•  
  •  
 

Abstract

Chronic kidney disease is a global health issue affecting more than 10% of the world's population and poses a significant disease burden, especially in developing countries. In Indonesia, the National Health Insurance program (JKN) has enabled access to dialysis care for patients with chronic kidney failure, but it also presents challenges in sustaining financing. This study aims to analyze the trends in dialysis service claims in Pematangsiantar City during the period from 2017 to 2022 and project the service needs until 2025. The research design is descriptive-analytic, using claim data from BPJS Health related to dialysis procedures. Analysis is conducted using polynomial trends to identify historical patterns and future projections. The results show that the average annual cost of dialysis service claims in Pematangsiantar City is 85 billion rupiah. There was an annual increase in visits and claims costs by 25.56% and 23.52%, respectively. In 2021, dialysis visits surged by 91.6%, with claim costs reaching Rp128.2 billion. Projections up to 2025 indicate a significant upward trend, with an estimated number of visits approaching 350,000 in that year. The study's conclusions emphasize the importance of maintaining sustainable health financing through the JKN program and adjusting dialysis service capacity according to demand to prevent over- or undersupply. Additionally, primary prevention efforts through health education and early detection of kidney disease should be prioritized to reduce the number of new patients requiring dialysis.

References

Basile, C., Combe, C., Pizzarelli, F., Covic, A., Davenport, A., Kanbay, M., Kirmizis, D., Schneditz, D., Van Der Sande, F., & Mitra, S. (2020). Recommendations for the prevention, mitigation and containment of the emerging SARS-CoV-2 (COVID-19) pandemic in haemodialysis centres. Nephrology Dialysis Transplantation, 35(5), 737–741.

Brown, J. S., & Elliott, R. W. (2021). Social Determinants of Health: Understanding the Basics and Their Impact on Chronic Kidney Disease. Nephrology Nursing Journal : Journal of the American Nephrology Nurses’ Association, 48(2), 131–145. https://doi.org/10.37526/1526-744x.2021.48.2.131

Hallan, S. I., Øvrehus, M. A., Romundstad, S., Rifkin, D., Langhammer, A., Stevens, P. E., & Ix, J. H. (2016). Long-term trends in the prevalence of chronic kidney disease and the influence of cardiovascular risk factors in Norway. Kidney International, 90(3), 665–673. https://doi.org/10.1016/j.kint.2016.04.012

Hetanews. (2016). Layanan Cuci Darah RSUD Djasamen Saragih yang Terbaik di Sumut. https://www.hetanews.com/article/56129/layanan-cuci-darah-rsud-djasamen-saragih-yang-terbaik-di-sumut

Hsu, C. M., & Weiner, D. E. (2020). COVID-19 in dialysis patients: outlasting and outsmarting a pandemic. Kidney International, 98(6), 1402–1404.

Jeloka, T., Gupta, A., Prasad, N., Varughese, S., Mahajan, S., Nayak, K. S., Agarwal, S. K., Abraham, G., & Nephrology, O. behalf of C.-19 W. G. of I. S. of. (2020). Peritoneal Dialysis Patients During COVID 19 Pandemic. Indian Journal of Nephrology, 30(3). https://journals.lww.com/ijon/fulltext/2020/30030/peritoneal_dialysis_patients_during_covid_19.8.aspx

Kalantar-Zadeh, K., & Li, P. K.-T. (2020). Strategies to prevent kidney disease and its progression. Nature Reviews Nephrology, 16(3), 129–130.

Kemenkes RI. (2021). Pedoman pelayanan Rumah Sakit Pada Masa Pandemi Covid-19. In Kemkes.go.id. https://www.kemkes.go.id/downloads/resources/download/info-terkini/COVID-19/Pedoman-Pelayanan-Rumah-Sakit-Pada-Masa-Pandemi-COVID-19_edisi-revisi-1.pdf

Kementerian Kesehatan. (2014). Masyarakat Antusias Ikut JKN – Sehat Negeriku. https://sehatnegeriku.kemkes.go.id/baca/rilis-media/20140103/179533/masyarakat-antusias-ikut-jkn/

Kementerian Kesehatan. (2017). Ginjal Kronis - Direktorat P2PTM. https://p2ptm.kemkes.go.id/informasi-p2ptm/ginjal-kronis

Kliger, A. S., & Silberzweig, J. (2020). Mitigating risk of COVID-19 in dialysis facilities. Clinical Journal of the American Society of Nephrology, 15(5), 707–709.

Kovesdy, C. P. (2022). Epidemiology of chronic kidney disease: an update 2022. Kidney International Supplements, 12(1), 7–11.

Kumparan. (2023). Lunasi Klaim Rp 113,47 Triliun, BPJS Kesehatan Tegaskan Bebas Utang | kumparan.com. Https://Kumparan.Com/Kumparanbisnis. https://kumparan.com/kumparanbisnis/lunasi-klaim-rp-113-47-triliun-bpjs-kesehatan-tegaskan-bebas-utang-20ofThWOkLa

Long, J., & Ryoo, J. (2010). Using fractional polynomials to model non‐linear trends in longitudinal data. British Journal of Mathematical and Statistical Psychology, 63(1), 177–203.

Manurung, P. (2023). RSUD Djasamen Saragih Miliki 47 Unit Mesin Cuci Darah, Layani Pasien BPJS Kesehatan. https://mistar.id/siantar/rsud-djasamen-saragih-miliki-4-unit-mesin-cuci-darah-layani-pasien-bpjs-kesehatanrsud-djasamen-saragih-miliki-sebanyak-4-unit-mesin-cuci-darah-layani-pasien-bpjs-kesehatan/

Ortiz, A., Covic, A., Fliser, D., Fouque, D., Goldsmith, D., Kanbay, M., Mallamaci, F., Massy, Z. A., Rossignol, P., Vanholder, R., Wiecek, A., Zoccali, C., & London, G. M. (2014). Epidemiology, contributors to, and clinical trials of mortality risk in chronic kidney failure. The Lancet, 383(9931), 1831–1843. https://doi.org/10.1016/S0140-6736(14)60384-6

Perez, A., Retzloff, S., Browne, T., Cruz, A., Wright, S., Pastan, S. O., & Patzer, R. E. (2022). Dialysis Staff–Reported Impact of COVID-19 on Early Kidney Transplant Steps. Kidney International Reports, 7(4), 904–907. https://doi.org/10.1016/j.ekir.2022.01.007

Prasad, N., Bhatt, M., Agarwal, S. K., Kohli, H. S., Gopalakrishnan, N., Fernando, E., Sahay, M., Rajapurkar, M., Chowdhary, A. R., Rathi, M., Jeloka, T., Lobo, V., Singh, S., Bhalla, A. K., Khanna, U., Bansal, S. B., Rai, P. K., Bhawane, A., Anandh, U., … Jha, V. (2020). The Adverse Effect of COVID Pandemic on the Care of Patients With Kidney Diseases in India. Kidney International Reports, 5(9), 1545–1550. https://doi.org/10.1016/j.ekir.2020.06.034

Robinson, B. M., Guedes, M., Alghonaim, M., Cases, A., Dasgupta, I., Gan, L., Jacobson, S. H., Kanjanabuch, T., Kim, Y.-L., & Kleophas, W. (2021). Worldwide early impact of COVID-19 on dialysis patients and staff and lessons learned: a DOPPS roundtable discussion. Kidney Medicine, 3(4), 619–634.

Soetedja, S. V., Atik Nurwahyuni, & Amelia Intan. (2022). Biaya Pelayanan Hemodialisis Pasien Gagal Ginjal Kronis di Era JKN : Literature Review. Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 5(10), 1213–1218. https://doi.org/10.56338/mppki.v5i10.2712

Vanholder, R., Annemans, L., Brown, E., Gansevoort, R., Gout-Zwart, J. J., Lameire, N., Morton, R. L., Oberbauer, R., Postma, M. J., & Tonelli, M. (2017). Reducing the costs of chronic kidney disease while delivering quality health care: a call to action. Nature Reviews Nephrology, 13(7), 393–409.

Verma, A., Patel, A. B., Tio, M. C., & Waikar, S. S. (2020). Caring for Dialysis Patients in a Time of COVID-19. Kidney Medicine, 2(6), 787–792.

Watnick, S., & McNamara, E. (2020). On the frontline of the COVID-19 outbreak: Keeping patients on long-term dialysis safe. Clinical Journal of the American Society of Nephrology, 15(5), 710–713. https://doi.org/10.2215/CJN.03540320

Zulailiah, Y., Hadrianti, D., & Saherna, J. (2022). Stres Pada Pasien Gagal Ginjal yang Menjalani Hemodialisa Di RSUD Ulin Banjarmasin. JIKES: Jurnal Ilmu Kesehatan, 1(1), 40–46.

Bahasa Abstract

Penyakit ginjal kronis merupakan masalah kesehatan global yang memengaruhi lebih dari 10% populasi dunia serta menjadi beban penyakit yang besar terutama di negara-negara berkembang. Di Indonesia, program Jaminan Kesehatan Nasional (JKN) telah memungkinkan akses perawatan dialisis bagi pasien gagal ginjal kronis, tetapi juga memunculkan tantangan keberlanjutan pembiayaan. Penelitian ini bertujuan untuk menganalisis tren klaim layanan dialisis di Kota Pematangsiantar selama periode 2017 hingga 2022 dan memproyeksikan kebutuhan layanan hingga 2025. Desain penelitian ini adalah deskriptif analitik dengan menggunakan data klaim BPJS Kesehatan terkait prosedur dialisis. Analisis dilakukan menggunakan tren polinomial untuk mengidentifikasi pola historis dan proyeksi masa depan. Hasil analisis menunjukkan rerata klaim biaya pelayanan dialisis di Kota Pematangsiantar adalah 85 milyar rupiah per tahun. Diketahui terjadi peningkatan kunjungan dan klaim biaya berturut-turut sebesar 25,56% dan 23,52% per tahun. Pada tahun 2021, kunjungan dialisis meningkat sebesar 91,6% dengan lonjakan klaim mencapai Rp128,2 miliar. Proyeksi hingga 2025 menunjukkan tren peningkatan yang signifikan dengan estimasi jumlah kunjungan mencapai 266.698 pada tahun tersebut. Kesimpulan penelitian ini menekankan pentingnya menjaga keberlanjutan pembiayaan kesehatan melalui program JKN serta penyesuaian kapasitas layanan dialisis sesuai kebutuhan untuk mencegah terjadinya kelebihan atau kekurangan suplai layanan. Selain itu, upaya pencegahan primer melalui edukasi kesehatan dan deteksi dini penyakit ginjal perlu diprioritaskan untuk mengurangi jumlah pasien baru yang memerlukan dialisis.

Download

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.