Department of Sociology, Universitas Sebelas Maret.
Department of Public Health, Universitas Sebelas Maret.
SAHARA J. 2021 Dec;18(1):1-16. doi: 10.1080/17290376.2020.1858946.
People Living with HIV/AIDS (PLWHA's) quality of life (QoL) is determined by the lifetime treatment sustainability. Republic of Indonesia Minister of Health's Decree Number 328 of 2003 stated that government subsidies the PLWHA's medication and treatment, despite not covering entire medication and treatment cost. The objective of research was to analyse the cost assumed by PLWHA in accessing HIV/AIDS treatment service in Surakarta, Indonesia. The target group in this case study was PLWHAs, and related stakeholders of medical treatment in one of Public Health Centers and a Public Hospital in Surakarta; AIDS Commission of Surakarta City; Solo Plus Peer Support Group and AIDS-Care NGO selected purposively. Data collection was carried out using observation, in-depth interview, and documentation. Method and data source triangulations were used to validate data that was then analysed using Grossman's Demand for Health Capital theory. The result of research showed that the sources of HIV/AIDS treatment cost were self-income, Social Insurance Administration Organization (BPJS) fund and Local Government subsidy. Admission and physican services are given for free to PLWHA because it has been paid by BPJS Fund or has been subsidied by Local Government. Otherwise, they should pay registration cost of IDR 50,000, in Public Hospital and IDR 75,000 in Private Hospital. Physician service costs IDR 50,000-IDR 200,000. VCT Counsellor costs IDR 35,000-IDR 150,000. Non-Subsidy ARV costs IDR 687,000. 1 bottle containing 60 TB meningitis drug capsules costs IDR 145,000 for 10-20 d use and maximally IDR 210,000, while herpes drug costs IDR 295,000. CD4 examination costs IDR 126,000-IDR 297,000, RNA Viral load IDR 1,275,000-IDR 1,471,000, Haematology IDR 60,000-IRD 90,000, Cholesterol and triglyceride IDR 100,000-IDR 250,000, and SGOT/SGPT IDR 100,000-IDR 200,000. There is monthly non-medical cost the patient should spend, including transportation cost to go to health centre, and food, beverage, and newspaper cost while waiting for the service. BPJS fund and local government subsidy relieved health economic burden of PLWHAs, so that the average HIV/AIDS treatment cost in PLWHAs was relatively low, less than 10% of expense. National Insurance System including BPJS fund and local government subsidy as the answer to the integration of HIV/AIDS treatment funding management into national insurance system had provided PLWHA a funding access involving prevention, care, support, and treatment, and mitigated the effect despite less optimum.
艾滋病毒/艾滋病感染者（PLWHA）的生活质量（QoL）取决于终生治疗的可持续性。2003 年印度尼西亚卫生部长第 328 号法令规定，政府补贴 PLWHA 的药物和治疗费用，尽管并未涵盖全部药物和治疗费用。本研究的目的是分析在三宝垄获得艾滋病毒/艾滋病治疗服务的 PLWHA 承担的成本。本案例研究的目标人群是 PLWHAs，以及三宝垄的一家公共卫生中心和一家公立医院、三宝垄市艾滋病委员会、Solo Plus 同伴支持小组和艾滋病护理 NGO 的相关医疗利益相关者，这些机构是经过精心挑选的。数据收集采用观察、深入访谈和文件记录法。使用格罗斯曼的健康资本需求理论对数据进行分析，同时使用方法和数据源的三角验证来验证数据。研究结果表明，艾滋病毒/艾滋病治疗费用的来源是个人收入、社会保险管理组织（BPJS）基金和地方政府补贴。PLWHA 的住院和医生服务是免费的，因为这些费用已经由 BPJS 基金支付，或者已经由地方政府补贴。否则，他们应在公立医院支付 IDR 50,000 的注册费，在私立医院支付 IDR 75,000。医生服务费用为 IDR 50,000-IDR 200,000。自愿咨询和检测顾问费用为 IDR 35,000-IDR 150,000。非补贴 ARV 费用为 IDR 687,000。一瓶含有 60 粒结核性脑膜炎药物胶囊的费用为 IDR 145,000，可使用 10-20 天，最多为 IDR 210,000，而疱疹药物费用为 IDR 295,000。CD4 检查费用为 IDR 126,000-IDR 297,000，RNA 病毒载量为 IDR 1,275,000-IDR 1,471,000，血液学检查费用为 IDR 60,000-IRD 90,000，胆固醇和甘油三酯检查费用为 IDR 100,000-IDR 250,000，SGOT/SGPT 检查费用为 IDR 100,000-IDR 200,000。患者每月还需要支付非医疗费用，包括前往保健中心的交通费用，以及在等待服务时的食物、饮料和报纸费用。BPJS 基金和地方政府补贴减轻了 PLWHAs 的健康经济负担，因此 PLWHA 的平均艾滋病毒/艾滋病治疗费用相对较低，不到支出的 10%。国家保险制度包括 BPJS 基金和地方政府补贴，作为将艾滋病毒/艾滋病治疗资金管理纳入国家保险制度的整合答案，为 PLWHA 提供了涉及预防、护理、支持和治疗的资金获取途径，并减轻了效果不佳的影响。
