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Jurnal Kebijakan Kesehatan Indonesia
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Analisis Perbedaan Kepuasan Pasien JKN dan Umum di RSUD Bantaeng Tahun 2015 Musdalifah Musdalifah; Irwandy Irwandy; Alimin Maidin
Jurnal Kebijakan Kesehatan Indonesia Vol 5, No 1 (2016)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (63.063 KB) | DOI: 10.22146/jkki.v5i1.36082

Abstract

Background: The national health (JKN) road map expected that in 2019 all health facilities including hospitals will meet the high quality standards and patient satisfaction. By developing and monitoring the patient satisfaction, in 2019 it is expected 85% of participants of JKN will satisfied with the quality of health services without any discrimination between patients. Research Purposes: This study aimed to analyze the differences level of patient satisfaction between JKN and General patients (non JKN patients) based on their perception about the quality of care they already received in Hospitals District Bantaeng in 2015. Methods: This research was a quantitative research with survey methods. Total respondents were 100 inpatients (JKN= 65 people and General = 35). The questionnaire was a modification from the hospital consumer assessment of healthcare providers and system (HCAHPS) questionnaire. The normality test and Mann-Whitney Test used to analyze the differences between patient satisfactions. Results and discussion: The study found there were no significant differences between patient satisfaction among general and JKN patients in all dimensions (communication between doctor, nurse communication, hospital environment, responsiveness, pain management, medication and discharge communication information). The whole dimension of patient satisfaction already meet the standard that is> 85%, except the environmental dimension of the hospital (71%). Conclusions and suggestions: The quality of services provided for JKN Patient has met the standard, without discrimination between JKN and general/non JKN patient. Recommendations to the hospital management are to improve the cleanliness, comfort and condition of hospital environment to increase the patient satisfaction level. Latar Belakang: Dalam road map jaminan kesehatan nasional (JKN) diharapkan pada tahun 2019 seluruh fasilitas kesehatan termasuk rumah sakit akan memenuhi standar yang berlaku agar kepuasan peserta terpenuhi. Dengan mengembangkan sistem dan pemantauan kepuasan peserta, pada tahun 2019 diharapkan 85% peserta puas terhadap layanan kesehatan berkualitas tanpa ada diskriminasi antara jenis kepesertaan pasien baik itu pasien JKN ataupun pasien Umum. Tujuan Penelitian: Penelitian ini bertujuan untuk menganalisis tingkat perbedaan kepuasan pasien JKN dan Umum terhadap kualitas pelayanan yang diterima di RSUD Bantaeng tahun 2015. Metode: Penelitian ini adalah penelitian kuantitatif dengan pendekatan survei. Total responden sebanyak 100 pasien rawat inap (pasien JKN=65 orang dan Umum=35 orang). Kuesioner penelitian merupakan modifikasi dari hospital consumer assessment of healthcare provider and system (HCAHPS). Uji normalitas dan Mann-Whitney Test digunakan untuk melihat perbedaan kepuasan antara pasien JKN dan Umum. Hasil dan Diskusi: Berdasarkan hasil penelitian ditemukan tidak ada perbedaan signifikan antara kepuasan pasien JKN dan umum dari semua dimensi yakni komunikasi dokter, komunikasi perawat, lingkungan rumah sakit, daya tanggap, manajemen nyeri, komunikasi obat dan discharge information. Seluruh dimensi kepuasan pasien telah berada di atas standar yakni >85% kecuali untuk dimensi kepuasan terhadap lingkungan rumah sakit baru sekitar 71% pasien yang puas. Kesimpulan dan Saran: Kualitas pelayanan yang diberikan kepada pasien JKN telah masuk kategori baik dimana tidak ditemukan adanya perbedaan kualitas pelayanan yang diberikan kepada pasien umum dan JKN. Disarankan kepada pihak rumah sakit untuk lebih meningkatkan kebersihan, kenyamanan dan kondisi bangunan lingkungan rumah sakit agar tingkat kepuasan pasien di RSUD Bantaeng dapat lebih meningkat.
Evaluasi Fungsi Regulasi Dinas Kesehatan Provinsi pada Sektor Kesehatan di Provinsi Bengkulu Adlin Fitri; Laksono Trisnantoro; Dwi Handono Sulistyo
Jurnal Kebijakan Kesehatan Indonesia Vol 3, No 1 (2014)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (234.112 KB) | DOI: 10.22146/jkki.36351

Abstract

Background: Government Act Number 38 issued in 2007 on the differentiation of government affairs between central government, local provincial and local district/municipal government stated the obligation of local district/municipal government to protect, serve, empower and ensure the welfare of the community as well as implement regulation in the health sector. Based on data from Bengkulu Provincial Health Office, some health facilities and staff do not register or undertake accreditation and certification. This indicates that regulation function is not yet well implemented. Thus it is necessary to evaluate the regulatory function of provincial health office in the implementation of regulation in the health sector. Objective: To evaluate the regulatory function of Bengkulu Provincial Health Office as a regulator in the health sector, viewed from input, process, output, and environment. Method: The study was qualitative with case study design. Evaluation of function of Bengkulu Provincial Health Office was made on regulation in the health sector, i.e. licensing, registration, accreditation, and certification of health facilities and staff against the standard in the implementation of regulation on licensing, registration and certification. Result: Performance in input for the implementation of regulation was still relatively weak: there was no support of regulation or policy in the implementation of regulation, there was no staff specifically responsible for the implementation of regulation, no budget allocation for regulation function implementation, no standard or method for the implementation of control and supervision, and limited facilities for the operation of regulation. This resulted in poor performance of regulation implementation so that the output was poor, some health facilities and staff were no registered, there was no accreditation and certification. There was no role of the environment, i.e. office of integrated registration service that regulates licensing. Conclusion: the Regulatory function of Bengkulu Provincial Health Office in the health sector was not well implemented due to lack of support from the government as viewed from the input, process, output, and the environment in the implementation of the regulatory function in the area of licensing, registration, accreditation and certification.Latar belakang: Peraturan Pemerintah No. 38/2007 tentang pembagian urusan Pemerintahan antara Pemerintah, Pemerintah Daerah Provinsi dan Pemerintah Daerah Kabupaten/Kota, dimana kewajiban/kewenangan Pemerintah Daerah dalam me- lindungi, melayani, memberdayakan dan mensejahterakan ma- syarakat dan juga peran Pemerintah Daerah melaksanakan regulasi pada sektor kesehatan. Berdasarkan data Dinas Kesehatan Provinsi Bengkulu masih terdapat sarana kesehatan dan tenaga kesehatan yang tidak melakukan registrasi, akre- ditasi dan sertifikasi. Hal ini menunjukkan bahwa pelaksanan fungsi regulasi belum berjalan optimal. Dengan demikian perlu dilakukan evaluasi terhadap fungsi dinas kesehatan provinsi dalam melaksanakan regulasi pada sektor kesehatan. Tujuan Penelitian: Melakukan evaluasi terhadap fungsi regu- lasi Dinas Kesehatan Provinsi Bengkulu sebagai regulator pada sektor kesehatan, dilihat dari input, proses, output dan lingkungan. Metode: Jenis penelitian ini adalah kualitatif dengan rancangan studi kasus, dengan melakukan evaluasi fungsi Dinas Kese- hatan Provinsi Bengkulu dalam melakukan regulasi pada sektor kesehatan yaitu perizinan, registrasi, akreditasi, dan sertifikasi sarana dan tenaga kesehatan dibandingkan dengan standar dalam pelaksanaan regulasi perizinan registrasi, akreditasi dan sertifikasi. Hasil: Kinerja input untuk pelaksanaan regulasi masih sangat lemah yaitu tidak adanya dukungan peraturan atau kebijakan dalam pelaksanaan regulasi, tidak adanya Sumber Daya Manu- sia yang khusus untuk melaksanakan regulasi, tidak ada anggar- an/dana yang dialokasikan untuk pelaksanaan fungsi regulasi, tidak adanya standar atau metode untuk pelaksanaan peng- awasan dan pembinaan, dan keterbatasan fasilitas yang terse- dia untuk operasional kegiatan regulasi. Hal ini menyebabkan proses pelaksanaan regulasi tidak berjalan optimal sehingga output dari pelaksanaan regulasi yaitu masih terdapat sarana dan tenaga kesehatan yang tidak melakukan registrasi, akredi- tasi dan sertifikasi. Dan belum ada peran lingkungan yaitu kantor pelayanan perizinan terpadu dalam regulasi perizinan. Kesimpulan: Fungsi regulasi Dinas Kesehatan Provinsi Beng- kulu pada sektor kesehatan belum dilaksanakan dengan opti- mal karena tidak adanya dukungan pemerintah yang bisa dilihat dari input, proses, output dan lingkungan dalam pelaksanaan fungsi regulasi perizinan, registrasi, akreditasi dan sertifikasi.
Faktor-Faktor yang Berhubungan dengan Kepesertaan Program JKN di Wilayah Kerja Puskesmas Remaja Kota Samarinda Husnun Nadiyah; Subirman Subirman; Dina Lusiana S
Jurnal Kebijakan Kesehatan Indonesia Vol 6, No 2 (2017)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (84.78 KB) | DOI: 10.22146/jkki.v6i2.28931

Abstract

ABSTRACTBackground: National health insurance program aims to provide health protection in health care benefits to fill basic health needs. In 2015 the number of membership of a JKN in Samarinda city is 398.135 or 40,25% of the total population of the city, membership are divided into subsidized member (PBI) of 89.876 and non subsidized member (Non PBI) of 308.259 people. It shows that 59.74% of the population is not yet not covered by health insurance.Aim: The purpose of this research to asses the factors related to the participation of the JKN program in working area Remaja Health Center Samarinda.Method: This study used analytic survey method with cross sectional approach. Population of the study was head of household in the district of Temindung Permai, Bandara, and Gunung Lingai with a sample of 371 respondents using purposive sampling. Data were analyzed descriptively with a frequency table using coefficient kontingency test and coefficientn corelated Phi.Result: This study showed 47% of respondents are not participants JKN and 53% of respondents are JKN participants, 75% of respondents with good knowledge of JKN, 93% of respondents with positive attitudes towards JKN, 78% of respondents trust the JKN service, and 70% of respondents have the support of family. The results of the bivariate analysis showed there was correlation between knowledge (p value 0.006), respondents attitude (p value 0.031), family support (p value 0,000) and there was no relationship of trust (p value 0.226) with membership of JKN program.Conclusion: There is a need to increasing public knowledge about the program JKN and improving the quality of health services.Keywords: Health Insurance, Membership, KnowledgeABSTRAKLatar belakang: Program JKN bertujuan memberikan perlindungan kesehatan dalam bentuk manfaat pemeliharaan kesehatan untuk memenuhi kebutuhan dasar kesehatan. Jumlah kepesertaan JKN tahun 2015 di Kota Samarinda saat ini sebanyak 398.135 atau 40,25% dari jumlah penduduk Kota Samarinda tahun2015, terdiri dari peserta Penerima Bantuan Iuran sebanyak 89.876 jiwa dan peserta Non Penerima Bantuan Iuran sebanyak308.259 jiwa. Jumlah tersebut menunjukkan bahwa sebanyak 59,74% penduduk Kota Samarinda belum terlindungi oleh Jaminan Kesehatan.Tujuan: Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kepesertaan program JKN di wilayah kerja Puskesmas Remaja Kota Samarinda.Metode: Metode yang digunakan dalam penelitian ini adalah metode penelitian survei analitik dengan pendekatan cross sectional. Populasi dalam penelitian ini adalah kepala keluarga yang tinggal di Kelurahan Temindung Permai, Kelurahan Bandara, dan Kelurahan Gunung Lingai dengan sampel sebanyak 371 responden yang dipilih secara purposive sampling. Data dianalisis secara deskriptif dengan tabel frekuensi dengan menggunakan uji Koefi sien Kontingensi dan Koefi sien Korelasi Phi.Hasil: Dalam penelitian ini diperoleh 47% responden bukan peserta JKN dan 53% responden peserta JKN, 75% responden berpengetahuan baik, 93% responden bersikap positif, 78% responden percaya terhadap pelayanan JKN, dan 70% responden mendapatkan dukungan dari keluarga terdekat. Hasil analisis bivariat menunjukkan terdapat hubungan pengetahuan (p value 0,006), sikap responden (p value 0,031), dukungan keluarga (p value 0,000) dan tidak ada hubungan kepercayaan (p value 0,226) dengan kepesertaan program JKN. Kesimpulan: Dalam hal ini, perlunya peningkatan pengetahuan masyarakat mengenai program JKN dan peningkatan mutu pelayanan kesehatan.Kata Kunci: Jaminan Kesehatan, Kepesertaan, Pengetahuan
Evaluasi Pelaksanaan Kebijakan Bantuan Operasional Kesehatan di Dinas Kesehatan (Studi Kasus di Dinas Kesehatan Kabupaten Bantul dan Dinas Kesehatan Kabupaten Lebong Tahun 2011) Handry Mulyawan; Laksono Trisnantoro; Siti Noor Zaenab
Jurnal Kebijakan Kesehatan Indonesia Vol 1, No 3 (2012)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (246.234 KB) | DOI: 10.22146/jkki.v1i3.36016

Abstract

Background: The low of budget in the health sector in par- ticular promotive causes and preventive health development through many obstacles in the arious fields. BOK program is one of the breakthroughs made by the Ministry of Health to assist in financing health sector. Entering the second year of the mechanisms that change the original BOK disbursed through the mechanism of Bantuan Sosial, in the year 2011 was replaced by Tugas Pembantuan fund. This change of course was followed by delegation of authority and responsi- bility of the Minister of Health to head the district / municipal health department in this regard. So the role of health of health district to be the main benchmark in the success of this programss. Objectives: To evaluate the role of health authorities in the implementation of the BOK in Bantul District Health Office and Lebong District Health office. Methods: The study used a qualitative design, with a de- scriptive case study approach. Results: Bantul district health office and Lebong district Health Office have done management functions including: Planning, Organizing, and Controling well, but due to funding limitations and delays the decline in terms of Actuating BOK it can not be perfect, it is characterized by the BOK funds sosilisasi still “riding” on the socialization of the activities funded in the bud- get. BOK funds from the Ministry of Health as a breakthrough viewed positively in improving staff motivation in the field, but the scope of the program have not seen an increase in the siginfikan. There are diverse opinions about the mechanism for channeling funds BOK, but in general the District Health Office in Bantul want that future BOK disbursed by DAK mecha- nism while at the District Health Office Lebong more likely to Tugas Pembantuan mechanism. Conclusion: Optimal health authorities have a role in financial management and program management views of the manage- ment function which includes Planning, Organizing, and Controling but due to funding limitations and delays the decline Actuating management functions can not be running optimally. BOK program is seen as a policy that needs to be maintained, noting the need for some improvements, especially the mecha- nism for channeling funds quickly and easily accounted for, although it has not been an increase in the scope of the pro- gram. Latar Belakang: Rendahnya anggaran di sektor kesehatan khususnya promotif dan preventif menyebabkan pembangunan di bidang kesehatan mengalami banyak kendala di berbagai bidang. Program BOK merupakan salah satu terobosan yang dilakukan oleh Kementerian Kesehatan untuk membantu penda- naan di bidang kesehatan. Memasuki tahun kedua mekanisme BOK mengalami perubahan, yang semula dikucurkan melalui mekanisme Bantuan Sosial, di tahun 2011 diganti melalui Tugas Pembantuan. Perubahan ini tentu saja diikuti dengan pelimpahan wewenang dan tanggung jawab dari Menteri Kesehatan kepa- da kepala daerah kabupaten/kota dalam hal ini dinas kesehatan. Sehingga peran dinas kesehatan menjadi tolok ukur utama dalam keberhasilan program BOK ini. Tujuan: Mengevaluasi peran dinas kesehatan dalam pelaksa- naan kebijakan BOK di Dinas Kesehatan Kabupaten Bantul dan Dinas Kesehatan Kabupaten Lebong. Metode: Penelitian ini menggunakan rancangan kualitatif, dengan pendekatan studi kasus deskriptif. Hasil: Dinas Kesehatan Bantul dan Dinas Kesehatan Lebong telah melakukan fungsi manajemen yang meliputi; Planning, Organizing, dan Controling secara baik, namun karena keter- batasan dan keterlambatan turunnya dana BOK maka dalam hal Actuating belum bisa berjalan sempurna, hal ini ditandai dengan sosilisasi dana BOK yang masih “menumpang” pada sosialisasi kegiatan-kegiatan yang di danai APBD. Dana BOK sebagai terobosan dari Kementrian Kesehatan dipandang positif dalam meningkatkan motivasi petugas dilapangan, namun secara cakupan program belum terlihat adanya peningkatan yang siginfikan. Ada beragam pendapat mengenai mekanisme penyaluran dana BOK, namun secara umum Dinas Kesehatan Kabupaten Bantul menginginkan bahwa kedepan BOK dikucurkan dengan mekanisme DAK sedangkan di Dinas Kesehatan Kabupaten Lebong lebih cenderung untuk tetap mempertahankan pada mekanisme Tugas Pembantuan. Kesimpulan: Dinas kesehatan telah berperan optimal dalam manajemen keuangan dan manajemen program dilihat dari fung- si manajemen yang meliputi Planning, Organizing, dan Con- troling namun karena keterbatasan dan keterlambatan turunnya dana fungsi manajemen Actuating belum bisa berjalan secara optimal. Program BOK dipandang sebagai suatu kebijakan yang perlu dipertahankan, dengan catatan diperlukannya beberapa perbaikan terutama mekanisme penyalura dana yang cepat dan mudah dipertanggungjawabkan, meskipun belum terjadi peningkatan cakupan program.
ANALISIS IMPLEMENTASI KEBIJAKAN JAMINAN PERSALINAN DALAM MENINGKATKAN CAKUPAN PERSALINAN TENAGA KESEHATAN DI KABUPATEN SITUBONDO TAHUN 2013 Gurendro Putro
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 3 (2013)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (45.823 KB) | DOI: 10.22146/jkki.v2i3.3208

Abstract

Background:The policy of Maternity Benefit for the Uninsured(Jampersal) is based on the philosophy to reduce maternalmortality and infant. The Minister of Health Regulation number2562/Menkes/Per/XII/2011 on A Maternity Benefit for theUninsured Persons’s Technical Guidelines ensures that thegovernment provides services to pregnant women withantenatal care (ANC), parturition and post-parturition for free,including the use of contraceptives post parturition.Objective:To know the confidence’s level of pregnant womenin seeking help for parturition from the health provider, theprovider commitment to Jampersal policy, and Jampersalsocialization in the community.Methods: Cross-sectional and purposive sampling are usedfor descriptive analysis. Data collection is conducted withinterview using a questionnaire to 40 mothers and 40 midwivesin the district Situbondo. Data is also collected throughsecondary data from the district health office Situbondo andhospital.Results: From the 40 respondents that had been interviewed,92.5% ask for help to providers, but as much as 7.5% ask forpartus help from traditional birth attendants. In addition, theJampersal still charged costs to maternal care to as many as12 people (30%). This is non-conforming to Jampersal policyof giving free maternal care. In Jampersal implementation inSitubondo, 50% of midwives have good commitment. While27.5% showed medium commitment and the remaining 22.5%is less committed. The magnitude of this commitment varies.Respondents with the age of 30-39 years shows excellentcommitment ( 55%), and those who work for 1-9 years arecommitted (50%). Socialization of Jampersal policy hasn’t beenoptimal. Jampersal is still not known by all pregnant womenyet. The term “free treatment” is confused with the health cardpolicy.Conclusion: There is a high trust level in pregnant womenwho asks for partus help (92.5%). Commitment of provider inrunning the Jampersal policy is still high. Jampersal socializationhasn’t reached the optimal level because people still do notunderstand the conditions of Jampersal.Suggestion: Since birth delivery by the traditional birth attendantsis still common, the midwife should work with traditionalbirth attendants in terms of infant care such as bathing, andgive incentives when collaborating in handling after partus.There is a need to improve midwife skills in detecting the riskof pregnancy and childbirth. Socialization Jampersal need toinvolve community leaders, and religion leaders.Keywords: Jampersal, pregnant women’ trust, Provider Commitment.
Pengaruh Potensi Fraud dalam Penerapan Sistem Jaminan Kesehatan Nasional terhadap Mutu Layanan di RSJ Dr. Radjiman Wediodiningrat Lawang, Malang Ika Nurfarida
Jurnal Kebijakan Kesehatan Indonesia Vol 3, No 4 (2014)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (332.329 KB) | DOI: 10.22146/jkki.36385

Abstract

Latar belakang: Sistem Jaminan Kesehatan Nasional diselenggarakan oleh pemerintah sebagai upaya untuk menyediakan layanan kesehatan yang terjangkau dan bermutu, tak terkecuali layanan kesehatan jiwa. Dalam pelaksanaannya diduga terdapat potensi fraud yang dapat merugikan banyak pihak, baik secara langsung maupun tidak langsung. Pengawasan terhadap potensi fraud di sektor kesehatan sudah mulai ditargetkan oleh Komisi Pemberantasan Korupsi, karena potensi kerugian yang diakibatkan cukup besar. Tujuan: Untuk mengetahui pengaruh potensi fraud dalam penerapan sistem jaminan kesehatan nasional terhadap mutu layanan di rumah sakit jiwa. Metode: Disain penelitian cross-sectional dengan sampel pasien skizofrenia rawat inap di RSJ dr. Radjiman Wediodiningrat Lawang selama penerapan sistem Jaminan Kesehatan Nasional. Hasil: Potensi fraud yang mungkin terjadi di rumah sakit jiwa antara lain upaya memperpanjang atau memperpendek lama perawatan (AvLOS), melakukan tagihan fiktif atas pemeriksaan dan tindakan yang dilakukan, dan pemondokan pasien atas indikasi yang tidak jelas. Hal ini didukung oleh data yang didapatkan bahwa terdapat penurunan AvLOS pada saat penerapan sistem jaminan kesehatan dengan sistem pembayaran per paket diagnosis, namun disertai peningkatan angka re-hospitalisasi sebesar lima kali lipat. Hal tersebut menunjukkan indikasi bahwa potensi fraud berpengaruh terhadap mutu luaran pasien rumah sakit jiwa. Kesimpulan: Terdapat potensi fraud dalam penerapan sistem jaminan kesehatan nasional yang mempengaruhi mutu layanan di rumah sakit jiwa. Background: The National Health Insurance System organized by the government as an effort to provide affordable and excellent health care, including for mental health services. In practice there is a potential of fraud that allegedly could be detrimental either directly or indirectly. Supervision of the potential fraud in the health sector has begun to catch the attention of the Corruption Eradication Commission, because the potential losses caused could be enormous. Aim: To determine the effect of potential fraud in the implementation of the national health insurance system versus quality services in The Mental Hospital. Methods: This study was cross-sectional design. The sample of this study were schizophrenia patients in the inward services in dr. Radjiman Wediodiningrat Mental Hospital Lawang during implementation of the National Health Insurance system. Result: The potential fraud that may occur in mental hospitals include attempts to extend or shorten the average length of stay (AvLOS), fictitious invoice on medical anamneses and proceeding treatment, and hospitalization inpatients without clear indication. This is supported by initial data obtained that AvLOS is decrease when the health insurance system apply packaged payment system, nevertheless there is increased rates up to five times of re-hospitalization. This shows that the indication of potential fraud could affect the output quality of mental hospital. Conclussion: There is a potential fraud in the implementation of the national health insurance system that affects the quality of services in a mental hospital.
Analisis Perubahan Kebijakan Peraturan Presiden No.19 Tahun 2016 tentang Jaminan Kesehatan Menjadi Peraturan Presiden No.28 Tahun 2016 tentang Jaminan Kesehatan Julian Simanjuntak; Ede Surya Darmawan
Jurnal Kebijakan Kesehatan Indonesia Vol 5, No 4 (2016)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (205.71 KB) | DOI: 10.22146/jkki.v5i4.30546

Abstract

ABSTRACKBackground: The rapid change from presidential regulation no. 19 year 2016 on health insurance into presidential regulation no. 28 year 2016 on health insurance get a big attention.Objectives: This research was purposed to analyze about health insurance policy which changed very quickly. It changed from presidential regulation no.19 year 2016 into presidential regulation no.28 year 2016 on health insurance.Research Methods: The researcher used qualitative methods.Results: The analysis from the input processing and output showed that the change of presidential regulation is a responsive form from president when he looked public rejection response for the increase of fee.Conclusions: The president extended it through the department of health affairs.This change has not been described a process of democracy because there’s still a lack of cross-sectoral coordination role in the discussion. This change of presidential regulation not yet affected to appropriate the fee adequacy on BPJS Implementation. The department of health affairs as a leader of health sector was recommended to increase the cross-sectoral coordination which can manifest the better product of health policy and to complete the policy instrument that yet to be determined. It also used to be concern from the department of health affairs, DJSN and BPJS which explained the increase of fee must be offset by a quality improvement rather than the implementation of national health insurance. Keywords; change, policy, presidential regulationABSTRAKLatar belakang: Perubahan Peraturan Presiden No.19/2016 tentang Jaminan Kesehatan menjadi Peraturan Presiden No. 28/2016 tentang Jaminan Kesehatan yang sangat cepat menjadi sorotan yang mencolok.Tujuan: penelitian ini untuk menganalisis perubahan yang begitu cepat tentang kebijakan jaminan kesehatan Peraturan Presiden No.19/2016 tentang Jaminan Kesehatan menjadi Peraturan Presiden No.28/2016 tentang Jaminan KesehatanMetode penelitian: pendekatan kualitatif.Hasil: Berdasarkan analisis bahwa dalam proses input, proses dan output, perubahan Peraturan Presiden ini merupakan bentuk responsif Presiden melalui lembaga pemerintah Kementerian Kesehatan dengan melihat respon penolakan masyarakat akan kenaikan iuran. Proses perubahan ini belum menggambarkan sebuah proses yang demokrasi dikarenakan masih kurangnya koordinasi peran lintas sektoral dalam pembahasannya.Kesimpulan: Dengan adanya perubahan Peraturan Presiden ini berdampak belum memadainya kecukupan iuran dalam penyelenggaraan BPJS. Peran Kementerian Kesehatan sebagai leader dalam regulasi bidang kesehatan disarankan dapat meningkatkan koordinasi lintas sektoral untuk dapat mewujudkan produk kebijakan kesehatan yang lebih baik serta melengkapi instrument kebijakan yang belum ditetapkan, serta untuk menjadi perhatian sektor terkait Kementerian Kesehatan, DJSN dan BPJS Kesehatan bahwa kenaikan iuran harus dapat diimbangi dengan peningkatan kualitas daripada penyelenggaraan jaminan kesehatan nasional. Kata kunci: Perubahan, Kebijakan, Peraturan Presiden
Analisis Pembiayaan Kesehatan Program Kesehatan Ibu dan Anak (KIA) Berdasarkan Standar Pelayanan Minimal (SPM) di Kabupaten Nunukan Mustaqim Hariyadi; Julita Hendrartini; M.Arief Budiarto
Jurnal Kebijakan Kesehatan Indonesia Vol 4, No 3 (2015)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (225.527 KB) | DOI: 10.22146/jkki.v4i3.36106

Abstract

Background: The role of regional government in decentralization period is very important to the health sector particularly in financing. This is because health is one of the sectors that was decentralized. Minimum service standard is the obligatory responsibility for the region that is the right of every citizen at a minimum level, and one of many basic services is Maternal and Child Health programs. Objectives: To asses the financing sufficiency for Maternal and Child Health Programs based on Minimum Service Standard cost calculation and the effectivity of financing for Maternal and Child Health programs to achieve program’s objectives and goals. Methods: This research is a descriptive study conducted in Nunukan in 2013 with quantitative data. Sufficiency analysis is done by calculating the cost of Maternal and Child Health program to the result of cost calculation based on Minimum Service Standard. Performance effectivity of the Maternal and Child Health Programs was analyzed by the achievement of Minimum Service Standard according to the national indicator target and Maternal Mortality and Infant Mortality to the target of RPJMN of 2010-2014. Results: The cost of Maternal and Child Health program that was available was Rp. 2.530.038.761, and the calculation result of the cost based on Minimum Service Standard at Rp. 3.707.719.364, thus there was fund deficit about Rp 1.177.680.603. The percentage of MCH programs financing by the central government was still hight that was about 75%. There are financing MCH programs for direct activities amounted to 74%, and indirect activities amounted to 26%. The financing performance of MCH program was not effective yet to achieve the target of national Minimum Service Standard indicator and maternal mortality was still high at 173 per 100.000 life birts and infant mortality at 14 per 1000 live births. Conclusion: The financing of MCH programs was not sufficient to perform activities in MCH programs, as there was fund deficit about Rp 1.177.680.603. There was high financing dependency to the central government at 75% because of the low regional government commitment to financing priority programs such as MCH programs. 
ANALISIS KEBIJAKAN DALAM MENGATASI KEKURANGAN BIDAN DESA DI KABUPATEN NATUNA Imam Syafari Dwi Handono Sulistyo Kristiani
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 1 (2013)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (261.617 KB) | DOI: 10.22146/jkki.v2i1.3224

Abstract

Background: Geographical condition of Natuna Islands whichis not in accordance with health development affects thequantity and availability of midwives distributed in villages inthe District of Natuna. In fact, the ratio between the number ofvillages and the number of midwives in the district has not metthe standard proposed by the Ministry of Health. Unfortunately,there are still around 13 villages from 51 villages that have nomidwives serving in those villages. The location of 13 villagesare separate Island, and it caused lack of provide access toquality health care services. One of efforts done by the localgovernment is to attract midwives’ interest through a varietyof strategies and policies in several fields such as financing,incentive, regulation, organization, and stakeholders’ behaviors.Method: This was a descriptive study with study-case designby using qualitative method. Study case in this study was asingle holistic study case. The informants were head of healthoffice, head of health empowerment and promotion division,head of general affairs and employment sub division, head ofBKD, head of Local Development Planning Agency, theCommission Two of Local Legislative, heads of communityhealth centers, and village midwives. The study case designaimed to know policies in overcoming the lack of midwives inthe District of Natuna.Results: The local government financing policy allocated thebudget or health less than 15%, which was only 3-4% usedfor improving the health workers’ capacity. The incentive givingfor midwives was relatively small compared to the incentiveregulated by the Ministry of Health. There was no specificregulation from the local government, so that the policy wasconsidered not optimal. In the organizational level, the role ofstakeholders was in accordance with their duty and provision;however, the f inal decision was dependent upon LocalLegislative and the local government’s leader. Lastly, midwives’low interest to work in Natuna was caused by its geographicalcondition.Conclusion: Local government’s policy in the field of financing,incentive, organization, regulation, and behavior in overcomingthe lack of village midwives was considered not optimalbecause of the absence of specific policy from the localgovernment in this matter. In addition, midwives’ low interest towork in Natuna contributed the lack of midwives in this district.Keywords: policy analysis, the lack of village midwives
Analisis Kesiapan Penerapan Kebijakan Badan Layanan Umum Daerah (BLUD) Puskesmas di Kabupaten Kulon Progo (Studi Kasus di Puskesmas Wates dan Puskesmas Girimulyo II Kabupaten Kulon Progo) Albertus Sunuwata Triprasetya; Laksono Trisnantoro; Ni Luh Putu Eka
Jurnal Kebijakan Kesehatan Indonesia Vol 3, No 3 (2014)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (390.772 KB) | DOI: 10.22146/jkki.36376

Abstract

Background: Some community health centers in Kulon Progo Regency had managed to meet their own operational needs without depending upon the subsidiary from the local govern- ment. However, bureaucratic problems often led to difficulties in realizing the funds. Long and exhausting bureaucratic pro- cedures and lack of flexibility in the fund use had delayed the public health services at the health centers. Implementation of the Local Public Service Agency (BLUD) at the Health Centers was a proposed solution for the problem. The Health Services that served as BLUD could use the budget/local income to support operation of the health facilities (i.e. flexibility in the fund use) without prior deposit to the local government ac- count. The purpose is to slim down the bureaucratic chains, thus allowing the Health Centers to improve their performance. This way, they could be more productive, effective, efficient, and ready to exercise the Social Security Agency (BPJS) in 2014. Of course, implementation of the policy requires active roles of the stakeholders and supporting conditions at the Health Centers. The study was conducted based on the facts, that all of the Health Centers in Kulon Progo Regency would implement the Local Public Service Agency (BLUD), as speci- fied by the Ministry of Domestic Affairs’ Regulation (Permendagri) No. 61/2007 on the Technical Guides for Finan- cial Management of BLUD. Objectives: To analyze to what extent the Health Centers were ready for the implementation of the Local Public Service Agency (BLUD) in Kulon Progo Regency. Methods: The research was a qualitative approach, using descriptive analytical method and case study design to as- sess the facts on readiness of the Health Centers to apply the BLUD policy. The analysis involved technical and administra- tive requirements of the Health Centers, analysis on the stake- holder roles, and analysis on the real situations at Wates and Girimulyo II Health Centers in Kulon Progo Regency. The re- search used purposive sampling technique, while the data were collected by means of in-depth interviews, observation, and library study. Results: Wates and Girimulyo II Health Centers in Kulon Progo were not fully prepared with technical requirements for the implementation of Health Center BLUD Policy: The increasing rate of earning during the last three years is not complemented by the result of evaluationservice performance thatwas not optimal.Health Centers in Kulon Progo were ready with admin- istrative requirements for the implementation of Health Center BLUD Policy.Stakeholders in Kulon Progo Regency also sup- ported the policy implementation, as evident from the analysis that the stakeholders played important roles and interests but were not ready with supporting regulation for Health Center BLUD Policy. However, the study found that the real conditions at the Health Centers were not ready to support BLUD, as evident from lack of commitment from the Health Centers, inad- equate financial management system, and inadequate human resources for financial management at the Health Centers. Conclusion: Overall, The Health Center in Kulon Progo has not been fully ready to implement BLUD, it must be supported by regulation and adequate resources. Latar Belakang: Beberapa Puskesmas di Kabupaten Kulon Progo sudah bisa mencukupi kebutuhan operasionalnya tanpa tergantung subsidi dari Pemda, namun untuk pencairan dananya sering kali tidak tepat waktu karena masih terkendala alur birokrasi. Alur birokrasi yang terlalu panjang dan tidak adanya fleksibilitas dalam penggunaan dana menghambat kelancaran pelayanan pada puskesmas. Penerapan kebijakan BLUD Pus- kesmas merupakan solusi untuk mengatasi permasalahan tersebut. Puskesmas BLUD, dana/pendapatan puskesmas bisa digunakan langsung untuk operasional (fleksibilitas penggunaan dana) tanpa disetor ke pemda, sehingga bisa memotong rantai birokrasi pemda dan dengan demikian puskesmas dapat meningkatkan kinerja pelayanannya secara produktif, efektif, dan efisien dan siap menyongsong diberlakukannya program BPJS Tahun 2014. Dibutuhkan peran stakeholder dan suasana di puskesmas yang mendukung kesiapan penerapan kebijakan ini. Penelitian ini dilakukan berdasarkan kenyataan, seluruh Puskesmas di Kabupaten Kulon Progo akan menerapkan Badan Layanan Umum Daerah (BLUD) sesuai dengan Peraturan Men- teri Dalam Negeri (Permendagri) No. 61 Tahun 2007 tentang Pedoman Teknis Pola Pengelolaan Keuangan Badan Layanan Umum Daerah. Tujuan: Menganalisis dan mengetahui sejauh mana kesiapan penerapan kebijakanBLUD Puskesmasdi Kabupaten Kulon Progo. Metode:Dalam penelitian ini, peneliti menggunakan jenis penelitian kualitatif dengan metode analisis deskriptif dengan rancangan studi kasus untuk menggambarkan keadaaan serta menggali secara luas kesiapan penerapan kebijakan BLUD Puskesmas, dengan menganalisis kesiapan persyaratan teknis dan administratif Puskesmas, analisis peran stakeholder, meng- analisis suasana yang ada di Puskesmas Wates dan Girimulyo II dalam kesiapan penerapan kebijakan BLUD Puskesmas diKabupaten Kulon Progo. Pengambilan sampel pada penelitian ini dilakukan secara purposive sampling. Metode pengumpulan data diperoleh dengan wawancara mendalam (indepth inter- view), observasi dan pemanfaatan dokumen. Hasil:Puskesmas Wates dan Girimulyo II di Kabupaten Kulon Progo belum siap sepenuhnya dengan persyaratan teknis, hal ini ditunjukkan dengan tingkat pendapatan puskesmas yang meningkat dalam tiga tahun terakhir tetapi hasil evaluasi kinerja pelayanan puskesmas belum optimal. Puskesmas telah siap dengan persyaratan administratif ditunjukkan dengan keleng- kapan dokumen BLUD Puskesmas. Stakeholder di Kabupaten Kulon Progo mendukung dalam penerapan kebijakan BLUD Puskesmas, ditunjukkan dari hasil analisis yang menunjukkan tingkat pengaruh dan kepentingan stakeholder yang cukup tinggi tetapi belum sepenuhnya siap dengan regulasi BLUD Puskesmas. Suasana yang terlihat pada Puskesmas kurang mendukung, dilihat dari komitmen puskesmas yang masih ku- rang, sistem pengelolaan keuangan puskesmas yang belum mendukung dan bendahara puskesmas yang belum terlatih pengelolaan keuangan BLUD. Kesimpulan: Secara keseluruhan kesiapan penerapan kebijakan BLUD Puskesmas di Kabupaten Kulon Progo belum sepenuhnya dilaksanakan, perlu segera ditindaklanjuti dengan regulasi yang mendukung dan kecukupan sumber daya.

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