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All Journal Jurnal Kebijakan Kesehatan Indonesia Jurnal Kesehatan Masyarakat Jurnal Kesehatan Masyarakat Andalas (Andalas Journal of Public Health) Jurnal Kesehatan Andalas Jurnal Media Gizi Indonesia (MGI) Jurnal Kesehatan Vokasional AcTion: Aceh Nutrition Journal JMM (Jurnal Masyarakat Mandiri) Jurnal Kesehatan Prima Journal of Maternal and Child Health Jurnal Ilmu Kesehatan Masyarakat (The Public Health Science Journal) Amerta Nutrition Jurnal Kreativitas PKM Jurnal Kesehatan Jurnal Ilmu dan Teknologi Kesehatan JURNAL MEDIA KESEHATAN SANITAS: Jurnal Teknologi dan Seni Kesehatan JURNAL GIZI DAN KESEHATAN Aksara: Jurnal Ilmu Pendidikan Nonformal Community Development Journal: Jurnal Pengabdian Masyarakat JPK: Jurnal Proteksi Kesehatan Jurnal Sains Kesehatan Indian Journal of Forensic Medicine & Toxicology Journal SAGO Gizi dan Kesehatan Jurnal Ilmiah Kesehatan (JIKA) Jurnal Gizi Masyarakat Indonesia (The Journal of Indonesian Community Nutrition) Jurnal Multidisiplin Madani (MUDIMA) JUMANTIK (Jurnal Ilmiah Penelitian Kesehatan) JURNAL PENELITIAN TERAPAN KESEHATAN Jurnal Gizi dan Kesehatan Jurnal Vokasi Kesehatan Proceeding of Bengkulu International Conference on Health Jurnal Svasta Harena Rafflesia Jurnal Kesehatan Cendikia Jenius Jurnal Pengabdian Masyarakat Cendikia Jenius Jurnal Bidan Cerdas Jurnal Ilmu Kesehatan Masyarakat (The Public Health Science Journal) Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)

Desri Suryani

Politeknik Kesehatan Kementerian Kesehatan Bengkulu

Author-ID : 395064

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ANALISIS KEBIJAKAN JAMINAN KESEHATAN KOTA BENGKULU DALAM UPAYA EFISIENSI DAN EFEKTIFITAS PELAYANAN DI PUSKESMAS Yandrizal Yandrizal; Betri Anita Anita; Desri Suryani
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 3 (2013)
Publisher : Center for Health Policy and Management

Background. Mayor of Bengkulu Regulation Number 13 Year2012 on The Implementation Guidelines for State HealthInsurance Assistance Costs (Jamkeskot) in Bengkulu city ismanaged by the Secretariate of the Government of CommunityWelfare Section in Bengkulu. The cost of referral health carein Provincial General Hospital could be made more efficient byoptimizing the role of community health centers as a curative,preventive and promotive health services. It is hoped to reducethe number of visits for treatment and referral to hospital. Thepurpose of this study is to analyze the City Health Insurancepolicies in an effort to improve the efficiency and effectivenessof primary health care and public health efforts to reduce thenumber of visits for treatment and referral to hospital.Method: The type of research is non-experimental research,or also called qualitative research. It is an exploratory researchto find a new role of the city government and AdministeringAgency to improve the efficiency and effectiveness of healthservices at the health center.Unit of Analysis: 1) Community Health Center Unit 20, 2)organizing: PT. Askes 2 person and Community Welfare section2 person, 3) the City: Head of the Community Welfare Section1 person, Bengkulu City Health Office 2 person. Data is collectedusing interview using questionnaire as the instrument, anddocuments review.Results: Bengkulu Jamkeskot policies have not applied theprinciple of insurance in which the organizers serves to controlthe quality and cost of health care provided in both basicservices/primary and referral services. Most of the healthcenters tend to refer patients (67%) that are still within theirauthorization to provide care. The reason being: the healthcenters have limited equipment and drugs, and some patientsdemanded to be referred due to perceived bad quality of serviceat the health centers. The Community Welfare section has notcoordinated with the City Health Office to conduct training forthe health center in an effort to increase the effectiveness ofservices.Recommendation: The City Government is to establish ateam to conduct technical guidance supervision to healthcenters to ensure that the health centers play the role ofgatekeeper and only refer patients that need complex care,providing medical equipment and drugs to the health centerswith proposed funding from Bengkulu City budget and provincialbudget. The Health Centers are to provide routine counselingon healthy behavior and IEC on nutrition and hygiene to everyposyandu. The City Health Office provides technical guidancein drafting POA for promotive and preventive activities to havemore focus in efforts to control the causes of disease. Improvepolicy management of Jamkeskot by submitting the managementto an administering body, so that the Jamkeskot can apply theinsurance principles where the strong help the weak, thehealthy help the sick, the rich help the poor; and also cancontrol the quality and cost of service.Keywords: Health Policy, Health Insurance, Gatekeeper

Analisis Ketersediaan Fasilitas Kesehatan dan Pencapaian Universal Health Coverage Jaminan Kesehatan Nasional se Provinsi Bengkulu Yandrizal Yandrizal; Desri Suryani; Betri Anita; Henni Febriawati; Riska Yanuarti; Bintang Agustina Pratiwi; Heldi Saputra
Jurnal Kebijakan Kesehatan Indonesia Vol 5, No 3 (2016)
Publisher : Center for Health Policy and Management

ABSTRACTIntroduction: The National Health Insurance began in 2014 gradually toward Universal Health Coverage. The purpose of the National Health Insurance in general is easier for people to access health services and obtain quality health services. Health providers are limited, extensive spread of population and limited access, leading to less supply (provision of services) by the government and other parties, so it would appear inequality and financing of health care.Purpose: to know the availability of health care facilities as well as efforts to achieve compliance with Univarsal Coverange Health in Bengkulu Province.Metoe Research: Research using design analysis method formative To assess the implementation of policies. Descriptive study is observational, presents an overview and focus on solving the actual problem. The unit analyzes the data collection was health facilities using quantitative and qualitative approaches.Results And Discussion: The first-level health facilities(FKTP) as much as 272 units, 590 units needs. Puskesmas capitation average Rp. 4847, -. All hospitals are already working with BPJS and needs a bed in 1769, the highest available FKTP 1329. Utilization of Physician Practice. Government encourages open pratama clinics and doctors as well as provide opportunities practice at the PPDS.Conclusion: The first-level health facilities are lacking. Doctors and dentists in the health centers are still less impact on the small capitation funds received. Local Government clinics and physician practices to encourage and develop the health center. Shortage of specialist doctors by maximizing all participants Medical Education Program Specialist of the Bengkulu Province can return by providing specialist medical support equipment and incentives.Keywords: Equity Services, Access Services, Equity Health Care Financing.ABSTRAKLatar belakang: Jaminan Kesehatan Nasional dimulai pada Tahun 2014 secara bertahap menuju Universal Health Coverage. Tujuan Jaminan Kesehatan Nasional secara umum yaitu mempermudah masyarakat untuk mengakses pelayanan kesehatan dan mendapatkan pelayanan kesehatan yang bermutu. Pemberi pelayanan kesehatan yang terbatas, penyebaran penduduk yang luas dan akses yang terbatas, menyebabkan kurang supply (penyediaan layanan) oleh pemerintah dan pihak lain, sehingga akan muncul ketidakmerataan pelayanan dan pembiayaan kesehatan.Tujuan: mengetahui ketersediaan fasilitas pelayanan kesehatan serta upaya pemenuhan untuk mencapai Univarsal Health Coverange di Provinsi Bengkulu.Metode: penelitian menggunakan rancangan metode analisisformatif Untuk menilai pelaksanaan kebijakan. Jenis penelitian deskriptif yang bersifat observasional, menyajikan Gambaran dan memusatkan pada pemecahan masalah aktual. Unit analisis fasilitas kesehatan. Pengumpulan data menggunakan pendekatan kuantitatif dan kualitatif.Hasil: Fasilitas kesehatan tingkat pertama (FKTP) sebanyak 272 unit, kebutuhan 590 unit. Kapitasi Puskesmas rerata Rp. 4.847,-. Semua rumah sakit sudah bekerja sama dengan BPJS dan kebutuhan tempat tidur 1769, tersedia 1329. Pemanfaatan FKTP tertinggi Dokter Praktek. Pemerintah mendorong buka klinik pratama dan prakter dokter serta memberi kesempatan Pendidikan Dokter Spesialis.Kesimpulan: Fasilitas kesehatan tingkat pertama masih kurang. Dokter umum dan dokter gigi di Puskesmas masih kurang berdampak kepada kecil dana kapitasi yang diterima. Pemerintah Daerah mendorong klinik dan dokter praktek dan mengembangkan Puskesmas Perawatan. Kekurangan dokter spesialis dengan memaksimalkan semua peserta Program Pendidikan Dokter Spesialis dari Provinsi Bengkulu dapat kembali dengan menyediakan peralatan penunjang medis spesialistik dan insentif .Kata Kunci : Pemerataan Pelayanan, Akses Pelayanan, Pemerataan Pembiayaan Kesehatan.

Analisis Besaran dan Pembayaran Kapitasi Berbasis Komitmen Pelayanan terhadap Pengendalian Rujukan di Puskesmas Kota Bengkulu Henni Febriawati; Yandrizal Yandrizal; Yulia Afriza; Bintang Agustina Pratiwi; Riska Yanuarti; Desri Suryani
Jurnal Kebijakan Kesehatan Indonesia Vol 6, No 4 (2017)
Publisher : Center for Health Policy and Management

Background: Puskesmas as primary health care center where the role of Puskesmas is interpreted as gate keeper or first contact and referral agent in accordance with standard of medical service. BPJS Kesehatan always strives to increase efficiency and effectiveness by developing quality control system of service and payment system of health service through capitation payment pattern to first level health facility. Problem formulation, how the implementation of Kapuas basaran policy based on fulfillment of service commitment to control at Public Health Center of Bengkulu City. Research Objective, knowing the role of policy of capitation scale based on fulfillment of service commitment to referral control at public health center Bengkulu City. Research methods: This research uses quantitative and qualitative method with exploratory research design, unit of Puskesmas analysis in Bengkulu City. The type of this research is descriptive research to describe the implementation of capitation policy based on fulfillment of service commitment to referral number in public health center Bengkulu City. Results and discussion:Referral from public health center in Bengkulu City decreased from 2014 as many as 113,075 visits and 25,183 (22.27%) referrals, by 2015 149,483 visits and 26,963 (18.04%) referrals, 2016 226,313 visitation and 23,545 referrals (10 , 40%) In 2016 the number of participants in Bengkulu City was 156,854 inhabitants and the number of contact rate was 15.726 (10.06%). Visits were 13,068 (8.33%) and healthy visits 2,658 (1.69%). All informants understand about the activities undertaken to achieve the safe zone target ratio. Conclusions and recommendations:The implementation of a service commitment-based capitation policy can control the referral of the public health center. Informants have a common perception in achieving contact numbers to achieve the target of safe zones and achievement zones by optimizing public health efforts and individual health efforts to make healthy visits and sick visits to the community. Policy implementation can be developed by maximizing existing community health efforts in Puskesmas, improving the achievement of contact rates indicator, non-specialist referral ratios, and proline visits routinely.

Analisis Ketersediaan Fasilitas Kesehatan dan Pemerataan Pelayanan pada Pelaksanaan Jaminan Kesehatan Nasional di Kota Bengkulu, Kebupaten Selumadan Kabupaten Kaur Yandrizal Yandrizal; Desri Suryani; Betri Anita; Henni Febriawati
Jurnal Kebijakan Kesehatan Indonesia Vol 3, No 2 (2014)
Publisher : Center for Health Policy and Management

Background: National health insurance is starting in 2014 to gradually move towards Universal Health Coverage. The program should make access health services easier for the community. However limited number of health care givers, a vast population and difficult geographical access mean that there is limited provision of services by the Government and other parties. It appears that the difficulty of access to health facilities remains. The provision of health services is dependent on infrastructure in the community. Without any infrastructure improvements, equitable health service becomes difficult and health coverage for the community is not real. The problem is that whether the national health insurance policy administered by the health-BPJS can improve access to medical services and quality health services to all citizens of Indonesia based on fundamental justice. Objective: To assess the availability and equitable health services as well as the policies for equitable distribution of health facilities within the national health insurance program in the city of Bengkulu, District Seluma and District Kaur. Method: This research is using a formative evaluation method, designed to assess how program policy was implemented and how to modify and to develop new policies so as to bring improvement.The kind of data collected are qualitative and quantitative data. Quantitative data is used to see availability and coverage health, while qualitative data is used to get perception of service provider and program manager of the national health insurance, as well as the challenge and barrier found in implementation process. Data qualitative is obtained using open questionnaire. Quantitative data is derived from a contract between District/municipality health office by health- BPJS and health facility data. Data analysis is compared between District/municipal data, standards according to the regulation and health system according to the WHO and scenario planning. Results: The ratio of the available primary care facilityin Kaur is 17,13 per 100.00o or one per 5.837 inhabitants; while in Bengkulu city it is 13,16 per 100.000 or one for 7.598 inhabitants; and in District Seluma it is one for 7.770 inhabitants. Percentage of contracts for primary services in Bengkulu city is 87,62 %, in District Seluma is 80.41 %, and in District Kaur is 80.73 %. The distance to access primary care facility in District Seluma and District Kaur is 2 hours away if using ‘ojek’ (motorcycle taxi), and the is fare IDR200.000,- (one-way). In Bengkulu, the most distant is 20 minutes and the fare is IDR10.000,-. The ratio of available referral care services in Bengkulu City is 1,88 per 100.000 inhabitants, while in District Seluma is 0,56 per 100.000 inhabitants, and in District Kaur is 0,90 per 100.000 inhabitants. Therefore we need additional primary health facilities supported by the agency of the social security (BPJS), District/City government/Provincial government and the Ministry of Health. While the ratio of beds in the Bengkulu City is 629, in District Seluma is 3.574, and in district Kaur is 2.778. District Seluma needs as many as 129 more beds while District Kaur needs another 60 beds to meet the requirement. The Regional Public hospital in District Kaur and District Seluma are still class D. To increase the capacity at these two hospitals to become class C within 5 (five) years is possible. However, these efforts require special policy from city/district government, Provinces and the Ministry of Health as well as the social security agency (BPJS) considering the limited capacity of the local governments. Conclusion: The availability of primary health facilities in Bengkulu city, Seluma districy and Kaur district are not enough according to Road Map to JKN 2019. Referral health facilities in Seluma district and Kaur district are much lower than the target, whereas in Bengkulu city the number is on target. Utilization of primary health facilities in Bengkulu city, Seluma district and Kaur district are still lower than national average. Utilization of referral helth facilities in the province of Bengkulu is still lower than national average. Latar Belakang: Jaminan Kesehatan Nasional dimulai pada tahun 2014 secara bertahap menuju ke Universal Health Coverage, secara umum yaitu mempermudah masyarakat untuk mengakses pelayanan kesehatan dan mendapatkan pelayanan kesehatan yang bermutu. Pemberi pelayanan kesehatan yang terbatas, penyebaran penduduk yang luas dan akses yang terbatas, menyebabkan kurang supply (penyediaan layanan) oleh pemerintah dan pihak lain, sehingga akan muncul kesulitan terhadap akses ke fasilitas kesehatan. Penyediaan pelayanan kesehatan tergantung pada infrastruktur di masyarakat, tanpa ada perbaikan infrastruktur pemerataan pelayanan kesehatan menjadi sulit dan jaminan kesehatan bagi masyarakat merupakan hal yang tidak riil. Permasalahan yang muncul apakah kebijakan Jaminan Kesehatan Nasional oleh BPJS Kesehatan ini dapat meningkatkan akses pelayanan kesehatan dan pelayanan kesehatan yang bermutu kepada seluruh warga Indonesia dengan asas keadilan. Tujuan: Mengetahui ketersediaan dan pemerataan pelayanan kesehatan serta upaya kebijakan pemerataan fasilitas kesehatan pada program Jaminan Kesehatan Nasional di Kota Bengkulu, Kabupaten Seluma dan Kabupaten Kaur. Metode: Penelitian ini menggunakan rancangan metode analisis evaluasi formatif yang dirancang untuk menilai bagaimana program/kebijakan sedang diimplementasikan dan bagaimana pemikiran untuk memodifikasi serta mengembangkan sehingga membawa perbaikan. Jenis data yang dikumpulkan kuantitatif dan kualitatif. Data kuantitatif digunakan untuk melihat ketersediaan dan cakupan layanan kesehatan, sedangkan data kualitatif untuk mendapatkan persepsi dari penyedia layanan dan manajer program terhadap Jaminan Kesehatan Nasional serta tantangan dan hambatan yang ditemukan pada proses implementasinya. Data Kualitatif diperoleh dengan mengunakan kuesioner terbuka, data kuantitatif berasal dari Kontrak Dinas Kesehatan Kaupaten/kota dengan BPJS dan data fasilitas kesehatan. Analisis data dibandingkan antar kabupaten/kota, standar yang ditetapkan berdasarkan peraturan, sistem kesehatan menurut WHO dan perencanaan berdasar skenario (scenario planning) Hasil: Rasio ketersediaan fasilitas pelayaan primer di Kabupaten Kaur 17,13 per 100.000 atau satu banding 5.837 penduduk, sedangkan di Kota Bengkulu lebih kecil 13,16 per 100.000 ribu atau satu banding 7.598 penduduk dan Kabupaten Seluma satu banding 7.770 penduduk. Persentase nilai kontrak untuk pelayanan primer di Puskesmas Kota Bengkulu sebesar 87,62%, Kabupaten Seluma sebesar 80.41%, Kabupaten Kaur sebesar 80.73% Jarak tempuh ke pelayanan primer di Kabu- paten Seluma dan Kabupaten Kaur paling jauh kira 2 jam perjalanan dengan mengunakan Ojek dan ongkos sekali jalan Rp. 200.000,- dibandingkan Kota Bengkulu paling jauh 20 menit dengan ongkos ojek Rp. 10.000,-, Rasio ketersediaan fasilitas pelayaan rujukan di Kota Bengkulu 1,88 per 100.000, Kabupa- ten Seluma 0,56 per 100.000 dan Kabupaten Kaur 0,90 per 100.000 penduduk, sehingga perlu penambahan fasilitas kese- hatan tingkat pertama oleh Badan Penyelenggaran Jaminan Sosial, Pemerintah kabupaten/kota/provinsi dan Kementerian Kesehatan. Sedangkan Rasio tempat tidur untuk Kota Bengkulu 629, Kabupaten Seluma 3574 dan Kabupaten Kaur 2778. Kebutuhan Kabupaten Seluma sebanyak 129 Tempat Tidur dan Kabupaten Kaur sebanyak 60 Tempat Tidur untuk memenuhi target, Rumah Sakit Umum Daerah Kabupaten seluma dan Kabu- paten Kaur masih kelas D. Peningkatan kelas rumah sakit men- jadi kelas C dalam kurun waktu 5(lima) tahun kedepan sangat memungkinkan, upaya ini memerlukan kebijakan khusus dari Pemerintah Daerah Kabupaten, Provinsi dan BPJS serta Kemen- terian Kesehatan mengingat keterbatasan pemerintah daerah. Kesimpulan: Ketersediaan fasilitas kesehatan tingkat pertama saat ini di Kota Bengkulu, Kabupaten Seluma dan Kabupaten Kaur belum mencukupi target yang ingikan menurut Peta Jalan Menuju JKN 2019. Fasilitas kesehatan rujukan di Kabupaten Seluma dan Kabupaten Kaur masih rendah dibandingkan tar- get, sedangkan Kota Bengkulu telah mencapai target. Pemanfaatan fasilitas kesehatan tingkat pertama di Kota Bengkulu, Kabupaten Seluma dan Kabupaten Kaur masih rendah dari Provinsi Daerah istimewa Yogjakarta. Pemanfaat fasilitas kesehatan rujukan di Provisinsi Bengkulu masih rendah dari pada dari Provinsi Daerah istimewa Yogjakarta.

Analisis Ketersediaan Fasilitas dan Pembiayaan Kesehatan pada Pelaksanaan Jaminan Kesehatan Nasional di Provinsi Bengkulu Yandrizal Yandrizal; Hendarin Hendarin; Desri Suryani
Jurnal Kebijakan Kesehatan Indonesia Vol 3, No 4 (2014)
Publisher : Center for Health Policy and Management

The Background: National health assurance program aims to facilitate community access to quality health services. Health financing toward Universal Coverage is a good breakthrough but it can cause negative effects in the form of injustice. Availability of health facilities, health care personel and geographical condition and the broad population dispersion can magnify the problem of inequities between subdistricts and district/city in Bengkulu province, making it appear unequal in health services and financing. Availability of health facilities with inappropriate amount of power impacting the financing needs of the social security in health facilities in the form of capitation and INA-CBG package, and equitable financing analysis needs to be done in the implementation of the national health assurance policy. The purpose: Assesing the availability of facilities and even distribution of financing health and also to equalize of health facilities and drawing up scenarios of possibility of the future in the implementation of the national health insurance in the Province of Bengkulu. Method: This research uses the formative analysis methods designed to assess how the program/policy is being implemented and how it is thought to modify and develop to bring an improvement. Results: The ratio of first-level health facilities (FKTP), which is likely a general practitioner, according to the road map leading to JKN 2012-2019 should achieve the ratio of general practitioners 1: 3000 inhabitants.Currently the average in Bengkulu is 1 per 7.715 inhabitants, thus the need for first- level health facilities in the province of Bengkulu is 590 units. Beginning in 2014, 229 is available until the year 2019, and is still lacking as much as 361 units. Clinics with magnitudes capitation of Rp. 3,000 up to Rp. 4500 is 51.57% and while capitation of Rp. 6,000 is 13.3%. Capitation quantity is uneven financing that have an impact especially on the health of urban areas due to lack of resources. The value of the contract for one year for the number of participants who choose Clinics as FKTP is 763.165 people which is 82,03% of the maximum value of capitation Rp. 6,000, or less Rp9,87M. The average rate on the 7 (seven) Regional public hospitals district and Province for outpatient is between Rp. 150.000 s. d Rp. 350,000 and hospitalization is Rp. 1.000.000,-until Rp. s. 3.700.000,-, compared to the rates based on regulation of the Minister of health RI Number 69 by 2013, the average price of outpatient service and inpatient medical action is very simple and only for mild categories of diseases. Shortage of specialist doctors in Hospital causes unabsorbed INA-CBG package for major treatment action and severe categories of disease. Financial support the Government district/city and Province in the form of program jamkesda 2014 is IDR 38,36 M to pay for the capitation for the poor who are not covered by central government funding and to ensure treatment for kabupaten/ kota that did not cooperate with the BPJS. Incentive specialist doctor/resident is between IDR10 million to 30 million per month, especially the big four specialists from the local government district is another inequalities that is burdensome to the local government; The fulfillment of resources especially General practitioners and dentists in clinics is difficult to materialize given that CPNS (civil servant) formation are very small; the County Government could offer contracts but they can not afford it and it is not worth the lack of capitation. While the fulfillment specialist doctors in Hospitals is also difficult because there is lack of enthusiasm to become specialist CPNS , and the Country Government could not affort contract for them. Fulfillment needs efforts in health facilities first-level, general practitioners, dentists and specialists required a revision of the regulation of the Minister of health no. 69 year 2013 by observing the rate of capitation and INA-CBG¡¯s package for underserved areas away from urban center, or with small population and vast distribution of people. Conclusion: First-level health facilities and the number of personnel in clinics and specialist doctors in the hospital are still lacking, impacting the small capitation and the claim is limited to a minor treatment and mild disease. Regulation of the Minister of health RI Number 69 by 2013 on Standard Rate of health services need to pay attention to differences in geographical situation where Clinics and public hospitals are in the region. Latar Belakang: Program Jaminan Kesehatan Nasional bertujuan mempermudah masyarakat untuk mengakses pelayanan kesehatan yang bermutu. Pembiayaan kesehatan menuju Universal Coverage merupakan terobosan yang baik tetapi dapat menimbulkan dampak negatif berupa ketidakadilan. Ketidamerataan ketersediaan fasilitas kesehatan, tenaga kesehatan dan kondisi geografis serta penyebaran penduduk yang luas dapat memperbesar masalah ketidakadilan antar kecamatan dan kabupaten/kota di Provinsi Bengkulu, sehingga muncul ketidakmerataan pelayanan dan pembiayaan kesehatan. Ketersedian fasilitas kesehatan dengan jumlah tenaga yang tidak sesuai kebutuhan berdampak pada pembiayaan dari Badan Penyelenggara Jaminan Sosial Kesehatan dalam bentuk kapitasi dan Paket INA-CBG¡¯s, maka perlu dilakukan analisis pemerataan pembiayaan pada kebijakan pelaksanaan jaminan kesehatan nasional. Tujuan: Mengetahui ketersediaan fasilitas dan pemerataan pembiayaan kesehatan serta upaya pemerataan fasilitas kesehatan dan menyusun skenario kemungkinan masa mendatang dalam pelaksanaan jaminan kesehatan nasional di Provinsi Bengkulu. Metode: Penelitian ini menggunakan rancangan metode analisis formatif yang dirancang untuk menilai bagaimana program/kebijakan sedang diimplementasikan dan bagaimana pemikiran untuk memodifikasi serta mengembangkan sehingga membawa perbaikan. Hasil: Rasio fasilitas kesehatan tingkat pertama (FKTP) yang disamakan satu dokter umum, Peta Jalan Menuju JKN 2012- 2019 rasio dokter umum 1 : 3000 penduduk, maka rata-rata 1 per 7.715 penduduk, kebutuhan fasilitas kesehatan tingkat pertama di Provinsi Bengkulu sebanyak 590 unit. Awal tahun 2014 yang tersedia 229 sampai tahun 2019 masih kurang sebanyak 361 unit. Puskesmas dengan besaran kapitasi Rp3000,00 s.d Rp4.500,00 sebanyak 51,57% dan Rp6.000,00 sebanyak 13,3%. Besaran kapitasi berdampak tidak merata pembiayaan terutama di Puskesmas yang jauh dari perkotaan karena kekurangan tenaga. Nilai kontrak selama satu tahun jumlah peserta yang memilih Puskesmas sebagai FKTP sebanyak 763.165 jiwa sebesar 82,03% dari nilai maksimal kapitasi Rp6.000,00 atau kurang 9,87M. Tarif rerata pada tujuh Rumah Sakit Umum Daerah Kabupaten dan Provinsi untuk rawat jalan antara Rp. 150.000 s.d Rp640.000,00 dan rawat inap Rp1.000.000,00 s.d Rp3.700.000,00 dibandingkan tarif berdasarkan Peraturan Menteri Kesehatan RI Nomor 69 Tahun 2013, rata-rata tarif pelayanan rawat jalan dan rawat inap merupakan tarif tindakan medis sangat sederhana dan penyakit- penyakit katagori ringan. Kekurangan dokter spesialis di RSUD menyebabkan tidak terserap paket INA-CB¡¯s untuk tindakan besar dan penyakit katagori berat. Dukungan dana Pemerintah Kabupaten/Kota dan Provinsi dalam bentuk program jamkesda tahun 2014 sebesar 38,36 M untuk membayar kapitasi masyarakat miskin bukan penerima bantuan iuran dan menjamin pengobatan bagi kabupaten/kota yang tidak bekerja sama dengan BPJS. Insentif dokter spesialis/residen antara 10 juta s.d 30 juta per bulan terutama spesialis empat besar dari pemerintah daerah kabupaten merupakan ketidakadilan pembiayaan yang menjadi beban daerah. Pemenuhan tenaga terutama dokter umum, dokter gigi di puskesmas sulit terwujud mengingat formasi CPNS sangat kecil, apabila dilakukan kontrak Pemerintah Kabupaten tidak mampu dan tidak sebanding dengan kekurangan kapitasi. Sedangkan pemenuhan dokter spesialis di RSUD juga sulit terwujud karena peminat CPNS untuk dokter spesialis tidak ada dan apabila dilakukan kontrak sebesar insentif Pemerintah Kabupaten tidak mampu. Upaya pemenuhan kebutuhan fasilitas kesehatan tingkat pertama, dokter umum, dokter gigi dan spesialis diperlukan revisi Peraturan Menteri Kesehatan No.69 tahun 2013 tentang tarif dengan memperhatikan kapitasi dan paket INA-CBG¡¯s di daerah tidak diminati atau jauh dari perkotaan, jumlah penduduk kecil serta sebaran yang luas. Kesimpulan. Fasilitas kesehatan tingkat pertama dan jumlah tenaga di puskesmas dan dokter spesialis di rumah sakit masih kurang, berdampak kecilnya kapitasi dan klaim terbatas pada tindakan kecil serta penyakit yang ringan. Peraturan Menteri Kesehatan RI Nomor 69 Tahun 2013 Tentang Standar Tarif Pelayanan Kesehatan perlu memperhatikan geografis dimana Puskesmas dan Rumah Sakit Umum Daerah.

Pengetahuan Gizi dan Keaktifan Ibu Balita dalam Kunjungan Posyandu Berhubungan dengan Status Gizi Balita Wahyu Elia Ramadani; Afriyana Siregar; Desri Suryani
Jurnal Ilmu dan Teknologi Kesehatan Vol 7 No 1 (2019): September 2019
Publisher : Poltekkes Kemenkes Jakarta III

Children nutritional problem in Indonesia remains as a challenge in health aspect. Several ways that can affect children nutrient status namely; the mothers’ knowledge towards nutrition and their activeness in Posyandu. In order to achieve the optimal status of children nutrition, the mothers need to be involved in Posyandu activity so the nutritional status can be monitored. This research aimed to discover the relation between nutrition knowledge and mother’s activeness in Posyandu visitation with children nutritional status in Puskesmas Pasar Ikan working area, Bengkulu, in 2019. This research used observational method and cross sectional approach. The technique that was used is quota sampling technique with 92 repondents. Chi square was used as statistic analysis tool. This research showed that 43,5% of children nutrition in normal status, 2,2% in critical status, and the last 54,3% in chronic status. The majority of sample showed a sufficient knowledge about nutrition with 40,2%. The active respondent with more that 8 visits showed a satisfying numbers with 68,5%, meanwhile the other only acquired 31,5%. The result of chi square statistic showed that there was a connection between knowledge about nutrition and mothers’ activeness in Posyandu visitation with children nutritional status.

Identification And Farmer Family's Preference Of Indigenous Food In Rural Bengkulu Betty Yosephin Simanjuntak; Desri Suryani; Miratul Haya; Ali Khomsan
Jurnal Kesehatan Prima Vol 14, No 2 (2020): AUGUST
Publisher : poltekkes kemenkes mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32807/jkp.v14i2.562

Indigenous food can be said as a local identity because of its existence as part of the culture of the community, such as certain procedures in processing their food, its role in community culture and governance, and recipes that are maintained from generation to generation. Purpose of this research was to identify the kinds of traditional foods, preferences in the consumption pattern in the family of farmers. FGD was performed on each ethnic group, and the members were mothers who understood the traditional foods consumed by people in the related ethnic group and they resided in the ethnic group. Most of the food sources of vegetables consumed by the community were vegetables that many people got from rice fields/dryfields/ gardens Traditional food snacks, side dishes and vegetables in the agricultural households as such as bolu semut, rebung asam ikan gaguk, guasan, gulai nangko,and gulai jamur gerigit.

Hubungan Faktor Internal dengan Perilaku Seksual Berisiko pada Remaja (Analisis SKAP Provinsi Bengkulu 2019) Betty Yosephin Simanjuntak; Desri Suryani; Meriwati Mahyudin; Agus Supardi; Frensi Riastuti
Jurnal Kesehatan Vokasional Vol 6, No 4 (2021): November
Publisher : Sekolah Vokasi Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkesvo.65849

Latar Belakang: Perilaku seksual berisiko pada remaja semakin mengkhawatirkan, biasanya diawali dengan meraba, berpegang tangan hingga berciuman. Ada beberapa faktor yang memungkinkan terjadinya perilaku seksual ini baik internal maupun eksternal.Tujuan: Menganalisis faktor internal yang berkaitan dengan perilaku seksual berisiko remaja di Provinsi Bengkulu.Metode: Penelitian bersifat kuantitatif dengan menggunakan pendekatan cross-sectional pada 301 keluarga yang memiliki remaja berusia 10—24 tahun di wilayah Provinsi Bengkulu. Analisis data dilakukan secara deskriptif (univariat) dan bivariat dengan menggunakan uji chi square.Hasil: Perilaku seksual berisiko pada remaja diawali dengan adanya perilaku berpegangan tangan (83,4%), berpelukan (34,2%), ciuman bibir (15,6%), dan meraba/merangsang (3,3%), sebagian besar berusia 15—19 tahun dengan tingkat pendidikan SLTA, serta mayoritas tinggal di pedesaan. Faktor risiko umur berpengaruh terhadap perilaku berpegangan tangan (p=0,018), berpelukan (p<0,001) dan ciuman bibir (p<0,001). Jenis kelamin berpengaruh terhadap perilaku berpelukan (p<0,001), ciuman bibir (p=0,010) dan meraba atau merangsang (p=0,008). Pendidikan berpengaruh terhadap perilaku berpegangan tangan (p<0,001) dan ciuman bibir (p=0,010), sedangkan faktor risiko tempat tinggal diketahui berpengaruh terhadap perilaku ciuman bibir (p=0,030).Kesimpulan: Umur, jenis kelamin, tingkat pendidikan serta tempat tinggal menjadi faktor risiko terjadinya perilaku seksual remaja khususnya berpegangan tangan, berciuman, berpelukan, dan meraba/merangsang. Oleh karena itu, perlu dikembangkan media informasi tentang pentingnya kesehatan reproduksi dan faktor risiko perilaku seksual kepada remaja.

Pemberian MP-ASI dini dengan status gizi (PB/U) usia 4-7 bulan di Kecamatan Ratu Samban Kota Bengkulu Rama Beka Sariy; Betty Yosephin Simanjuntak; Desri Suryani
AcTion: Aceh Nutrition Journal Vol 3, No 2 (2018): AcTion Vol 3 No 2 Tahun 2018
Publisher : Jurusan Gizi Politeknik Kesehatan Kemenkes Aceh

Infants who fail to grow much occur in the third month or fourth month of early life. Early breastfeeding of the ASI causes mothers not to give breast milk and cause infectious diseases that result in stunting in infants. The purpose of this research is to find out the relationship of early breastfeeding with nutritional status (PB/U) age 4-7 months in Ratu Samban Sub-district of Bengkulu City. This research uses analytic observational with a cross-sectional design. The results showed the nutritional status of PB / U short category 18.3% and MP ASI early 66.7% while the statistical test showed probability (p) of 0.273 (p> 0.05). There is no correlation between early breastfeeding of MP and nutritional status of PB / U age 4-7 months in Ratu Samban Sub-district of Bengkulu City. Need to do re-research a using Cohort method and with other variables.Bayi yang gagal tumbuh banyak terjadi pada bulan ketiga atau bulan ke empat awal kehidupan. Pemberian MP ASI dini mengakibatkan ibu tidak berusaha memberikan ASI dan menyebabkan terjadinya penyakit infeksi yang mengakibatkan stunting pada balita. Tujuan dari penelitian ini adalah untuk mengetahui hubungan pemberian MP-ASI dini dengan status gizi (PB/U) pada bayi usia 4-7 bulan di Kecamatan Ratu Samban Kota Bengkulu. Jenis penelitian ini menggunakan observasional analitik dengan desain cross sectional. Hasil penelitian menunjukan status gizi PB/U kategori pendek 18,3% dan MP ASI dini 66,7% sedangkan uji statistik menunjukkan nilai probabilitas (p) sebesar 0,273 (p > 0,05). Tidak ada hubungan antara pemberian MP ASI dini dengan status gizi PB/U usia 4-7 bulan di Kecamatan Ratu Samban Kota Bengkulu . Hal ini berkaitan dengan pemberian makanan pendamping ASI sementara sebagai makanan prelaktal sebelum ASI ibu keluar dan diberikan dalam jumlah sedikit. Lebih baik dilakukan penelitian lanjutan dengan menggunakan metode Kohort dan dengan variabel lain.

Asupan zat gizi makro dan mikro pada anak sekolah dasar yang stunting di Kota Bengkulu Kusdalinah Kusdalinah; Desri Suryani
AcTion: Aceh Nutrition Journal Vol 6, No 1 (2021): May
Publisher : Jurusan Gizi Politeknik Kesehatan Kemenkes Aceh

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30867/action.v6i1.385

The Lack of intake of macro nutrients such as energy, protein, and micronutrients such as zinc, iron, calcium, and vitamin A, especially during the growth period will disrupt the growth process of a child which has an impact on stunting. The purpose of this study was to determine the characteristics of respondents and the relationship between macro and micro nutrient intake and stunting in elementary school (SD) children in Bengkulu City. The research design was cross-sectional with cluster sampling. The sample consisted of 82 elementary school children who were stunted in the Teluk Segara District, Bengkulu City. Data collection was carried out by interview and SQ-FFQ. Data processed in computerized. Data analysis using correlation test. The average energy intake was 783.5 kcal, protein 28.3 grams, carbohydrates 103.1 grams, calcium intake 198.1 mg, while the median value for fat intake was 36.7 grams, zinc 3.1 mg, iron 4 mg, and vitamins. A 201.6 mcg. All of these nutrient intakes are very low when compared to the recommended nutritional adequacy rate for school-age children. There is no relationship between macro and micro nutrient intake and stunting in elementary school children in Bengkulu City (p > 0,05). In conclusion, the intake of both micro and macro nutrients is still low in elementary school children and does not show an association with the incidence of stunting.

Co-Authors Adelia Ajelika Adelia Aperiliana Bella Afifah Putri Azzahra Afriyana Siregar Agus Supardi Ahmad Rizal ahmad rizal Ahmad, Che An Ali Khomsan Anang Wahyudi Anang Wahyudi Anang Wahyudi Anggryani Margaretha Angraini, Wulan Aprita Dwi Putri Elliza Arie Nugroho Baruara, Guntur Betri Anita Betri Anita Anita Betty Yosephin Simanjuntak Bintang Agustina Pratiwi Che An Ahmad Cicilia Fransiska Darmawati Santoso darwis darwis, darwis Dayanti, Lestari Rahmah Demsa Simbolon Deswita Maharani Br Mataniari Dinda Puspita Gita Dinda, Inge dita kodrati alaina Dwi Permata Sari Eliana Eliana Elly Wahyuni Elsha Cristin Sipahutar Emy Yuliantini Erva Aulia Janna Eva Anggi Puspita Evi Fitriani EVI FITRIANI Febriyanto, Tedy Fitria Ogina Frensi Riastuti Halimatussa Diah Halimatussa'diah, Halimatussa'diah Hawani, Ikat Tri Heldi Saputra Hendarin Hendarin Henni Febriawati, Henni Husin, Hasan Izzatul Ilmi Juita Sari Jumiyati Jumiyati Jumiyati Jumiyati Jumiyati Karunia, Mekti Ketut Murni Krisnasary, Arie kusdalinah Kusdalinah Kusdalinah Kusdalinah Kusdalinah Lela Hartini Lesmi, Anisa Lestari, Sinta Wahyu Lista Maharani Maharani, Maharani Maigoda, Tonny Cortis Mawar Maysara Dwi Alfiana Melinda Putri, Sinthya Melita Sari Meriwati Meriwati Mahyudin Meriwati, Meriwati Meta Irwanda Miratul Haya miratul haya Miratul Haya Miratul Haya, Miratul Mita Apriani Muhammad Revil Syaputra Nadilla Putri Sp Natan, Okdi Nevike Amanda P Nugraheni, Diah Eka Nur Elly Okfriani, Yenni Peny Dwi Oktavia Putra, Boy Zedra Ananda Pratama Qotima, Shania Rama Beka Sariy Rinsesti Junita Risda Yulianti Risda Yulianti Riska Hafiani Riski Amalia RS, Sunita Serly Lestari Shafiyyah Ummu K Sinta Agustina Sinta Wahyu Lestari Sunita R S Susilo Damarini Tadzkia Maghfira Tamala, Ramtina Tetes Wahyu Tetes Wahyu W Tetes Wahyu W Tetes Wahyu Witradharma Tonny C Maigoda Tonny Cortis Maigoda Ummi Hasanah Wahnil Dia Handayani Wahyu Elia Ramadani Wulan Angraini wulandari, Gite Putri Wulandari, Melsa Putri Yandrizal Yandrizal Yanuarti, Riska Yorita, Epti Yulia Afriza YUNITA Yunita Yunita Yunita Yunita Yunita Yunita Yunita Yunita Yunita Yunita Zahra, Intan Sefti

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