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Lutfan Lazuardi
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jmpkfk@ugm.ac.id
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Jl. Farmako Sekip Utara, Yogyakarta, Indonesia 55281 Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada
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INDONESIA
Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management)
Published by Universitas Gadjah Mada
ISSN : 14106515     EISSN : 28286774     DOI : https://doi.org/10.22146/jmpk.v25i03.5186
Core Subject : Health,
Health Professions Public Health
Misi JMPK adalah menerbitkan, menyebarluaskan dan mendiskusikan berbagai tulisan ilmiah mengenai manajemen pelayanan kesehatan yang membantu manajer pelayanan kesehatan, peneliti, dan praktisi agar lebih efektif. Jurnal ini ditujukan sebagai media komunikasi bagi kalangan yang mempunyai perhatian terhadap ilmu manajemen pelayanan kesehatan antara lain para manajer, pengambil kebijakan manajerial di organisasi-organisasi pelayanan kesehatan seperti rumah sakit, dinas kesehatan, Kementerian Kesehatan, pusat-pusat pelayanan kesehatan masyarakat, BKKBN, pengelola industri obat, dan asuransi kesehatan, serta institusi pendidikan penelitian.
Arjuna Subject : Kedokteran - Kesehatan Masyarakat, Kesehatan Lingkungan dan Pekerjaan
Articles 4 Documents
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Search results for , issue "Vol 22 No 1 (2019)" : 4 Documents clear
PENGEMBALIAN BERKAS KLAIM PASIEN PESERTA JAMINAN KESEHATAN NASIONAL (JKN) DI RSUD SULTAN SYARIF MOHAMAD ALKADRIE KOTA PONTIANAK Andi Sulaimana; Andreasta Meliala; Julita Hendrartini
Journal of Health Service Management Vol 22 No 1 (2019)
Publisher : Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (225.228 KB) | DOI: 10.22146/jmpk.v22i1.4471

Abstract

Background: Approach of managed care in the National Health Insurance Program (JKN) puts hospitals as a health facility referral with the prospective payment system. Treatment of patients should be done and handled in primary health facilities. Although the number of patient referral to hospitals in JKN era remains high. The impact of the hospital is faced with an increase in claims bills to BPJS Kesehatan. By 2016 in RSUD Pontianak it was noted that 6.98% of the income came from JKN hospital patients which had not been paid by BPJS Kesehatan, so some were returned. A research needs to be conducted on the cause of the returned claim file from BPJS Kesehatan verifier to RSUD Pontianak. Objective: To find out the cause of the claims pending in RSUD Pontianak. Methods: The research is an exploratory case study with a single case study design approach. Results: The claim process at RSUD Pontianak is still not as good as never completed every month. Most of the causes of returned claims are administrative errors and medical reasons. Maladmin istration in the form of typing errors, dates, but a sign from the doctor. Medical reasons include coding disagreements, differences in perceptions about specific inspection directions, lack of support, differences in perceptions about secondary diagnostic inputs. Performance coding is limited to differences in perceptions between Coder and BPJS Kesehatan Verifier, positive physician response to file claims reversed, BPJS Kesehatan Verifier perceptions are constrained in capacity, differences in educational background, differences in understanding with Coder on Reselected Coding, and differences in regulatory implementation in the claims process. Conclusion: Technical error of claims administration process, difference of perception of coding, difference of comprehension about complementary examination, special treatment and secondary diagnosis input, and difference of perception to JKN regulation on verifier of cause of claim file of JKN patients return to RSUD Pontianak.
KINERJA TIM KENDALI MUTU KENDALI BIAYA CABANG SURAKARTA DALAM PENGENDALIAN MUTU DAN BIAYA PADA PROGRAM JAMINAN KESEHATAN NASIONAL Sholahuddin Sanjaya; Dwi Handono Sulistyo; Julita Hendrartini
Journal of Health Service Management Vol 22 No 1 (2019)
Publisher : Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (141.653 KB) | DOI: 10.22146/jmpk.v22i1.4472

Abstract

Background: Indonesia in 2014 implemented the National Health Insurance (JKN) program. The implementation of the comparison between contribution and health insurance expenditure in the Surakarta Branch Office is not optimal. The Coordinating Team in TKMKB plays an important role in JKN quality and cost control. Hence, we need to evaluate the performance with the TKMKB Surakarta Branch coordination team. Objective: To evaluate the performance of TKMKB Surakarta Branch Coordination Team in quality and cost control of JKN program and to identify performance inhibiting factors. Methods: The research was descriptive with case study design using qualitative approach focusing on developing the description and depth analysis about Coordination Team performance on national health insurance program at Surakarta Branch Office. Performance was assessed based on the implementation of the job description. Data were collected using interviews and document review. Results: The utilisation review task was not standardised yet because it was only implemented once and there was no monitoring and follow-up of utilisation review indicators, the discussion of the problem and the evaluation of the policy has not been in accordance with the standards because the recommendation issues have not been in accordance with the issues raised. The socialisation of authority, ethical guidance and professional discipline of health personnel have not been up to standard because they are not conveyed to all members of professional organisations. Factors that hamper performance were limited time, lack of data access, and facilitation. Conclusion: The performance of the Coordination Team on the task of utilisation review has not been optimal yet, the task of discussing the problem and the evaluation of the policy has not been optimal, and in the task of authority socialisation, ethics coaching and health professional discipline has not been optimal. Factors that hinder performance were limited time, lack of data access, and facilitation of TKMKB.
EVALUASI KEBIJAKAN RUMAH TUNGGU KELAHIRAN (RTK) DI KABUPATEN KONAWE PROVINSI SULAWESI TENGGARA TAHUN 2016 Sri Ayu Lestari; Laksono Trisnantoro; Dwi Handono Sulistyo
Journal of Health Service Management Vol 22 No 1 (2019)
Publisher : Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (127.479 KB) | DOI: 10.22146/jmpk.v22i1.4473

Abstract

Background: The high maternal mortality rate (MMR) in Indonesia prompted the government to issue a Jampersal fund policy. One of the objectives of Jampersal fund is to provide budget for operational activities of Maternity Waiting Home (MWH) Program, a government strategy to facilitate access of pregnant mother to get health service to overcome pregnant, childbirth and childbirth problems as an effort to decrease maternal MMR in Indonesia. Objective: To describe the implementation of MWH policy as an effort to facilitate pregnant women, childbirth, and postpartum to get access to health service in Konawe Regency of Southeast Sulawesi Province. Methods: The study was descriptive using qualitative design with case study approach focusing on developing in-depth description and analysis of cases also studying MWH program. Results: MWH Program in Konawe Regency has been running for one year but there was still one Puskesmas that has not run the MWH program because the location of Puskesmas is far from the citizen’s residence. MWH is not only used by pregnant women who are far from the health facility and have a high risk but also used for all pregnant women who will give birth. MWH already meets the criteria set by the Ministry of Health. The operational cost of the waiting house guarantees all the costs of pregnant and family needs during their stay. The obstacles to MWH programs were disbursement of funds, rejection of pregnant women to the waiting house and difficult road access. Conclusion: MWH Program has been effective because it has been used by all pregnant women who have risk and who will give birth are placed in the waiting house of birth. The barriers that exist during the MWH program runs were disbursement of funds, the rejection of pregnant women into waiting homes and difficult road access.
MANAJEMEN LEAN PADA LAYANAN KEMOTERAPI ANAK RAWAT INAP DI RUMAH SAKIT CIPTO MANGUNKUSUMO Teny Tjitra Sari; Andreasta Meliala; Firman
Journal of Health Service Management Vol 22 No 1 (2019)
Publisher : Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (780.648 KB) | DOI: 10.22146/jmpk.v22i1.4475

Abstract

Background: Cancer in children has high morbidity and mortality. Retinoblastoma is the most common solid tumor in children at the Cipta Mangunkusumo Hospital (RSCM). Chemotherapy is one of the therapeutic modalities, interdisciplinary and many procedures. Lean management continuously reduces waste and improves work flow. Objective: This study used lean management to determine the efficiency of health care in teaching hospital. Methods: Action research was conducted at RSCM. Sampling by purposive sampling that represents the role in the flow of the service process. The observation guide uses cycle time observation sheets, value-added analysis sheets, waiting time and lead time. The waste found is listed in the DOWNTIME matrix. Observations were made on inpatient chemotherapy services for children and then a diagnosis was made using Value Stream Mapping. The Kaizen team consisted of pharmacists, nurses, doctors doing a plan-do-study-action, prepared an intervention plan, and conducted post-intervention observations. The 5S method is used to improve service flow. Results: In this study, patients with retinoblastoma in class III in patient ward included were 7 patients in the pre-intervention group and 16 patients in the postintervention group. Major decreases in lead time happened in the subprocesses of ordering chemotherapy (75%), decision-making of chemotherapy administration (55%) and filling of the resume (41%). Lead time process in chemotherapy administration for retinoblastoma changed from 48 hours, 36 minutes (more than 2 days) to 38 hours, 38 minutes (1.6 days or less than 2 days). The efficiency of the process was measured using value added ratio which showed changes from 33% to 37%. Conclusion: Lean management applied in the process of chemotherapy administration in the inpatient wards increased the efficiency of the process.

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