Population-based study on coverage and healthcare processes for cancer during implementation of national healthcare insurance in Indonesia
Summary: Background: A national healthcare insurance has been implemented in Indonesia since 2014. Although cancer care currently represents a smaller part of the healthcare support, the demographic development will lead to a rapid growth of the population within age groups at cancer risk. This req...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-11-01
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| Series: | The Lancet Regional Health - Southeast Asia |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772368222000555 |
| _version_ | 1811214586624344064 |
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| author | Juergen Schaefers Supriyatiningsih Wenang Andi Afdal Ali Ghufron Mukti Sri Sundari Joerg Haier |
| author_facet | Juergen Schaefers Supriyatiningsih Wenang Andi Afdal Ali Ghufron Mukti Sri Sundari Joerg Haier |
| author_sort | Juergen Schaefers |
| collection | DOAJ |
| description | Summary: Background: A national healthcare insurance has been implemented in Indonesia since 2014. Although cancer care currently represents a smaller part of the healthcare support, the demographic development will lead to a rapid growth of the population within age groups at cancer risk. This requires strategic and developmental planning of cancer care resources. Based on data of the national healthcare insurance, current cancer care processes and their determinants were evaluated. Methods: Nationwide reimbursement data as well as demographic, economic and healthcare infrastructure data were used for the study. Poor and underserved population was stratified according to the national classification system. Availability of healthcare resources was evaluated at provincial level. Cancer care usage was analysed applying descriptive and multivariate statistical approaches (regression, cluster analysis, tree classification). Findings: Cancer care was provided in primary care (PHC) for 2.6/1000 and advanced care (AHC) for 4.8/1000 participants within the family-based membership structure. Regression analysis revealed human resource availability in rural/remote areas a determinant for cancer PHC. Cancer care in AHC was determined by PHC provided by general practitioners (GP), availability of AHC infrastructure (Class A & B hospital beds) and treatment migration between provinces. Tree classification confirmed predominant roles of GP, AHC infrastructure and referral between cancer care provider levels. Interpretation: Cancer care will gain much higher importance for the Indonesian healthcare system within the next decade. Infrastructure, human resources, and process development should avoid rising overload of cancer care delivery by targeting reduction of treatment migration (availability of GPs in rural/remote provinces), improvement of referral systems (effective clinical selection processes and back-referral) and AHC cancer care structures (regional distribution of Class A & B hospitals). Funding: This project was supported by grants from Centre for Research, Publication, and Community Development Muhammadiyah University of Yogyakarta (SW, ID), and data provision by BPJS Indonesia. |
| first_indexed | 2024-04-12T06:07:12Z |
| format | Article |
| id | doaj.art-54bb0b386515437eb7f8163637f15879 |
| institution | Directory Open Access Journal |
| issn | 2772-3682 |
| language | English |
| last_indexed | 2024-04-12T06:07:12Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health - Southeast Asia |
| spelling | doaj.art-54bb0b386515437eb7f8163637f158792022-12-22T03:44:49ZengElsevierThe Lancet Regional Health - Southeast Asia2772-36822022-11-016100045Population-based study on coverage and healthcare processes for cancer during implementation of national healthcare insurance in IndonesiaJuergen Schaefers0Supriyatiningsih Wenang1Andi Afdal2Ali Ghufron Mukti3Sri Sundari4Joerg Haier5Comprehensive Cancer Center Hannover, Hannover Medical School, Hannover, Germany; IGP Institute for Health Sciences and Public Health, Muenster, GermanyDept. of Pediatric Oncology, University Hospital Muenster, Muenster, Germany; Faculty of Medicine and Health Sciences, University of Muhammadiyah Yogyakarta, IndonesiaBPJS Kesehatan (Social Insurance Administration Organization), IndonesiaBPJS Kesehatan (Social Insurance Administration Organization), IndonesiaFaculty of Medicine and Health Sciences, University of Muhammadiyah Yogyakarta, IndonesiaComprehensive Cancer Center Hannover, Hannover Medical School, Hannover, Germany; IGP Institute for Health Sciences and Public Health, Muenster, Germany; Faculty of Medicine and Health Sciences, University of Muhammadiyah Yogyakarta, Indonesia; Corresponding author at: Comprehensive Cancer Center Hannover, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.Summary: Background: A national healthcare insurance has been implemented in Indonesia since 2014. Although cancer care currently represents a smaller part of the healthcare support, the demographic development will lead to a rapid growth of the population within age groups at cancer risk. This requires strategic and developmental planning of cancer care resources. Based on data of the national healthcare insurance, current cancer care processes and their determinants were evaluated. Methods: Nationwide reimbursement data as well as demographic, economic and healthcare infrastructure data were used for the study. Poor and underserved population was stratified according to the national classification system. Availability of healthcare resources was evaluated at provincial level. Cancer care usage was analysed applying descriptive and multivariate statistical approaches (regression, cluster analysis, tree classification). Findings: Cancer care was provided in primary care (PHC) for 2.6/1000 and advanced care (AHC) for 4.8/1000 participants within the family-based membership structure. Regression analysis revealed human resource availability in rural/remote areas a determinant for cancer PHC. Cancer care in AHC was determined by PHC provided by general practitioners (GP), availability of AHC infrastructure (Class A & B hospital beds) and treatment migration between provinces. Tree classification confirmed predominant roles of GP, AHC infrastructure and referral between cancer care provider levels. Interpretation: Cancer care will gain much higher importance for the Indonesian healthcare system within the next decade. Infrastructure, human resources, and process development should avoid rising overload of cancer care delivery by targeting reduction of treatment migration (availability of GPs in rural/remote provinces), improvement of referral systems (effective clinical selection processes and back-referral) and AHC cancer care structures (regional distribution of Class A & B hospitals). Funding: This project was supported by grants from Centre for Research, Publication, and Community Development Muhammadiyah University of Yogyakarta (SW, ID), and data provision by BPJS Indonesia.http://www.sciencedirect.com/science/article/pii/S2772368222000555Healthcare deliveryReferralPoor populationPrimary careRemote populationAvailability |
| spellingShingle | Juergen Schaefers Supriyatiningsih Wenang Andi Afdal Ali Ghufron Mukti Sri Sundari Joerg Haier Population-based study on coverage and healthcare processes for cancer during implementation of national healthcare insurance in Indonesia The Lancet Regional Health - Southeast Asia Healthcare delivery Referral Poor population Primary care Remote population Availability |
| title | Population-based study on coverage and healthcare processes for cancer during implementation of national healthcare insurance in Indonesia |
| title_full | Population-based study on coverage and healthcare processes for cancer during implementation of national healthcare insurance in Indonesia |
| title_fullStr | Population-based study on coverage and healthcare processes for cancer during implementation of national healthcare insurance in Indonesia |
| title_full_unstemmed | Population-based study on coverage and healthcare processes for cancer during implementation of national healthcare insurance in Indonesia |
| title_short | Population-based study on coverage and healthcare processes for cancer during implementation of national healthcare insurance in Indonesia |
| title_sort | population based study on coverage and healthcare processes for cancer during implementation of national healthcare insurance in indonesia |
| topic | Healthcare delivery Referral Poor population Primary care Remote population Availability |
| url | http://www.sciencedirect.com/science/article/pii/S2772368222000555 |
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