high claim costs from JKN. Special attention is needed to manage these diseases effectively. Disparities in healthcare facilities, specialists, and variations in Case Mix Group (CMG) payment are suspected to be important contributing factors to the variation in JKN fund absorption across provinces. This study uses 2014 claim data from BPJS Kesehatan in Jakarta and East Nusa Tenggara (NTT) provinces to explore the extent of these differences. The total number of claims analyzed was 309,301. The results show statistically significant differences in claim payments per case, per admission, and per hospital day. These differences are primarily due to variations in CMG prices, which do not provide adequate incentives for specialists to work in smaller hospitals of classes B, C, and D in lower-income provinces. This study does not prove the transfer of JKN funds from NTT to Jakarta.
Analisis Pembiayaan Kesehatan Daerah Bersumber Publik: Studi Kasus di Dinas Kesehatan Kabupaten Bogor Tahun 2012, 2013 dan 2014 Handayani, Tuti; Nadjib, Mardiati
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 2
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Abstract

This study aims to look at the picture of health expenditures in Bogor District Health Office to see the allotment according to the four dimensions of District Health Accounts (DHA) in 2014 to see the trend in 2012 and 2013. This study took data from a secondary data source realization of health spending that was then processed and presented according to the funding source, budget managers, service providers, and programs. The study used a descriptive research design with evaluative approach and was conducted in Bogor District Health Office. Analysis showed that the total health financing in Bogor District Health Department public sources in 2012 amounted to Rp 289.069.378.168 , - in 2013 the number increased to Rp 338 469 794 825 , - and in 2014 that number was dropped to Rp337.451.928.421 , - . The funding in 2012 and 2013 came from the state budget , district budget and provincial budget , whereas in 2014 from the state budget , district budget , provincial budget and other public funds . Judging from its designation , The most dominant spending, in 2012 , is health financing programs spent of 36.29 % , in 2013 also still dominant health financing program , its share reached 40.09 % , and in 2014 expenditure on health financing portion significantly decreased to only 23.69 %, with the largest health spending in 2014 was for program administration and management , that was 30.92 %.
Analisis Pengaruh Dimensi Fraud Triangle Dalam Kebijakan Pencegahan Fraud Terhadap Program Jaminan Kesehatan Nasional di RSUP Nasional Cipto Mangunkusumo Sadikin, Hasan; Adisasmito, Wiku
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 2
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Abstract

The National Health Insurance (JKN) held by the Social Security Agency (BPJS) Health started to be implemented from 1 Indonesia’s Health Insurance Program in January 2014. The implementation of a national insurance program found the risk. The risk of occurrence of fraud in Indonesia is very high but it is still difficult to identify its risk. This is supported by the lack of awareness of all parties, including patients, providers and insurance companies although such actions exists. Health fraud is a serious threat to the entire world, which led to financial abuse of scarce resources and the negative impact on access to health care, infrastructure, and social determinants of health. Health fraud is associated with increased health care costs in the United States. This study was to analyze the influence of the dimensions of the fraud triangle in fraud prevention policies towards the National Health Insurance program which is the reason for health fraud. This study used a qualitative approach. Data collection techniques such as interview guides, recorders, written records and documents. The study reported stress analysis, opportunity, and rationalization of the risk of fraud incident and presents examples of how policy has an impact on the National Hospital Dr. Cipto Mangunkusumo. This thesis will then provide advice on how to prevent future fraudulent health to reduce health spending and use of resources for the benefit of the National Hospital Dr. Cipto Mangunkusumo.
Malnutrition in Eastern Indonesia: Does food access matter? Fauziyah, Arina Nur
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 2
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Abstract

Meningkatnya prevalensi kekurangan gizi dan kelebihan berat badan di Indonesia Timur menimbulkan dugaan bahwa keterbatasan akses pangan, baik dari sisi akses ke pasar maupun akses secara ekonomi berpengaruh terhadap beban ganda malnutrisi. Studi ini bertujuan untuk menganalisis pengaruh akses pangan terhadap kekurangan gizi pada balita dan kelebihan berat badan individu dewasa serta kemungkinan terjadinya beban ganda malnutrisi dalam satu rumah tangga di Indonesia Timur. Dengan menggunakan data IFLS East tahun 2012 dan metode estimasi probit serta probit with sample selection, hasil studi menemukan bahwa keterbatasan akses pangan secara ekonomi, dari sisi pendapatan dan harga pangan pokok tidak hanya meningkatkan kemungkinan kekurangan gizi pada anak balita, tetapi juga dapat beban ganda malnutrisi dalam satu rumah tangga. Hasil studi ini mengimplikasikan bahwa diperlukan kebijakan yang berbeda antara satu daerah dengan daerah lainnya karena kecenderungan malnutrisi yang dialami juga berbeda. Selain itu, diperlukan pula upaya peningkatan pendapatan masyarakat serta kebijakan stabilisasi harga pangan, terutama pangan pokok untuk mengatasi malnutrisi, termasuk menurunkan kemungkinan beban ganda malnutrisi dalam satu rumah tangga di Indonesia Timur.
Analisis Estimasi Biaya Langsung Medis Penderita Rawat Jalan Diabetes Mellitus Tipe 2 di RSUD Dr. Abdul Aziz Singkawang Tahun 2013 Mursalin, Mursalin; Soewondo, Prastuti
Jurnal Ekonomi Kesehatan Indonesia Vol. 1, No. 2
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Abstract

Diabetes mellitus is an epidemic disease that seriously threatens global health. In addition to the high levels of morbidity and mortality, it also causes many countries around the world to spend a significant amount of money on healthcare. This study aims to calculate the direct medical costs and influencing factors of type 2 diabetes mellitus outpatient care. The study was conducted from January to February 2015 at RSUD dr. Abdul Aziz Singkawang in West Kalimantan. The study design used quantitative analysis with secondary data retrospectively collected from 2013, with a sample size of 200. The results of the multivariate analysis showed significant differences in the direct medical costs of type 2 diabetes mellitus outpatient care based on the type of care, disease duration, and complications. Health promotion and prevention interventions for type 2 diabetes mellitus should be increased to achieve effective and efficient care costs and to improve patients' quality of life.
KEMAMPUAN MEMBAYAR IURAN JAMINAN KESEHATAN NASIONAL PESERTA PENERIMA BANTUAN IURAN (JKN PBI) KOTA TANGERANG TAHUN 2023 Darwati, Darwati; Pujiyanto, Pujiyanto; Hidayat, Budi
Jurnal Ekonomi Kesehatan Indonesia Vol. 8, No. 2
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Abstract

The number of National Health Insurance (JKN) participants receiving Contribution Assistance (PBI) in Tangerang City from regional funding continues to increase by around 8.85% per year. On the other hand, the number of JKN participants who are non-wage earners (PBPU) and non-workers (BP) who pay contributions independently has decreased by around 0.7% per year from 2017-2022. One of the implications of this phenomenon is that the regional budget to finance JKN contributions for PBI participants is much larger than the budget for other programs. In 2020, JKN contribution payments for Tangerang City APBD PBI participants amounted to 57.81%, in 2021 it amounted to 75.32%, and in 2022 it amounted to 77.09% of the total Tangerang City Health Service budget excluding personnel expenditure and government governance. The research aims to analyze the ability to pay JKN contributions for the people of Tangerang City in 2023 and the influencing variables. The research used a cross-sectional design with a sample of 400 JKN PBI segment participants who had been selected by accident. Data was collected at two hospitals in the Tangerang City area in June 2023 using a questionnaire instrument. The average ability to pay JKN contributions is IDR 54,904/person/month. As many as 61.25% of respondents have the ability to pay JKN contributions of IDR 35,000/person/month. There is potential for savings in Tangerang City APBD expenditure of IDR 92.7 billion/year if 61.25% of JKN PBI APBD participants who have the ability to pay IDR 35,000/person/month are excluded from PBI membership. The results of the multivariate analysis found that the dominant variable influencing the ability to pay JKN contributions was non-food expenditure.
PELAYANAN KESEHATAN PRIMER SEBAGAI GATEKEEPER DAN KEBIJAKAN DISKUSI PEER REVIEW: ANTARA KUALITAS DAN REALITAS UNTUK MENURUNKAN KASUS RUJUKAN NON SPESIALISTIK Zahrina, Zahrina; Ramadani, Royasia Viki; Hulwah, Khairun Nisa il; Nurlatifah, Siti; Andalan, Aldi; Gani, Ascobat; Kurniawaty, Golda; Setiawan, Ery
Jurnal Ekonomi Kesehatan Indonesia Vol. 8, No. 2
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Abstract

Almost 80% of the source of funds is spent on hospital. This situation indicates the failure of the gatekeeper function in primary health care. Performance-based capitation is implemented to ensure the cost and quality of primary care, with non-specialist referral rate as one of the particular parameters. The peer review policy is a discussion between BPJS Health, District/City Health Services, IDI, provincial and branch Team of KMKB and other relevant stakeholders to determine which diagnoses must be handled at FKTP also to accommodate and improve the capacity of FKTP to handle patients and minimize referral cases. This study aims to evaluate the implementation of peer review discussions and analyze the obstacles, challenges and potential of peer review policies to optimize the FKTP gatekeeper function. The research method is qualitative, and it involves conducting in-depth interviews, FGDs, and literature reviews. In general, the peer review policy is quite good in controlling referral cases, especially RNS (Non-Specialist Referrals). In general, the peer review policy is entirely reasonable to control referral cases, especially RNS. Evaluation of the "peer review discussion" policy on the communication aspect is the lack of socialization regarding the management of tiered referrals. Resources, especially human resources, health equipment and drugs, still need to be increased in FKTP. Payment mechanisms such as capitation are essential to adjust the risk and capacity of FKTP or incentive mechanisms—determination of PPK on FKTP, clear boundaries and medical authority for FKTP and FKRTL. As well as, the role and coordination among stakeholders need to be improved to strengthen the prerequisites for FKTP infrastructure.
PENGARUH KEPEMILIKAN ASURANSI KESEHATAN PADA KELOMPOK MISKIN TERHADAP UTILISASI PELAYANAN KESEHATAN DI INDONESIA: SEBUAH STUDI RETROSPEKTIF Wanti, Dian Ira
Jurnal Ekonomi Kesehatan Indonesia Vol. 8, No. 2
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Abstract

Health is the main priority of the Indonesian government in order to improve the health status of the Indonesian people in order to become a healthy, qualified and productive society. Health insurance is one of the programs held by the government to make this happen. Health insurance ownership from year to year continues to increase, but this increase is not accompanied by high utilization of health services, both outpatient and inpatient. The low utilization of health services raises the questions of how health insurance ownership affects the utilization of health service utilization. Therefore, this study aims to analyze the impact of health insurance on health service utilization in Indonesia. This study uses the Propensity Score Matching method. The sample used was IFLS 5 2014 data in the form of individuals who received Social Protection Cards (KPS), totaling 22,500 individuals. The dependent variable were frequency of outpatient use in the last 4 weeks and frequency of inpatient use in the last 12 months. This study found that the health insurance variable had a negative effect on inpatient utilization with a significance level of 10%. However, it has a positive effect on outpatient utilization at the 5% significance level. The results showed that having health insurance can increase outpatient utilization by 14.6% higher than individuals who do not have health insurance.

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