Laksono Trisnantoro
Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran Kesehatan Masyarakat dan Keperawatan Universitas Gadjah Mada

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ANALISIS IMPLEMENTASI LAYANAN JANTUNG PROGRAM JKN DI PROVINSI NTT TAHUN 2019 (Analysis of cardiovascular services utilization in the JKN program in NTT Province in 2019) Edit Oktavia Manuama; Stevi Ardianto Nappoe; Tri Aktariyani; M. Faozi Kurniawan; Laksono Trisnantoro
Jurnal Kebijakan Kesehatan Indonesia Vol 10, No 3 (2021): Special Issues
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.66583

Abstract

Keterbatasan fasilitas kesehatan dan tenaga kesehatan yang terjadi di NTT berdampak pada penyerapan dana JKN yang semakin kecil. Adanya ketimpangan rasio dokter juga berpengaruh terhadap mutu layanan kesehatan. Artikel ini bertujuan untuk melihat implementasi JKN di NTT dilihat dari: 1) tata kelola; 2) sisi ketersediaan dan mutu layanan jantung. Penelitian ini merupakan penelitian evaluative dengan design mix methods di mana menggabungkan design kualitatif dan kuantitatif. Hasil penelitian menunjukan bahwa kelompok PBI yang menjadi sasaran program JKN sudah dapat menggunakan layanan. Namun secara umum, jika dilihat dari angka absolut penggunaan layanan mungkin masih jauh dari kebutuhan. Data BPS menunjukkan bahwa 84% kematian terjadi di rumah. Selain itu, pada aspek tata kelola, transparansi dalam JKN belum terwujud. Implementasi JKN dari aspek tata kelola dan ekuitas khusus pada layanan jantung di Provinsi NTT belum berjalan optimal The limitations of health facilities and health workers in NTT province have an impact on the limited absorption of JKN funds in this region. The ratio of doctor specialist also affects the quality of health services. This is an analysis of the utilization of cardiovascular services in NTT. Using a mixed-method study, this study aims to evaluate the implementation of JKN in a rural area in terms of governance, availability, and quality of cardiovascular services.  This study found that the PBI groups (poor), the main target of the JKN program, has been able to access cardiovascular services. However, based on the absolute figures, underutilization of cardiovascular care services is recorded which is likely far below the actual needs.  Transparency in JKN policy remains a significant issue. In conclusion, the implementation of JKN  has not run optimally to achieve its objective to promote good governance and equity in cardiovascular in NTT province.  
An Exploration study into Good Governance and Equity Aspects of JKN Program in Cardiovascular Care Services in Central Java, Indonesia Suryani Yulianti; Edit Oktavia Manuama; Tri Aktariyani; Tiara Marthias; Laksono Trisnantoro
Jurnal Kebijakan Kesehatan Indonesia Vol 10, No 3 (2021): Special Issues
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.68350

Abstract

To achieve equitable access of its citizen to health care, since 2014, the Government of Indonesia has implemented the national health insurance scheme, namely JKN. However, equal access to specialistic health care is still challenging. Using a convergent parallel mixed-method approach, and the utilization of cardiovascular services as an example, this study aims to evaluate the good governance and equity aspects of the JKN program in Central Java, a province in Indonesia which records a high poverty rate above the national rate. Based on IHME, Central Java has the highest proportion of mortality associated with cardiovascular diseases among the provinces in Indonesia. This study found that most of the districts in this province are struggling to achieve the 2019 JKN roadmap target in terms of JKN participation coverage.  Unequal distribution of health facilities and human resources is recorded affecting access to and utilization of cardiovascular care services. More contribution from the district and provincial government as well participation from private sectors (the employers) to fund the JKN program is essential to ensure the availability of specialistic care services in rural areas to narrow the gaps in cardiovascular care services.