Evaluasi Cost-Effectiveness Pembiayaan Jaminan Kesehatan Nasional pada Pengobatan Tuberkulosis
Abstract
Tuberculosis (TB) is still a major public health problem in Indonesia and imposes a significant economic burden on the health system. The National Health Insurance (JKN) plays an important role in ensuring access to TB treatment, but the efficiency of financing needs to be evaluated. This study aims to evaluate the cost-effectiveness of JKN financing in the treatment of tuberculosis in Semarang City. This study is an observational quantitative study with a cross-sectional design. The study population is 6,527 TB cases in Semarang City in 2023, with a sample of 99 patients determined using the Slovin formula (α = 10%). Cost data was obtained from administrative data on JKN claims which included drug, laboratory, radiology, and nursing costs, while effectiveness data was collected through patient questionnaires related to changes in cough conditions and ability to carry out daily activities. The analysis was carried out through descriptive analysis, cost analysis, effectiveness analysis, and Cost-Effectiveness Ratio (CER) calculation. The results showed that the average cost of TB treatment per patient was ±Rp2,787,914. In terms of effectiveness, as many as 35% of patients experienced improvement in cough conditions, while 61% of patients did not experience limitations in daily activities after undergoing treatment. The Cost-Effectiveness Ratio (CER) value of Rp7,965,468 shows the amount of cost required to produce one patient with an effective clinical outcome based on the indicators used. These findings indicate that JKN financing has supported the success of TB treatment, but still this CER value only describes the relationship between JKN financing costs and clinical outcomes, so it cannot be used to conclude that JKN financing has or is not cost-effective because this study does not use a comparator or cost-effectiveness threshold. This study emphasizes the need to strengthen more efficient financing strategies and optimize TB services to increase the effectiveness of tuberculosis control programs.
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Copyright (c) 2026 Rizkiyatul Amalia, Eliyah, M. Rifqi Aufa Daffa, Donal Nababan, Rakhmat Alyakin Dakhi
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