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RISS 인기검색어
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- 저자 : ( Lintong Hottua Simbolon ) (검색결과 1 건)
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( Lintong Hottua Simbolon ),( Aprilia G. A. Maay ),( Rosinta Hotmaida Pebrianti Purba ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: In Indonesia, Cirrhosis Hepatitis is the 5th disease with the most social insurance claims after heart disease, stroke, kidney failure, and cancer. Hepatitis Cirrhosis case-control program is focused on preventing Mother to Child Transmission (PPIA) because 95% of hepatitis B transmission is vertical, ie from mothers who are positive for hepatitis B to the fetus. Thus, every baby (0-11 months old) is required to get a complete basic immunization consisting of 1 dose of Hepatitis B, 1 dose of BCG, 3 doses of DPT-HB-HiB, 4 doses of polio drops, and 1 dose of measles / MR. Program coverage reaches 90.61% in 2018 nationally. Nevertheless, the prevalence of hepatitis sufferers increased from 0.2% in 2013 to 0.4% in 2018, equivalent to 13.5 million sufferers dominated from remote provinces such as Papua Island and the Nusa Tenggara Islands. This number makes Indonesia the 3rd country in Asia with the most cases of chronic hepatitis B sufferers after China and India. This study aims to analyze and evaluate risk factors of national policy objectives implementation. Methods: Using the juridical-empirical approach, this study analyzes whether Indonesia’s health service practices conformity is in line with national policy objectives. In accordance with National Social Security and Law Number 11 of 2009 concerning Article 19 of Law concerning Social Welfare, the government is obliged to ensure equal health services access and facilities due to Universal Health Coverage including promotive, preventive, curative, and rehabilitative services by adhering to the cooperation principle (gotong royong). Results: JKN aims to protect the citizens from financial risks through the Social Security Organizing Agency (BPJS) that will cover all types of diseases (Minister of Health Regulation 28/2014). Thus, the cost burden is allocated by the BPJS for curative Cirrhosis Hepatitis absorbs U $ 21.17 million in 2017 and U $ 14 million in 2018. Meanwhile, almost 784.3 thousand individuals each year fall into poverty as a result of hepatic health costs. However, the provisions on the National Formulary 2017 on drugs to reduce symptoms such as pegylated injection, adefovir dipropyl, entecavir, lamivudine, ribavirin, tenofovir, and telbivudine are limited in number and can only be accessed at level 1 facilities at hospitals that are difficult to access community in remote areas. Further, when performing surgery, it turns out there are costs that are not covered and eventually patients become difficult to pay for health care costs. Meanwhile, patients fall into poverty as a result of Cirrhosis Hepatitis health costs. The patient has to spend the cost of illness that is borne for life by 2.7 percent of total household consumption expenditure. This has an impact on reducing the quality of life of patients. Conclusions: The government has not achieved the goal of eliminating Cirrhosis Hepatitis patients from “out of pocket” yet. The government needs to overcome the health policies overlapping and develop hospital formularies due to prevention and health promotion programs. Further, the national health insurance program needs to be allocated more effectively for the construction of the health infrastructure in remote areas to improve the patient’s QoL.
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