Medical problem in Asia pacific and ways to solve it: The roles of primary care/family physician (Indonesia Xperience)

Werdhani, Retno Asti

doi:10.4103/jfmpc.jfmpc_154_19

Cited by 15 publications

(15 citation statements)

References 1 publication

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“…12 While the primary healthcare (PHC) centres are designed as gatekeepers for primary prevention for NCDs, studies have found limited capacity of PHC in proper management of NCDs. 13–15 There is also high public funding allocations to curative services at the hospital-level, 16 with limited investment in preventive and promotive health services. 12 Further, the poor and those living in limited-resource regions have generally lower hospital utilisation due to geographical barriers and high transportation costs.…”

Section: Introductionmentioning

confidence: 99%

Impact of non-communicable disease multimorbidity on health service use, catastrophic health expenditure and productivity loss in Indonesia: a population-based panel data analysis study

Marthias

Anindya

et al. 2021

BMJ Open

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ObjectivesTo examine non-communicable diseases (NCDs) multimorbidity level and its relation to households’ socioeconomic characteristics, health service use, catastrophic health expenditures and productivity loss.DesignThis study used panel data of the Indonesian Family Life Survey conducted in 2007 (Wave 4) and 2014 (Wave 5).SettingThe original sampling frame was based on 13 out of 27 provinces in 1993, representing 83% of the Indonesian population.ParticipantsWe included respondents aged 50 years and above in 2007, excluding those who did not participate in both Waves 4 and 5. The total number of participants in this study are 3678 respondents.Primary outcome measuresWe examined three main outcomes; health service use (outpatient and inpatient care), financial burden (catastrophic health expenditure) and productivity loss (labour participation, days primary activity missed, days confined in bed). We applied multilevel mixed-effects regression models to assess the associations between NCD multimorbidity and outcome variables,ResultsWomen were more likely to have NCD multimorbidity than men and the prevalence of NCD multimorbidity increased with higher socioeconomic status. NCD multimorbidity was associated with a higher number of outpatient visits (compared with those without NCD, incidence rate ratio (IRR) 4.25, 95% CI 3.33 to 5.42 for individuals with >3 NCDs) and inpatient visits (IRR 3.68, 95% CI 2.21 to 6.12 for individuals with >3 NCDs). NCD multimorbidity was also associated with a greater likelihood of experiencing catastrophic health expenditure (for >3 NCDs, adjusted OR (aOR) 1.69, 95% CI 1.02 to 2.81) and lower participation in the labour force (aOR 0.23, 95% CI 0.16 to 0.33) compared with no NCD.ConclusionsNCD multimorbidity is associated with substantial direct and indirect costs to individuals, households and the wider society. Our study highlights the importance of preparing health systems for addressing the burden of multimorbidity in low-income and middle-income countries.

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Section: Introductionmentioning

confidence: 99%

Impact of non-communicable disease multimorbidity on health service use, catastrophic health expenditure and productivity loss in Indonesia: a population-based panel data analysis study

Marthias

Anindya

et al. 2021

BMJ Open

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“…8 The P-Care system and the list of diseases should be continuously improved to allow explanation of the GPs' clinical judgement, and primary care accreditation programs initiated by the Indonesian government can also be further applied to upgrade clinical resources rather than focusing on the administration aspects. 34,35 Above all, the Indonesian government is already in an appropriate stage of ensuring affordable and convenient access for people to meet their basic health care needs in primary care. The JKN implementation is relatively recent, and strategies aiming to improve the GP practice would obviously require quite some time.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Indonesian General Practitioners’ Experience of Practicing in Primary Care under the Implementation of Universal Health Coverage Scheme (JKN)

Ekawati

Claramita

2021

J Prim Care Community Health

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Introduction The Indonesian government has been implementing Jaminan Kesehatan Nasional (JKN) as the national universal coverage scheme to help Indonesian citizens affording medical care since 2014. However, after a few years of its implementation, a very limited study has been conducted to explore general practitioners’ (GPs) views and experiences of practicing in primary care under JKN implementation. Methods The study applied semi-structured interviews with GPs from January to February 2016, guided by a phenomenology approach in Yogyakarta province, Indonesia. The GPs were recruited using a maximum variation sample design. The interviews were recorded and transcribed, and the data were analyzed thematically. Result A total of 19 GPs were interviewed. Three major themes emerged, namely: powerlessness, clinical resources, and administration. Transition to the JKN system has improved patient access to primary care without significant economic barrier, however, GP participants experienced a sense of powerless practice during JKN implementation. They also commented on limited clinical resources and claimed that JKN administration was complicated and burdened their practice. Conclusion This study identifies various perspectives from GPs practicing in primary care under JKN implementation. The JKN improves access to primary care practice, but there are limited supports for GPs to practice optimally and maintain their relationships with patients. Extensive improvements are needed to upgrade the GP practice in primary care.

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“…Indonesia mengalami triple burden masalah kesehatan, yaitu penyakit menular, penyakit tidak menular, dan re-emerging disease. 1 Dari ketiga masalah tersebut, penyakit tidak menular (PTM) menyebabkan lebih banyak kematian dibanding dengan penyakit lain, terdapat 38 juta kematian pada tahun 2012 dan angka ini akan terus bertambah menjadi 52 juta kematian pada tahun 2030. 2 Empat PTM utama adalah penyakit pernapasan kronis, kardiovaskular, kanker, dan diabetes melitus (DM).…”

Section: Pendahuluanunclassified

Hubungan Kadar HbA1c dengan Glukosuria pada Pasien Diabetes Melitus Tipe 2 di RSUD Al-Ihsan Bandung Provinsi Jawa Barat

2021

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Diabetes melitus (DM) merupakan penyakit kronis yang disebabkan oleh kekurangan produksi insulin atau akibat ketidakefektifan insulin yang diproduksi. Kekurangan tersebut meningkatkan konsentrasi glukosa yang akan merusak berbagai macam sistem tubuh, salah satunya organ ginjal. Pada DM, glukosa urine dapat ditemukan apabila kadar glukosa darah sudah melebihi threshold ginjal. Tujuan penelitian ini mengetahui hubungan antara kadar HbA1c dan glukosuria pada pasien diabetes melitus tipe 2. Penelitian ini menggunakan metode analitik observasional dengan proses pendekatan cross-sectional. Data penelitian menggunakan rekam medis pasien DM tipe 2 di RSUD Al-Ihsan periode Januari-Desember 2019 dengan jumlah subjek yang memenuhi kriteria inklusi dan tidak termasuk eksklusi sebanyak 66 orang yang terdiri atas 24 laki-laki (36%) dan 42 perempuan (64%), rentang usia tertinggi 40-65 tahun sebanyak 45 orang (68%). Analisis bivariat menggunakan uji chi-square didapatkan hasil analisis hubungan kadar HbA1c dengan glukosuria dengan nilai p=0,036 dan nilai r=0,243. Berdasar atas hasil penelitian disimpulkan bahwa terdapat hubungan antara kadar HbA1c dan glukosuria pada pasien DM dengan korelasi positif lemah. Hal ini tidak semata-mata dapat menjadikan HbA1c menjadi kriteria diagnosis DM karena menurut beberapa penelitian yang dilakukan sebelumnya, HbA1c dapat meningkat pada penyakit ginjal (nefropati DM), kanker, uremia, dan iskemia serebral. Hal serupa terjadi pada glukosuria yang kejadiannya tidak selalu terjadi pada pasien dengan DM. Oleh karena itu, korelasi positif lemah pada penelitian ini kemungkinan disebabkan oleh faktor-faktor yang telah disebutkan di atas.

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Medical problem in Asia pacific and ways to solve it: The roles of primary care/family physician (Indonesia Xperience)

Cited by 15 publications

References 1 publication

Impact of non-communicable disease multimorbidity on health service use, catastrophic health expenditure and productivity loss in Indonesia: a population-based panel data analysis study

Impact of non-communicable disease multimorbidity on health service use, catastrophic health expenditure and productivity loss in Indonesia: a population-based panel data analysis study

Indonesian General Practitioners’ Experience of Practicing in Primary Care under the Implementation of Universal Health Coverage Scheme (JKN)

Hubungan Kadar HbA1c dengan Glukosuria pada Pasien Diabetes Melitus Tipe 2 di RSUD Al-Ihsan Bandung Provinsi Jawa Barat

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