Budi Hidayat
Departemen Administrasi dan Kebijakan Kesehatan FKM Universitas Indonesia

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BUKTI EMPIRIS KEBIJAKAN ASURANSI KESEHATAN SOSIAL: ANALISIS DATA SURVEI ASPEK KEHIDUPAN RUMAH TANGGA INDONESIA (SAKERTI) Hidayat, Budi
Jurnal Manajemen Pelayanan Kesehatan Vol 13, No 03 (2010)
Publisher : Jurnal Manajemen Pelayanan Kesehatan

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Abstract

Objective: Research that produced empirical evidences forhealth policy formulation presumably limited. This articleelaborates this perception by synthesizing four studies on thedemand for outpatient care (OP), e.g., (i) health insurance andthe number of OP visits, social health insurance and (ii) theuse of OP, (iii) providers choices, and (iv) equity in access.Methods: This study uses data from the second round of theIndonesian Family Life Survey (IFLS). Two considerations havebeen taken into account in selecting estimation methods: thedesign of observational study and type of the data used tomeasure the demand. To predict the number of OP visits, theauthor explored six count data estimators, whilst to investigatethe impact of social insurance on the use of OP, providerchoices, and equity, the author applied a multinomial logisticregression.Results: Whilst the distribution of health insurance isconcentrated on the rich, the highest effect of insurance onaccess found among the lowest income group. Given provideralternatives, the insured tend to choose public rather thanprivate providers. Those who are sicker, not married, wealthierand highly educated also prefer to use private than publicproviders. The impact of social insurance on equity in accessto health care was not observed.Conclusions: Efforts to increase access to health careservices through a national health insurance (NHI) will be moreeffective if the program accommodates consumer preferences.Changes in the demand from public to private providers mustbe taken into account, especially when setting premium subsidyand benefits baskets of the NHI. In general, the NHI policy hasalready empirical evidences. However, NHI implementationrequires a set of technical regulations as a translation of theNational Social Security Act, which also must be supportedfrom the results of empirical studies.Keywords: social health insurance, demand for health care,endogeneity, applied econometrics in health
PELEMBAGAAN SISTEM PEMANTAUAN DAN EVALUASI: PELAJARAN DARI BERBAGAI NEGARA Hidayat, Budi
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 04 (2008)
Publisher : Jurnal Manajemen Pelayanan Kesehatan

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Abstract

This article provides lessons learned on the experience ofseveral countries that have succeeded in building a wellfunctioning government monitoring and evaluation (M&E)system. Discussions on this article are focused on: terms andconcepts in the field of M&E, outputs of M&E, utilization of M&Einformation, key success and pre-requisite to succes ininstitutionalizing M&E as well as actors M&E. The result indicatesthat ouputs of M&E system are used oftenly for: (i) supportingpolicy making, performance budgeting and national planning;(ii) helping ministries in their policy development and policyanalysis work, and in program development; (iii) managingactivities at the sector, program and project levels; and (iv)enhancing transparency and support accountabilityrelationships. The successful institutionalization of M&E involvesthe creation of a sustainable, wellfunctioning M&E system withina government, where good quality M&E information is usedintensively. This implies that key success for institutionalizingM&E system depends on: utilization of M&E information, qualityof M&E information and sustainability. Meanwhile prerequisiteto successful in institutionalizing of the M&E system must besupported by a substantive demand from the government,insentive mechanisms, powerful champion, and provision oftraining in a range of M&E tools, methods, approaches andconcepts. Actors involved in M&E system are not onlygovernment. Civil society (i.e., universities, NGOs, researchinstitutes, think tanks and the media) also can play a role inM&E in several ways, including as a user and producer ofM&E information.Keywords: monitoring, evaluation, policy, program, project
MODELLING THE DEMAND FOR HEALTH CARE GIVEN INSURANCE: NOTES FOR RESEARCHERS Hidayat, Budi
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 02 (2008)
Publisher : Jurnal Manajemen Pelayanan Kesehatan

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Abstract

Understanding on health care demand given insurance givesprecious information to anticipate health care costs in the future,which in turn provides valuable information for policy makers,among other, to estimate claim rate, set up premium, designcost-sharing policy, etc. Unfortunately, estimating the effectsof health insurance on health care demand is not straightforward. This paper identifies crucial factors (e.g., adverseselection and provider behaviour) that need to be consideredin estimating the effects of health insurance on health caredemand. These considerations persuade researchers to usea rigorous econometric model in estimating health care demandgiven insurance with a view to isolate the true effects ofhealth insurance program. Such considerations can be furtherclassified into two-main factors. First is the features of thedependent variables used to measure the demand, and secondis the source of the data (or study design) used in the analysis.Keywords: modelling, health insurance, demand healthcareservices, applied econometrics
ESTIMASI DAMPAK PROGRAM ASURANSI KESEHATAN PADA JUMLAH KUNJUNGAN RAWAT JALAN DI INDONESIA Hidayat, Budi
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 01 (2008)
Publisher : Jurnal Manajemen Pelayanan Kesehatan

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Abstract

Background and method: This research aimed to selectthe best methods to predict the effect of health insuranceprogram on the numbers of outpatient visits in Indonesia. Theanalysis was applied to the second round of the IndonesianFamily Life Survey data (IFLS2).Result: The author compares the estimation results derivedfrom 6(six) econometrics technique count data model and selectthe best alternatives based on several statistics tests. Theresults confirm that Generalized Method of Moments (GMM)estimator is best to model the number of visits to public outpatient,whilst Hurdle Negative Binomial (HNB) is superior to model thenumber of visits to private one. It is proved that the insuredhave higher probability in the number of visits for outpatientservices then uninsured (p<1%). Supplies induce demandphenomena was not detected among the insured, howeverthis behaviour was likely happen where provider’s competitionare relatively high.Conclusions: This study concludes that estimates of healthcare demand given insurance have been shown to depend onthe empirical specification used in the analysis. Not controllingthe existence endogeneity of insurance leads to lower theparameter estimates. This study supports a national healthinsurance policy as an instrument to increase access to formalhealth care services.Keywords: health insurance, modeling, demand for health careservices
Model Spesifikasi Dinamis Permintaan Rokok: Rasionalkah Perokok Indonesia? Hidayat, Budi; Thabrany, Hasbullah
Jurnal Kesehatan Masyarakat Nasional Vol. 3 No. 3 Desember 2008
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (228.395 KB) | DOI: 10.21109/kesmas.v3i3.223

Abstract

Studi ini mengestimasi model spesifikasi dinamis permintaan (demand) rokok di Indonesia. Tujuannya adalah untuk menguji hipotesis kecanduan rasional perokok, dan menghitung elastisitas harga rokok jangka pendek dan jangka panjang. Analisis diaplikasikan pada data agregat individu yang dibentuk dari tiga tahapan survei panel IFLS selama tahun 1993-2000. Studi ini menjajagi sejumlah teknik ekonometrik dan memilih teknik tercocok atas dasar serangkaian uji statistik. Hasilnya menunjukkan bahwa rokok terbukti sebagai produk yang menimbulkan kecanduan (koefisien konsumsi masa lampau positif dan signifikan pada 1%). Sedangkan koefisien negatif dan signifikan untuk konsumsi rokok masa depan menunjukan sifat kecanduan miopik, artinya para perokok bersifat tidak rasional. Studi ini juga menunjukkan permintaan rokok lebih sensitif terhadap perubahan harga untuk jangka panjang ketimbang untuk jangka pendek. Temuan bahwa perokok memiliki sifat kecanduan miopik mengharuskan pengambil kebijakan mendisain ulang strategi promosi kesehatan masyarakat tentang larangan merokok di Indonesia. Berbagi implikasi kebijakan temuan studi disajikan pula pada bagian akhir tulisan ini.Kata kunci : Kecanduan rasional, sigaret, tembakau, elastisitas, data panel.AbstractThis study estimates a dynamic model specification of demand for cigarette in Indonesia. The objectives are to test the rational addiction hypothesis of cigarettes demand, and to calculate price elasticity of cigarettes in the short-run and long-term. The data for this analysis were aggregate individual data from three-wave a panel surveys of the IFLS (Indonesian Family Life Survey) from 1993-2000. This study explores several econometric approaches, and selects the best fit of several statistical measures. The results indicate that cigarette indeed an addictive good (the lags consumption coefficients are a positive with p-value <1%). Whilts a negative coefficient and significancy of future consumption indicate that smokers are myopic addicts, they are not rational. The study also confirms that the demand is more price sensitive for the long-run than the short-run. The finding of myopic addiction has pratical implications with which policy-makers should re-design current public health campaign against cigarette smoking in the country. Various policy implications of the research findings are also discussed in this article.Key words : Rational addiction, cigarettes, tobacco, price elasticity, panel data.
Praktik Dokter Terkait Perilaku Merokok Pasien Pujianto, Pujianto; Thabrany, Hasbullah; Hidayat, Budi; Ong, Michael; Fitriah, Fitriah
Jurnal Kesehatan Masyarakat Nasional Vol. 4 No. 3 Desember 2009
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (197.689 KB) | DOI: 10.21109/kesmas.v4i3.183

Abstract

Kini Indonesia berada pada awal tahap kedua epidemi tembakau dengan prevalensi perokok pada penduduk berumur di atas 10 tahun mencapai 23,7%. Dalam memerangi epidemi tembakau, dokter memegang peran kunci membantu pasien berhenti merokok. Untuk mengetahui praktik dokter terkait perilaku merokok pasiennya telah dilakukan survei di Jakarta dengan sampel 96 dokter yang dipilih secara acak. Hasil survei menunjukkan hanya 1 dari 50 dokter yang merokok setiap hari (2,1%). Pengetahuan dan sikap dokter tentang merokok pada umumnya sangat baik, yaitu 93,8% mengetahui dampak negatif perokok pasif, 84,4% mengetahui bahwa rokok dengan kadar tar/nikotin rendah tetap membahayakan, 93,8% setuju menjadikan dokter sebagai role model peri-laku tidak merokok, dan 95,8% setuju dengan kondisi bebas asap rokok di rumah sakit. Namun, dokter yang tidak selalu menanyakan kebiasaan merokok pasien cukup tinggi (66,7%) dan dokter yang tidak selalu memberikan nasehat kepada pasien untuk berhenti merokok (38%). Analisis regresi logistik mene-mukan bahwa dokter yang bekerja di bagian jantung dan paru berpeluang 28,4 kali lebih besar untuk menanyakan kebiasaan merokok pasien daripada dokter yang bekerja di bagian penyakit dalam. Penulis menyarankan agar dilaksanakan pendidikan dokter berkelanjutan tentang bahaya merokok dan pengendalian merokok.Kata kunci : Dokter, pengetahuan, sikap, perilaku, tembakauAbstractIndonesia is in the second phase of tobacco epidemic shown by 23,7% of people age 10+ years are smoking. In tobacco control programs, physicians play significant roles. To know how Indonesian physicians behave in facing smoking habits, a survey to 96 practicing physicians in three clinical departments has been undertaken in Jakarta. The survey identified that only one in 50 (2,1%) physicians smoke daily. As high as 93.8% physicians know about negative impact of passive smokers, 84.4% know that low tar/nicotine has significant impact on health, 93.8% agree that physicians should be one of the role model to smoking cessation, and 95.8% agree on free smoke environment in all hospital premises. However, 66.7% physicians did not regularly asking smoking be-havior of their patients and 38% did not advice patients to stop smoking. Logistic regression produce 28.4 times higher probability of physicians in Lung and Heart Clinic to ask smoking behavior of their patients as compared to physicians in Internal Medicines. The authors suggest to introduce a special continuing medical education on smoking and smoking cessation of practicing physicians.Key words : Physician, knowledge, attitude, practice, tobacco 
Mengenal Rancang Bangun Program Keluarga Harapan Kesehatan Hidayat, Budi
Jurnal Kesehatan Masyarakat Nasional Vol. 4 No. 6 Juni 2010
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (604.983 KB) | DOI: 10.21109/kesmas.v4i6.162

Abstract

Pemerintah Indonesia sedang melakukan uji coba program bantuan tunai bersyarat (BTB), yakni Program Keluarga Harapan (PKH). Program ini memberikan bantuan tunai kepada rumah tangga miskin dengan mensyaratkan mereka melakukan investasi sumber daya manusia. Pelaksanaan BTB di berbagai negara selalu diikuti upaya sistematis untuk mengukur efektivitas dan memahami dampak yang lebih luas dari program pada perilaku rumah tangga. Artikel ini menyajikan bukti nyata bahwa BTB telah meningkatkan kehidupan penduduk miskin. BTB dipuji sebagai cara untuk mengurangi kesenjangan terutama di sejumlah negara Amerika Latin; membantu rumah tangga keluar dari lingkaran setan kemiskinan yang ditularkan dari satu generasi ke generasi berikutnya; meningkatkan status kesehatan dan gizi anak, serta membantu negara memenuhi tujuan-tujuan pembangunan millenium. Artikel ini juga mengupas lebih dalam mengenai rancang bangun PKH, termasuk alasan-alasan pengembangan PKH kesehatan serta proses penetapan persyaratan kesehatan.Kata kunci: Program keluarga harapan, bantuan tunai bersyaratAbstractThe Government of Indonesia is testing a conditional cash transfer (CCT) program, e.g., Family Hope Program. This program provides money to poor households conditional on investments in human capital. CCTs implementation in various countries has been followed by systematic efforts to measure their effectiveness and understand their broader impact on households’ behavior. The article shows empirical evidence that CCTs have improved the lives of poor people.CCTs have been hailed as a way of reducing inequality, especially in Latin America countries; helping households break out of a vicious cycle whereby poverty is transmitted from one generation to another; promoting child health and nutrition; and helping countries meet the Millennium Development Goals. This article explores more deeply on the design of the Indonesian CCT program, including the reasons for the development of CCT health and health conditionalitiesdetermination process. Key words: Family hope program, conditional cash transfer
Program Keluarga Harapan dan Pemanfaatan Pelayanan Kesehatan Preventif Hidayat, Budi; Tuhiman, Hendratno; Prawiradinata, Rudy; Sumadi, Pungky
Jurnal Kesehatan Masyarakat Nasional Vol. 5 No. 5 April 2011
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (273.466 KB) | DOI: 10.21109/kesmas.v5i5.130

Abstract

Program keluarga harapan (PKH) yang berbasis bantuan tunai bersyarat (conditional cash transfers, CCT) di bidang pendidikan dan kesehatan telah diluncurkan Pemerintah Indonesia sejak Juli 2007 di 348 kecamatan dari 48 kabupaten/kota di 7 provinsi, namun dampaknya dalam mengurangi angka kemiskinan dan meningkatkan kualitas sumber daya manusia warga miskin belum pernah dievaluasi. Studi ini mengevaluasi dampak awal PKH terhadap penggunaan layanan kesehatan preventif. Evaluasi ini menggunakan rancangan eksperimen, intervensi program PKH berbasis rumah tangga dengan pengukuran sebelum dan sesudah intervensi pada kelompok perlakuan dan kontrol yang sebelumnya dipilih acak pada tingkat kecamatan.Data diperoleh dari survei dasar CCT tahun 2007 dan survei lanjutan PKH tahun 2008 yang dikumpulkan di 6 provinsi. Hasil estimasi metode double-difference menunjukkan dampak program intervensi PKH pada kenaikan sejumlah indikator pelayanan kesehatan preventif seperti kunjungan posyandu, pemantauan tumbuh kembang anak, dan imunisasi. Temuan ini penting sebagai dasar pengambilan keputusan untuk melanjutkan program. Namun karena evaluasi awal ini memiliki sejumlah keterbatasan, hasil studi ini harus ditafsirkan hati-hati dan divalidasi lebih lanjut dengan data survei PKH tahun 2009 menggunakan berbagai metode analisisKata kunci: Evaluasi dampak, bantuan tunai bersyarat, program keluarga harapan, pelayanan kesehatan preventifAbstractFamily hope program (PKH), a conditional cash transfers (CCT)-based program in education and health, has been launched by the Government of Indonesia since 2007 in 348 sub-districts of 48 regencies/cities in 7 provinces, but its impact on the reduction of poverty and improvement of poor human resources has not been evaluated. This study valuates initial impact of the PKH on the utilization of preventive healthcare services. This evaluation applies experimental design, a household-based intervention program with measurements prior to and after-intervention in both treatment and control groups that previously were chosen randomly at the sub-district level. The data were obtained from CCT baseline surveys 2007 and PKH follow-up survey 2008 in 6 provinces. Double-difference estimates show the impact of PKH on the increase of preventive health care services indicators such as visit to posyandu, child growth monitoring, and immunization. These findings are important for decision making to continue the program. However, as this initial evaluation has a number of limitations, this study should be interpreted with caution and be validated further by PKH survey 2009 data using different methods of analysis.Key words: Impact evaluation, conditional cash transfers, family hope program, preventive health services
Mengenal Rancang Bangun Program Keluarga Harapan Kesehatan Hidayat, Budi
Jurnal Kesehatan Masyarakat Nasional Vol. 4 No. 6 Juni 2010
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (604.983 KB) | DOI: 10.21109/kesmas.v4i6.162

Abstract

Pemerintah Indonesia sedang melakukan uji coba program bantuan tunai bersyarat (BTB), yakni Program Keluarga Harapan (PKH). Program ini memberikan bantuan tunai kepada rumah tangga miskin dengan mensyaratkan mereka melakukan investasi sumber daya manusia. Pelaksanaan BTB di berbagai negara selalu diikuti upaya sistematis untuk mengukur efektivitas dan memahami dampak yang lebih luas dari program pada perilaku rumah tangga. Artikel ini menyajikan bukti nyata bahwa BTB telah meningkatkan kehidupan penduduk miskin. BTB dipuji sebagai cara untuk mengurangi kesenjangan terutama di sejumlah negara Amerika Latin; membantu rumah tangga keluar dari lingkaran setan kemiskinan yang ditularkan dari satu generasi ke generasi berikutnya; meningkatkan status kesehatan dan gizi anak, serta membantu negara memenuhi tujuan-tujuan pembangunan millenium. Artikel ini juga mengupas lebih dalam mengenai rancang bangun PKH, termasuk alasan-alasan pengembangan PKH kesehatan serta proses penetapan persyaratan kesehatan.Kata kunci: Program keluarga harapan, bantuan tunai bersyaratAbstractThe Government of Indonesia is testing a conditional cash transfer (CCT) program, e.g., Family Hope Program. This program provides money to poor households conditional on investments in human capital. CCTs implementation in various countries has been followed by systematic efforts to measure their effectiveness and understand their broader impact on households’ behavior. The article shows empirical evidence that CCTs have improved the lives of poor people.CCTs have been hailed as a way of reducing inequality, especially in Latin America countries; helping households break out of a vicious cycle whereby poverty is transmitted from one generation to another; promoting child health and nutrition; and helping countries meet the Millennium Development Goals. This article explores more deeply on the design of the Indonesian CCT program, including the reasons for the development of CCT health and health conditionalitiesdetermination process. Key words: Family hope program, conditional cash transfer
Pengaruh Kepemilikan Jaminan Kesehatan terhadap Belanja Kesehatan Katastropik Rumah Tangga di Indonesia Tahun 2012 Situmeang, Lena Elfrida; Hidayat, Budi
Jurnal Kebijakan Kesehatan Indonesia Vol 7, No 1 (2018)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (375.988 KB) | DOI: 10.22146/jkki.12186

Abstract

Background: Indonesia’s health development geared to achieve national health insurance scheme (JKN). However, funding of health in Indonesia is still dominated by domestic funding through out-of-pocket (OOP). Objective: Catastrophic health expenditure of households will disrupt household consumption and can lead to poverty. Using secondary data of the National Social Surveys 2 (Susenas) 2012, this study aims to prove health insurance ownership lowers catastrophic health expenditure of households in Indonesia in 2012. Methods: This study used a cross-sectional study design with models probit and bivariate probit. Results: The results found that the health insurance ownership lowers catastrophic health expenditure amounted 12.97% at the threshold 10% of total expenditure and amounted 18.42% at 20% of total non-food expenditure. Conclutions: Health insurance ownership provides protection for catastrophic health expenditure in Indonesia in 2012.ABSTRAKLatar Belakang: Pembangunan kesehatan Indonesia diarahkan untuk mencapai Jaminan kesehatan Nasional (JKN). Namun, sebagian besar pendanaan kesehatan masih didominasi oleh rumah tangga melalui out-of-pocket (OOP). Pengeluaran biaya kesehatan katastrofik rumah tangga akan mengganggu konsumsi rumah tangga dan dapat mengakibatkan kemiskinan. Tujuan: Menggunakan data sekunder Survei Sosial Nasional (Susenas) tahun 2012, penelitian ini bertujuan membuktikan bahwa kepemilikan jaminan kesehatan menurunkan belanja kesehatan katastrofik rumah tangga di Indonesia tahun 2012. Metode: Penelitian dengan desain studi potong lintang ini, menggunakan pendekatan ekonometrik dengan model probit dan bivariat probit. Hasil: Hasil penelitian menunjukkan bahwa kepemilikan jaminan kesehatan menurunkan belanja kesehatan katastrofik sebesar 12.97% pada ambang batas 10% dari total pengeluaran dan sebesar 18.42% pada ambang batas 20% total pengeluaran non-makanan. Kesimpulan: Kepemilikan jaminan kesehatan memberikan perlindungan terhadap belanja kesehatan katastrofik di Indonesia pada Tahun 2012.