Article Sidebar

Submitted
17 July 2025
Accepted
2 October 2025
Published
30 December 2025
Download
PDF
Statistic
Read Counter : 530 Download : 302

Main Article Content

Abstract

Preterm birth and low birth weight are major contributors to neonatal morbidity, mortality, and healthcare costs in Indonesia. This study investigates how maternal risk factors and hospital characteristics jointly influence length of stay and inpatient costs for preterm and low birth weight infants covered by the national health insurance program (JKN) in 2022–2023. Using a retrospective cohort of administrative claims data and multilevel generalized linear models, we find that younger maternal age, neonatal complications, and concurrent diagnoses of prematurity and low birth weight significantly increase both length of stay and costs. Infants from non-government-subsidized members group (PBI – Penerima Bantuan Iuran) and those admitted to referral or public hospitals experience longer stays, while regional tariff differences and hospital ownership shape cost variations. By linking maternal risk, facility capacity, and financial burden under Indonesia’s case-based payment system (INA-CBGs – Indonesia Case-Based Groups), this study highlights pathways to improve neonatal care efficiency. Strengthening antenatal services and referral systems may help reduce avoidable admissions and optimize resource use.

Keywords

Inpatient Costs Length of Stay Low Birth Weight National Health Insurance Preterm Birth

Article Details

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite
Kurniawan, F., Yulianty Permanasari, V. ., Nadjib, M., & Chandra Nugraha, E. . (2025). Hospitalization Costs and Duration for Preterm and Low Birth Weight Infants under National Health Insurance. Jurnal Jaminan Kesehatan Nasional, 5(2), 169–183. https://doi.org/10.53756/jjkn.v5i2.377
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. Anggondowati, T., et al. (2017). Maternal characteristics and obstetrical complications impact neonatal outcomes in Indonesia: A prospective study. BMC Pregnancy and Childbirth, 17(1).
  2. Ardissino, M., et al. (2022). Maternal Hypertension Increases Risk of Preeclampsia and Low Fetal Birthweight: Genetic Evidence from a Mendelian Randomization Study. Hypertension, 79(3), 588–598.
  3. Ariawan, I., et al. (2022). Data Sampel BPJS Kesehatan. BPJS Kesehatan.
  4. Thalib, A.L., Abdullah, M.N.A. (2024). Dampak Tingginya Early-Age Marriage Terhadap Kelahiran Prematur dan Bayi Berat Badan Lahir Rendah (BBLR). SABANA: Jurnal Sosiologi, Antropologi, dan Budaya Nusantara, 3(3), 249–257.
  5. Atinuke, A., Shola, A., & Mark, G. (2015). Empirical analysis of factors associated with neonatal length of stay in Sunyani, Ghana. Journal of Public Health and Epidemiology, 7(3), 59–64.
  6. Beam, A.L., et al. (2020). Estimates of healthcare spending for preterm and low-birthweight infants in a commercially insured population: 2008–2016. Journal of Perinatology, 40(7), 1091–1099.
  7. Chafik, K., et al. (2023). Factors associated with neonatal near miss: Case of the University Hospital Center IbnSina of Rabat Morocco 2021. Journal of Neonatal-Perinatal Medicine, 16(1), 105–110.
  8. Darmstadt, G.L., et al. (2023). New World Health Organization recommendations for care of preterm or low birth weight infants: health policy. eClinicalMedicine, 63.
  9. de Melo, T.F.M., et al. (2022). Direct costs of prematurity and factors associated with birth and maternal conditions. Revista de Saude Publica, 56.
  10. BPS, Kemenkes RI, USAID, et al. (2017). Survei Demografi dan Kesehatan Indonesia. BPS.
  11. Deressa, A.T., & Desta, M.S. (2023). Prevalence and Determinants of Neonatal Near Miss in Ethiopia: A Systematic Review and Meta-Analysis. PLoS ONE, 18.
  12. Doku, D.T., & Neupane, S. (2017). Survival analysis of the association between antenatal care attendance and neonatal mortality in 57 low- And middle-income countries. International Journal of Epidemiology, 46(5), 1668–1677.
  13. Espinoza, E., et al. (2021). Modeling the Count Data of Public Health Service Visits with Overdispersion Problem by Using Negative Binomial Regression. Journal of Physics: Conference Series.
  14. Subagja, S.F., et al. (2024). Hubungan Usia Ibu Hamil dengan Kejadian Berat Bayi Lahir Rendah di Ruang Bersalin RSUD Kabupaten Sumedang. Jurnal Ners, 8(2).
  15. Fu, M., et al. (2023). Risk factors for length of NICU stay of newborns: A systematic review. Frontiers in Pediatrics, 11.
  16. Goisis, A., et al. (2017). Advanced Maternal Age and the Risk of Low Birth Weight and Preterm Delivery: A Within-Family Analysis Using Finnish Population Registers. American Journal of Epidemiology, 186(11), 1219–1226.
  17. Kemenkes RI. (2023). Survei Kesehatan Indonesia 2023. Kemenkes RI.
  18. Krasevec, J., et al. (2022). Study protocol for UNICEF and WHO estimates of global, regional, and national low birthweight prevalence for 2000 to 2020. Gates Open Research, 6.
  19. Liznindya. (2023). Hubungan Usia Ibu Hamil dengan Kejadian Bayi Berat Lahir Rendah (BBLR) di Desa Serangmekar Ciparay Kab. Bandung Tahun 2021. Jurnal Ilmiah Indonesia, 3(1).
  20. Mahovo, R., & Velaphi, S. (2020). Duration of Hospital Stay and Factors Associated with Prolonged Hospital Stay in Very Low Birth Weight Infants Surviving to Hospital Discharge. Journal of Pediatrics, Perinatology and Child Health, 3(4).
  21. Nainggolan B.C., Sitompul M. (2019). Hubungan Berat Badan Lahir Rendah (BBLR) dengan Kejadian Stunting pada Anak Usia 1-3 Tahun. Nutrix Journal, 3(1).
  22. Novianti, I., Mardianti, D., Safitri Muchtar, A. (2020). Pemberian ASI dan BBLR Berhubungan dengan Kejadian Stunting pada Balita Usia 12-36 Bulan. Jurnal Kebidanan, 6(3).
  23. Nurwahyuni, A. (2015). Pengembangan Model Penetapan Tarif Rawat Inap di Rumah Sakit Berdasarkan INA-CBG (Studi Kasus CMG O). Universitas Indonesia.
  24. Nurwahyuni, A., Setiawan, E. (2019). Kinerja Rumah Sakit Swasta dengan Pembayaran INA-CBGs di Era Jaminan Kesehatan Nasional: Casemix, Casemix Index, Hospital Base Rate. Jurnal Ekonomi Kesehatan, 4(2).
  25. Persson, M., et al. (2018). Association of Maternal Diabetes With Neonatal Outcomes of Very Preterm and Very Low-Birth-Weight Infants An International Cohort Study. JAMA Pediatrics, 172(9), 867–875.
  26. Prashanti, N.A.P., et al. (2023). Risk Factors Affecting Length of Stay in Preterm Infants at Wangaya Regional General Hospital, Indonesia. Bioscientia Medicina: Journal of Biomedicine and Translational Research, 8(1), 3892–3901.
  27. Rolnitsky, A., et al. (2023). The price of neonatal intensive care outcomes – in-hospital costs of morbidities related to preterm birth. Frontiers in Pediatrics, 11.
  28. Sámano, R., et al. (2024). Low Antenatal Care Number of Consultations Is Associated with Gestational Weight Gain and Birth Weight of Offspring of Teenage Mothers: A Study Based on Colombian and Mexican Cohorts. Nutrients, 16(21).
  29. Sharma, D., & Murki, S. (2021). Making neonatal intensive care: cost effective. Journal of Maternal-Fetal and Neonatal Medicine, 34(14).
  30. Su, Z., et al. (2022). Increased Risk for Respiratory Complications in Male Extremely Preterm Infants: A Propensity Score Matching Study. Frontiers in Endocrinology, 13.
  31. UNICEF. (2024). Neonatal mortality. UNICEF.
  32. Wahyuni, W., et al. (2021). Hubungan Usia Ibu, Paritas dan Kadar Hemoglobin dengan Kejadian Bayi Berat Lahir Rendah (BBLR) di RSUD Siti Fatimah Provinsi Sumatera Selatan Tahun 2020. Jurnal Keperawatan Sriwijaya, 8(2).
  33. WHO. (2020). Newborns: Improving Survival and Well-Being. WHO.
  34. WHO. (2022). WHO recommendations for care of the preterm or low-birth-weight infant. WHO.
  35. Zhou, J., et al. (2023). Estimating Costs Associated with Disease Model Stages Using Generalized Linear Models: A Tutorial. Pharmacoeconomics, 42(3), 261–273.