Abstract
Objective: To formulate a convergent and consensus expert panel to calculate normative drug cost in the top twenty diseases in primary care. Method: In the first round, the expert panel define a list of consensus statements based on data derived from non-systematic reviews of treatment standard for the top twenty disease in primary care. In the second round, experienced doctors in treatment at primary care were involved to express individual consent to the statements using questionnaire. Face-to-face meeting were held simultaneously with filling questionnaire. Consensus was defined as 75% agreement. Result: Delphi process at the first round, the expert panel consisting of 11 doctors in primary care defined a list of 60 statements from 20 diseases on the treatment standard calculated the normative cost of acute and chronic disease in primary care. The second round involved 11 doctors who are experienced in primary care with more than 6 years’ experience in doing treatment in primary care. Conclusion: The identified consensus statement can help doctors to apply the normative cost calculation results on the top 20 diseases in primary care as evidence based policy study material for calculating the percentage of drug cost in the capitation system in Indonesia. Bangladesh Journal of Medical Science Vol. 21 No. 02 April’22 Page : 291-301
Highlights
World Health Organization (WHO) determines that Universal Health Coverage(UHC) is ankey problem for developed and developing country, so it is important for the countries to develop a health financing system with the aim of ensuring health for all people[1]
Health insurance according to Ministry of Health Regulation Number 71 of 2013 is defined as insurance in the form of health protection so that the participant receive healthcare benefit and protection in fulfilling basic health needs provided to everyone who have pair the dues or contribution are paid by the government 2.All insurance participant are registered at the First Level Health Facility and provide nonspecialized care and they can visit without a prior appointment 3
There are two groups in this modified method. (1) working group consist of researcher who organized the instrument based on literature review (2) consensus group member of the expert panel who is considered capable of providing input on the cost of normative drug in primary care
Summary
World Health Organization (WHO) determines that Universal Health Coverage(UHC) is ankey problem for developed and developing country, so it is important for the countries to develop a health financing system with the aim of ensuring health for all people[1]. National Health Insurance (NHI) in Indonesia has been implemented since January 1st, 2014. Health insurance according to Ministry of Health Regulation Number 71 of 2013 is defined as insurance in the form of health protection so that the participant receive healthcare benefit and protection in fulfilling basic health needs provided to everyone who have pair the dues or contribution are paid by the government 2.All insurance participant are registered at the First Level Health Facility and provide nonspecialized care and they can visit without a prior appointment 3. Canada incurred 29% for the cost of hospital care and the Western Europe countries incurred less than 40%while in Indonesia, the cost of hospital care is very high, it reach around 60%4. The concept of capitation system, in the form of prevention and promotion, intrinsically changes the orientation of health services from curative to preventive[5]. In 2016, a new regulation set the standard for the implementation of capitation system in primary services on capitation rates.
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