Research Center for Public Health and Nutrition, Research Organization for Health, National Research and Innovation Agency, Bogor, Indonesia.
Regional Research and Development Agency South Sumatra Province, Palembang, Indonesia.
Front Public Health. 2023 Mar 31;11:1148394. doi: 10.3389/fpubh.2023.1148394. eCollection 2023.
The disease burden related to non-communicable diseases is a major public health problem in Indonesia. About one-third of all deaths in Indonesia are caused by cardiovascular disease. This study describes the cost of cardiovascular disease from claims data for Advanced Referral Health Facilities at BPJS Kesehatan before and during the COVID-19 pandemic. We analyzed claims data on the National Health Insurance system managed by BPJS. The data comes from referral health facilities throughout Indonesia in 2019 and 2020. Cardiovascular service claims data by sex and age group were analyzed descriptively and with different tests between years. There was a decrease in the number of patients accessing cardiovascular services at referral health facilities for all genders, age groups, and types of main diagnoses, by around 27.8%, from 933,017 (2019) to 673,801 (2020). There was a significant decrease in total claims for all types of cardiovascular disease during the COVID-19 pandemic compared to before, especially the reduction in aneurysms and aortic dissection (40.2%) and hypertensive heart disease (39.6%). The decline also occurred in all sexes and age groups, with an average percentage decline of 31.2%. Our findings show that the reduction in the cost of cardiovascular disease claims goes hand in hand with the decrease in the number of cardiovascular patient visits. To guarantee treatment for cardiovascular disease patients during the COVID-19 pandemic, BPJS can maximize the telemedicine services that have been built. The organizer of the National Health Insurance program in Indonesia has developed a JKN mobile application that has the potential for telemedicine services guaranteed by JKN. On the other hand, BPJS needs to limit promotive and preventive budgets related to CVD so that it does not become a potential catastrophic financing.
在印度尼西亚，与非传染性疾病相关的疾病负担是一个主要的公共卫生问题。大约三分之一的印度尼西亚人死亡是由心血管疾病引起的。本研究描述了在 COVID-19 大流行之前和期间，从 BPJS Kesehatan 的高级转诊医疗机构的索赔数据中得出的心血管疾病成本。我们分析了 BPJS 管理的国家健康保险系统的索赔数据。这些数据来自印度尼西亚各地的转诊医疗机构。2019 年和 2020 年按性别和年龄组对心血管服务索赔数据进行了描述性分析，并在不同年份进行了不同的测试。所有性别、年龄组和主要诊断类型的患者到转诊医疗机构接受心血管服务的人数都减少了，大约减少了 27.8%，从 933,017（2019 年）减少到 673,801（2020 年）。与 COVID-19 大流行之前相比，所有心血管疾病类型的总索赔都显著减少，尤其是动脉瘤和主动脉夹层（40.2%）和高血压性心脏病（39.6%）减少。这种下降也发生在所有性别和年龄组中，平均下降幅度为 31.2%。我们的研究结果表明，心血管疾病索赔成本的降低与心血管疾病患者就诊人数的减少是同步的。为了保证 COVID-19 大流行期间心血管疾病患者的治疗，BPJS 可以最大限度地利用已经建立的远程医疗服务。印度尼西亚国家健康保险计划的组织者已经开发了一个 JKN 移动应用程序，该应用程序具有由 JKN 保证的远程医疗服务的潜力。另一方面，BPJS 需要限制与 CVD 相关的促进和预防预算，以免成为潜在的灾难性融资。
