Chairun Wiedyaningsih

Estimating the Burden of Cancer and Treatment Cost Related to Alcohol Consumption in Indonesia: a Descriptive Study

Background Alcohol consumption has become one of the most common cancer risk factors after smoking. Nowadays, estimation of the burden of disease attributable to alcohol has become standard in documenting the impact of health problems, but it has been rarely performed in Indonesia. The aim of this study was to estimate treatment cost of cancer related to alcohol consumption among the Indonesian population. Methods This research design was descriptive with a prevalence-based approach using secondary data. Proportions of cancers were calculated using an alcohol-attributable fractions (AAF) formula. Treatment costs for eight types of cancer were assessed according to average treatment cost per patient from the national universal health coverage database for 2016. Result The top three AAFs for males were cancers of the pharynx, esophagus and larynx (17.5%, 15.3% and 7.98%, respectively), while in females they were cancers of the esophagus, pharynx and stomach (2.15%; 1.39%; 0.83%). Among the eight types of cancer studied, the highest incidence in males was noted for liver cancer (132 cases) while colorectal cancer was the most common among females (31 cases). Treatment cost for cancers related to alcohol consumption were highest for colorectak cancer followed by laryngeal and liver cancer (116,083, 98,325 and 93,253 USD, respectively. Conclusion The expenditure for treatment of cancers related to alcohol consumption accounts for about 1.71% of total cancer treatment cost. Since cancers related to alcohol consumption can be considered having an economic impact in Indonesia, it becomes important for the government to control alcohol consumption so that related healthcare expenditure can be minimized.

Health Care Cost of Noncommunicable Diseases Related to Smoking in Indonesia, 2015

This study aimed to estimate the current prevalence and treatment cost of noncommunicable diseases attributed to tobacco in the Indonesian population in 2015. An epidemiological study was performed. Using the national universal coverage database, we calculated the morbidity and treatment cost of 19 diseases. Proportion of smoking-attributed diseases and treatment costs because of smoking were calculated using smoking-attributable fraction. The study revealed that the morbidity of smoking-related diseases accounted for 991 331 cases, about 21.6% of total cases of chronic diseases in Indonesia. The highest incidences of disease were hypertension, chronic obstructive pulmonary diseases, and ischemic heart disease. The treatment cost of smoking in Indonesia was conservatively estimated to be at least US

PERSEPSI PASIEN RAWAT JALAN TERHADAP KUALITAS OBAT GENERIK

2177 million, approximately 2.5% of the 2015 gross domestic product. A majority of the cost was largely concentrated in the male population (US

EVALUASI TERAPI ORAL TERHADAP HASIL TERAPI PASIEN ASMA

2164 million). Treatment costs of hypertension, chronic obstructive pulmonary diseases, and ischemic heart disease had the highest cost burden. This study’s findings provide scientific evidence about the economic burden of smoking, particularly the health care expenditure covered by the government. This study’s evidence is important for informing national public health policy to advocate the health promotion and prevention program.

The Effect of BPJS Service Quality Level and Patient Characteristics to Patient Satisfaction in Primary Health Facilities

Upaya peningkatan penggunaan obat generik sebenarnya sudah dilakukan pemerintah jauh sebelum pemberlakuan skema Jaminan Kesehatan Nasional (JKN). Akan tetapi, persepsi pasien terhadap obat generik di masa penerapan JKN ini dinilai oleh banyak pengamat masih buruk. Penelitian ini dilakukan untuk mengetahui persepsi pasien terhadap kualitas obat generik ditinjau dari dimensi safety, efficacy, dan acceptability serta mengidentifikasi pengaruh karakteristik pasien dengan persepsi pasien. Rancangan penelitian adalah penelitian deskriptif-analitik dengan pendekatan kuantitatif, desain survei cross sectional. Jumlah sampel sebanyak 150 responden. Penelitian dilakukan di RS PKU Muhammadiyah 1, Yogyakarta, Indonesia. Alat penelitian yang digunakan adalah kuesioner. Analisis data meliputi analisis deskriptif, analisis bivariat (uji Chi-square dengan alternatif yaitu uji Kolmogorov-Smirnov) dan analisis multivariat regresi logistik. Hasil penelitian menunjukkan bahwa persepsi pasien terhadap kualitas obat generik mayoritas tergolong baik, yaitu sebesar 113 responden (75,3%), rata-rata skor mulai dari yang terbesar berturut-turut safety (3,02), efficacy (2,75), dan acceptability (2,73). Hal ini bermakna bahwa pasien percaya dengan kualitas obat generik. Analisis bivariat menunjukkan persepsi pasien tidak dipengaruhi secara signifikan oleh usia dan jenis kelamin. Analisis multivariat menunjukkan persepsi pasien secara positif dan signifikan dipengaruhi tingkat pendidikan dan status kepemilikan asuransi kesehatan, namun tidak signifikan dipengaruhi tingkat penghasilan per bulan. Kata kunci: persepsi pasien, kualitas, obat generik

Drug Management Evaluation Focusing on Procurement at Muntilan District Hospital Magelang in Year 2015–2016

Asma merupakan salah satu penyakit kronis yang banyak ditemui dan secara klinis ditandai oleh adanya episode batuk rekuren, napas pendek, rasa sesak di dada dan mengi ( wheezing ). Terapi asma pada pasien dewasa diberikan secara oral, inhalasi dan parenteral. Peresepan pasien asma rawat jalan di Balai Kesehatan Paru Masyarakat (BKPM) Wilayah Magelang sebagian besar menggunakan obat yang diberikan secara oral karena mahalnya harga inhaler. Penelitian ini bertujuan untuk mengetahui pengaruh terapi oral terhadap hasil terapi pasien asma. Penelitian ini merupakan penelitian observasional dengan pengambilan data secara prospektif dari Februari sampai April 2014. Data diambil dari hasil pemeriksaan Peak Flow Meter , rekam medis dan lembar pengumpul data. Pasien yang memenuhi kriteria inklusi sebanyak 75 pasien tetapi hanya 71 pasien yang mengikuti seluruh proses penelitian. Untuk membuktikan adanya pengaruh sebelum dan sesudah menggunakan terapi oral terhadap hasil terapi digunakan uji t paired dan uji Wilcoxon . Untuk membandingkan besarnya perubahan digunakan uji t independent dan uji Chi-square dan alternatifnya Fisher . Hasil penelitian menunjukkan terjadi peningkatan nilai Arus Puncak Ekspirasi (APE) sebesar 92,68± 66,70 setelah 1 bulan menggunakan terapi oral Frekuensi serangan pada awal penelitian sebagian besar pasien ≥4x/minggu sebanyak 33 pasien (46,48%), setelah 1 bulan menggunakan terapi oral frekuensi serangan sebagian besar pasien menjadi 1-2x/bulan sebanyak 48 pasien (67,61%). Penggunaan terapi oral menunjukkan kemajuan hasil terapi berupa peningkatan nilai APE dan penurunan frekuensi serangan asma. Kata kunci: asma , terapi oral, hasil terapi