“Currently the number of National Health Insurance (JKN) participants continues to grow, as well as the number of health facilities and hospitals. There are at least two important aspects that must be considered related to how the utilization of health services occurs. The first is how the distribution of health facilities is carried out, and the second are other factors that influence the health service itself,” said Andi Afdal Abdullah in an open session for his doctoral promotion with a dissertation entitled “Development of a Predictive Model for Utilization of Hospital Outpatient and Inpatient Services in the National Health Insurance Scheme” on Tuesday, July 18, 2023.
Andi said that every additional hospital that cooperates with BPJS Kesehatan will have an impact on increasing the number of utilizations of hospital services. For this reason, a tool is needed that can predict hospital service utilization due to the addition of factors that affect hospital service utilization rates, both outpatient and inpatient care. Andi also made a model equation with the FGDMM estimator as the final model for outpatient and advanced inpatient rates.
From his research, Andi got the result that the value of billed claims paid per visit had a positive effect on the advanced outpatient rate (RJTL), and the fragmentation ratio had an effect on the RJTL rate, and the readmission rate had an effect on advanced hospitalization (RITL). In addition, the higher the participant’s age (> 50 years) the higher the RJTL rate. Andi suggested a number of things for public policy, including adjusting the allocation of funding for the JKN program to offset the impact of the increase in the RJTL rate due to the increase in health service costs, controlling fragmentation and readmissions and handling events proven to be fraud, and the need to formulate a strategy to improve the quality of life for elderly participants (eg adjusting the flow of geriatric services).
In this open doctoral promotion session, acting as promoter Prof. Budi Hidayat, S.K.M., MPPM., Ph.D.; co-promoter Dr. Pujiyanto, S.K.M., M.Kes., as well as a team of examiners consisting of Dr. drg. Mardiati Nadjib, M.S.; Prof. dr. Ali Ghufron Mukti, M.Sc., Ph.D.; Dr. Nurwahyuni, S.K.M., M.Kes.; Dr. Soewarta Kosen, M.D., M.P.H., Dr. PH., and Dr. dr. Mahlil Ruby, M. Kes.
For the success of defending his dissertation, Andi Afdal Abdullah was declared a doctorate graduate in the field of Public Health as a graduate of the 19th Doctoral of Public Health 2023, 294th Doctoral of Public Health graduate, and 378th doctoral of FPH UI. (WR)
