Cost-Effectiveness Analysis Of The Medical Check-Up Program In Early Detection Of Non-Communicable Diseases (NCDs) At The Main Clinic Of The DPR RI
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Abstract
The DPR RI Main Clinic organizes a Medical Check-Up (MCU) program for employees of the Secretariat General (Setjen) of the DPR RI as an effort to early detect non-communicable diseases (PTM). DEDICATION 2024 Program data (n=1,063) showed a very high prevalence of NCDs: 89.6% of participants had at least one clinical disorder, with a predominance of central obesity (69.0%), hypertension (60.7%), and dyslipidemia (52.6%). Even though the MCU program budget ranges from IDR 1.3 million to IDR 2.5 million per participant, there has never been a formal economic study that calculates the cost efficiency per case of NCDs detected. Analyze the cost-effectiveness of the MCU program in early detection of NCDs at the DPR RI Main Clinic, including calculating the Average Cost-Effectiveness Ratio (ACER), Incremental Cost-Effectiveness Ratio (ICER), and Return on Investment (ROI) in preventing NCDs for four MCU package scenarios (Plan I–IV). Research using mixed methods approach with sequential explanatory design. The quantitative component is descriptive-analytic retrospective based on secondary data from MCU echelon II–IV medical records (n=208, total sampling), 2024 DEDICATION data (n=1,063), and 2022–2024 clinic financial reports. Unit cost calculations use the Activity-Based Costing (ABC) method. The qualitative component uses semi-structured in-depth interviews with 9 key informants based on Edward III's (1980) policy implementation framework. This research will produce ACER, ICER, and ROI values for the four MCU scenarios, as well as identify the implementation factors that have the most influence on program efficiency. Projections of budget requirements for the expansion of the MCU to 2,786 active employees of the Secretariat General of the DPR RI will also be produced based on an economics of scale analysis. Expected The MCU Main Clinic Program of the DPR RI is hypothesized to be cost-effective with an ACER value below the WHO willingness-to-pay (WTP) threshold of 1× Indonesia's GDP per capita (Rp. 66 million/case). Scenarios with greater participant coverage are predicted to produce lower ACER due to the economies of scale effect. The results of the research will be the basis for recommendations for MCU policies that are efficient, high quality and fair for all employees of the Secretariat General of the DPR RI.
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References
Apovian, C. M. (2016). Obesity: Definition, comorbidities, causes, and burden. The American Journal of Managed Care, 22(7 Suppl), s176–s185. https://doi.org/10.37765/ajmc.2016.88379
Chapman, L. S. (2012). Meta-evaluation of worksite health promotion economic return studies: 2012 update. American Journal of Health Promotion, 26(4), TAHP-1–TAHP-12. https://doi.org/10.4278/ajhp.26.4.tahp
Data Kepegawaian Setjen DPR RI. (2026). Laporan bahan rekon gaji pegawai Sekretariat Jenderal DPR RI periode Januari 2026 [Dokumen internal]. Bagian Sumber Daya Manusia Setjen DPR RI.
Data Rekam Medis DEDIKASI Klinik Utama DPR RI. (2024). Rekapitulasi hasil pemeriksaan deteksi dini karyawan Sekretariat Jenderal DPR RI sebelum indikasi (DEDIKASI) tahun 2024 [Dokumen internal]. Klinik Utama DPR RI.
Donabedian, A. (1966). Evaluating the quality of medical care. The Milbank Memorial Fund Quarterly, 44(3), 166–206. https://doi.org/10.2307/3348969
Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart, G. L., & Torrance, G. W. (2015). Methods for the economic evaluation of health care programmes (4th ed.). Oxford University Press.
Edward III, G. C. (1980). Implementing public policy. Congressional Quarterly Press.
Finkler, S. A., Smith, D. L., & Calabrese, T. D. (2019). Financial management for public, health, and not-for-profit organizations (6th ed.). SAGE Publications.
Gold, M. R., Siegel, J. E., Russell, L. B., & Weinstein, M. C. (1996). Cost-effectiveness in health and medicine. Oxford University Press.
Goettler, A., Grosse, A., & Sonntag, D. (2017). Productivity loss due to overweight and obesity: A systematic review of indirect costs. BMJ Open, 7(10), e014632. https://doi.org/10.1136/bmjopen-2017-014632
Kementerian Kesehatan RI. (2018). Riset Kesehatan Dasar (Riskesdas) 2018: Laporan nasional. Badan Penelitian dan Pengembangan Kesehatan Kemenkes RI.
Kementerian Kesehatan RI. (2022). Profil Kesehatan Indonesia 2022. Pusat Data dan Informasi Kemenkes RI.
Neumann, P. J., Sanders, G. D., Russell, L. B., Siegel, J. E., & Ganiats, T. G. (2016). Cost-effectiveness in health and medicine (2nd ed.). Oxford University Press.
Nugroho, A., Siregar, P., & Harahap, R. (2022). Evaluasi program kesehatan korporat di kementerian pemerintah Indonesia. Jurnal Administrasi Kesehatan Indonesia, 10(2), 145–158. https://doi.org/10.20473/jaki.v10i2.2022
Peraturan Pemerintah Republik Indonesia Nomor 28 Tahun 2024 tentang Pemeriksaan Kesehatan Pekerja. (2024). Lembaran Negara RI Tahun 2024 Nomor 28.
Pratama, B. A., & Wahyuni, T. (2021). Efektivitas medical check-up dalam deteksi dini diabetes melitus tipe 2 pada pegawai pemerintah. Jurnal Epidemiologi Kesehatan Indonesia, 5(1), 14–22.
Sari, D. N., & Sulistiadi, W. (2020). Analisis biaya program pemeriksaan kesehatan berkala di RSUD Jakarta. Jurnal Administrasi Kesehatan Indonesia, 8(1), 45–54.
Tim Penyusun Klinik Utama DPR RI. (2025). Konsep penyelenggaraan pemeriksaan kesehatan berkala di Sekretariat Jenderal DPR RI [Dokumen internal, Februari 2025]. Bagian Layanan Kesehatan Setjen DPR RI.
Undang-Undang Republik Indonesia Nomor 17 Tahun 2023 tentang Kesehatan. (2023). Lembaran Negara RI Tahun 2023 Nomor 105.
World Health Organization. (2023). Noncommunicable diseases: Key facts. https://www.who.int/news-room/factsheets/detail/noncommunicable-diseases