Comparative Study of Unit Cost-analysis among Urban and Rural Dental Primary Health Services in Padang City, Indonesia

Introduction: The reformation of The Indonesian Health System that became National Health Insurance (NHI) by using capitation method made a significant change in basic healthcare services. Capitation method is influenced by utilisation and unit cost calculation. Puskesmas that stand for Community-based health service is a primary healthcare full financed by Indonesian government capitation and focus on free simple healthcare. Inequalities of puskesmas distribution spread all over Indonesia, including in urban and rural area and impacted the oral health outcome and dental service delivery. Aim: To calculate and to analyse the comparison of dental service-unit cost value after the reformation of Indonesian NHI at the urban and rural puskesmas in Padang City, Indonesia. Materials and Methods: Two of 22 total puskesmas were chosen by random sampling, one puskesmas was representative for urban and rural the counterpart. The data was collected, extracted and analysed the database, then interviewed the two administrative officers at each puskesmas. The Activity Based Costing (ABC) method was used to calculate the unit cost of dental healthcare services. Results: Unit cost of dental service in urban puskesmas was IDR 86,652, and rural was IDR 108,721. Rural puskesmas has high total cost and low activity driver. On the other hand, low total cost with high activity driver was found at urban puskesmas. Conclusion: Rural puskesmas has higher unit cost value than urban puskesmas. Hence, it may help the Indonesian government to distribute equal capitation expenditure on dental service at each puskesmas in Indonesia