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All Journal International Journal of Public Health Science (IJPHS) Jurnal Kebijakan Kesehatan Indonesia Majalah Kedokteran Gigi Indonesia Jurnal Manajemen Kesehatan Indonesia Jurnal Farmasi Sains dan Komunitas Berkala Ilmiah Kedokteran Duta Wacana Jurnal Ners The Journal of Hospital Accreditation (JHA) Jurnal Jaminan Kesehatan Nasional Indonesian Journal of Cancer Berita Kedokteran Masyarakat Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management) JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Academic Hospital Journal
Andreasta Meliala
Departemen Kebijakan Dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, Dan Keperawatan, Universitas Gadjah Mada
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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The Hospital Claims of HIV/AIDS Inpatient at Working Area of BPJS Kesehatan Cabang Mojokerto Sihombing, Gustina Fajarwati; Meliala, Andreasta
Jurnal Jaminan Kesehatan Nasional Vol. 4 No. 1 (2024): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v4i1.186

Abstract

This study aims to see and analyze the inpatient claims of Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome at Mojokerto Hospitals. The research design used is a type 2 case study, namely an embedded single case and uses a qualitative approach. The results of the study show that the largest proportion of HIV/AIDS inpatient JKN patients is the type of Beneficiaries of Contribution Assistance (PBI) membership which is a segment of the underprivileged community. Until now, the Global Fund still contributes significantly to the efforts of the Indonesian government in terms of spending on HIV/AIDS programs. The Indonesian government has not yet had any serious regulations and efforts that lead to optimizing financing independently.
The Caesarean Sections Claims of National Health Insurance in the East Java Region Hospital Mustofa, Tika Rahhmatillah; Meliala, Andreasta
Jurnal Jaminan Kesehatan Nasional Vol. 4 No. 1 (2024): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v4i1.188

Abstract

WHO (2015) sets the standard for sectio caesarea at 10-15%. The proportion of SC deliveries in East Java was 22.4% in 2018, higher than the national average of 17.6%. The burden of JKN financing on childbirth is increasing and is among the top 10 most CBGs cases nationally. As an effort to control quality and control costs, BPJS Health in coordination with the Quality Control Cost Control Team (TKMKB) issued guidelines and self-assessment instruments for cesarean section (SC) in 2020. This study was conducted to explore the picture of SC before and during the implementation of the SC Self-Assessment Instrument in National Health Insurance patients in East Java. Of the 837,809 study subjects, 247,508 (60.5%) had SC delivery. Sectio Caesarea delivery of National Health Insurance patients at FKRTL in East Java is associated with individual factors, namely age and type of JKN membership and service factors, namely SC Self-Assessment Instrument, class of care, severity level, and hospital type. Implementation of the SC Self-Assessment Instrument has not been optimal in reducing the SC rate. A comprehensive strategy is needed to reduce the rate of sectio caesarean delivery, including interventions for pregnant women and families; health workers, health facilities, and professional organizations.
Co-Authors Abdul Azis Aditya Lia Ramadona Agustino, Rizki Anang Anang Andi Sulaimana Anggita Ratna Damayanti Anggoro Budi Hartopo Anggrahini, Dyah Wulan Arifandi Arifandi Armanda Prima Astri Ferdiana Bhintani Embriana Darwito, Darwito Dina Anjayani Dira Mediani Djayanti Sari Dwi Handono Dwi Handono Sulistyo Dwi Handono Sulistyo Dyah Anggraini Fajarwati, Prahesti Faridha Hanum Firman Firman Firman Firman Firman Fitri Haryanti Fitrina Rachmadanty Siregar Gunadi Gunadi Gustina Fajarwati Sihombing Hapsari, Wulandari Indri Henny Marchelina Hilda Mutia Hanum Husna Yulianingsih Ika Widyastuti Arumsari Irene Waine Iwan Dwiprahasto Julita Hendrartini Kartini Hasballah Katherina Adisaputro Khonsa, Oni Khorida, Arifatul Laksono Trisnantoro Laksono Trisnantoro Likke Prawidya Putri Lisma Evareny, Mohammad Hakimi, Retna Siwi Padmawati Lucia Kris Dinarti Lutfan Lazuardi Mariane Erika Pay Mochamat Helmi Mubasysyir Hasanbasri Muhammad Reyhan Hadwiono Mustofa, Tika Rahhmatillah Nilasari Nurjannah Nurjannah Pratiwi, Citra Sari Prima, Armanda Purwoadi Sujatno Qaimamunazzala, Hayu Ratmasari, Dewi Ratna Budi Setiani Resti Dewi Rina K. Kusumaratna Rina Kusumaratna Rizaldy T. Pinzon Rizaldy Taslim Pinzon Rizaldy Taslim Pinzon Ruth Reza Hanggraini Sarto Setyowati Siti Ayu Putriasih Sito Meiyanto Sudirman Sugianto Adisaputro Suryanti Klase Sutena, Marthinus Teny Tjitra Sari Tjahjono Kuntjoro Tri Juli Wati Trismayanti, Ni Made Rika Valentina Dwi Yuli Siswianti Vena Jaladara Vera Otifa Visnu, Jodi Widyawati Wiradhika, Abdul Majid Halim Wiranto Yasmine, Rosanna Yohan Wenas Gunawan Yohana Puji Dyah Utami Yulita Hendrartini Yulita Hendrartini