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"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. 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. Penelitian dengan desain studi potong lintang ini, menggunakan pendekatan ekonometrik dengan model probit dan bivariat probit. 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. Kepemilikan jaminan kesehatan memberikan perlindungan terhadap belanja kesehatan katastrofik di Indonesia pada Tahun 2012.

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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-ofpocket (OOP). Catastrophic health expenditure of households will disrupt household consumption and can lead to poverty. By using secondary data of the National Social Surveys (Susenas) 2012.

This study aims to prove health insurance ownership lowers catastrophic health expenditure of households in Indonesia in 2012. This study used a cross-sectional study design with models probit and bivariate probit.

The results found that the health insurance ownership lowers catastrophic health expenditure in the amount 12.97% at the threshold 10% of total expenditure and 18.42% at 20% of total non-food expenditure. Health insurance ownership provides protection for catastrophic health expenditure in Indonesia in 2012."

"ABSTRAKBackground: Indonesia is the second-highest country for tuberculosis (TB) incidence worldwide. Hence, it urgently requires improvements and innovations beyond the strategies that are currently being implemented throughout the country. One fundamental step in monitoring its progress is by preparing a validated tool to measure total patient costs and catastrophic total costs. The World Health Organization (WHO) recommends using a version of the generic questionnaire that has been adapted to the local cultural context in order to interpret findings correctly. This study is aimed to adapt the Tool to Estimate Patient Costs questionnaire into the Indonesian context, which measures total costs and catastrophic total costs for tuberculosis-affected households. Methods: the tool was adapted using best-practice guidelines. On the basis of a pre-test performed in a previous study (referred to as Phase 1 Study), we refined the adaptation process by comparing it with the generic tool introduced by the WHO. We also held an expert committee review and performed pre-testing by interviewing 30 TB patients. After pre-testing, the tool was provided with complete explanation sheets for finalization. Results: seventy-two major changes were made during the adaptation process including changing the answer choices to match the Indonesian context, refining the flow of questions, deleting questions, changing some words and restoring original questions that had been changed in Phase 1 Study. Participants indicated that most questions were clear and easy to understand. To address recall difficulties by the participants, we made some adaptations to obtain data that might be missing, such as tracking data to medical records, developing a proxy of costs and guiding interviewers to ask for a specific value when participants were uncertain about the estimated market value of property they had sold. Conclusion: the adapted Tool to Estimate Patient Costs in Bahasa Indonesia is comprehensive and ready for use in future studies on TB-related catastrophic costs and is suitable for monitoring progress to achieve the target of the End TB Strategy."

"As societies become more complex and interconnected, the global risk for catastrophic disasters is increasing. Demand for expertise to mitigate the human suffering and damage these events cause is also high. A new field of disaster medicine is emerging, offering innovative approaches to optimize disaster management. Much of the information needed to create the foundation for this growing specialty is not objectively described or is scattered among multiple different sources. This definitive work brings together a coherent and comprehensive collection of scientific observations and evidence-based recommendations with expert contributors from around the globe. This book identifies essential subject matter, clarifies nomenclature, and outlines necessary areas of proficiency for healthcare professionals handling mass casualty crises. It also describes in-depth strategies for the rapid diagnosis and treatment of victims suffering from blast injuries or exposure to chemical, biological, and radiological agents."

"Indonesia sangat rawan terhadap risiko bencana alam tektonik dan vulkanik gempa bumi, tsunami dan letusan gunung berapi , karena: 1 terletak di antara tiga lempeng tektonik: Indo-Australia, Eurasia dan Pasifik, 2 berada di jalur cincin api 'Asia Pacific Ring of Fire' dengan 127 gunung berapi aktif terbanyak di dunia, dan 3 negara kepulauan terbesar dunia dengan 13.466 pulau. Sudah banyak terjadi bencana alam dari masa lalu hingga sekarang, dan masih akan terjadi lagi di masa depan, hanya waktunya yang tidak pasti. Korban meninggal dunia, cidera dan kerusakan, kehancuran rumah tinggal penduduk sudah jutaan dengan kerugian ekonomi yang sangat besar.Timbul permasalahan dalam aksi rehabilitasi dan rekonstruksi pasca bencana alam untuk rumah tinggal yang telah rusak dan hancur, karena memerlukan biaya yang tidak sedikit. Korban bencana tidak mempunyai uang yang cukup, banyak yang kehilangan sumber penghasilan, sementara anggaran dana pemerintah sangat tidak mencukupi untuk memberikan bantuan dan ganti kerugian, jika terjadi suatu bencana alam katastrofe. Hal itu mengakibatkan rehabilitasi dan rekonstruksi rumah tinggal penduduk tidak bisa dilakukan dengan baik dan cepat, sehingga memperpanjang penderitaan korban bencana alam.Berdasarkan hal tersebut di atas, penelitian ini melakukan studi pada 7 negara paling rawan bencana alam yang telah menerapkan skema asuransi bencana alam untuk mengkaji dan mengganalisis: 1 skema asuransi bencana alam yang tepat diterapkan di Indonesia; 2 peranan reasuransi dan catastrophic bond dalam mendukung skema asuransi bencana alam di Indonesia; dan 3 pembaruan hukum yang diperlukan untuk mewujudkan skema asuransi bencana alam.Penelitian dilakukan dengan metode penelitian hukum normatif dengan analisis data secara juridis kualitatif. Penelitian ini menjawab: 1 skema asuransi bencana alam yang dapat dan tepat diterapkan di Indonesia adalah skema asuransi bencana alam yang bersifat wajib tolong-menolong untuk menjamin setiap rumah tinggal terhadap risiko bencana alam, 2 reasuransi dapat memberikan dukungan terhadap skema asuransi bencana alam di Indonesia dengan jaminan reasuransi dari pasar reasuransi tradisional dan catastrophic bond dapat memberikan jaminan reasuransi innovatif yang lebih besar melalui investor korporasi di pasar modal global; 3 diperlukan pembaruan hukum perasuransian dan hukum penanggulangan bencana untuk mewujudkan skema asuransi bencana di Indonesia.Hasil penelitian ini menyarankan Indonesia penting menyelenggarakan skema asuransi bencana alam rumah tinggal yang sifatnya wajib tolong-menolong untuk risiko gempa bumi, tsunami dan letusan gunung berapi, sehingga penduduk korban bencana alam akan mendapatkan ganti kerugian yang lebih besar dan lebih cepat untuk dapat membangun kembali rumah tinggal mereka yang rusak dan hancur sesuai princip 'build back better' dari deklarasi dan kerangka kerja Sendai 2015-2030.

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Indonesia is very prone to tectonic and vulcanic natural disaster earthquakes, tsunami and volcanic eruptions due to 1 it located between three tentonic plates Indo Australia, Eurasia and Pacific, 2 within the Asia Ring of Fire with 127 active volcanoes, the largest number of active volcanoes in the world, and 3 the largest archipelago country in the world with total number of islands 13,466. A large number of natural disasters calamities have occurred in the past and that will occur again in the future with unknown times and places. Those have caused million fatalities deaths, bodily injuries, damage, destruction to residential buildings houses with huge economic losses.

There is always a serious problem in the rehabilitation and reconstruction of damaged residential buildings houses which needs a lot of fund whilst the victims did not have sufficient fund and they were suffering from loosing sources of income caused by the natural disasters.The government rsquo s annual budget for natural disasters rsquo relief and compensation is very limited, not sufficient, when a catastrophic calamity natural disaster occur. That situation caused rehabilitation and reconstruction program for residential buildings houses cannot be performed well, properly and fast, it prolongs the suffering of the victims. Based on the above description, this research did a study in seven countries prone to natural disasters which have natural disaster insurance schemes for houses.

The objective of this study is to answer the research questions 1 what is the type of natural disaster insurance can and most suitably be implemented in Indonesia, 2 how reinsurace and catastrophic bond can support the natural disaster insurance scheme, and 3 is law amendment necessary for the implementation of natural disaster insurance scheme.

This study use legal normative method research with statute, conceptual and comparative approaches. This study answers 1 a mandatory compulsory natural disaster insurance scheme covering residential buildings houses for earthquake, tsunami and volcanic eruption risks is suitably implemented in Indonesia 2 reinsurance can provide reinsurance coverage from the traditional reinsurance market and catastrophic bond can provide larger innovative reinsurance coverage from corporate investors of the global capital market 3 amendment or change to the current insurance law and disaster mitigation law is necessary for the establishment and implementation of natural disaster insurance scheme in Indonesia.

The result of this study suggests it is necessary for Indonesia to establish and implement a natural disaster insurance scheme for residential buildings houses covering earthquake, tsunami and volcanic eruption risks. With that scheme, homeowners will get larger and faster compensation from the insurers for rebuilding their damaged houses with the principle of ldquo build back better rdquo in accordance with Sendai Declaration and Framework 2015 2030."

"ABSTRAKPenyakit TB menempatkan beban luar biasa bagi penderita, keluarga, masyarakat,dan anggaran pemerintah. Selain kehilangan produktivitas kerja efek palingmendalam adalah penurunan tingkat kesejahteraan bahkan pemiskinan. Tujuanpenelitian ini menganalisis beban ekonomi yang ditanggung pasien dan anggotarumah tangga akibat penyakit Tuberculosis. Merupakan penelitian eksploratifdeskriptif secara retrospektif dengan desain studi cross sectional. Sampel adalahpasien TB Paru BTA + dengan metode pengambilan sample probabilityproportional to size sebanyak 71 pasien.Estimasi total beban ekonomi akibat sakit TB di Kota Bengkulu adalah Rp7.259.600,- atau sebesar 28.48% dari rata-rata pendapatan rumah tangga.Komponen biaya yang paling dominan adalah biaya tidak langsung yaitu sebesarRp 5.134..400,- atau 20.14% rata-rata pendapatan rumah tangga di ikuti biayalangsung sebesar Rp 2.125.200,- (8.34%) rata-rata pendapatan rumah tangga.Pasien dengan penghasilan rendah, umur lebih dari 43 tahun, tidak memilikijaminan kesehatan, memiliki jumlah anggota rumah tangga lebih dari 4,melakukan coping strategy dan pernah menjalani rawat inap akan menangalamikatastropik dibandingkan dengan kelompok lainnya, pada akhirnyamempengaruhi tingkat kesejahteraan dan pemiskinan rumah tangga. Diperlukankajian kebijakan kesehatan yang dapat melindungi rumah tangga dari semua aspekbiaya karena sakit, khususnya TB dalam mengurangi pengeluaran kesehatandalam biaya non medis maupun indirect cost.

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ABSTRACTTuberculosis puts a tremendous burden for patients, families, communities andgovernment budgets. In addition to the work productivity loss, the most profoundeffect is the decrease in the level of well-being even impoverishment. The purposeof this study is analyze the economic burden by patient and households as a resultof Tuberculosis. It is an explanatory retrospective descriptive study with crosssectional design. Total respondents were 71, they were pulmonary TB patientswith smear positive. Sampling technique used probability proportional to size.Estimated total economic burden of illness due to Tuberculosis int the Bengkulucity is Rp 7.259.600, which is 28.48% of the average household income. The mostdominant component costs are indirect costs amounting to RP 5.134.400,-whilethe direct cost is Rp 2.125.200,-. Patients with low income, age over 43 years, donot have health insurance, have a household size of more than 4, do copingstrategy and have ever hospitalized will experience catastrophic compared to othergroups, which then affecting the level of household welfare and poverty. It is aneed to produce a health policy with the that can protect householdsexpencesndue to do TB illness, especially expenses on non medical costs andindirect costs."

"Kapitalisme global, yang lahir dari proses globalisasi, menciptakan budaya konsumsi dan masyarakat konsumen yang eksistensinya dilihat hanya dengan pembedaan komoditi yang dikonsumsi, dengan terus menerus mengkonsumsi berbagai tanda dan status sosial di balik komoditi. Kapitalisme global dalam dirinya sendiri mempunyai daya kemajuan yang bisa mempermudah dan membantu manusia dalam menjalankan aktivitas hidupnya. Namun kemajuan yang sama bisa membawa dunia dalam perubahan yang semakin sulit untuk dikendalikan oleh manusia. Semangat kemajuan yang melekat dalam diri kapitalisme global mempunyai kecenderungan untuk membawa dunia dalam situasi yang penuh dengan ketidakpastian, penuh dengan ketimpangan dan hegemoni. Tulisan ini ingin menelusuri fenomena kapitalisme global ini, mulai dari hal-hal positif yang dihasilkannya sampai pada dampak-dampaknya bagi perubahan kehidupan manusia sebagai masyarakat konsumen.

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Global capitalism, which is born in the globalization process, has created consumption culture and consumer society whose existence is seen just in the differences of their consumption commodities, and on and on consumes the signs and social status that marked on the commodities. In itself, global capitalism has the progressive-power which can help us in our daily live. However, the same progressiveness could bring the world in the unrecoverable and uncontrollable progressiveness. Progressive-power that inherent in the global capitalism has the tendency to lead the world into undetermined, injustice and hegemonic situation. This paper would discover this global capitalism phenomena, includes its positive result and negative effects on human?s live changes as the consumer society."

"ABSTRACTTuberkulosis merupakan salah satu dari banyak penyakit dengan biaya kesehatan yang mahal baik untuk pasien maupun keluarga pasien. Tuberkulosis menyebabkan peningkatan biaya kesehatan, kehilangan pendapatan, dan kehilangan produktifitas bagi pasien untuk bekerja. Penelitian ini menggunakan analisis potong lintang untuk mengetahui perbandingan biaya kesehatan katastropik pasien TB tanpa resistensi obat dengan pasien TB dengan resistensi obat di Jakarta Timur. Dari 159 subjek, diperoleh 97 61 subjek TB tanpa resistensi obat dan 62 39 subjek TB dengan resistensi obat. Dari uji Mann-Whitney didapatkan perbedaan yang bermakna.

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ABSTRACTTuberculosis is one of many diseases with a costly health care either for patients or families in general. Tuberculosis causes an increase in health care costs, loss of income, and productivity losses for patients to work. This study used an cross sectional analysis to compare catastrophic health expenditures in TB patients without drug resistance and in TB patients with drug resistance in East Jakarta. From a total of 159 subjects, obtained 97 subjects 61 suspected TB without drug resistance and 62 subjects 39 suspected TB with drug resistance. In Mann Whitney test, there was a significantly different."

"ABSTRAKKemampuan ekstrak daun Physalis angulata daun ciplukan sebagai inhibitor ramah lingkungan di lingkungan HCl 1 M diinvestigasi menggunakan pengujian polarisasi linear dan weight loss. Adapun diinvestigasi flavonoid dan antioksidan yang menginhibisi permukaan Baja API 5L melalui pengujian FTIR. Variabel bebas yang dipakai yaitu ekstrak konsentrasi inhibitor dalam HCl 1 M, yakni 10 mL, 20 mL, 30 mL, 40 mL, dan 50 mL. Ekstrak daun ciplukan mengandung senyawaan flavonoid yang merupakan inhibitor campuran yang dominan katodik. Inhibitor ini mampu mencegah kerusakan catastrophic akibat agresivitas HCl 1 M dengan mekanisme physisorption hingga 192 jam. Efisiensi inhibitor yang paling tinggi ada di konsentrasi 50 mL sebesar 98,9. Inhibitor ekstrak daun ciplukan berpotensi sebagai inhibitor ramah lingkungan bagi Baja API 5L dilingkungan HCl 1 M.

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ABSTRACTThe ability of Physalis angulata leaves extract as green inhibitor in HCl 1 M environment has been investigated with linear polarization measurement and weight loss method. FTIR analysis was used to investigate flavonoid and antioxidant compound that plays an important role to inhibit corrosion. The free variable that has been used in this study was 10 mL, 20 mL, 30 mL, 40 mL, dan 50 mL. Physalis angulata leaves extract that contain flavonoid play role as mixed inhibitor that predominantly cathodic. This inhibitor can prevent cathasthropic damage due to aggressiveness of HCl 1 M with physisorption mechanism up to 192 hours. The concentration that showed highest efficiency 98.9 was 50 mL. It can be concluded that Physalis angulata leaves extract could be used as an alternative and environmental friendly inhibitor for API 5L in HCl 1 M environment."

"Penelitian ini membahas tentang peran Jaminan Kesehatan Nasional terhadap pengeluaran biaya kesehatan tunai katastropik penduduk lanjut usia di Provinsi Daerah Istimewa Yogyakarta dengan menggunakan data sekunder Susenas Kor Tahun 2018. Tujuan dari penelitian ini adalah diketahuinya peran Jaminan Kesehatan Nasional terhadap penurunan risiko pengeluaran biaya kesehatan tunai katastropik, diketahuinya proporsi kejadian pengeluaran biaya kesehatan tunai katastropik, serta faktor-faktor yang berhubungan dengan pengeluaran biaya kesehatan tunai katastropik pada penduduk lansia di Provinsi DI Yogyakarta. Unit analisis penelitian ini adalah individu lansia dengan jumlah sampel yang memenuhi kriteria inklusi dan eksklusi sebanyak 806 orang. Analisis multivariat pada data dilakukan dengan pendekatan model regresi binary choice model dengan model Logit. Hasil penelitian didapatkan bahwa proporsi kejadian pengeluaran biaya kesehatan tunai katastropik sebesar 4,34% di antara penduduk lansia di Provinsi DI Yogyakarta. Faktor-faktor yang secara statistik berhubungan signifikan dengan pengeluaran biaya kesehatan tunai katastropik meliputi pendidikan, jumlah anggota rumah tangga, pemanfaatan JKN, dan utilisasi rawat inap. Hasil penelitian ini juga mendapatkan bahwa Jaminan Kesehatan Nasional berperan menurunkan risiko kejadian pengeluaran kejadian katastropik sebesar 0,2 kali lebih rendah bagi penduduk lansia yang memanfaatkannya pada layanan kesehatan.

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This study discusses the role of the National Health Insurance against catastrophic out of pocket health expenditures among the elderly in The Special Region of Yogyakarta using 2018 Core Susenas secondary data. The study intends to examine the proportion of catastrophic out of pocket health expenditure, analyze the factors related to catastrophic out of pocket health expenditure in the elderly population, as well as assess the role of the national health insurance in the special region of Yogyakarta. The unit of analysis of this study were elderly individuals who met the inclusion and exclusion criteria, with a total sample of 806 people. Multivariate analysis of the data was carried out using the binary choice model regression approach with the Logit model.

The results showed that the proportion of catastrophic out of pocket health expenditure was 4.34% among the elderly population in The Special Region of Yogyakarta, a proportion that is still considered managable. Catastrophic out of pocket health expenditures indicated a statistically significant correlation with education, number of household members, JKN utilization, health complaints, and utilization of inpatient care. Moreover, National Health Insurance played a role in reducing the risk of catastrophic events resulting in 0.2 times lower occurance for elderly residents who use them in health services."

"Guncangan kesehatan berupa gangguan penyakit kronis memiliki pengaruh tidak hanya kepada penderitanya namun juga anggota rumah tangga lainnya termasuk kemungkinan keterlibatan anak untuk bekerja. Mayoritas penyakit kronis menimbulkan morbiditas, mortalitas serta biaya kesehatan yang tinggi (penyakit katastropik). Penelitian ini bertujuan untuk menganalis hubungan penyakit kronis anggota rumah tangga terhadap jam kerja anak di Indonesia dengan menggunakan data IFLS-5 2014. Dengan menggunakan metode estimasi Ordinary Least Square (OLS), hasil penelitian ini dapat disimpulkan bahwa tidak ada hubungan antara jumlah anggota rumah tangga yang menderita penyakit kronis serta biaya kesehatan katastropik rumah tangga dengan jam kerja anak. Selain itu, tidak ada hubungan adanya finansial katastropik dan jaminan kesehatan dalam rumah tangga terhadap jam kerja anak. Variabel bebas kontrol yaitu umur anak, jenis kelamin anak, partisipasi sekolah anak, lapangan pekerjaan kepala rumah tangga, tempat tinggal dan jumlah anggota rumah tangga mampu menjelaskan hubungannya dengan jam kerja anak.

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Health shocks in the from of chronic disease disorders have an effect not only on the sufferer but also on other household members including the possibility of children's involvement in work. The majority of chronic diseases cause morbidity, mortality and high health costs (catastrophic disease). This study aims to analyze the relationship between chronic disease of household members and working hours of children in Indonesia using IFLS-5 2014 data. By using the Ordinary Least Square (OLS) estimation method, the results of this study can be concluded that there is no relationship between the number of household members who suffer from chronic diseases and catastrophic health expenditure for households with working hours of children. The independent control variables consist of the age of the child, the sex of the child, the child's school participation, the employment of the head of the household, the place of residence and the number of household members were able to explain the relationship with the working hours of children."