Outlook of Diabetic Retinopathy Management through Universal Health Care in Indonesia from 2015 – 2020 Oral Presentation - Observational Study - Resident
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Diabetic retinopathy, Jaminan Kesehatan Nasional, cost, INA-CBGs
Abstract
Introduction & Objectives
To identify the National Health Expenditure associated with diabetic retinopathy (DR) from the
perspective of Jaminan Kesehatan Nasional [JKN].
Methods
A dataset of 1% of all individuals registered in JKN database was used from 2015 to 2020. We
retrieved primary diagnosis with type 2 diabetes mellitus (T2DM) (ICD-10 E11) and/or T2DM with
ophthalmic complications (E11.3). Further diagnosis with DR (H36) was retrieved. Four groups of
medical procedures related to DR management were developed according to Indonesian Case Base
Groups (INA-CBGs): diagnostic, laser photocoagulation and cryotherapy, minor (intravitreal
injection), and major surgical procedures (e.g., vitrectomy). We performed descriptive analyses for
the annual costs incurred for procedures, premium classifications, and regions.
Results
Overall DR costs were US $41.5 million from 156,752 individuals with DR in JKN database sample.
The total cost and per unit procedures cost specifically increased annually from 2015 to 2019 but
declined substantially in 2020. The largest amount was spent on intravitreal injection ($36.3 million
[87.5%]), whereas vitrectomy was the least ($145.0 million [0.3%]). Region 1 (Java Island) with nonbeneficiaries
of government subsidies (PBPU and PPU) was the major number of claims ($12.5
million [30.1%] and ($7.3 million [17.7%]), while beneficiaries of government subsidies (PBI) outside
Java Island, conversely, were under average.
Conclusion
There was significant increase in health expenditure associated with DR in Indonesia from 2015 to
2019, but decreased in 2020 possibly due to COVID-19 pandemic. Majority of funding was spent to
treat severe spectrum of DR and concerned in urban area.
Full text article
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Authors
Copyright (c) 2023 Alfia Fatma Zaharo, Firman Setya Wardhana, Supanji, Muhammad Bayu Sasongko
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