BackgroundThe Corona Virus Disease 2019 (COVID-19) pandemic has created a substantial socioeconomic impact, particularly in developing countries such as Indonesia.Purpose(s)/objective(s)This study aimed to describe the COVID-19-related out-of-pocket spending of Indonesian citizens and the proportion of whom experienced catastrophic health spending during the COVID-19 pandemic using the patient's perspective.MethodologyWe conducted a rapid cross-sectional online survey across provinces in Indonesia to capture participants' experiences due to COVID-19. Data were collected between September 23rd to October 7th of 2021 including demographics, income, and expenditures. Descriptive statistics were used to analyze the respondents' characteristics. Patients's perspective of total cost was estimated from out-of-pocket of COVID-19 direct costs and compared them to total expenditure. If the proportion of COVID-19 total costs exceeded 40% of the total expenditure, the respondents were deemed to have faced catastrophic costs.ResultsA total of 1,859 respondents answered the questionnaire. The average monthly income and expenditure of respondents were 800 USD, and 667 USD respectively. The monthly expenditure was categorized into food expenditure (367 USD) and non-food expenditure (320 USD). The average of COVID-19-related monthly expenditure was 226 USD, including diagnostic expenditure (36 USD), preventive expenditure (58 USD), medical expenditure (37 USD for COVID-19 treatment; and 57 USD for post-COVID-19 medical expenses), and non-medical expenditure (30 USD). Analysis showed that 18.6% of all respondents experienced catastrophic costs while 38.6% of the respondents who had COVID-19 treatment experienced catastrophic costs.ConclusionThe high proportion of catastrophic costs among respondents suggests the need for COVID-19 social protection, especially for COVID-19 diagnostic and prevention costs. The survey findings have led the government to increase the benefit coverage other than medical costs at the hospitals.

IntroductionPublic information and regulations related to the coronavirus disease 2019 (COVID-19) have been widely published and continuously changed. The Indonesian government has responded to the emerging evidence by regularly updating its unprecedented and preventive measures against the transmission of COVID-19 to the public. It is important to understand how the public responded to these updates. This study aimed to investigate the knowledge, attitudes, and practices of Indonesians toward COVID-19 after the emergence of the delta variant wave.MethodsA cross-sectional study was conducted among the adult population of non-healthcare workers in Indonesia through an online questionnaire using the SurveyMonkey platform. A total of 1,859 respondents completed this survey from September to October 2021. The knowledge, attitudes, and practices data were analyzed descriptively to find their frequency and percentage. A multivariate analysis was conducted to confirm the factors affecting the respondents' knowledge, attitudes, and practices with a p-value of <0.05 set as significant.ResultsBeing female, having a higher education level, and having a higher frequency of access to COVID-19 news showed significant impacts on knowledge, attitudes, and practices (p<0.001). Older age stratification influenced the knowledge level (p<0.05) but had no significant effect on people's attitudes and practices toward COVID-19. Respondents' perceived probability of being exposed to COVID-19 (p < 0.05) and their COVID-19 infection frequency (p < 0.001) significantly influenced their knowledge. Household income and respondents' knowledge significantly affected their attitudes toward COVID-19. Furthermore, only their attitudes had a significant impact on the respondents' practices. Perceived severity, perceived susceptibility, and vaccination status did not significantly influence their knowledge, attitudes, and practices (p > 0.05).ConclusionAfter more than a year of the COVID-19 pandemic, Indonesians maintain their high level of knowledge, attitudes, and practices. COVID-19 disinformation must be combatted by strengthening authorized media, empowering communities, and improving governance among institutions during and post-pandemic.

Sejak terjadinya pandemi Covid-19 pada akhir Januari 2020, Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan sebagai pembayar memiliki bagian penting dalam penanganan Covid-19,  yaitu dengan melakukan proses verifikasi klaim kasus Covid-19 sedangkan pembiayaan dilakukan oleh Kementerian Kesehatan. Namun demikian, tidak menutup kemungkinan adanya pengalihan manfaat Covid-19 pada manfaat Jaminan Kesehatan Nasional (JKN) di masa endemi. Oleh karena itu, penelitian ini bertujuan untuk mengevaluasi layanan dan memperoleh rekomendasi kebijakan alih manfaat Covid-19.  Penelitian kualitatif melalui focus grup discussion dilakukan pada bulan September 2021 bersama pengambil kebijakan, klinisi, penyintas Covid-19, dan BPJS kesehatan. Hasil dari studi kualitatif menunjukkan bahwa masih banyak kendala dalam proses layanan. Oleh karena itu perlu diatur dengan ketentuan regulasi pelayanan. Adapun terkait proses klaim, fasilitas kesehatan merasa kesulitan atas perubahan regulasi yang dinamis selama pandemi. BPJS kesehatan memerlukan kepastian kebijakan penetapan berakhirnya masa pandemi. Jika menjadi manfaat Covid-19 dialihkan kepada JKN pasca pandemi, maka sumber pembiayaan mungkin hanya dilakukan melalui konversi iuran saja namun juga ada opsi dana pendampingan dari pemerintah. Dari segi tarif perlu dilakukan perhitungan biaya sesuai paket manfaat yang telah disepakati melalui INA CBG. Diperlukan persiapan bertahap dan matang untuk pelaksanaan alih manfaat Covid-19 dalam manfaat JKN.