BackgroundSocial health insurance administrative databases were established in Indonesia, Vietnam and the Philippines in 2014, 2017 and 2012, respectively; however, these databases have been scarcely used for research, if at all. This study explored the feasibility and accessibility of using these databases for scientific research, highlighting challenges and barriers in their use.MethodologyThe databases included in this evaluation comprised the Jaminan Kesehatan Nasional (JKN) from Indonesia, Vietnam Health Insurance Scheme (VHIS) from Vietnam and PhilHealth from the Philippines. These databases were qualitatively assessed based on the data capture, potential linkage to other databases or registries, data access and extraction, privacy and security, and quality and validation procedures.ResultsAll databases contain population-based cohort data on the medical costs of reimbursed medical conditions, identified using International Classification of Diseases, Tenth Revision (ICD-10) codes. Linkage to other national databases, ensuring protection of patient privacy data, would improve their usability. Duration to database access and data extraction varies from country to country. The main limitations of all databases include the short span of data records, and the unknown degree of internal validity. Both JKN and PhilHealth databases capture bundled claims, inherently excluding information on prescriptions and out-of-pocket expenditure. Due to the recent establishment of the VHIS database, it may not be suitable for studies that intend to explore trends.ConclusionThe JKN, VHIS and PhilHealth databases offer population-based, financial, utilization, and demographic data, which could provide valuable epidemiological and pharmacoeconomic insights if the findings are interpreted within the limitations of each database.Electronic supplementary materialThe online version of this article (10.1007/s41669-019-0127-2) contains supplementary material, which is available to authorized users.

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Income has a role as an effect modifier in the relationship between BMI and HRQoL that can be construed as an indirect income inequality. Efforts to promote HRQoL in populations should consider the different impact of being overweight and obese in different socioeconomic groups.

Background: Indonesia integrated all social health insurance and social assistance program into the National Health Insurance Scheme (NHIS) aiming to achieve universal health coverage by 2019. Currently, 194 million people are registered in the NHIS. Lung cancer absorbed a significant amount of the NHIS Indonesia and one of the leading cause of deaths among men in Indonesia. Lung cancer is rising major public health concern due to a high prevalence of smokers yet most lung cancer is diagnosed at late stage leading to short survival rate in Indonesia. Aim: This study aimed at investigating access, utilization, and clinical outcomes of lung cancer's patients. The second aim is to investigate differences in access to treatments of lung cancer patients among different member groups of the NHIS. Methods: The data were drawn from a 2014-2015 claim of the NHIS. The number of lung cancer patients of the outpatient's care was 5939 in 2014 and was 6595 in 2015. The number of inpatients diagnosed with lung cancer was 8969 and 9455 respectively for 2014 and 2015. Descriptive analysis was performed to investigate the differences in access, utilization (consumption), and in clinical outcome across class and membership. Results: Access to treatment of lung cancer patients was 0.5 for outpatient care and 0.7 for inpatient care per 10,000 members. This prevalence was higher compared with the national reported prevalence of lung cancer which was 0.3 per 10,000 populations. However, access and utilization among poorer members (third class and PBI membership) were only 0.1 for outpatient and 0.2 for inpatient per 10,000 members. The quality of treatment mortality and self-discharges were 6.04% and 5.68% compared with the higher class of members which account for 0.48% and 2.31% in 2015. Conclusion: There were inequities in access, utilization, and clinical outcomes among lung cancer patients suggesting disparities of supplies side and nonfinancial barriers among lower socioeconomic groups. The authors suggest the national and local governments should accelerate to produce oncologists and subnational cancer centers to ensure access among NHIS members.

This study examines a newly introduced DRG system in Indonesia. We use secondary data for 2015 and 2017 from Jaminan Kesehatan Nasional (JKN), a patient level dataset for Indonesia created in 2014 to record public and private hospitals’ claims to the national health insurance system to investigate whether there is an association between changes in tariffs paid and the severity of inpatient activity recorded in hospitals. We find a consistent small, positive and statistically significant correlation between changes in tariffs and changes in concentration of activity, indicating discretionary but limited coding behaviour by hospitals. The results indicate that reducing price differentials may mitigate discretionary coding, but that the benefits of this are limited and need to be compared to the potential risk of having to rebase all prices upwards.