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Abstract

This research investigates the capacity of the Siscobikes (Health Costing System) application to forecast the financial requirements for the execution of Minimum Service Standards (SPM) within Indonesia’s health sector at the district and city levels.. The study utilized cross-sectional data from 166 districts/cities to ascertain the projected health financing requirements and juxtaposed these estimates with the actual budgetary allocations. The results show that each district/city requires approximately IDR 16 billion annually for SPM. Districts require around IDR 17 billion annually, while cities require approximately IDR 13 billion. Substantial regional disparities are observed: Eastern Indonesia has the highest per capita needs and experiences a significantly larger financing gap (277% shortfall) compared to Western Indonesia (5% deficit). Intra-regional differences are also evident; for example, cities in Eastern Indonesia require nearly three times the budget needed by districts within the same region. These findings demonstrate that current budget allocations are insufficient to meet overall needs, resulting in significant financing gaps. Accordingly, this study recommends integrating Siscobikes into the official planning and budgeting system (SIPD), implementing needs-based fiscal transfers, and strengthening local government capacity to better align health financing requirements with available resources.

References

Akita, T., Riadi, A.A. & Rizal, A. (2021) ‘Fiscal disparities in Indonesia in the decentralization era: Does general allocation fund equalize fiscal revenues?’, Regional Science Policy & Practice, 13(6), pp. 1842–1866. https://doi.org/10.1111/rsp3.12326

Alves, A.T.J., Nobre, F.F. & Waller, L.A. (2016) ‘Exploring spatial patterns in the associations between local AIDS incidence and socioeconomic and demographic variables in the state of Rio de Janeiro, Brazil’, Spatial and Spatio-Temporal Epidemiology, 17, pp. 85–93. https://doi.org/10.1016/j.sste.2016.04.008

Arrohmah, M., Suryoputro, A. & Budiyono, B. (2023) ‘Implementation of minimum service standards (MSS) in the health sector at district level and its obstacles: A systematic literature review’, Jurnal Penelitian Pendidikan IPA, 9(10), pp. 776–783. https://doi.org/10.29303/jppipa.v9i10.5251

Apriliani, A.T., Martini, S. & Murti, B. (2021) ‘Analysis of malaria risk factors in Indonesia: Data analysis of Basic Health Research 2018’, International Journal of Multicultural and Multireligious Understanding, 8(4), pp. 96–105. https://doi.org/10.18415/ijmmu.v8i4.2477

Bachtiar, A., Edward, A., Candi, C. & Sarena, A. (2020) ‘Qualitative appraisal of stakeholders’ perspectives on diabetes mellitus policy in Jakarta, Indonesia’, European Journal of Public Health, 30(Suppl. 5). https://doi.org/10.1093/eurpub/ckaa166.1143

Barasa, E., Nyawira, L., Musiega, A., Kairu, A., Orangi, S. & Tsofa, B. (2022) ‘The autonomy of public health facilities in decentralised contexts: Insights from applying a complexity lens in Kenya’, BMJ Global Health, 7(11). https://doi.org/10.1136/bmjgh-2022-010260

Deka, A. & Bhattacharyya, S. (2019) ‘Game dynamic model of optimal budget allocation under individual vaccination choice’, Journal of Theoretical Biology, 470, pp. 108–118. https://doi.org/10.1016/j.jtbi.2019.03.014

Harsono, H.F. (2024) ‘10 tahun menurunkan stunting’, MediaKom, Edisi 167, Kementerian Kesehatan RI. Available at: http://link.kemenkes.go.id/mediakom

Hendarwan, H., Rosita, R. & Suriani, O. (2016) ‘Analisis implementasi standar pelayanan minimal bidang kesehatan kabupaten/kota’, Jurnal Ekologi Kesehatan, 14(4), pp. 367–380. https://doi.org/10.22435/jek.v14i4.4716

Idaiani, S., Hendarwan, H. & Herawati, M.H. (2023) ‘Disparities of health program information systems in Indonesia: A cross-sectional Indonesian Health Facility Research 2019’, International Journal of Environmental Research and Public Health, 20(5), p. 4384. https://doi.org/10.3390/ijerph20054384

Kartiasih, F., Nachrowi, N.D., Wisana, I.D.G.K. & Handayani, D. (2022) ‘Inequalities of Indonesia’s regional digital development and its association with socioeconomic characteristics: A spatial and multivariate analysis’, Information Technology for Development, 29(2–3), pp. 299–328. https://doi.org/10.1080/02681102.2022.2110556

Kementerian Dalam Negeri Republik Indonesia (2019) Peraturan Menteri Dalam Negeri Nomor 100 Tahun 2019 tentang Penerapan Standar Pelayanan Minimal. Jakarta: Kemendagri RI.

Kementerian Dalam Negeri Republik Indonesia (2021) Peraturan Menteri Dalam Negeri Nomor 59 Tahun 2021 tentang Penerapan Standar Pelayanan Minimal. Jakarta: Kemendagri RI.

Kementerian Kesehatan Republik Indonesia (2019) Peraturan Menteri Kesehatan Nomor 4 Tahun 2019 tentang Standar Teknis Pemenuhan Standar Pelayanan Minimal Bidang Kesehatan. Jakarta: Kemenkes RI.

Kementerian Kesehatan Republik Indonesia (2024) Peraturan Menteri Kesehatan Nomor 6 Tahun 2024 tentang Standar Teknis Pemenuhan Standar Pelayanan Minimal Bidang Kesehatan. Jakarta: Kemenkes RI.

Latupeirissa, J.J.P., Dewi, N.L.Y., Prayana, I.K.R., Srikandi, M.B., Ramadiansyah, S.A. & Pramana, I.B.G.A.Y. (2024) ‘Transforming public service delivery: A comprehensive review of digitization initiatives’, Sustainability, 16(7), p. 2818. https://doi.org/10.3390/su16072818

Liu, K., Wang, T., Bai, C. & Liu, L. (2022) ‘Strengthening local governance in health financing in China: A text-mining analysis of policy changes between 2009 and 2020’, Health Policy and Planning, 37(6), pp. 677–689. https://doi.org/10.1093/heapol/czab153

Loewenson, R. & Mukumba, C. (2023) ‘Recovering lost tax to meet the health financing gap for universal public sector health systems in East and Southern Africa’, BMJ Global Health, 8(Suppl. 8). https://doi.org/10.1136/bmjgh-2023-011820

McCoy, D., Chigudu, S. & Tillmann, T. (2017) ‘Framing the tax and health nexus: A neglected aspect of public health concern’, Health Economics, Policy and Law, 12(2), pp. 179–194. https://doi.org/10.1017/S174413311600044X

McGuire, F., Revill, P., Twea, P., Mohan, S., Manthalu, G. & Smith, P.C. (2020) ‘Allocating resources to support universal health coverage: Development of a geographical funding formula in Malawi’, BMJ Global Health, 5(9). https://doi.org/10.1136/bmjgh-2020-002763

Nair Narayanan, D. et al. (2024) ‘Giving meaning to quality of healthcare in Malaysia’, International Journal for Quality in Health Care, 36(3). https://doi.org/10.1093/intqhc/mzae063

Ndabarora, E., Chipps, J. & Uys, L. (2014) ‘Systematic review of health data quality management and best practices at community and district levels in LMICs’, Journal of International Development. https://doi.org/10.1177/0266666913477430

Rainer, P. (2024) ‘Angka kemiskinan RI jadi 9,03%, wilayah mana yang tertinggi?’, GoodStat. Available at: https://goodstats.id/article/persentase-kemiskinan-ri-jadi-9-03-tertinggi-di-mana-K79Ns

Ravishankar, N. et al. (2024) ‘Reconciling devolution with health financing and public financial management: Challenges and policy options for the health sector’, BMJ Global Health, 9(5). https://doi.org/10.1136/bmjgh-2024-015216

Risdiyanti, A., Paramu, H. & Sunarto (2024) ‘Health financing analysis in the implementation of minimum service standards in Lumajang Regency’, Jurnal Kedokteran dan Kesehatan Indonesia, 15(1), pp. 16–26. https://doi.org/10.20885/jkki.vol15.iss1.art4

Roudo, M., Campbell, A. & Delay, S. (2018) ‘Is decentralisation compatible with performance management? The impacts of minimum service standards on local government motivation in Indonesia’, Journal of Regional and City Planning, 29(2), pp. 135–148. https://doi.org/10.5614/jrcp.2018.29.2.5

Sayogo, D.S., Yuli, S.B.C. & Amalia, F.A. (2023) ‘Data-driven decision-making challenges of local government in Indonesia’, Transforming Government: People, Process and Policy, 18(1), pp. 145–156. https://doi.org/10.1108/TG-05-2023-0058

Tan, X. & Wong, C. (2022) ‘Anatomy of intergovernmental finance for essential public health services in China’, BMC Public Health, 22(1), p. 914. https://doi.org/10.1186/s12889-022-13300-y

Wirandana, P.A. & Khoirunurrofik, K. (2024) ‘Educational inequality in Indonesia: Are intergovernmental fiscal transfers effective in reducing the gap?’, Educational Studies, 50(6), pp. 1424–1443. https://doi.org/10.1080/03055698.2022.2103647

Zamboni, L.M. & Martin, E.G. (2020) ‘Distributing local resources for public health preparedness grants: A data-driven approach’, Journal of Public Health Management and Practice, 26(4), pp. 349–356. https://doi.org/10.1097/PHH.0000000000000824

Bahasa Abstract

Penelitian ini mengkaji kapasitas aplikasi Siscobikes (Sistem Costing Biaya Kesehatan) dalam memproyeksikan kebutuhan pembiayaan untuk pelaksanaan Standar Pelayanan Minimal (SPM) di bidang kesehatan di Indonesia, baik pada tingkat kabupaten/kota. Penelitian ini menggunakan data potong lintang dari 166 kabupaten/kota untuk menghitung estimasi kebutuhan pembiayaan kesehatan dan membandingkannya dengan alokasi anggaran yang tersedia. Hasil menunjukkan bahwa setiap kabupaten/kota rata-rata membutuhkan sekitar Rp16 miliar per tahun untuk SPM. Kabupaten membutuhkan sekitar Rp17 miliar, sedangkan kota membutuhkan Rp13 miliar. Terdapat perbedaan antarwilayah yang cukup jelas: Indonesia bagian Timur memiliki kebutuhan per kapita tertinggi, tetapi juga mengalami kesenjangan pembiayaan jauh lebih besar (defisit 277%) dibandingkan dengan Indonesia bagian Barat (defisit 5%). Perbedaan intrawilayah juga ditemukan, misalnya kota-kota di wilayah Timur membutuhkan hampir tiga kali lipat anggaran dibandingkan dengan kabupaten di wilayah yang sama. Data ini menunjukkan bahwa alokasi saat ini belum mampu memenuhi seluruh kebutuhan, sehingga menimbulkan kekurangan yang signifikan. Penelitian ini merekomendasikan agar Siscobikes diintegrasikan ke dalam sistem perencanaan dan penganggaran resmi (SIPD), penerapan transfer fiskal dilakukan berdasarkan kebutuhan, serta pemerintah daerah diberikan penguatan kapasitas untuk menyesuaikan kebutuhan pembiayaan kesehatan dengan sumber daya yang tersedia.

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