HEALTH SERVICES UTILIZATION OF REFERRAL HOSPITAL IN SIX LARGEST ISLANDS DURING THE COVID-19 PANDEMIC: EVIDENCE FROM INDONESIA

Andi Afdal Abdullah; Ari Dwi Aryani; Pujiyanto Pujiyanto; Budi Hidayat

doi:10.17501/24246735.2022.7104

Authors

Andi Afdal Abdullah BPJS Kesehatan
Ari Dwi Aryani BPJS Kesehatan
Pujiyanto University of Indonesia, Indonesia
Budi Hidayat University of Indonesia, Indonesia

DOI:

https://doi.org/10.17501/24246735.2022.7104

Keywords:

Covid-19, health services, utilization, JKN Program

Abstract

Background: Covid-19 pandemic caused changes in hospital utilization. Studies in several countries show decrease in hospital utilization. What about Indonesia, which has thousands of islands? There has been no research that can answer empirically. Purpose: This study aims to make comparative analysis of health services utilization before-after pandemic (2019-2020) in Indonesia's 6 largest islands: Sumatra, Java, Kalimantan, Sulawesi, Bali-Nusa Tenggara, Maluku-Papua. Method: This study is retrospective study. Data sources are taken from outpatient and inpatient claims for National Health Insurance Program (JKN Program). Comparisons are described by: hospital class (D-C-B-A), age group (ten years multiple), diagnosis and medical procedures. Result: Based on island, outpatient’s decreases range: 14%-31%, inpatient: 21%-34%. Outpatient’s highest decrease is in Maluku-Papua (-31%), and lowest is in Bali-Nusa Tenggara (-14%). Inpatient’s highest decrease happens in Sumatra and Sulawesi (-34%), while lowest is in Bali-Nusa Tenggara (-21%). Although Java is an island with largest population and Covid-19 cases, it does not show highest decrease. Each variable's decrease as follows: (a) outpatient: D hospital (-27%); 0-9 years old (-36%); Typhoid (-54%), dental procedures (-44%); (b) inpatient: C hospital (-32%); 10-19 years old (-38%); URTI (-54%), eye surgery (-36%). Conclusion: Outpatient’s highest decrease occurred in Maluku-Papua, while inpatient occurred in Sumatera and Sulawesi. Decreases occurred for young age group, bacterial infection diseases, also dental and eye procedures. While Bali-Nusa Tenggara were lowest decreases for outpatient and inpatient. Recommendation: This study recommends that authorities find out which health services are most needed during pandemic in each island, develop teleconsulting policies to minimizing spread of Covid-19 and effective financing. Further research could be conducted on correlation between decline in utilization and number of Covid-19 in each island.

Downloads

Download data is not yet available.

References

Andersen, R., & Newman, J. F. (2005). Societal and Individual Determinants of Medical Care Utilization in the United States. The Milbank Quarterly, 83(4), 10.1111/j.1468-0009.2005.00428.x. https://doi.org/10.1111/j.1468-0009.2005.00428.x

Birkmeyer, J. D., Barnato, A., Birkmeyer, N., Bessler, R., & Skinner, J. (2020). The Impact Of The COVID-19 Pandemic On Hospital Admissions In The United States. Health Affairs (Project Hope), 39(11), 2010–2017. https://doi.org/10.1377/hlthaff.2020.00980

Blecker, S., Jones, S. A., Petrilli, C. M., Admon, A. J., Weerahandi, H., Francois, F., & Horwitz, L. I. (2021). Hospitalizations for Chronic Disease and Acute Conditions in the Time of COVID-19. JAMA Internal Medicine, 181(2), 269–271. https://doi.org/10.1001/jamainternmed.2020.3978

Bollmann, A., Hohenstein, S., Pellissier, V., Stengler, K., Reichardt, P., Ritz, J. P., Thiele, H., Borger, M. A., Hindricks, G., Meier-Hellmann, A., & Kuhlen, R. (2021). Utilization of In- and Outpatient Hospital Care in Germany During the Covid-19 Pandemic Insights from the German-Wide Helios Hospital Network. PloS one, 16(3), e0249251. https://doi.org/10.1371/journal.pone.0249251

Czeisler, M. É., Barrett, C. E., Siegel, K. R., Weaver, M. D., Charles, ;, Czeisler, A., Rajaratnam, S. M. W., Mark, ;, Howard, E., & Bullard, K. M. (n.d.). Morbidity and Mortality Weekly Report Health Care Access and Use Among Adults with Diabetes During the COVID-19 Pandemi-United States, February-March 2021.

Haikin Herzberger, E., Efros, O., Herzberger, S., Biron-Shental, T., & Shechter-Maor, G. (2021). Differences in Obstetric Healthcare Utilization and Delivery Complications Before and After the COVID-19 Pandemic - a Retrospective Study. The Journal of Maternal-Fetal & Neonatal Medicine: the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 1–6. Advance online publication. https://doi.org/10.1080/14767058.2021.1946506

Lee, M., & You, M. (2021). Avoidance of Healthcare Utilization in South Korea during the Coronavirus Disease 2019 (COVID-19) Pandemic. International Journal of Environmental Research and Public Health, 18(8), 4363.

Moynihan, R., Sanders, S., Michaleff, Z. A., Scott, A. M., Clark, J., To, E. J., Jones, M., Kitchener, E., Fox, M., Johansson, M., Lang, E., Duggan, A., Scott, I., & Albarqouni, L. (2021). Impact of COVID-19 Pandemi on Utilisation of Healthcare Services: A Systematic Review. BMJ Open, 11(3). https://doi.org/10.1136/bmjopen-2020-045343

Nowlin, A., Lai, K., Maillis, A., Waters, P., Gee, B., & Lane, P. A. (2020). Healthcare Utilization Among Children and Adolescents with Sickle Cell Disease During the COVID-19 Pandemi. Blood, 136(Supplement 1), 30–31. https://doi.org/10.1182/blood-2020-136151

Pengurus Besar Ikatan Dokter Indonesia (PB IDI)/Executive Board of the Indonesian Doctors Association. (2020). Pedoman Perlindungan Standar Dokter di Era COVID 19. Jakarta: Ikatan Dokter Indonesia. Retrieved from: https://www.pdspatklin.or.id/assets/files/pdspatklin_2020_09_09_18_05_48.pdf

Pemerintah Repuplik Indonesia. (2020). Peraturan Pemerintah Republik Indonesia Nomor 21 Tahun 2020 tentang Pembatasan Sosial Berskala Besar Dalam Rangka Percepatan Penanganan Corona Virus Desease 2019 (Covid-19). Retrieved from: https://covid19.go.id/p/regulasi/pp-no-21-tahun-2020-tentang-psbb-dalam-rangka-penanganan-covid-19

Sii, S. S. Z., Chean, C. S., Sandland-Taylor, L. E., Anuforom, U., Patel, D., Le, G. T., & Khan, A. J. (2021). Impact of COVID-19 on Cataract Surgery- Patients’ Perceptions While Waiting for Cataract Surgery and Their Willingness to Attend Hospital for Cataract Surgery During the Easing of Lockdown Period. In Eye (Basingstoke) (Vol. 35, Issue 11, pp. 3156–3158). Springer Nature. https://doi.org/10.1038/s41433-020-01229-8.

Tsai Y, & Tzu-Ting Y. (2021). Measuring Voluntary Responses in Healthcare Utilization During and After COVID-19 Pandemi: Evidence from Taiwan. Research Square. https://doi.org/10.21203/rs.3.rs-681310/v1

World Health Organization. (2020, August 27). Pulse Survey on Continuity of Essential Health Services During the COVID-19 Pandemic. WHO Interim Report. Retrieved from: https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS_continuity-survey-2020.1

Yamamoto, H., Morikawa, Y., Hagiwara, Y., & Hataya, H. (2022). Pediatric Emergency Healthcare Utilization During the Coronavirus Disease 2019 Pandemic in Tokyo. Pediatrics International: Official Journal of the Japan Pediatric Society, 64(1), e14936. https://doi.org/10.1111/ped.14936

Ziedan, E., K. I. Simon, and C. Wing. (2020). Effects of State COVID-19 Closure Policy on NON- COVID-19 Health Care Utilization. National Bureau of Economic Research. NBER Working Paper No. 27621. doi: 10.3386/w27621.