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All Journal 2-TRIK: TUNAS-TUNAS RISET KESEHATAN Jurnal Jaminan Kesehatan Nasional
Yulita Hendrartini
Universitas Gadjah Mada
Decision Sciences, Operations Research & Management Dentistry Health Professions Medicine & Pharmacology Public Health

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PEMANFAATAN PELAYANAN KESEHATAN BERDASARKAN STATUS WILAYAH DAN KEPEMILIKAN JAMINAN KESEHATAN NASIONAL (KAJIAN SUSENAS TAHUN 2015) Prisilya Prety Ruhukail; Yulita Hendrartini; Heni Wahyuni
2-TRIK: TUNAS-TUNAS RISET KESEHATAN Vol 9, No 1 (2019): FEBRUARI 2019
Publisher : FORUM ILMIAH KESEHATAN

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (117.67 KB)

Abstract

Background: Changes in funding towards Universal Health Coverage (UHC) also have side risks such as inequitable availability of health facilities and health workers, as well as a lack of socialization on JKN policies. Indonesia's Health Profile in 2014 shows that there is still an imbalance in the utilization ratio of health services by region. This is due to the relatively small population, but has a large working area. The same thing is found in the aspects of health insurance membership. Injustice in accessing health services is a challenge faced to achieve equity in health services, where equity will occur if health services are distributed according to geography, socio-economy and community needs. Objective: To analyze the utilization of health services based on regional status and JKN ownership. Method: This research is a quantitative study that examines secondary data, namely Susenas in 2015, using a cross-sectional design. The unit of analysis in this study is the individual. This research uses descriptive, bivariate and multivariate analysis. The multivariate test uses a logistic regression test to determine the effect of regional status and ownership of health insurance on the utilization of health services. Results: Utilization of health services is mostly done by individuals in non-DTPK areas. A p value (0,000) indicates a relationship between the status of the area and the utilization of health services. Individuals in non-DTPK areas are more likely to utilize health services. Individuals who have private health insurance use more health services than those who JKN. There is a relationship between JKN ownership and health service utilization (p-value = 0,000). Individuals who have private health insurance, and who are more than one, are more likely to utilize health services. The control variables which include age, sex, education and occupation have a significant relationship with the utilization of health services. Conclusion: JKN ownership and territorial status are significantly related to the utilization of health services in Indonesia. Keywords: utilization; health services; JKN; Susenas 2015 ABSTRAK Latar Belakang: Perubahan pembiayaan menuju Universal Health Coverage (UHC) juga memiliki resiko sampingan seperti ketidakmerataan ketersediaan fasilitas kesehatan dan tenaga kesehatan, serta kurangnya sosialisasi kebijakan JKN. Profil Kesehatan Indonesia tahun 2014 menunjukkan masih adanya ketimpangan rasio pemanfaatan pelayanan kesehatan berdasarkan wilayah. Ini disebabkan oleh jumlah penduduk yang relatif sedikit, namun memiliki wilayah kerja yang luas. Hal yang sama ditemukan dalam aspek kepesertaan jaminan kesehatan. Ketidakadilan dalam akses pelayanan kesehatan merupakan tantangan yang dihadapi untuk mencapai ekuitas dalam pelayanan kesehatan, dimana ekuitas akan terjadi jika pelayanan kesehatan terdistribusi menurut geografi, sosial ekonomi dan kebutuhan masyarakat. Tujuan: Menganalisis pemanfaatan pelayanan kesehatan berdasarkan status wilayah dan kepemilikan JKN. Metode: Penelitian ini merupakan penelitian kuantitatif yang mengkaji data sekunder yaitu Susenas tahun 2015, menggunakan rancangan cross-sectional. Unit analisis dalam penelitian ini adalah individu. Penelitian ini menggunakan analisis deskriptif, bivariat dan multivariat. Uji multivariat menggunakan uji regresi logistik untuk mengetahui pengaruh status wilayah dan kepemilikan jaminan kesehatan terhadap pemanfaatan pelayanan kesehatan. Hasil: Pemanfaatan pelayanan kesehatan lebih banyak dilakukan oleh individu yang berada di wilayah non-DTPK. Nilai p (0,000) menunjukkan adanya hubungan antara status wilayah dan pemanfaatan pelayanan kesehatan. Adapun individu pada wilayah non-DTPK lebih berpeluang untuk memanfaatkan pelayanan kesehatan. Individu yang memiliki jaminan kesehatan swasta lebih banyak memanfaatkan pelayanan kesehatan dibandingkan dengan yang JKN. Ada hubungan antara kepemilikan JKN dan pemanfaatan pelayanan kesehatan (p-value=0,000). Individu yang memiliki jaminan kesehatan swasta, dan yang lebih dari satu, lebih berpeluang untuk memanfaatkan pelayanan kesehatan. Adapun variabel kontrol yang meliputi umur, jenis kelamin, pendidikan dan pekerjaan memiliki hubungan yang signifikan dengan pemanfaatan pelayanan kesehatan. Kesimpulan: Kepemilikan JKN dan status wilayah berhubungan secara signifikan dengan pemanfaatan pelayanan kesehatan di Indonesia. Kata kunci: pemanfaatan; pelayanan kesehatan; JKN; Susenas 2015
Faktor Yang Mempengaruhi Rawat Inap Berulang Pasien JKN di FKRTL Kantor Cabang Semarang Tahun 2021 Anisa Hidayah; Diah Ayu Puspandari; Yulita Hendrartini
Jurnal Jaminan Kesehatan Nasional Vol. 2 No. 2 (2022): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v2i2.59

Abstract

Repeated hospitalization is one of the performance indicators of global budget payments. Unplanned repeated hospitalization is a preventable event and its interval is influenced by several factors including the patients, the patients’ clinical condition, and the policy. This research is aimed at analyzing the effect of  disease severity, Length of Stay (LOS), and patient discharge status on the repeated hospitalization interval among JKN patients at hospitals BPJS Kesehatan Semarang Branch Office in 2021. This study contributes to the claim management literature by focusing on repeated hospitalization as an evaluation tool to improve the quality of inpatient care. This research was a quantitative study with a cross-sectional design involving hospitalized patients returning for hospitalization within 30 days. Patients who were discharged being referred to other health facilities and those with transplantation, delivery, physiotherapy, and chronic diseases were excluded. Univariate and bivariate analyzes were then performed using the STATA software. The majority of repeated hospitalized patients were aged 12-25 years (69.47%), women (53.88%), and found in type C hospitals (32.85%). There was an association between disease severity and LOS with the repeated hospitalization interval. Increasing severity of illness was found to show a higher risk of repeated hospitalization < 12 days (OR=1.23). Patients with LOS ≥ 4 days increased the risk of repeated hospitalization < 12 days (OR = 1.33). There was no association between discharge status with repeated hospitalization. Conclusion: There is a significant association between disease severity and LOS with repeated hospitalization interval.
Kesiapan Rumah Sakit Dalam Implementasi Sistem Pembayaran Global Budget Di Kabupaten Purworejo Dina Anjayani; Andreasta Meliala; Yulita Hendrartini
Jurnal Jaminan Kesehatan Nasional Vol. 2 No. 2 (2022): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v2i2.89

Abstract

In 2018, BPJS Kesehatan initiated a pilot project to integrate the INA CBGs and Global Budget mixed-method hospital payment system (global budget). Purworejo Regency is one of the areas designated as a pilot for the Global Budget payment system's deployment. The outcomes of the Hospital performance indicators in the first-semester review were less than ideal. Consequently, it is required to study the Hospital's readiness to implement the Global budget Payment System. This study set out to determine how prepared the hospitals in Purworejo Regency were to implement the Global Budget payment scheme. A descriptive design and a qualitative methodology were used in the research. The management of four hospitals in Purworejo Regency is the topic of the study.  Observations and interviews were used to explore hospitals’ readiness to implement the Global Budget payment system in terms of health facilities’ perception, Quality Control and Cost Control strategies, Global Budget calculations, and patient satisfaction through the results of the Walk Through Audit.  Through the four key variables mentioned above, the scoring technique is used to evaluate the readiness of hospitals to implement the Global Budget payment system.  The modified CCCEAR (California Community Clinic EHR Evaluation and Readiness) tool is used for the readiness assessment, which has three readiness levels: 1) not ready (score 0-33), 2) moderately ready (34-66), and 3) ready (67-100).  Result:  According to a qualitative examination of data from observations and interviews, the hospital scored 26 from assessor II and 24 from assessor I, positioning it in the second range. This demonstrates that the hospital is not ready and has not considered developing a more comprehensive and in-depth plan for implementing the Global Budget payment system, nor how to create capacity to enable successful adoption and implementation.  Conclusion: The hospital is not yet at its highest level of readiness to adopt the Global Budget payment system in Purworejo Regency, according to the scoring findings on four variables of hospital readiness.
Co-Authors Anak Agung Gede Sugianthara Andreasta Meliala Anisa Hidayah Dina Anjayani Prisilya Prety Ruhukail