38. Exploratory Analysis of Industrial Hygiene Data From Non-Manufacturing Facilities: Using Analysis of Variance and the Proportional Odds Model to Develop Similar Exposure Groups

Purpose The operation safety of the high-speed railway has been widely concerned. Due to the joint influence of the environment, equipment, personnel and other factors, accidents are inevitable in the operation process. However, few studies focused on identifying contributing factors affecting the severity of high-speed railway accidents because of the difficulty in obtaining field data. This study aims to investigate the impact factors affecting the severity of the general high-speed railway. Design/methodology/approach A total of 14 potential factors were examined from 475 data. The severity level is categorized into four levels by delay time and the number of subsequent trains that are affected by the accident. The partial proportional odds model was constructed to relax the constraint of the parallel line assumption. Findings The results show that 10 factors are found to significantly affect accident severity. Moreover, the factors including automation train protection (ATP) system fault, platform screen door and train door fault, traction converter fault and railway clearance intrusion by objects have an effect on reducing the severity level. On the contrary, the accidents caused by objects hanging on the catenary, pantograph fault, passenger misconducting or sudden illness, personnel intrusion of railway clearance, driving on heavy rain or snow and train collision against objects tend to be more severe. Originality/value The research results are very useful for mitigating the consequences of high-speed rail accidents.

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Analysis Of Risk for Class Shifting And Determinants of BPJS Kesehatan Membership Using Generalized Ordered Logit-Unconstrained Partial Proportional Odds Model

Jurnal Ekonomi Kesehatan Indonesia ◽

10.7454/eki.v4i2.3390 ◽

2020 ◽

Vol 4 (2) ◽

Author(s):

Siskarossa Ika Oktora ◽

Ika Yuni Wulansari ◽

Geri Yesa Ermawan

Keyword(s):

Lower Class ◽

Proportional Odds Model ◽

Ordered Logit ◽

Class Iii ◽

Proportional Odds ◽

Medical Benefits ◽

Partial Proportional Odds Model ◽

Generalized Ordered Logit ◽

The Difference ◽

Premium Contributions

Abstract The main source of funding of BPJS Kesehatan comes from the different premium class in which the participant registered. The medical benefits among classes are equivalent, except inpatient facilities. But when the improvement health degree is not linear with the incurred costs, problem would arise. This study aims to analyze class shifting and determinants of BPJS Kesehatan mem- bership. Around 1.53 percent of participants access higher classes, while 5.62 percent access lower classes. Class III participants with inpatient status severity level 2 and 3, reaching 41% and 43%, respectively. In addition, 60% of non-PBI participants are Class II premium participants; most of them are male, productive age, and workers. This research using Generalized Ordered Log- it-Unconstrained Partial Proportional Odds Model concludes that participants who are married tend to choose higher premium class. Whereas productive age participants and a worker is in the lower premium class. The recommendation is the evaluation of membership based on class premium contributions considering potential participants (productive age and workers) who tend should be conducted in a lower class. Although mutual assistance is the principle of National Health Insurance, specific mechanisms should be established to examine the relation of age and health status to each participant regarding the difference in the registered class, besides their economic factors. Abstrak Pendanaan utama BPJS Kesehatan adalah iuran peserta yang besarnya tergantung dari kelas premi yang didaftarkan peser- ta. Manfaat medis setiap kelas adalah setara kecuali fasilitas ruang inap. Di sisi lain, hal ini dapat menimbulkan permasalahan ketika derajat kesehatan tidak linier dengan biaya yang seharusnya dikeluarkan. Penelitian ini bertujuan untuk melihat per- bedaan antara kelas premi saat peserta mengakses pelayanan kesehatan dengan kelas premi yang didaftarkan. Ditemukan 1,53 persen peserta mengakses kelas lebih tinggi dibanding kelas yang terdaftar, dan 5,62 persen peserta yang mengakses kelas lebih rendah dibanding kelas yang terdaftar. Berdasarkan tingkat keparahan saat menjalani rawat inap, diketahui bah- wa peserta kelas III dengan status rawat inap tingkat keparahan 3 (berat) dan 2 (sedang) masing-masing mencapai 41% dan 43%. Selain itu hampir 60 persen peserta yang membayar iuran sesuai dengan ketentuan yang ditetapkan (non PBI) adalah peserta iuran premi Kelas II yang sebagian besar merupakan peserta laki-laki, berusia produktif, dan berstatus sebagai pekerja. Hasil analisis dengan metode Generalized Ordered Logit-Unconstrained Partial Proportional Odds Model disimpulkan bahwa peserta berstatus kawin cenderung berada pada kelas premi yang lebih tinggi. Sedangkan peserta usia produktif serta peserta dengan status pekerja cenderung berada pada kelas premi yang lebih rendah. Rekomendasi yang diberikan adalah evaluasi kepesertaan berdasarkan iuran premi kelas dapat dilakukan kembali mengingat peserta potensial (usia produktif dan berstatus sebagai pekerja) cenderung berada pada kelas yang lebih rendah. Selain itu meskipun asas gotong royong menjadi prinsip pelaksanaan Program JKN, namun sebaiknya dapat dibuat mekanisme tertentu agar dapat dicermati terkait dengan faktor usia dan derajad kesehatan peserta terhadap perbedaan kelas premi peserta yang didaftarkan tanpa mengabaikan kemampuan ekonomi yang bersangkutan.

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