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Abstrak :
[ABSTRAK Tingginya kejadian menunggak rata ? rata nasional 33% dalam pembayaran iuran Jaminan Kesehatan Nasional (JKN) oleh kepesertaan mandiri Badan Penyelenggara Jaminan Sosial Kesehatan dalam jangka panjang bisa mengganggu kelancaran, kelangsungan, dan keberlanjutan pembiayaan kesehatan. Terlebih lagi dengan adanya penyakit kronis pada peserta mandiri semakin memberikan beban ekonomi dan dampak negatif (adverse selection) bagi program JKN. Tujuan dari penelitian ini adalah untuk mengetahui apakah terdapat korelasi antara penyakit kronis pada peserta mandiri dengan kepatuhan membayar iuran Jaminan Kesehatan Nasional di Kota Depok. Metode penelitian cross-sectional dengan mengambil sampling keseluruhan peserta mandiri yang pernah mendapat layanan kesehatan di Kota Depok dari Januari 2014 ? Agustus 2015 didapat bahwa penyakit kronis dengan kepatuhan membayar iuran Jaminan Kesehatan Nasional di Kota Depok berbeda menurut kelas perawatan. Semakin rendah kelas perawatan peserta mandiri dengan penyakit kronis akan cenderung semakin meningkat. Oleh karena itu, distribusi proteksi risiko keuangan harus lebih berpihak atau pro kepada kelompok yang kurang mampu.

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ABSTRACT The high occurences of arrears in paying dues towards the independent membership of the National Health Coverage upto 33% at national average in the long term may interfere/hinder the continuity and sustainability of the program. Moreover, the presence of chronic illness among the members will contribute more economic burden and negative impacts (adverse selection). The purpose of this study is to analyze whether the presence of chronic illness has correlations in connection with paying dues compliance among the independent member of the National Health Coverage in Depok, Jawa Barat, Indonesia. By taking the total sampling against the independent membership of National Health Coverage in Depok who have received treatment at the medical facilities found that chronic illness and the compliance of paying dues is unsimilar depend on class of treatment. The lower class of treatment, the members with chronic illness more comply. It is, therefore, important to distribute public financial risk sharing that more inclined to lower class of treatment/pro poor.;The high occurences of arrears in paying dues towards the independent membership of the National Health Coverage upto 33% at national average in the long term may interfere/hinder the continuity and sustainability of the program. Moreover, the presence of chronic illness among the members will contribute more economic burden and negative impacts (adverse selection). The purpose of this study is to analyze whether the presence of chronic illness has correlations in connection with paying dues compliance among the independent member of the National Health Coverage in Depok, Jawa Barat, Indonesia. By taking the total sampling against the independent membership of National Health Coverage in Depok who have received treatment at the medical facilities found that chronic illness and the compliance of paying dues is unsimilar depend on class of treatment. The lower class of treatment, the members with chronic illness more comply. It is, therefore, important to distribute public financial risk sharing that more inclined to lower class of treatment/pro poor.;The high occurences of arrears in paying dues towards the independent membership of the National Health Coverage upto 33% at national average in the long term may interfere/hinder the continuity and sustainability of the program. Moreover, the presence of chronic illness among the members will contribute more economic burden and negative impacts (adverse selection). The purpose of this study is to analyze whether the presence of chronic illness has correlations in connection with paying dues compliance among the independent member of the National Health Coverage in Depok, Jawa Barat, Indonesia. By taking the total sampling against the independent membership of National Health Coverage in Depok who have received treatment at the medical facilities found that chronic illness and the compliance of paying dues is unsimilar depend on class of treatment. The lower class of treatment, the members with chronic illness more comply. It is, therefore, important to distribute public financial risk sharing that more inclined to lower class of treatment/pro poor., The high occurences of arrears in paying dues towards the independent membership of the National Health Coverage upto 33% at national average in the long term may interfere/hinder the continuity and sustainability of the program. Moreover, the presence of chronic illness among the members will contribute more economic burden and negative impacts (adverse selection). The purpose of this study is to analyze whether the presence of chronic illness has correlations in connection with paying dues compliance among the independent member of the National Health Coverage in Depok, Jawa Barat, Indonesia. By taking the total sampling against the independent membership of National Health Coverage in Depok who have received treatment at the medical facilities found that chronic illness and the compliance of paying dues is unsimilar depend on class of treatment. The lower class of treatment, the members with chronic illness more comply. It is, therefore, important to distribute public financial risk sharing that more inclined to lower class of treatment/pro poor.]

Abstrak :
Latar Belakang: Tuberkulosis dan diabetes melitus masih menjadi permasalahan utama kesehatan di Indonesia. Korelasi antara kedua penyakit ini menyebabkan peningkatan risiko kegagalan pengobatan, kekambuhan, yang berpengaruh pada lamanya durasi pengobatan dan beban pembiayaan yang tinggi. Tujuan: Mengetahui faktor-faktor yang berhubungan dengan kejadian dan biaya perawatan tuberkulosis dan diabetes mellitus pada peserta JKN tahun 2019. Metode: Penelitian ini menggunakan pendekan kuantitatif dengan studi cross sectional menggunakan Data Sampel BPJS Kesehatan Tahun 2019. Sampel penelitian ini adalah pasien dengan diagnosis tuberkulosis dan diabetes mellitus pada pelayanan FKRTL. Hasil: Pasien dengan komobiditas TBDM di Indonesia adalah sebanyak 21.105 peserta. BPJS Kesehatan menghabiskan anggaran sebesar Rp. 120.563.754.830,00 untuk biaya pengobatan pasien dengan komobiditas TBDM selama satu tahun. Faktor-faktor yang berhubungan dengan komorbiditas dan pembiayaan perawatan TBDM adalah jenis kelamin, umur, hak kelas rawat, segmen kepesertaan, jenis FKTP, kepadatan penduduk, persentase merokok, dan kualitas lingkungan hidup (p-value <0,05). Kesimpulan: Variabel tingkat keparahan kasus dan tingkat kunjungan FKTP tidak memiliki pengaruh terhadap tingginya biaya perawatan pasien dengan komorbid TBDM. ......Background: Tuberculosis and diabetes mellitus are major health problems in Indonesia. The correlation between these two diseases leads to an increased risk of treatment failure, relapse, which affects the duration of treatment and high financial burden. Objective: To identify factors associated with the incidence and cost of treating tuberculosis and diabetes mellitus among JKN participants in 2019. Methods: This study used a quantitative approach with a cross-sectional study using BPJS Health Sample Data in 2019. The samples of this study were patients with a diagnosis of tuberculosis and diabetes mellitus at FKRTL services in 2019. Results: Patients with TBDM comorbidities in Indonesia were 21,105 participants. BPJS Kesehatan spent a budget of Rp. 120,563,754,830.00 for the treatment of patients with TBDM comorbidities for one year. Factors associated with TBDM comorbidities and treatment costs were gender, age, entitlement to treatment class, membership segment, type of primary care provider, population density, smoking percentage, and environmental quality (p-value <0.05). Conclusion: The variables of case severity and primary care visit rate did not influence the high cost of care for patients with TBDM comorbidities