KAJIAN ATAS RISIKO KELOMPOK USIA DAN KLAIM RUMAH SAKIT (RS) COVID-19 DI INDONESIA, 2020 – 2021

Penelitian ini menganalisis risiko COVID-19 untuk kelompok usia dan korelasinya dengan tingkat keparahan, durasi rawat inap (Length of Stay/LOS), klaim rumah sakit, dan status keluar pasien rawat inap rumah sakit. Definisi dari kelompok usia adalah dari anak-anak, usia produktif, dan usia lanjut. Pertengahan tahun 2020 pemerintah Indonesia menetapkan pembatasan sosial di beberapa daerah seiring dengan peningkatan kasus COVID-19 namun situasi ekonomi diharapkan tetap berjalan. Namun dalam melakukan kegiatan ekonomi akan mempunyai risiko lebih tinggi ketika mereka melakukan kegiatan ekonomi, apalagi jika mereka menggunakan transportasi publik ke lokasi pekerjaan mereka. Penelitian ini juga mengukur signifikansi perbedaan dalam penerapan Pedoman Pencegahan dan Pengendalian COVID-19 Pedoman Revisi Ke-4 dan Ke-5 dan dampaknya terhadap durasi rawat inap dan klaim RS untuk pasien rawat inap. Penelitian ini menggunakan data E-Klaim Kementerian Kesehatan dengan total 206 ribu pasien rawat inap COVID-19 seluruh Indonesia antara Maret 2020 sampai dengan Januari 2021. Temuan awal adalah anak-anak mempunyai proporsi tingkat kesembuhan paling tinggi dibandingkan usia produktif, dan usia lanjut mempunyai tingkat kesembuhan paling rendah untuk status pasien keluar rawat inap. Sedangkan proporsi meninggal menunjukkan hal yang sebaliknya untuk status pasien keluar rawat inap. Hasil dari regresi hampir semua variabel mempunyai pengaruh yang berarti terhadap klaim pasien rawat inap COVID-19

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

AbstractIt 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, how­ever the local governments will hold the key to the sustainability of the post- termination GF ATM FundingObjectivesThis study aimed to get a picture of the local government’s commitment as an implementing insti­tution to respond the financing needs specifically for TB programs.MethodsThis economic evaluation compared the amount of the existing budget of local governments and the amount needed based on the Minimum Standards of Services (MSS) of TB Programs. We sampled two district in west java that were Cirebon and Garut. The cost component calculated in these evaluation were: medicines, medical supplies, case findings, and administrative cost.Results and DiscussionTotal budget needed in Garut according to MSS amounted 2,5 Billion Rupiahs, whereas the total budget which has been alocated approximately 2 Billion Rupiahs. For those budget allocated in Garut, 90% of the total was supported by the Government then the rest of that was supported by GF. A similar trend showed in Cirebon, which was found a budget shortage amounted 700 Million Rupiahs from approximate­ly 1,6 Billion Rupiahs budget needed and 80% of those was sourced by The Government. The particular finding showed that prevention and case detection program in Garut still dominated by GF support which slightly above 65%. Otherwise, budget allocated for those Activity in Cirebon has been dominated by the government approximately 80%.ConclusionIn general, both Garut and Cirebon faced two common challenges in terms of financing the TB program. First, the high shortage between needs and budget alocated of the program becomes an important concern for addressing TB cases reduction in related district. The second is program’s sustainibility after termination of Global Fund, particularly for prevention and case detection programs. Therefore, it might be need a support from NGO or other related institution to advocate the local government and DPRD to allocate more budget for reducing TB cases. 

Assessing the burden of pneumonia using administrative data from Malaysia, Indonesia, and the Philippines

Objectives: To describe the incidence, mortality, cost, and length of stay (LOS) of hospitalized community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) in three Southeast Asian countries: Malaysia, Indonesia, and the Philippines. Methods: Using Casemix system data from contributing hospitals, patients with International Classification of Diseases 10th revision (ICD-10) codes identifying pneumonia were categorized into CAP or HAP using a logical algorithm. The incidence among hospitalized patients, case fatality rates (CFR), mean LOS, and cost of admission were calculated. The population incidence was calculated based on Malaysian data. Results: For every 100 000 discharges, CAP and HAP incidences were 14 245 and 5615 cases, respectively, in the Philippines, 4205 and 2187, respectively, in Malaysia, and 988 and 538, respectively, in Indonesia. The impact was greatest in the young and the elderly. The CFR varied from 1.4% to 4.2% for CAP and from 9.1% and 25.5% for HAP. The mean LOS was 6.1–8.6 days for CAP and 6.9–10.2 days for HAP. The cost of hospitalization was between USD 254 and USD 1208 for CAP and between USD 275 and USD 1482 for HAP. Conclusions: The burden of CAP and HAP is high. Results varied between the three countries, likely due to differences in socio-economic conditions, health system differences, and ICD-coding practices