Objective:This study was conducted to analyze the impact of universal health coverage in Indonesia, known as Jaminan Kesehatan Nasional (JKN) on percentage of patients who did fasting blood glucose (FBG) tests each hospital visit and clinical outcomes (CO) among type 2 diabetes mellitus (T2DM) patients. Methods:We conducted a longitudinal retrospective study to collect the data from 6-month before JKN and 1-year after JKN at three hospitals in Jakarta Province. All T2DM outpatient's services using Asuransi Kesehatan (ASKES) with at least 6 hospital visits were included in the study. The subject with double insurances and died before implementation of JKN were excluded from the study. The CO before and after JKN were compared with Wilcoxon test.Results: Total samples that collected were 296 patients divided to predominance female with 166 (56%) and male 125 (44%). From the data, it seemed that there were no all patients who did FBG test. We founded 50% of patients had FBG test before JKN. Meanwhile, the percentage at the beginning of JKN tended to be lower about 37% than before JKN. Number of patients decreased associate with JKN but number of hospital visit increased. Based on FBG level, 17 (9.19%) patients had better CO and this number increased slightly after JKN to 22 (11.89%). In contrast, patients with worse FBG level decreased about 9%. More patients had bad stable and less patients had good stable FBG level. Statistical analysis showed that CO between before and after JKN had p=0.404 among T2DM outpatients in Type A hospitals and p=0.877 in Type B hospital.Conclusion: Implementation of JKN had an impact to decrease percentage of patients who did FBG tests and number of patients but raised hospital visit. CO was different significantly between before and after JKN among T2DM outpatients in Type A hospitals but was no different in Type B hospital.
Objective: The study was carried out to observe the impact of NHI to availability, usage, stock of antihypertensive drug enrolled in a national formulary in one of the primary health care centre in Jakarta. Methods: A longitudinal time series design was performed retrospectively to analyse the availability, usage, and stock of antihypertensive drug. The data period was from January 2013 (1 y before NHI) to December 2015 (2 y after NHI). The Independent-Samples T or Mann-Whitney test was conducted to compare these parameters before and after NHI. Results: We found amlodipine 5 mg and 10 mg tablet, hydrochlorothiazide 25 mg tablet, captopril 12.5 mg and 25 mg tablet, nifedipine 10 mg tablet were available in Primary Health Care. These drug were generic and tablet dosage form. The most common drug used was captopril and Nifedipine, respectively. The highest availability was diuretic hydrochlorothiazide. The availability of amlodipine 5 mg and 10 mg tablet, captopril 12.5 mg tablet increased significantly (P<0.05) after NHI was implemented. Moreover, hydrochlorothiazide decreased (P<0.05) as well. The usage of amlodipine and hydrochlorothiazide risen (P<0.05) but the nifedipine decreased (P<0.05) after NHI. All stock of antihypertensive except captopril 25 mg different significantly (P<0.05) after the application of NHI. Conclusion: This study highlights the implementation of NHI impacted the availability, usage, and stock of antihypertensive drug enrolled in national formulary.
The aim of study was carried out to determine differences of health related qualitiy of life (HRQoL)
Survei rumah tangga merupakan salah satu metode untuk mendapatkan informasi yang akurat terhadap obat yang digunakan oleh masyarakat. Tujuan penelitian adalah untuk mengidentifikasi akses obat dan profil obat yang digunakan. Metode convenient sampling dilakukan pada 30 rumah tangga dengan Jaminan Kesehatan Nasional yang memiliki penyakit kronis. Setiap rumah tangga diamati seminggu sekali selama 8 minggu untuk menganalisa penyakit, obat yang digunakan dan akses dalam mendapatkan obat. Sebanyak 19 (63,3%) responden adalah laki-laki dan 11 (36,7%) responden adalah perempuan. Rata-rata usia responden adalah 55,87±12,486 tahun. Sebanyak 23 (76,7%) responden akses obat melalui rumah sakit dan 7(23,3%) responden melalui apotek. Penyakit yang paling banyak ditemukan adalah kardiovaskular dan endokrin. Obat kardiovaskular, saluran pencernaan dan metabolisme, sistem saraf adalah obat yang paling banyak ditemukan. Mayoritas responden menggunakan 1-3 jenis obat dalam satu bulan. Sebanyak 101 jenis obat yang digunakan, 74 obat diantaranya adalah generik dan 27 obat non generik. Sebanyak 12 (40%) responden menggunakan vitamin dan 8 (26,67%) responden menggunakan suplemen. Studi ini menunjukkan bahwa akses obat oleh responden melalui rumah sakit dan obat kardiovaskular adalah yang paling banyak digunakan.
Indonesia merupakan negara kedua dengan jumlah kasus tuberkulosis terbanyak di dunia. Pengobatan Tuberkulosis di Indonesia semakin sulit dengan munculnya Multidrug Resistant Tuberculosis (MDR-TB). Penelitian dilakukan untuk mengetahui faktor resiko yang menyebabkan terjadinya MDRT-TB di Indonesia. Sistematik review dilakukan terhadap artikel dengan studi case control. MDR-TB sebagai kelompok kasus dan Non MDR-TB sebagai kelompok kontrol. Artikel yang dipilih adalah artikel yang dipublikasikan pada tahun 2015-2020. Artikel dicari melalui database google schoolar dan dianalisa menggunakan Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Terdapat 9 original artikel yang memenuhi kriteria inklusi untuk dianalisa. Faktor resiko terjadinya MDR-TB dibagi menjadi tiga kelompok yaitu karakteristik responden, Riwayat TB dan pengobatan, dan komorbiditas. Karakteristik responden yang signifikan mempengaruhi terjadinya MDR TB adalah dukungan keluarga, pengetahuan, usia, dan akses ke fasilitas kesehatan. Tidak patuh minum obat, adanya riwayat pengobatan TB, tidak aktif pengawas minum obat, efek samping obat dan adanya komorbiditas juga merupakan faktor resiko terjadinya MDR-TB. Hasil yang diperoleh dapat disimpulkan bahwa identifikasi faktor resiko terjadinya MDR TB perlu dilakukan dengan baik. Selain itu, Pasien TB yang memiliki faktor resiko perlu diberikan edukasi yang lebih komprehensif dan pengawasan minum obat secara lebih ketat untuk mencegah terjadinya MDR TB.
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