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Jurnal JKN
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INDONESIA
Jurnal Jaminan Kesehatan Nasional
Published by Badan Penyelenggara Jaminan Sosial Kesehatan
ISSN : 27987183     EISSN : 27986705     DOI : 10.53756
Core Subject : Health, Science,
Decision Sciences, Operations Research & Management Dentistry Health Professions Medicine & Pharmacology Public Health
Jurnal Jaminan Kesehatan Nasional merupakan salah satu bentuk upaya pengembangan dan menjadi rujukan ilmiah bagi para akademisi dan praktisi terkait Jaminan Kesehatan Nasional. Jurnal ini memuat artikel-artikel terkait bidang Jaminan Kesehatan Nasional melalui berbagai pendekatan ilmiah yang berfokus pada pembahasan mengenai Risk Pooling, Strategic Purchasing, Revenue Collection yang dapat menjadi pengayaan ilmu di bidang Jaminan Sosial Kesehatan. Selain itu, jurnal ini juga memuat berbagai aspek lainnya yang relevan, yakni Stakeholder Engagement dan Institutional Capability terkait penyelenggaraan Jaminan Kesehatan Nasional
Arjuna Subject : Umum - Umum
Articles 79 Documents
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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.
Pengaruh Simplifikasi Alur dan Berkas Layanan Administrasi Kepesertaan Terhadap Kepuasan Peserta JKN di Kantor BPJS Kesehatan Cabang Kupang Bau, Ariasto; Kapitan, Gregorius D.
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.v4i1.190

Abstract

The Social Insurance Administration Body for Health (BPJS Health), the institution administering national health insurance in Indonesia, has an important role in ensuring people have access to quality health services. The method taken by The Social Insurance Administration Body for Health to minimize complaints and reduce waiting times for services is by simplifying administrative service flows and files. This research design is quantitative and descriptive to describe the effect of simplifying participant service flows and files at branch offices on the satisfaction of the National Health Insurance participants at the Kupang Branch Office. The research sample consisted of 50 people using the Simple Random Sampling technique. Research data analysis was carried out univariately. The research results show that a simple flow and file of service requirements will make it easier for the National Health Insurance participants to obtain administrative services and simplifying services for participants will have an impact on achieving participant satisfaction with services at the Social Insurance Administration Body for Health office. The Social Insurance Administration Body for Health is expected to pay attention to the satisfaction of the National Health Insurance participants by committing to implementing simplification of service flows and processes to achieve good service quality.
GAMBARAN INEFESIENSI PENAGIHAN CT SCAN SIMULATOR SEBAGAI INISIASI AWAL AUDIT ADMINISTRASI KLAIM (AAK) BPJS KESEHATAN PADA RS VINA ESTETIKA: GAMBARAN INEFESIENSI PENAGIHAN CT SCAN SIMULATOR SEBAGAI INISIASI AWAL AUDIT ADMINISTRASI KLAIM (AAK) BPJS KESEHATAN PADA RS VINA ESTETIKA Yusti, Rahayu
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.v4i1.192

Abstract

A CT Scan Simulator is a tool used to determine the size, shape, and location of a tumor to help the radiotherapy team determine the next treatment plan. Vina Estetica General Hospital is a public hospital that provides CT Scan Simulator services based on the permission of Perka BAPETEN as radiotherapy management and follow-up in malignancy cases. This study uses a descriptive method through a quantitative approach, aiming to describe the inefficiency of CT-Scan Simulator billing used as a support for diagnosis enforcement based on the Indonesian-Case Based Groups (INA CBGs) tariff costs. The technique used was purposive sampling with inclusion and exclusion criteria. Secondary data collection was carried out retrospectively in the form of claim files for the period January 2020 - November 2023 as many as 308 samples were taken randomly. The results showed that there were 283 (83%) CT Scan Simulator billing claims aimed at supporting diagnosis enforcement and resulting in billing inefficiencies in the INA CBGs claim rates being higher
Implementation of the National Health Insurance Programme in Achieving Universal Health Coverage in Indonesia Alkayyis, Muhammad Youri
Jurnal Jaminan Kesehatan Nasional Vol. 4 No. 2 (2024): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v4i2.197

Abstract

Many countries have agreed to and enforced the implementation of Universal Health Coverage (UHC), yet achieving it is only occasionally seen in certain countries. The National Health Insurance (JKN) Programme is an Indonesian government initiative aimed at providing health protection to all residents of Indonesia through the JKN Programme. The oversight of the Programme and its pivotal role in Indonesia's pursuit of Universal Health Coverage (UHC) is managed by the Social Health Insurance Administration Body (BPJS Kesehatan). The objective of the JKN Programme is to furnish the populace with healthcare services and monetary safety. In Indonesia, the JKN Programme represents a concrete endeavour towards realising universal health coverage through the facilitation of health accessibility, financial safeguards, and the enhancement of healthcare service quality for all individuals. Based on this paper's foundation, this study aims to assess how the JKN Programme in Indonesia has been utilised to achieve UHC and identify the factors contributing to its success through a Systematic Literature Review (SLR). The methodology utilised in this research is the literature review approach. This investigation analysed research results linked to the subject matter being studied. Recent journals published between 2019 and 2023 were identified as the data sources for the literature review.
Beyond Immediate Needs: An Analysis of Social Insurance and Its Behavioral Economic Impact in Indonesia Palupi, Ucca Bhanuwati Astutiningtyas
Jurnal Jaminan Kesehatan Nasional Vol. 4 No. 2 (2024): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v4i2.199

Abstract

Despite the relatively high GDP growth of around 5.3 in 2022, Indonesia still faces high inequality (Gini index 37.9), which challenges social-economic-security instruments. In January 2023, the government spent around IDR 5.3 trillion to protect public health, a 12% increase compared to last year (2022), making Badan Penyelenggara Jaminan Sosial Kesehatan shortened by BPJS Kesehatan as a medic-aid social insurance manager need to keep evolving to suffice the need. In this research, we investigate the potential impact of social insurance in Indonesia to determine the possible direction of the relationship between the adequacy of social-economic-security instruments and spending. The study utilises a vector error correction model (VECM) test as a tool to analyse quarter data from several online source datasets, including household consumption expenditures, gross national income, and capital stock from bps.go.id, social insurance participations from djsn.go.id, inflation and national savings proxy by broad money M2 from bi.go.id in the form of quarterly data, starts from 2016 Q1 until 2023 Q3. The regression result shows no immediate and significant relationship between social insurance and consumption. However, the analysis reveals that social insurance might contribute to economic resilience, potentially leading to higher productive spending and a potential behavioural transformation towards risk.
Evaluating Primary Care Providers' Compliance with Special Capitation in Indonesia's National Health Insurance Anindita, Rahma; Aryani, Ari Dwi; Ritonga, Rahmad Asri; Darmasurya, Aditya; Trisnanto, Tedo Arya; Tsani, Pranatawati Nur; Yudanto, Bayu; Trisnasari, Trisnasari
Jurnal Jaminan Kesehatan Nasional Vol. 4 No. 2 (2024): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v4i2.206

Abstract

To increase the effectiveness of the special capitation payment scheme implemented by the primary care providers (PCPs), to expand health service coverage and to provide additional incentives for the health workforce in remote areas, a commitment agreement with the primary care provider has been established. However, the PCP's achievement after implementing the commitment agreement was unclear. Hence, this study aims to analyse the commitment and achievements of the PCP in the special capitation payment scheme in 2021 and 2022. About 178 PCPs in 2021 and 191 PCPs in 2022 across Indonesia were included in this descriptive analysis using the quantitative method. The results reflected that special capitation payments accompanied by commitment agreements might influence increasing the capacity, access, and quality of health services. There was a 58% increase in the number of PCPs that achieved all PCP commitment indicators for capitation recipients in 2022 compared to 2021. The highest commitment indicator attained by PCP recipients of special capitation is the sending of health personnel. The quantity of capitation rates received, the simplicity of using capitation funds, the accessibility of physicians and other health professionals, and the assessment of service commitment accomplishments, which will affect payment, all influence the achievement of commitment indicators.
Reform of the Calculation of Premium Contributions for State Administrator Participants Jath, Ar Razaq Subhan; Arvita, Widhy; Isrok, Muhammad; Siregar, Manda Ananda Doly
Jurnal Jaminan Kesehatan Nasional Vol. 4 No. 2 (2024): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v4i2.207

Abstract

This study aims to assess the impact of the reform of the calculation of premium contributions from state administrators collecting based on Presidential Regulation Number 64 of 2020 with Local Government Contribution Reconciliation Application (ARIP), which involves a collaboration with stakeholders, namely the regional government, which is related to increasing the receipt of contributions from regional civil servants in revenue and stakeholder involvement for the sustainability of the National Health Insurance Program. ARIP is an information system that aims to ensure accountability in calculating contributions from regional officials through reconciling contributions between local governments and BPJS Kesehatan. The research used a population of 547 regional governments that used ARIP during 2020-2023. Each sample was analyzed before and after using ARIP quantitatively and descriptively based on receiving contributions from regional civil servants. The hypothesis was tested using paired samples t-test, with significance 0.001< 0.05 and value of t-count = 6.973> t-table = 1.964, then Ha was accepted. Thus, the acceptance of contributions from regional civil servants differs before and after the implementation of ARIP. According to the Cohen classification table, ARIP had a medium impact on accepting the receipt of contributions from regional civil servants, with an effect size of 0.298. Based on the analysis, implementing ARIP increases the receipt of contributions from regional officials, which was 41.303 billion rupiah and increased by 3.234 billion rupiah to 44.537 billion rupiah
English . Tanggu Bore, Angela Yunita; Pradipta, Ngakan Bagus Danip
Jurnal Jaminan Kesehatan Nasional Vol. 4 No. 2 (2024): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v4i2.210

Abstract

The community's preference for registering in the Regional Government-Subsidized Sumba segment rather than the informal workers segment may be influenced by several factors, such as income, family size, occupation, education, and the premium amount. This quantitative study uses a cross-sectional approach with a questionnaire and a minimum sample size of 415 participants selected through convenient sampling. The data were analyzed using binary logistic regression analysis. The results indicate that factors affecting participation in the Regional Government-Subsidized Sumba segment include education (OR = 0.53; p-value < 0.05), occupation (OR = 0.75; p-value < 0.05), family size (OR = 4.85; p-value < 0.05), and income (OR = 0.99; p-value < 0.05). However, the perception of premiums did not have a statistically significant effect (OR = 1.54; p-value > 0.05). This study's binary logistic regression model has a pseudo R² of 0.57, meaning that participation in the Regional Government-Subsidized Sumba segment is influenced by the independent variables by 57%. In comparison, 43% is influenced by other variables not examined in this study. Local governments must continue allocating health insurance funding each year. BPJS Kesehatan should also adopt a comprehensive approach and establish strong relationships with local governments to sustain Universal Health Coverage (UHC) in Sumba Regency
The Creation of Health Content on Social Media to Attract Public Interest in Health Literacy Ali, Mohammad
Jurnal Jaminan Kesehatan Nasional Vol. 4 No. 2 (2024): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v4i2.217

Abstract

This research aims to analyse health content creation on social media to attract public interest in health literacy. Because social media is considered a medium of entertainment, health education is a medical approach. The method used in this research is qualitative, and data collection is a review of journals, books, and other relevant sources for this research. The data analysis is done by reviewing each data source and analysing the correlation with the research. The results showed that creating health content on social media is an effort to attract public interest in health literacy because social media is a medium of entertainment in interacting and sharing information. People are interested in getting information from social media due to the creation of exciting content such as YouTube, x / Twitter, TikTok, Instagram, and other media. The efforts to create health content on social media are because social media has good effectiveness and can be used as a medium for promotion and health education. In addition, communication is part of the success of health policy. It is appropriate for every individual to pay attention to health factors as primary needs in their lives.

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