Despite the fact that morbidity and mortality rates due to dengue infection in Indonesia are relatively high, a dengue vaccination has not yet been introduced. Next to vaccination, Wolbachia-infected mosquitoes and health education have been considered to be potential interventions to prevent dengue infection in Indonesia. This study was aimed to analyse the cost-effectiveness of dengue vaccination in Indonesia whilst taking Wolbachia and health education programs into account. An age-structured decision tree model was developed to assess the cost-effectiveness. Approximately 4,701,100 children were followed-up in a 10-year time horizon within a 1-year analytical cycle. We compared three vaccination strategies: one focussing on vaccination only, another combining vaccination and a Wolbachia program, and a third scenario combining vaccination and health education. All scenarios were compared with a no-intervention strategy. The result showed that only vaccination would reduce dengue fever (DF), dengue haemorrhagic fever (DHF), and dengue shock syndrome (DSS) by 123,203; 97,140 and 283 cases, respectively. It would save treatment cost at $10.3 million and $6.2 million from the healthcare and payer perspectives, respectively. The combination of vaccination and a Wolbachia program would reduce DF, DHF and DSS by 292,488; 230,541; and 672 cases, respectively. It would also save treatment cost at $24.3 million and $14.6 million from the healthcare and payer perspectives, respectively. The combination of vaccination and health education would reduce DF, DHF, and DSS by 187,986; 148,220; and 432 cases, respectively. It would save treatment cost at $15.6 million and $9.4 million from the healthcare and payer perspectives, respectively. The incremental cost-effectiveness ratios (ICERs) from the healthcare perspective were estimated to be $9995, $4460, and $6399 per quality-adjusted life year (QALY) gained for the respective scenarios. ICERs from the payer perspective were slightly higher. It can be concluded that vaccination combined with a Wolbachia program was confirmed to be the most cost-effective intervention. Dengue infection rate, vaccine efficacy, cost of Wolbachia program, underreporting factor for hospitalization, vaccine price and mortality rate were considered to be the most influential parameters affecting the ICERs.

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AbstrakPelayanan farmasi merupakan salah satu kegiatan di rumah sakit yang dapat menunjang pelayanan kesehatan yang bermutu. Faktor yang dapat meningkatkan mutu pelayanan farmasi salah satunya yaitu pelayanan resep. Pada era Jaminan Kesehatan Nasional (JKN), resep yang diberikan terhadap pasien harus mengacu pada formularium nasional. Jika resep tidak sesuai dengan formularium nasional maka akan mempengaruhi mutu pelayanan di instalasi farmasi. Penelitian ini bertujuan untuk mengetahui kesesuaian resep pasien rawat jalan JKN dengan formularium nasional dan mengetahui hubungan variabel tersebut terhadap mutu pelayanan instalasi farmasi di salah satu RSU di Bandung. Penelitian dilakukan menggunakan desain penelitian potong lintang dengan kuesioner servqual mengenai mutu pelayanan pasien rawat jalan JKN dan data 262 resep yang diambil pada bulan Januari tahun 2017. Analisis data bivariat yang digunakan adalah uji Mann Withney. Hasil penelitian menunjukkan resep yang sesuai dengan formularium nasional sebanyak 91,7% dan sisanya tidak sesuai. Hasil lainnya adalah terdapat perbedaan bermakna antara kesesuaian penulisan resep dengan mutu pelayanan dengan nilai sig 0,00 (p < 0,05). Kesimpulannya adalah semakin tinggi persentase kesesuaian resep dengan formularium nasional di RS maka mutu pelayanan instalasi farmasi semakin baik. AbstractPharmaceutical service is one of the activities in hospital that support health service quality. One of the factors that can improve quality of pharmaceutical services is prescription services. In the era of National Health Insurance, prescription given to the patients should be based on the National Formulary. If prescriptions did not suit the national formulary, it would influence the services quality on pharmacy unit. The purposes of this study were to determine suitability of prescription outpatients' national health insurance with national formulary and to determine the relationship of the suitability of prescription with a national formulary to service quality in pharmacy unit in one of general hospitals in Bandung. A cross sectional with servqual questionnaire was used to the patients and the 262 prescription samples needed were taken in January 2017. Mann Whitney test is used for bivariate analysis. The result indicated 91.7% prescriptions was suited the national formulary and the rest was not. There was a significant difference between prescription suitability with the national formulary to service quality in pharmacy unit in the hospital with p-value 0.00 (p< 0,05). It can be concluded that higher percentage of prescriptions suitability with the national formulary in hospital related with the better service quality of pharmacy unit.