Plenary Session. 1. Challenges-opportunity of Cvd Services in Universal Coverage. Dr. Anwar Santoso...

Anwar SantosoDept. of Cardiology Faculty of Medicine; University of Indonesia

National Cardiovascular Centre Harapan Kita HospitalPresident of Indonesian Heart Association

Jakarta - Indonesia

Challenges (Opportunity) in

Cardiovascular Services

in Universal Coverage Era

Promotif Preventif Kuratif Rehabilitatif

PARADIGMA PRAKTIK KESEHATAN/KEDOKTERAN SAAT INI: PENDEKATAN SAKIT!

(PERLU PENATAAN SISTEM PELAYANAN KESEHATAN/KEDOKTERAN DAN SISTEM PEMBIAYAAN SECARA PARALEL)

SAAT INI

Orientasi PraktikKedokteran/Pelayanan Kesehatan

??

Under 5-y mortality rates in South-East Asia 1970 - 2010

Chongsuvivatwong V et.al. The Lancet 2010; 377: 429 - 37 3

Average life expectancy at birth in Southeast Asia 1950 - 2010

Chongsuvivatwong V et.al. The Lancet 2010; 377: 429 - 37 4

Better economic growth drives

increased CV risk factors

Percentage of Central Obesity based on

Basic Health Research 2007 & 2013

Indonesia Basic Health Research 2013


Prevalence of Dyslipidemia by gender and

residence in Basic Health Research 2013

Male Female Urban Rural

Prevalences of Hypertension based on


Predictors of Hypertension in urban

population in Indonesia

Risk factors ORadj 95% CI P

Age:

18 34 years

35 54 years

55+ yeasr

1

2.45

6.95

2.22 2.70

6.14 7.90

0.0001

Blood sugar:

Normal

IGT

DM

1

1.35

1.95

1.19 1.54

1.65 2.30

0.0001

Overweight

BMI > 25 1.80 1.61 2.00 0.0001

Low education

Complete high school vs lower 1.54 1.40 1.68 0.0001

Abdominal obesity 1.52 1.36 1.69 0.0001

(Indonesia Basic Health Research 2007)

Prevalences of Diabetes Mellitus based on



Prevalence of Smoking in Indonesia

2007-2013

34,236,3

0

10

20

30

40

2007 2013

Series 1

Year

%



Prevalences of Stroke per 1000*) by

provinces 2007 - 2013

Indonesia Future Trend-Economy

Health Expenditure in Indonesia

Indonesia Health Expenditure

National Health Insurance Scheme

Scope of JKN Benefit

Medicines components in JKN:Medicines list and proces covered by BPJS will be regulated by MoH(UU SJSN ps 25, Perpres Jamkes ps 32)

Courtesy: dr S. Soeryanata 2015

Distribution of Cardiologist & Internist in Indonesia

(updated 2014)


Increased awareness of ACS to Action


Household air pollution

50% reduction in

SFU for cooking

Essential NCD

medicines and

technologies

80% coverage

Drug therapy &

counseling

50% coverage

Diabetes/obesity

0% increase

Raised blood

pressure

25% reduction

Tobacco use

30% reduction

Salt/sodium intake

30% reduction

Physical inactivity

10% reduction

Harmful use of alcohol

10% reduction

Regional Targets for NCD

25% reduction in NCD mortality

by 2025

Risk FactorNational System ResponseRegional Target

Conclusions

Though good economic prospect in Indonesia financial budget for health sector is still limited.

Better economic growths and urbanization lead to increased CVD risk factors

Universal coverage in Indonesia would be reshaping health care system should be mostly relied on health promotion and prevention

Conclusions

Each Asia-Pacific country faces a unique set of barriers that prevent optimal translation of evidence-based guideline

recommendations into practice

Establishing cardiac networks and local/individual hospital models/clinical pathways will be central to optimization of

ACS medical management in the

Asia-Pacific region

Plenary Session. 1. Challenges-opportunity of Cvd Services in Universal Coverage. Dr. Anwar Santoso...

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