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All Journal SOEPRA Jurnal Hukum Kesehatan
Yohanes Budi Sarwo
Master of Health Law, Soegijapranata Catholic University Semarang
Health Professions Law, Crime, Criminology & Criminal Justice Social Sciences

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Application of the Principle of Portability for Participants of National Health Insurance outside the Domicile Area in Gaining Access to Health Services in the City of Semarang Marni Dominika Oenunu; Yohanes Budi Sarwo; Daniel B. Wibowo; Endang Wahyati Yustina
SOEPRA Vol 7, No 1: Juni 2021
Publisher : Universitas Katolik Soegijapranata Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24167/shk.v7i1.2017

Abstract

Abstract: The portability principles in the National Health Insurance Program (JKN) implementation are principles that guarantee JKN participants whenever and wherever they are as far as in the Indonesian area. This includes any participant who moves his/her job or residence, has a vacation, does a study or does other business. This happens in all areas in Indonesia, including in Semarang City. The philosophical base for the implementation of the portability principle is the right to access health services. When suffering sick a JKN participant should receive his or her health insurance rights by possibly accessing health services at the nearest degree of First Level Health Facility. However, the fact was that remained facing obstacles. The purpose of this study was to obtain an overview of the form regulations, the factors influencing the implementation of portability principles for out-domiciled JKN participants in getting access to health services at Semarang City. This study used a socio-legal approach having a descriptive-analytical specification. The primary data of this study were obtained through interviews with the Health Social Security Organizing Agency (BPJS) of Semarang Branch and five health centre’s heads, namely Pandanaran, Sekaran, Ngesrep, Srondol, and Kedungmundu health centres beside 25 out-domiciled JKN participants of Semarang as informants. The sampling technique used purposive sampling with qualitative analysis. The implementation of the portability principles for out-domiciled JKN participants in getting access to health services at Semarang City, especially in the 5 health centres does not go well. The form regulations of the implementation portability principles based on a circular letter issued by Health BPJS Office of Semarang Branch number 766 / VI-01/0518 on Out-Domiciled Participant Services of FKTP is maximum visit limit 3 times which is contrary to the portability principles in Article 4 of Act No. 40 of 2004 on National Social Security System and Act No. 24 of 2011 on the Social Security Organizing Agency. Need for technical regulations in the form of a binding Minister Decree concerning requirements, administrative procedures, and service procedures for the implementation of portability principles. Juridical factors influencing were there are no technical regulations on the implementation of the portability principles for out-domiciled JKN participants in getting access to health services including the utilization of the JKN Mobile application. Social factors and technical factors had no adequate information and understanding to implement the portability principles. Keywords: principles portability, JKN, domicile, services. Abstrak: Prinsip portabilitas dalam penyelenggaraan Program Jaminan Kesehatan Nasional (JKN) merupakan prinsip menjamin peserta JKN kapan dan dimanapun di Indonesia termasuk saat berpindah pekerjaan atau tempat tinggal, liburan, kuliah atau urusan lainnya tak terkecuali di Kota Semarang. Landasan filosofis penerapan prinsip portabilitas adalah hak akses pelayanan kesehatan. Peserta JKN ketika sakit seharusnya memperoleh hak akses pelayanan kesehatan di Fasilitas Kesehatan Tingkat Pertama (FKTP) terdekat, namun faktanya masih ditemui kendala. Tujuan penelitian adalah untuk mendapatkan gambaran bentuk pengaturan, faktor-faktor yang mempengaruhi dan penerapan prinsip portabilitas bagi peserta JKN di luar wilayah domisili dalam memperoleh akses pelayanan kesehatan di Kota Semarang.Metode penelitian yang digunakan adalah pendekatan yuridis sosiologis dengan spesifikasi penelitian deskriptif analitis. Data primer diperoleh melalui wawancara dengan Badan Penyelenggaraan Jaminan Sosial (BPJS) Kesehatan Kantor Cabang Semarang dan lima Kepala Puskesmas: Pandanaran, Sekaran, Ngesrep, Srondol, dan Kedungmundu sebagai narasumber serta 25 responden peserta JKN luar wilayah domisili Kota Semarang. Metode sampling menggunakan purposive sampling dengan analisis kualitatif.Penerapan prinsip portabilitas bagi peserta JKN di luar wilayah domisili dalam memperoleh akses pelayanan kesehatan di Kota Semarang terutama di kelima Puskesmas yang diteliti belum optimal. Bentuk pengaturan penerapan prinsip portabilitas didasarkan Surat Edaran BPJS Kesehatan Kantor Cabang Semarang Nomor 766/VI-01/0518 tentang Pelayanan Peserta Peserta Luar Wilayah di FKTP yaitu batasan maksimal kunjungan 3 kali yang bertentangan dengan prinsip portabilitas dalam Pasal 4 huruf f Undang-Undang Nomor 40 Tahun 2004 tentang SJSN dan Undang-Undang Nomor 24 Tahun 2011 tentang BPJS. Perlu peraturan teknis berupa Keputusan Menteri yang mengikat tentang persyaratan, prosedur administratif, dan prosedur layanan penerapan prinsip portabiltas tersebut. Faktor yuridis yang mempengaruhi yaitu belum ada peraturan teknis tentang penerapan prinsip portabilitas bagi peserta JKN di luar wilayah domisili dalam memperoleh akses pelayanan kesehatan termasuk pemanfaatan aplikasi Mobile JKN. Faktor sosial dan faktor teknis juga masih kurang informasi dan pemahaman dalam penerapannya.Kata kunci: prinsip portabilitas, JKN, domisili, pelayanan.
Analysis of National Health Insurance Patient Satisfaction on Quality of Outpatient Services at Tugurejo Hospital Semarang Desy Widyaningrum; Yohanes Budi Sarwo; Daniel Budi Wibowo
SOEPRA Vol 7, No 1: Juni 2021
Publisher : Universitas Katolik Soegijapranata Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24167/shk.v7i1.1992

Abstract

Abstract: Health service quality refers to the level of health service perfection in generating the patients’ satisfaction. In realizing qualified health services a hospital should have service standards to measure the service standard indicators. To measure whether the predetermined standards have been reached or not  indicators are used, namely to measure the compliance toward predetermined standards. Health service provision to JKN patients should be in accordance with the service standard so that the patients would feel satisfied. The incresing JKN membership coverage and the number of  JKN patients’ made the researcher interested to study.This study used a socio-legal approach having descriptive-analytical specification  that was conducted to the outpatient services provided by Tugurejo Regional Hospital Semarang. The type of data were primary and secondary data whereas the sampling technique was purposive sampling. The data gathering was conducted by literature and field studies. The data obtained were then quantitatively and qualitatively analyzed. The results of the study showed that the service standard of Tugurejo Regional Hospital was based on the the Central Java Governor's regulation by the issuance of the regulation of the Director of Tugurejo Regional Hospital Nr. 38 of 2017 on the Standard of the Tugurejo Regional Hospital of Central Java of 2018. In providing health services Tugurejo Regional Hospital should implement minimum service standard of Tugurejo Rgional Hospital Semarang that was in accordance with the Minister of Health of the Republic of Indonesia’s Decree  Nr. 129/Menkes/SK/II/2008 on Minimum Service Standards. The levels of JKN patients’ satisfaction in effectiveness dimension were feeling satisfied  44.4% and very satisfied 55.6%,. Based on efficiency dimension the level of satisfied was 60% and very satisfied was 40% whereas according to accessibility dimension the levels were dissatisfied at 11.1%, satisfied  46.7%, and very satisfied  42.2%. The acceptability/patient-centered dimension showed that 40% satisfied and 60% very satisfied whereas equitablity dimension showed 33.3% satisfied and 66.7% very satisfied. Safety dimension showed that 60% satisfied and 40% very satisfied. Some factors caused dissatisfaction, namely the facts that the health workers did not comply with the existing health service standards beside lack of patients’ awareness to their obligations.Keywords: service quality, hospital, satisfaction, JKN patient Abstrak: Mutu pelayanan kesehatan adalah yang merujuk pada tingkat kesempurnaan pelayanan kesehatan dalam menimbulkan rasa puas pada diri setiap pasien. Dalam mewujudkan pelayanan kesehatan  yang bermutu rumah sakit harus memiliki standar pelayanan untuk mengukur indikator standar pelayanan. Untuk mengukur tercapai atau tidaknya standar yang telah ditetapkan maka dipergunakan indikator, yaitu ukuran kepatuhan terhadap standar yang telah ditetapkan. Pada pelaksanaan dalam memberikan pelayanan kesehatan kepada pasien JKN harus diberikan sesuai dengan standar pelayanan sehingga pasien merasa puas. Cakupan kepesertaan JKN yang semakin meningkat dan  banyaknya kasus ketidakpuasan yang terjadi pada pasien pengguna JKN sehingga peneliti tertarik untuk meneliti.Penelitian ini menggunakan metode pendekatan yuridis sosiologis. Penelitian ini bersifat deskriptif analitis dilakukan pada pelayanan rawat jalan di RSUD Tugurejo Semarang. Jenis data menggunakan data primer dan data sekunder. Metode sampling yang digunakan yaitu purposive sampling. Metode pengumpulan data menggunakan studi pustaka dan studi lapangan. Teknik analisis data menggunakan analisis kuantitatif dan kualitatif.                             Hasil penelitian didapatkan RSUD Tugurejo Semarang memiliki standar pelayanan dibuat berdasarkan peraturan gubernur jawa tengah dengan dikeluarkannya Peraturan Direktur Rumah Sakit Umum Daerah Tugurejo Provinsi Jawa Tengah Nomor 38 Tahun 2017 Tentang Standar Rumah Sakit Umum Daerah Tugurejo Provinsi Jawa Tengah Tahun 2018 dalam memberikan pelayanan kesehatan RSUD Tugurejo Semarang menerapkan Standar Pelayanan Minimal Rumah Sakit Tugurejo Semarang sesuai dengan Keputusan Menteri Kesehatan Republik Indonesia Nomor 129/Menkes/SK/II/2008 tentang Standar Pelayanan Minimal. Tingkat kepuasan pasien JKN pada dimensi Effective pasien merasakan puas sebesar 44,4% dan sangat puas sebesar 55,6%, dimensi efficient didapatkan hasil responden puas 60% dan sangat puas 40%, dimensi Accessible didapatkan hasil tidak puas sebesar 11,1%, puas sebesar 46,7%, dan sangat puas sebesar 42,2%, dimensi Acceptable/patient-centred didapatkan hasil responden puas sebesar 40% dan sangat puas 60%, dimensi equitable didapatkan hasil responden puas sebesar 33,3% dan sangat puas sebesar 66,7%, pada dimensi safe didapatkan hasil responden puas sebesar 60% dan sangat puas sebesar 40%. Faktor yang menyebabkan ketidakpuasan dikarenakan tenaga kesehatan kurang mematuhi standar pelayanan kesehatan yang telah ditetapkan dan kurangnya kesadaran pasien akan kewajibannyaKata kunci: mutu pelayanan, rumah sakit, kepuasan, pasien JKN
Co-Authors Daniel B. Wibowo Daniel Budi Wibowo Marni Dominika Oenunu Widyaningrum, Desy Yustina, Endang Wahyati