Health Economics Commons^™

Analysis Of Risk For Class Shifting And Determinants Of Bpjs Kesehatan Membership Using Generalized Ordered Logit-Unconstrained Partial Proportional Odds Model, Siskarossa Ika Oktora, Ika Yuni Wulansari, Geri Yesa Ermawan

Jurnal Ekonomi Kesehatan Indonesia

The main source of funding of BPJS Kesehatan comes from the different premium class in which the participant registered. The medical benefits among classes are equivalent, except inpatient facilities. But when the improvement health degree is not linear with the incurred costs, problem would arise. This study aims to analyze class shifting and determinants of BPJS Kesehatan membership. Around 1.53 percent of participants access higher classes, while 5.62 percent access lower classes. Class III participants with inpatient status severity level 2 and 3, reaching 41% and 43%, respectively. In addition, 60% of non-PBI participants are Class II premium participants; most …

Orthodontic Camouflage Treatment Of A High-Angle Severe Skeletal Class Ii Discrepancy, Deryana Marshadhianti, Miesje Karmiati Purwanegara

Journal of Dentistry Indonesia

Proper orthodontic treatment in adult patients with severe skeletal Class II discrepancy can be challenging. Recently, miniscrew implants have been used as a strategy to treat skeletal Class II patients. Objective: This report illustrates a skeletal Class II malocclusion management combining straight wire technique and miniscrew implant anchorage. Case report: The patient was a 21-years- old Indonesian female with Class II skeletal discrepancy, a retrognathic mandible, a high mandibular plane angle, and a mouth breathing habit due to a history of allergic rhinitis. Anchorage control is important in the sagittal and vertical directions. Miniscrew implants were placed in the …

Antimicrobial Efficacy Of Myrmecodia Pendens Extract And Fraction Combination Against Enterococcus Faecalis Atcc 29212, Faisal Kuswandani, Mieke H. Satari, Ani M. Maskoen

Journal of Dentistry Indonesia

Enterococcus faecalis can withstand harsh environmental conditions in the root canal and cause a secondary infection. Myrmecodia pendens is an herbal medicine rich in polyphenol compounds that have antibacterial, antioxidant, and anticancer properties. Objectives: To analyze the effects of M. pendens fraction combination on the sensitivity of E. faecalis. Methods: The minimum inhibitory concentration (MIC) was determined using a serial microdilution method, and the minimum bactericidal concentration (MBC) was determined by adding the test sample to sterile Mueler Hinton agar medium. Results: The MIC of combination 1 (hexane-ethyl acetate, HE) was 0.049 mg/mL, whereas those of combinations 2 (hexane-water, HA) …

Kajian Literatur Sistematis: Skema Pengendalian Biaya Dalam Asuransi Kesehatan Nasional Di Beberapa Negara, Eka Pujiyanti, Ery Setiawan, Euis Ratna Sari, Indah Pratiwi Suwandi

Jurnal Ekonomi Kesehatan Indonesia

Cost-containment is one of several strategies to ensure the financial sustainability of the National Health Insurance scheme. Several cost-containment models were commonly globally, such as cost-sharing, capping, and others. This review aims to determine the costs and impacts of implemented policy schemes as cost-containment instruments in various countries. We performed a systematic review from several primary databases (Proquest, Pubmed, and Cochrane Library) with the primary intervention are the cost-sharing methods. The results of our review focused on the cost containment scheme from the government perspective, in which the context of social insurance can be a modification of payment systems, cost-sharing, …

Kemampuan Dan Kemauan Pasien Umum Rawat Inap Dalam Membayar Pelayanan Kesehatan Rawat Inap Di Rumah Sakit Umum Kaliwates Kabupaten Jember, Yanuar Anafia, Eri Witcahyo

Jurnal Ekonomi Kesehatan Indonesia

testRational rates were determined by calculating unit costs into account characteristics of product as information related ability and willingness to pay. Ability and willingness were calculated for quality control and cost at the hospital. Community satisfaction index in Kaliwates General hospital released number of customer satisfaction that hasn’t met the standard was rate of inpatient services. Results of preliminary study on general inpatients were 70% having an estimated rate of less than rate set by the hospital, 20% said rates were less affordable and 10% couldn’t estimate rates, then this study was calculate ability and willingness to pay for inpatient …

Analisis Biaya Satuan (Unit Cost) Dengan Metode Activity Based Costing (Abc) Di Poliklinik Jantung Rsu Dr. H. Koesnadi Bondowoso, Sumiati Sumiati, Eri Witcahyo, Andrei Ramani

Jurnal Ekonomi Kesehatan Indonesia

Determination of rate calculated based on unit cost, based on Bondowoso Regent Regulation Number 62 of 2017, RSU dr. H. Koesnadi Bondowoso unit cost calculates using the Double Distribution method. Double Distribution (DD) method is not appropriate to be applied because it does not reflect activity, method based on activity, precise and accurate so that it can provide the right information is Activity Based Costing (ABC) method. RSU Dr. H. Koesnadi Bondowoso has not made unit cost calculation using Activity Based Costing (ABC) method, especially for outpatient installation. The purpose of this research is unit cost analysis with Activity Based …

An Analysis Of The Economic Barriers To Oral Healthcare Access In Omaha, Nebraska, Elias Witte

Theses/Capstones/Creative Projects

Existing research regarding the analysis of the distribution of oral healthcare practitioners has been conducted across large metropolitan areas within the United States in order to determine the magnitude of healthcare resource deficits. Such research has demonstrated significant deficits in access to oral healthcare predominantly in lower-income urban areas. Consequently, patients in these socioeconomically disadvantaged areas have less access to routine oral care, which impacts their overall health and well-being. While there is an abundance of studies examining this issue in other localities across the country, there is a lack of information regarding the distribution of oral healthcare practitioners in …

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience: Master of Public Health

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

Treatment Patterns And Economic Burden Of Sickle-Cell Disease Patients Prescribed Hydroxyurea: A Retrospective Claims-Based Study, Nirmish Shah, Menaka Bhor, Lin Xie, Rashid Halloway, Steve Arcona, Jincy Paulose, Huseyin Yuce

Publications and Research

Background: This study aimed to evaluate sickle-cell disease (SCD) treatment patterns and economic burden among patients prescribed hydroxyurea (HU) in the US, through claims data.

Methods: SCD patients with pharmacy claims for HU were selected from the Medicaid Analytic Extracts (MAX) from January 1, 2009 - December 31, 2013. The first HU prescription during the identification period was defined as the index date and patients were required to have had continuous medical and pharmacy benefits for ≥6 months baseline and 12 months follow-up periods. Patient demographics, clinical characteristics, treatment patterns, health care utilization, and costs were examined, and variables were …

Improving End Stage Renal Disease Quality Incentive Payment Total Performance Scores, Shelly Guyer, Gina Gregg, Bradley Warady

Posters

The End Stage Rena Disease (ESRD) Quality Incentive Program (QIP) promotes high quality, transparent, cost-efficient care in outpatient dialysis facilities by establishing performance standards that are linked to payment.

The development of a subject matter expert and the sharing of ESRD QIP knowledge resulted in buy-in from dialysis staff and physicians leading to a higher total performance score and the avoidance of payment reduction.

The Effects Of Opioids On Kentucky's Workforce, Michael W. Clark, Jenny A. Minier, Charles J. Courtemanche, Bethany L. Paris, Michael T. Childress

CBER Research Report

From the executive summary:

Opioid abuse represents a significant and growing public health issue for both the nation and Kentucky. In 2016, opioids contributed to more than 62,000 deaths nationally and 1,406 deaths in Kentucky. National studies have placed the societal costs of opioid abuse at $55.7 billion in 2007 and $78.5 billion in 2013 (Birbaum et al. (2011) and Florence et al. (2016)). These costs included increased health care expenditures, higher criminal justice costs, and lost earnings due to reduced employment and premature deaths. The While House Council of Economic Advisors (2017) estimated the societal costs of opioid abuse …

The Cost-Effectiveness Of Neonatal Versus Prenatal Screening For Congenital Toxoplasmosis, Christine Binquet, Catherine Lejeune, Valérie Seror, François Peyron, Anne-Claire Bertaux, Olivier Scemama, Catherine Quantin, Sophie Béjean, Eileen Stillwaggon, Martine Wallon

Economics Faculty Publications

Congenital Toxoplasmosis (CT) can have severe consequences. France, Austria, and Slovenia have prenatal screening programs whereas some other countries are considering universal screening to reduce congenital transmission and severity of infection in children. The efficiency of such programs is debated increasingly as seroprevalence among pregnant women and incidence of congenital toxoplasmosis show a steady decrease. In addition, uncertainty remains regarding the effectiveness of pre- and postnatal treatments.

Out-Of-Pocket Expenditure For Home And Facility Based Delivery Among Rural Women In Zambia: A Mixed-Methods, Cross-Sectional Study, Jeanette L. Kaiser, Kathleen L. Mcglasson, Peter C. Rockers, Rachel M. Fong, Thandiwe Ngoma, Davidson H. Hamer, Taryn Vian, Godfrey Biemba, Jody R. Lori, Nancy A. Scott

Nursing and Health Professions Faculty Research and Publications

Purpose: Out-of-pocket expenses associated with facility-based delivery are a well-known barrier to health care access. However, there is extremely limited contemporary information on delivery-related household out-of-pocket expenditure in sub-Saharan Africa. We assess the financial burden of delivery for the most remote Zambian women and compare differences between delivery locations (primary health center, hospital, or home).

Methods: We conducted household surveys and in-depth interviews among randomly selected remote Zambian women who delivered a baby within the last 13 months. Women reported expenditures for their most-recent delivery for delivery supplies, transportation, and baby clothes, among others. Expenditures were converted to …

Comparative Spending Of Medicaid Dollars On Child Participants Of Kentucky’S Sobriety Treatment And Recovery Teams Program Versus A Matched Comparison Group., Matthew Thomas Walton

Electronic Theses and Dissertations

Child protective services agencies have long observed the complicating role that parental substance use and addiction plays in cases of child maltreatment. Families who struggle with these problems present unique challenges for child welfare professionals. These families are typically more difficult to engage, more likely to have children removed from the home, and have poorer outcomes when compared to other families. These poorer outcomes often include health problems. Addiction has well-known effects on health, and the specific manifestations of these problems for parents have been documented for years in child protection casework. However, what has been less investigated are the …

To Extubate Or Not To Extubate: Risk Factors For Extubation Failure And Deterioration With Further Mechanical Ventilation, Jingui Xie, Guang Cheng, Zhichao Zheng, Haidong Luo, Oon Cheong Ooi

Research Collection Lee Kong Chian School Of Business

Background: Extubation is a critical step in the intensive care unit (ICU). In this study, we aim to investigate the risk factors for both extubation failure and deterioration with further mechanical ventilation (MV). Methods: Data were collected from a cardiothoracic ICU in a tertiary hospital. The risk factors for extubation failure and deterioration with further MV were investigated by multivariate logistic regression. Results: A total of 676 patients were enrolled in the study. Patients with extubation failure had a longer ICU length of stay and a higher mortality rate than patients without extubation failure. An age greater than 65 years, …

Perhitungan Biaya Satuan Pada Tindakan Intensive Unit Care Di Rumah Sakit X Di Jember Melalui Metode Activity Based Costing (Abc), Eri Witcahyo

Jurnal Ekonomi Kesehatan Indonesia

Hospital X in Jember is one of the government hospitals with C type status. In National Health Insurance (JKN) era, the payment scheme in hospital by using the INA CBG’s tariff package. Hospital could have profit or even loss, therefore health services effiency was needed. The objective of study was to identify service product and calculate of service product unit cost at Intensive Care Unit (ICU) in Hospital X in Jember. The type of this research was observational descriptive with cross sectional approach. The unit of analysis was ICU at Hospital X in Jember. The unit cost calculation method is …

Ekuitas Layanan Rawat Inap Rumah Sakit Di Indonesia, Devi Senja Ariani, Pujiyanto Pujiyanto

Jurnal Ekonomi Kesehatan Indonesia

In order to encourage the achievement of UHC in Indonesia, the government organized National Health Insurance (JKN) program. One of the objectives of the JKN program is the improvement of access and equity utilization of health services. This study aims to analyze Equity of Inpatient Utilization in Health Service in second and third year of JKN program implementation in 2015 and 2016. This study uses secondary data of SUSENAS in 2015 and 2016 with analysis using concentration curve and concentration index. The results showed that the Utilization of inpatient services in hospitals in the JKN group of participants increased in …

Determinan Sosial Ekonomi Konsumsi Minuman Berpemanis Di Indonesia: Analisis Data Susenas 2017, Widi Astutty Casimira Daeli, Atik Nurwahyuni

Jurnal Ekonomi Kesehatan Indonesia

Sugar-Sweetened Beverages (SSBs) are added liquids with various of sugar. Consumption of SSBs contributes to Non-Communicable Diseases (NCDs) such as weight gain, increasing the risk of type 2 diabetes mellitus and cardiovascular diseases. NCDs can be prevent ed as early as possible by reducing the consumption of calories in sugar. WHO recommends adults and children to reduce sugar intake to less than 10% of total energy intake and continue to less than 5% of total energy intake. This study aims to determine the socio-eco nomic factors consumption of SSBs. We employed secondary data from the 2017 National Socio-Economic Survey (Susenas) …

Penghitungan Biaya Satuan Pada Instalasi Rawat Jalan Di Rumah Sakit X Jambi Menggunakan Metode Step Down, Susilo Wulan, Ade Herman Surya Direja, Dian Reflisiani

Jurnal Ekonomi Kesehatan Indonesia

Hospital has a responsibility to provide quality and affordable health care to the community. Therefore, determining tariffs by calcu lating the actual cost is very important, especially for internal stakeholders in undergoing cost analysis, performance evaluation and decision making, including tariff negotiation with external stakeholders. This research objective is to calculate unit costs and compar atively analyzing costs between units in an outpatient installation using the step-down method. This research used a partial economic evaluation which only portrays the description of cost object without comparing the output from the analyzed unit. The stages of data analysis include identifying the resource …

Determinan Cakupan Imunisasi Dasar Lengkap Pada Penerima Program Keluarga Harapan, Wulansari Wulansari, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

Poverty is a multidimensional social problem and related to the problems of health, education and other social welfare. National Basic Immunization Coverage (IDL) reached 57.9%, with 32.9% was incomplete and 9.2% were not immunized, while national coverage indicators were at least 90%. This study aims to determine the determinants that affects basic complete immunization coverage for babies receiving the Family Hope Program (PKH). The study design used was cross sectional. The research was located in 34 provinces. The total population is 9,205 respondents using secondary data from the National Socio-Economic Survey (Susenas) in 2017. The research shows that the achievement …

Prevention And Mitigation Of Congenital Toxoplasmosis: Economic Costs And Benefits In Diverse Settings, Branko Bobić, Isabelle Villena, Eileen Stillwaggon

Economics Faculty Publications

Congenital toxoplasmosis (CT), the result of a primary infection of pregnant women with Toxoplasma gondii which was transmitted to the fetus, may result in mild to deep injuries occurring in the newborn or later in its development or in adolescence. The visual and cognitive impairment that can result imposes substantial economic costs on the individual and society. Numerous observational studies favor the conclusion that, with preventive measures currently available, it is possible to reduce the incidence of infections in pregnant women, the incidence of fetal infection by preventing transplacental transmission, and the gravity of injury in infected newborns. Treatment of …

The Impact Of Cleft Lip/Palate And Clp Surgical Intervention On The Social Integration Of Adolescents In India, Mustafa Zahid

Master's Theses

Cleft Lip/Palate, a congenital orofacial anomaly, carries an incidence rate of approximately 1 in every 1000 births. In addition to the stigma associated with the condition, the varying levels of cleft severity might result in lower life outcomes which could include lower cognitive ability, physical and psychological well-being, social and behavioral outcomes of adolescents. This paper focuses on the social integration element of life outcomes, which is composed of the social inclusion and prosocial behavior of the adolescent. Despite the affordability of restorative surgeries, patients in rural areas of Low and Middle-Income Countries (LMICs) such as India face accessibility and …

Impacts Of Contraception On Women’S Decision-Making Agency In Indonesia, Michaela J. Fogarty

Undergraduate Economic Review

Increasing access to contraception has the potential to empower women and improve the economic standing of families across the globe. Many researchers have explored the impacts of contraception on families and the determinants of women’s level of empowerment, but little scholarship exists on their direct relationship. This paper explores the impacts of contraceptive use on women’s empowerment, measured by a sum of women’s household decision-making agency. Panel data from three rounds of the Indonesian Family Life Survey is used to run multiple regressions with household fixed effects. Results suggest that women who use contraception have input on two additional types …

An Evaluation Of The Impact Of Leading Pedestrian Interval Signals In Nyc, Jeremy J. Sze

Theses and Dissertations

I evaluated the impact of the phased introduction of Leading Pedestrian Interval Signals (LPIs) on collision and injury outcomes at 12,987 signalized traffic intersections in New York City over the course of 25 quarters from 2012 to 2018. An intersection is treated when a LPIs is installed to give pedestrians lead time to cross the street before vehicles are allowed to move. Outcomes from NYPD’s Motor Vehicle Collisions data were matched to signalized intersections. I hypothesize that LPIs would reduce collisions and reduce injuries for pedestrians at intersections. A difference in difference fixed effects panel regression was used to identify …

A Framework For Learning During An Honors Internship: Embold Health Inc., Haley Haldeman

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Embold Health Inc. is a health care analytics start-up company that identifies top performing providers using large data sets and clinically nuanced measurement. A comprehensive assessment of quality, appropriateness, and cost is what Embold Health delivers. Embold allows payers more control in choosing providers within their region. Being able to identify top provider behaviors through rigorous data driven measurement is significant both clinically and commercially; it provides the opportunity to increase value of care, decrease waste, and drive down cost.

Over the past year as an intern, I’ve had a first-hand look into the complexity that surrounds data driven health …

Differences In Tsimane Children’S Growth Outcomes And Associated Determinants As Estimated By Who Standards Vs. Within-Population References, Melanie Martin, Aaron Blackwell, Hillard Kaplan, Michael Gurven

Economics Faculty Articles and Research

Anthropometric measures are commonly converted to age stratified z-scores to examine variation in growth outcomes in mixed-age and sex samples. For many study populations, z-scores will differ if calculated from World Health Organization (WHO) growth standards or within-population references. The specific growth reference used may influence statistical estimates of growth outcomes and their determinants, with implications for biological inference. We examined factors associated with growth outcomes in a sample of 152 Tsimane children aged 0–36 months. The Tsimane are a subsistence-scale population in the Bolivian Amazon with high rates of infectious disease and growth faltering. To examine the influence of …

Quality Over Quantity: A Comparative Analysis Of The Quality Measures And Performance Between Switzerland And The United States, Lexi Farina

Independent Study Project (ISP) Collection

Even in the best health systems, poor quality of care continues to cause harm to patients and prevent them from receiving the best treatment possible. Thus, it is important to record and report quality of care measures because they can help inform policy changes and improve performance. In this paper, a comparative analysis between the United States and Switzerland is conducted to understand the process for defining and assessing quality indicators in each country as well as compare their quality of care performance results. The methods for this study include a literature review of relevant background information relating to quality …

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the …

Maintaining Stability In A Changing Climate: A Comparative Analysis Of Public Health Systems And Migration Policies In The U.S. And Canada, Laura Cutlip

Climate and Society

This paper examines the relation between climate change, migration, and public health to better understand how the United States health system is positioned to deal with likely challenges to human health posed by environmental changes. The author reviews probable impacts of climate change on population displacement and disease before considering how the current structure of the health system of the United States will render it unable to adapt to these changes and challenges. The Canadian health care system and refugee policies are then reviewed to provide a counterpoint to this analysis. These findings are then considered in tandem as the …

Short-Run Health Consequences Of Retirement And Pension Benefits: Evidence From China, Plamen Nikolov, Alan Adelman

Justice & Well-Being Studies Faculty Scholarship

This paper examines the impact of the New Rural Pension Scheme (NRPS) in China. Exploiting the staggered implementation of an NRPS policy expansion that began in 2009, we used a difference-in-difference approach to study the effects of the introduction of pension benefits on the health status, health behaviors, and healthcare utilization of rural Chinese adults age 60 and above. The results point to three main conclusions. First, in addition to improvements in self-reported health, older adults with access to the pension program experienced significant improvements in several important measures of health, including mobility, self-care, usual activities, and vision. Second, regarding …