It 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.
Background Recent Coronavirus Disease-19 (COVID-19) pandemic shows that health system, particularly hospital care, takes the highest toll on COVID-19. As hospital gets to manage the surge of COVID-19 cases, it is important to standardize treatment standard and package for COVID-19. Until recently, in Indonesia, COVID-19 curative package in hospital is paid using a retrospective payment system (claims system) using a per-diem rate. Quantifying standard cost using an established retrospective claims dataset is important as a basis for standard formulation for COVID-19 package treatment, should COVID-19 be accommodated into the benefit package for Universal Health Coverage (UHC) under the National Health Insurance. Methods We estimated a standard cost for COVID-19 treatment using provider’s perspective. The analysis was conducted retrospectively using established national COVID-19 claims dataset during January 2020 until 2021. Utilizing individual-or-patient level analysis, claims profile were broken down per-patient, yielding descriptive clinical and care-related profile. Estimate of price and charge were measured in average. Moreover, indicators were regressed to the total charged price (in logarithmic scale) so as to find the predictors of cost. Results Based on the analysis of 102,065 total claims data received by MOH in 2020-2021, there is an average claim payment for COVID-19 in the amount of IDR 74,52 million (USD$ 5175). Significant difference exists in hospital tariffs or price to the existing claims data, indicating profit for hospital within its role in managing COVID-19 cases. Claim amount predictors were found to be associated with change of claim amount, including high level of severity, hospital class, intensive care room occupancy and ventilator usage, as well as mortality. Conclusion As COVID-19 pandemic shifts towards an endemic, countries including Indonesia need to reflect on the existing payment system and move towards a more sustainable payment mechanism for COVID-19. The COVID-19 payment system needs to be integrated into the existing national health insurance allowing bundled payment to become more sustainable, which can be achieved by comprehensively formulating the bundled payment package for COVID-19.
Penelitian ini bertujuan untuk mengevaluasi rasionalisasi pos stasiun hujan menggunakan metode Kagan. Metode ini menghasilkan jumlah pos stasiun dan letak penempatan jaringan pos stasiun hujan di suatu wilayah. Hasil evaluasi yang dilakukan di Wilayah Sungai Sumbawa menunjukkan bahwa jumlah stasiun hujan yang perlu ditambahkan sebanyak 152 buah stasiun. Namun, setelah dievaluasi menggunakan Google Earth software untuk melihat kesesuaian lokasi terhadap kriteria lokasi pembangunan stasiun hujan, hanya 50 titik yang memenuhi kriteria. Untuk mengoptimalkan metode tersebut, titik-titik rekomendasi yang tidak memenuhi syarat dipindahkan ke lokasi bangunan air terdekat, seperti bendungan, embung, atau bendung. Jumlah titik yang dipindahkan ke bangunan air terdekat sebanyak 31 titik dan 70 titik lainnya tidak direkomendasikan untuk dibangun stasiun hujan. Hal ini membuktikan bahwa rekomendasi jumlah dan titik penempatan dari hasil analisis rasionalisasi metode Kagan tidak bisa langsung diaplikasikan di lapangan. Rekomendasi yang diberikan harus dievaluasi kembali dengan memperhatikan kaidah-kaidah dalam penentuan lokasi pembangunan pos stasiun hujan.
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