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All Journal Proceedings of the International Conference on Applied Science and Health Indian Journal of Forensic Medicine & Toxicology Jurnal Jaminan Kesehatan Nasional
Hasbullah Thabrany
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Decision Sciences, Operations Research & Management Dentistry Education Health Professions Medicine & Pharmacology Nursing Public Health

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The Experience of Health Services in Handling Covid-19 Pandemic in Nine Provinces of Indonesia Wahyu Pudji Nugraheni; Risky Kusuma Hartono; Hasbullah Thabrany
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17665

Abstract

Background: Indonesia’s experience in handling the Covid-19 pandemic is essential to prepare for future pandemic.Aim: This research aims to know the experience of health services in handling Covid-19 pandemic in nine provinces of Indonesia.Methods: This research used qualitative and case study approach, with a total of 94 informants coming from all levels of health service agencies from nine provinces in Indonesia. The data collection process was carried out by in-depth interviews, and data analysis were done by means of triangulation of sources between informants.Results: Each province has a variety of local policies with the addition of varying amouns of the budget for handling Covid-19. In addition, the workload of health workers increased after the pandemic, and the availability of facilities, medicines, and single-usage medical materials were deemed inadequate in dealing with the Covid-19 pandemic.Discussions: Accounting for the use of funds for handling Covid-19 as well as increasing surveillance capacity needed to prepare for future pandemic in Indonesia.
DELAYED CLAIM PAYMENT AND THE THREAT TO HOSPITAL CASH FLOW UNDER THE NATIONAL HEALTH INSURANCE SCHEME IN INDONESIA Citra Yuliyanti; Hasbullah Thabrany
Proceedings of the International Conference on Applied Science and Health No. 3 (2018)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Abstract

Background: Indonesia commits to ensure health care access for all population through the National Health Insurance (JKN) managed by the BPJS Health. By February 2018, the JKN covered 193 million people (73% of the total population). To ensure health delivery, 2,104 public and private hospitals are contracted by the BPJS and prospective payment using Case-mix Based Group (CBG) that changes hospital managements. Hospitals become more dependent on payments by BPJS. Delay in claim payment will have serious impact on hospital managements. This study aims to identify current practices in timely payment to hospitals and finding factors correlate with delay in payments. Methods: This study used trend analysis of the secondary claim data of BPJS with the total sample of 57,475 bundles of claims. Total claim population was used in this study. In addition, qualitative study via in-depth interview with six informants consisting of members of National Social Security Council, hospital director of three different classes, and BPJS. Results: This study found 60% of claims were paid within one month (N-1) of claim submission, below the target of 100%. There were tendencies of delays in claim settlements since November 2017. Informants believed that late payments were correlated with non-compliance of doctor to complete medical records, incompetence coders, inadequate management information system, and financial condition of BPJS. There were three main problems faced by hospitals as a result of delay in payments: 1) disturbed drug availability, 2) decreased performance of doctors, 3) poorer maintenance of medical equipment. Conclusion: Delayed in claim payments were occurred and led to a threat of decreasing quality of care to patients. The study suggests the government should fix the problems to protect patients from decreasing quality of care. Hospitals should provide reserve funds to protect them from financial hardship when delays occur. 
Mengukur Kemampuan Mengiur untuk Jaminan Kesehatan Nasional (JKN) tahun 2021 di Indonesia Andhika Nurwin Maulana; farah Purwaningrum; hasbullah thabrany; Yuli Fitrianti; Farida Tri Hartini
Jurnal Jaminan Kesehatan Nasional Vol. 2 No. 1 (2022): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v2i1.51

Abstract

Abstract: The purpose of this study is to conduct measurements of the of Indonesians in the National Health Insurance (JKN) in 2020-2021. Indonesia, as of now, implements a national health insurance service since 2014. It is expected that JKN will expand its coverage to achieve universal health coverage (UHC) in Indonesia. BPJS Kesehatan (BPJS-K) was appointed as the administrator of JKN and had experienced deficit until 2019. One of the weaknesses of JKN in revenue collection is the absence of cross subsidy and pegged contribution in certain level of income that makes the contribution very low for the rich and vice versa for the poor. this, the current study is to increase public awareness that JKN is a cross-subsidy between the rich and the poor in order to produce a more sustainable JKN, better healthcare coverage, and better quality. The methods used in the study are quantitative and qualitative analyses using expenditure data from SUSENAS (National Socio-Economic Survey) data in March 2021 and income analysis from SAKERNAS (National Labor Survey) data in March 2021 to measure the ability to contribute to JKN proportional to their spending and income. In this study several simulations were used to calculate potential contributions based on the percentile distribution of accumulated income levels and expenditure levels of the poorest (0%) and richest (100%). The result of this study shows that 75% of the population had the ability to contribute JKN above the class 3 (informal workers) percapita per month premium (Rp. 42,000,-), 40% of the population has the ability to contribute more than Rp. 100,000, - percapita per month (class 2 informal workers contribution), and the richest 10% of the population has the ability to contribute above Rp. 215,000, - percapita per month. The results of this study demonstrate that some people have the ability to contribute more to JKN, thus making JKN to have a better sustainable financial capacity. Keywords: ability-to-contribute; JKN; income level; spending; increasing rate   Abstrak: Tujuan kajian ini adalah menghitung kemampuan mengiur (ability-to-contribute) penduduk Indonesia untuk Jaminan Kesehatan Nasional (JKN) pada tahun 2020-2021. Indonesia mengimplementasikan sistem jaminan sosial sejak 2014 yang diharapkan ke depannya JKN tersebut akan lebih luas cakupannya untuk mencapai cakupan kesehatan semesta (Universal Health Coverage/UHC). Namun BPJS Kesehatan (BPJS-K) yang ditunjuk sebagai penyelenggara JKN masih mengalami defisit hingga pada tahun 2019. Salah satu kelemahan JKN dalam pengumpulan iuran adalah masih kurangnya subsidi silang dan kontribusi dipatok pada pendapatan tertentu membuat kontribusi sangat rendah bagi si kaya dan sebaliknya bagi si miskin. Maka kajian ini untuk meningkatkan kesadaran penduduk untuk meningkatkan kontribusinya ke JKN dengan subsisi silang antara si kaya dan si miskin agar dapat menciptakan JKN yang lebih berkesinambungan, cakupan kepesertaan yang lebih luas, dan perbaikan mutu layanan. Metode yang digunakan dalam kajian ini adalah metode kuantitatif dan kualitatif dengan analisis pengeluaran menggunakan data SUSENAS (Survei Sosial-Ekonomi Nasional) Maret 2021 dan analisis pendapatan menggunakan data SAKERNAS (Survei Tenaga Kerja Nasional) Maret 2021 untuk mengukur kemampuan individu dalam membayar iuran JKN sebagai proporsi dari pengeluaran pendapatan mereka. Dalam kajian ini beberapa simulasi digunakan untuk menghitung kontribusi potensial berdasarkan persentil distribusi akumulasi tingkat pendapatan dan tingkat pengeluaran penduduk dari termiskin (0%) dan terkaya (100%). Hasil dari kajian ini adalah sebanyak 75% penduduk mempunyai lebih besar dari iuran peserta bukan penerima upah (PBPU) kelas 3 per orang per bulan (Rp. 42.000,-), 40% penduduk mempunyai kemampuan mengiur lebih besar dari Rp. 100.000,- per orang per bulan (setara iuran PBPU kelas 2 per orang per bulan), dan 10% penduduk terkaya mempunyai kemampuan mengiur lebih besar dari Rp. 215.000,- per orang per bulan. Dari hasil kajian ini ditemukan bahwa sebagian orang mempunyai kemampuan mengiur untuk berkontribusi lebih untuk JKN, sehingga JKN dapat mempunyai kapasitas keuangan berkelanjutan yang lebih baik. Kata kunci: kemampuan mengiur; iuran JKN; tingkat pendapatan; pengeluaran; kenaikan iuran        
Co-Authors Andhika Nurwin Maulana Andhika Nurwin Maulana Citra Yuliyanti farah Purwaningrum Farida Tri Hartini firda tania Hartono, Risky Kusuma heni wati Kalsum Komaryani Ruli E Al Faizin Wahyu Pudji Nugraheni Yuli Fitrianti