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Pengorganisasian Chronic Care Model dalam Pengelolaan Keteraturan Kontrol Pasien Pasca Stroke RSUD Sultan Syarif Mohamad Alkadrie Kota Pontianak Ade Muhammad Cahyadi; Lely Lusmilasari
Jurnal Kebijakan Kesehatan Indonesia Vol 6, No 4 (2017)
Publisher : Center for Health Policy and Management

Background: Recurrent strokes are alarming because they can aggravate the situation and increase maintenance costs. With the prevalence of cases that continue to increase from year to year, the potential for lost follow-up in the regularity of post-stroke patient control. The organization of chronic care model-based services is able to maintain and bridge the regularity of post-stroke patient control whose service concept focuses on the patient's active participation and health system. This study aims to explore the organization of Chronic Care Model in the management of post-stroke patient control regularity. Methods: Qualitative research with case study design. Participants in this study is the administration consisting of elements of leadership and implementer that have met the criteria taken by way of purposive sampling time research February-April 2017 Research instruments in the form of interview guidelines, qualitative analysis. Results: Decision support refers to clinical practice guidelines, shared information through multiprofession coordination in education, service integration is still passive which has more emphasis on curative and rehabilitative. The design of the service system in the service policy on the implementation of using service standards and imposing a classless service, on the design elements of the lack of human resources health, as well as facilities and infrastructure, on the chronic service model refers to the structure and hierarchy of organizations that emphasize the responsibility of the service to the physician in charge of medical. Clinical information systems are not available for group support and information technology-based coordination to support high quality health services. Conclusion: Management of post-stroke patient control regularity can not be separated from the support and ability of the implementer as well. Service upgrades can be improved through the implementation of the Chronic Maintenance Model in which there are several important elements such as systematic configuration, updating in service system design, modern clinical information systems.

Pelaksanaan Pengawasan Intern oleh Dewan Pengawas dalam Rangka Menuju Optimalisasi Kinerja Studi Kasus RSUD BLUD Dr. H.M. Rabain Kabupaten Muaraenim Andi Andi; Laksono Trisnantoro
Jurnal Kebijakan Kesehatan Indonesia Vol 3, No 1 (2014)
Publisher : Center for Health Policy and Management

Background: Surveillance is a systematic effort to establish performance standards in planning to design a system of feedback information, to compare actual performance against the standards that have been determined, to establish whether there has been diversion, as well as to take the necessary corrective actions to ensure that all corporate or Government resources have been used as effective and efficient as possible in order to achieve the objectives of the company or the Government. Hospital is one of the integral parts that play an important role in providing health care services to the community, therefore internal supervision efforts to improve performance of the hospital is crucial. In order to do that, the Government requires Local Public Service Agency (BLUD) to have a functioning supervisory board. Objectives: To assess effectiveness of internal audit conducted by the supervisory board on the hospital performance as a Local Public Service Agency (BLUD). Methods: This research is a descriptive qualitative research design case studies. Data are obtained through in-depth interviews and observations. Results: There are a number of irregularities in the process of monitoring performance of hospitals in particular tasks, functions and duties of the supervisory board. The Board has yet to run its full duties, functions and obligations according to government’s guideline on intern supervision (APIP). Conclusion: (a) The supervisory board in BLUD hospitals dr.HM Rabain does not fully functioned in accordance to the standards of supervision and (b) the board has not been able to contribute positively in achieving good governance and clean governance. Internal auditing results have not been followed up in accordance to the standards. Results of monitoring have not shown any significant impact of improved performance to indicate whether the hospital is well-functioning or not. Latar belakang: Pengawasan adalah suatu upaya yang sistematik untuk menetapkan kinerja standar pada perencanaan untuk merancang sistem umpan balik informasi, untuk membandingkan kinerja aktual dengan standar yang telah ditentukan, untuk menetapkan apakah telah terjadi suatu penyimpangan tersebut, serta untuk mengambil tindakan perbaikan yang diperlukan untuk menjamin bahwa semua sumber daya perusahaan atau pemerintahan telah digunakan seefektif dan seefisien mungkin guna mencapai tujuan perusahaan atau pemerintahan. Rumah sakit merupakan salah satu bagian integral yang penting sebagai tempat pelayanan kesehatan bagi masyarakat, sehingga perlu pengawasan secara khusus upaya dalam meningkatkan kinerja rumah sakit tersebut. Dalam rangka itu, pemerintah menetapkan bahwa rumahsakit BLUD perlu memiliki dewan pengawas. Tujuan: Untuk mengetahui efektifitas pengawasan yang dilakukan oleh dewan pengawas terhadap kinerja rumah sakit BLUD. Metode: Penelitian ini merupakan penelitian deskriptif kualitatif dengan rancangan studi kasus. Sedangkan teknik yang digunakan dalam penelitian ini adalah quota sampling, dengan jumlah sampel 11 orang. Hasil penelitian: Pelaksanaan pengawasan intern di rumah sakit oleh dewan pengawas secara keseluruhan belum memenuhi standar yang sudah ditetapkan pemerintah yaitu standar audit APIP (Aparat Pengawasan Intern Pemerintah). Kesimpulan: Dari hasil penelitian ini: (a) dewan pengawas di RSUD BLUD dr.H.M. Rabain belum sepenuhnya melakukan pengawasan sesuai dengan standar dan (b) dewan pengawas yang ada belum dapat memberikan sumbangan positif dalam mewujudkan good governance dan clean governance. Tindak lanjut hasil pengawasan dewan pengawas di RSUD BLUD dr.H.M Rabain belum sesuai dengan standar yang berlaku. Dari hasil pengawasan belum terlihat dampak peningkatan kinerja rumah sakit secara signifikan yang menunjukkan bahwa rumah sakit dalam kondisi sehat atau tidak sehat.

Prevalensi Rasio Pelayanan Kesehatan Maternal dan Ketersediaan Fasilitas Kesehatan di ERAJKN/KIS di Indonesia Niniek Lely Pratiwi; Hari Basuki
Jurnal Kebijakan Kesehatan Indonesia Vol 5, No 2 (2016)
Publisher : Center for Health Policy and Management

ABSTRACTBackground: Indonesia is one country that is feared to may not reach the MDG targets by 2015. According to WHO data, as many as 99 percent of maternal deaths due to labor problems or births occured in developing countries. The maternal mortality ratio in developing countries is the highest with 450 maternal deaths per 100 thousand live births compared to the ratio of maternal deaths in nine developed countries and 51 Commonwealth countries.Methods: This study is a further analysis of Riskesdas in 2010, 2013 and Rifaskes in 2011 to assess the magnitude of the prevalence of maternal health ratio in relation to the availability of health facilities.Results: Examination of the first trimester ANC services by doctors has a higher prevalence ratio approaching a value of one, and has statistically significant value compared to ANC by a midwife. A greater tendency prevalence of ANC first examination at the gestational age aging in rural area is observed, compared to the urban areas. Some did not even know the age of their pregnancy when they are getting their first ANC, as high as 10.7% in rural areas.Conclusion: There should be a regional policy regarding the competence of midwives, and systematically involving professional organizations IBI, IDI on improving midwife practice. Empowering people in the village has not been working as expected, shown by the lack of knowledge about the importance of ANC with health workers. Keywords: Midwives, MDGs, Accessibility Maternal of Health ABSTRAKLatar Belakang: Indonesia merupakan salah satu negara yang dikhawatirkan tidak dapat mencapai target sasaran MDGs pada tahun 2015. Menurut data WHO, sebanyak 99 persen kematian ibu akibat masalah persalinan atau kelahiran terjadi di negara- negara berkembang. Rasio kematian ibu di negara-negara berkembang merupakan yang tertinggi dengan 450 kematian ibu per 100 ribu kelahiran bayi hidup jika dibandingkan dengan rasio kematian ibu di sembilan negara maju dan 51 negara persemakmuran.Metode:Penelitian ini merupakan analisis lanjut Riskesdas tahun 2010, 2013 dan Rifaskes tahun 2011 untuk mengkaji besaran prevalensi rasio kesehatan maternal terhadap ketersediaan fasilitas kesehatan.Hasil: Pemeriksaan ANC trimester 1 pelayanan oleh tenaga dokter lebih tinggi prevalensi rasio mendekati nilai satu dan mempunyai nilai yang bermakna secara statistik dibandingkan pelayanan ANC oleh bidan desa. Terlihat kecenderungan semakin besar prevalensi pemeriksaan ANC pertamakali pada umur kehamilan yang semakin tua di pedesaan dibandingkan perkotaan bahkan yang menjawab tidak tahu umur kehamilan saat ANC pertamakali pun di pedesaan 10,7%.Kesimpulan: Perlu kebijakan daerah tentang kompetensi bidan secara konkrit, dan sistematis melibatkan organisasi profesi IBI, IDI tentang bidan layak praktek. Pemberdayaan masyarakat di desa belum berfungsi terbukti dengan rendahnya pengetahuan masyarakat tentang pentingnya pemeriksaan ANC pada tenaga kesehatan. Kata kunci: Bidan, MDGs, Aksesibilitas Kesehatan Maternal

Ketersediaan Obat Esensial pada Sarana Kesehatan di Kabupaten Bangka Barat Achmad Nursyandi; Mustofa Mustofa; Mubasysyir Hasanbasri
Jurnal Kebijakan Kesehatan Indonesia Vol 1, No 3 (2012)
Publisher : Center for Health Policy and Management

Background: The effectiveness of treatment at government health facilities is largely determined by the availability of the drug. In addition to essential drugs, doctors and the public can choose medications that are considered more suitable for medical needs. Bureaucratic rigidity and lack of funds the government plans to make the supply of medicines in health centers to be minimalist in terms of number and variety of drugs. Such inflexibility encourage minimalist prescribing behavior among primary care physicians and health workers. Objective: This study want to learn management practices that deal with drug supply and its distribution in government owned primary health care facilities. It specifically tried to identify strategies at health center level that allow the provision of more drugs in accordance with the medical needs and rational drug use practices. Method: Data were collected by observation report drug use and demand for health facilities in January-June 2010 and in- depth interview of chief health official, the head of pharmacy department, 7 of pharmacy main health centers and 11 midwives/nurses extending health center, village health clinic and village health post. Results: This case illustrates a successful story about making drugs available at primary health care facilities. Five main health centers, four extending health centers, and ten village health clinic and village health posts are classified as “safe” based on MOH standard. This success reflects human resource capacity and decentralized management of drug supply. Pharmacists and pharmacy assistants throughout the Bangka Barat Regency has already trained in drug supply management. The study also found that the procurement of drugs has been based on bottom-up planning. Although under the coordination of district level pharmacy unit, health care centers has broader authority to determine their drug needs. They also have their own drug procurement budget that are part of district budget that can be used for unexpected situations. Conclusion: This study attempted to show effort to change local government health sector bureaucracy in decentralization era. This case study shows the involvement and bigger participation of primary care facilities in the planning and implementation of drug supply. Health centers have a greater authority in managing the medication needs to circumstances beyond expectations. Communication, information and education to doctors about the drug delivery mechanism will allow doctors to prescribe drugs according to the medical needs of patients and drug development, and because it makes health care facilities into place an effective treatment. Latar Belakang: Efektivitas pengobatan di fasilitas kesehatan pemerintah sangat ditentukan oleh ketersediaan obat. Di samping obat esensial, dokter dan masyarakat dapat memilih obat-obat yang dipandang lebih cocok untuk kebutuhan medik. Kekakuan birokrasi perencanaan dan keterbatasan dana pemerintah membuat penyediaan obat di puskesmas menjadi minimalis dari sisi jumlah dan variasi obat. Kekakuan seperti itu mendorong praktik peresepan minimalis yang diragukan manfaat terapetiknya. Tujuan: Penelitian ini mempelajari manajemen penyediaan obat dan distribusinya di fasilitas kesehatan dasar. Ia secara khusus berusaha menemukan strategi-strategi di tingkat puskesmas yang membuat penyediaan obat lebih sesuai dengan kebutuhan lapangan dan pengobatan rasional. Metode: Data dikumpulkan dengan observasi laporan pemakaian dan permintaan obat sarana kesehatan bulan Januari-Juni 2010 dan wawancara mendalam terhadap kepala dinas kesehatan, kepala instalasi farmasi, 7 pengelola obat puskesmas dan 11 bidan/perawat pustu, polindes serta poskesdes. Hasil: Penelitian ini menunjukkan bahwa lima puskesmas, empat puskesmas pembantu, dan sepuluh polindes dan poskesdes berhasil merencanakan dan menyediakan obat hingga pada tingkat yang “aman”. Keberhasilan ini merupakan bukti dari kapasitas tenaga yang memadai. Apoteker dan seluruh pengelola obat puskesmas Kabupaten Bangka Barat sudah memiliki mengikuti pelatihan manajemen pengelolaan obat. Penelitian juga menemukan bahwa pengadaan obat telah berbasis desentralisasi dan mencerminkan perencanaan bottom up. Meski di bawah koordinasi instalasi farmasi kabupaten, puskesmas memiliki kewenangan menentukan kebutuhan. Mereka juga memiliki fleksibilitas pengadaan obat sendiri untuk situasi di luar dugaan. Kesimpulan: Penelitian ini berusaha memperlihatkan upaya perubahan birokrasi di bidang kesehatan dalam era desentralisasi. Studi kasus dalam penyediaan obat esensial di Kabupaten Bangka Barat menunjukkan keterlibatan dan partisipasi puskesmas yang lebih besar dalam perencanaan dan implementasinya. Puskesmas juga memiliki kewenangan lebih besar dalam mengelola kebutuhan obat untuk situasi di luar dugaan. Komunikasi, informasi dan edukasi kepada dokter tentang mekanisme penyediaan obat akan memudahkan dokter meresepkan obat sesuai dengan kebutuhan medik pasien dan perkembangan obat, dan karena itu membuat fasilitas kesehatan menjadi tempat pengobatan yang efektif.

ANALISIS KEBIJAKAN PEMERINTAH DAERAH DALAM PENGEMBANGAN ‘JAMINAN SOSIAL KESEHATAN SUMATERA SELATAN SEMESTA’ MENYAMBUT UNIVERSAL HEALTH COVERAGE Misnaniarti Misnaniarti
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 3 (2013)
Publisher : Center for Health Policy and Management

Background: The ‘Jamsoskes Sumsel Semesta’ is a localprogram that offered free medical treatment for health servicesfor the people of South Sumatra who do not have healthinsurance. Meanwhile, starting in 2014, the national Governmentwill implement the Universal Health Coverage as mandated bythe Social Security Law. As insurance have a principle ofindemnity where there should not be a duplicate social security,there should be no society that is assured by the two programswith the aim of speculating to make a profit. This study aims toexplore the implementation of the expansion plan of ‘JamsoskesSumsel Semesta’ to pave the way to Universal Health Coveragein 2014 in South Sumatera.Methods: This study was a qualitative policy research withexploratory design. The focus are policy content, context,actors, and policy processes. Data were collected by in-depthinterviews and observation. Sources of information obtainedfrom five informants from the institution of Provincial HealthOffice, Planning and Regional Development Agency of SouthSumatra, and Provincial Government who selected bypurposive technique based on considerations of participationin Jamsoskes. The analysis used is the analysis of policy.Results and Discussion: Based on the results of study it isfound that the South Sumatra provincial government willcontinue to provide the Jamsoskes program in 2014 as it is,managed by the Health Office. Some of the considerations arefor efficiency and flexibility and that it does not include all thepeople. Also, in the Presidential Decree No. 12 of 2013, thenational government still provides opportunities for local schemeto grow until 2019. Some development is done in Jamsoskesincluding improving the quality and quantity of health careproviders. Preparations are coordinated with Social SecurityAgency about number of contribution beneficiaries. One ofthe challenges is that the community rather go to the hospitaldirectly so it can interfere with the referral system.Conclusion: There has not been a lot of development effortundertaken by local government onJamsoskes in preparationfor the 2014 to welcome Universal Health Coverage. The SouthSumatra provincial government should develop further theservices under Jamsoskes as adjustments in welcoming theimplementation of the second phase of the National HealthInsurance.Keywords: Policy, Health Insurance, Jamsoskes, Efficiency

Analisis determinan ketersediaan dokter spesialis dan gambaran fasilitas kesehatan di RSU pemerintah kabupaten/kota Indonesia (analisis data rifaskes 2011) Heri Priyatmoko; Lutfan Lazuardi; Mubasysyir Hasanbasri
Jurnal Kebijakan Kesehatan Indonesia Vol 3, No 4 (2014)
Publisher : Center for Health Policy and Management

Determinants of specialist availability in public hospitals: analysis of 2011 RifaskesABSTRACT Background:Indonesia still faces theproblem of unequal distribution of specialist doctors. The ratio of health workers per 100.000 population has not met the target. In 2008, the ratio of health workers to medical specialist per 100.000 population amounted to 7,73 compared to the target which is 9. Some areas of development in underserved areas, such as low economic power, lack of hospital system capacity and hospital medical equipment, have been neglected by government. Engagement of stakeholder to improve hospital quality system is a critical element to contribute to the policy of specialist doctors dsitribution, typically to increase the number of specialist doctors practising in rural and remote areas. Objective: To assess the determinants ofavailability of specialist doctors in government/public hospitals and to find out the correlation of variable factors. Methods: A cross sectional design was adopted for this study, in which 7 factors were chosen to assess determinant of availability of specialist doctors using a Health Facilities Research (Rifaskes) conducted Bay the HealthMinistry in 2011 and to describe availibility of hospital facilities in the Indonesian public hospitals. Results: Bivariate analysis indicated that level of district, hospital accredited, BLU versus Non-BLU, remuneration, hospital facilities, dan GNP significantly affect to the number of specialist doctors (p <0,05). Logistic regression indicated that the strongest predictors of availibility specialist is accredited public hospital with 12 standard of care (odds ratio 9,32 ; 95% CI: 1,2-72,4) ; p < 0.03). Level of district have significantly associated to availibility specialist in public hospital (odds ratio 2,15 ; (95% CI: 1,36-3,39) ; p = 0,001). Conclusion: The current study makes an important contribution to the literature in finding the determinants of distribution of specialist doctors in public hospital in Indonesia to address maldistribution between urban and rural barriers. Additional research is needed to examine preference to choose rural location and the incorporation of other retention strategies, such as medical educationinitiatives, community and professional support, differential rural fees and alternate funding models. Keywords: Availability,specialist doctors, specialistic facilities

Proses Pembentukan Peraturan Daerah tentang Kawasan Tanpa Rokok di Kota Medan Tahun 2013 Juanita Juanita
Jurnal Kebijakan Kesehatan Indonesia Vol 3, No 4 (2014)
Publisher : Center for Health Policy and Management

Background: The number of smokers in Indonesia is still high and in the absence of serious attention by government, then this problem would be a time bomb in the future. Results of previous studies have shown a variety of diseases associated with cigarette consumption. Medan city as the capital of North Sumatra province has been concerned with this problem and have proposed smoke- free zone regulation since 2010. However, the enactment of smoke-free zone regulation requires a long process and a strong commitment from the local government. Methods: The study design was a case study with a qualitative approach. Informants of this studyis the city of Medan legislators in charge of health, industry, labor, trade and agriculture. Data is collected using in-depth interview techniques to explore the views of relevant legislative regulation on smoke-free zone. Results: Stages of the process of establishing regulations smoke-free zone are: 1) the initiation stage than has been started since 2010 and was initiated by the Health Ministry, assisted by the city of Medan Indonesia Heritage Foundation, which is one of the NGOs involved in the protection of children and women. 2) discussion stage, which has been proposed (ranperda) until 2011 and has not been a priority for Parliament, because there is no political will to protect the public from the dangers of cigarette smoke. A discussion process regulation is the most crucial step to achieve a common understanding among the members of the legislature. 3) determination phase. After going through the long process through meetings (paripurna) in the decision making process and consent on smoke-free zone then the regulation is validated by approved by allfactions. 4) Promulgation phase, which is the issuance of Regulation No.3 of 2014 on smoke-free zone, which consists of 16 chapters 47 subchapters; and 5) Dissemination, socialisation of smoke free zone Regulation. Conclusion: The process of forming regulation of smoke- free zone through several stages, which initiated in 2010 by the Ministry of Health that began to organize activities related to problems of cigarettes. In the early stage, smoke-free zone regulation was not a priority to be discussedin meetings in Parliament, due to arising pros and cons. Commitment from the local government and community support are the factors that made this regulation be processed so that in December 2013 the Parliament plenary meeting pass the regulation and in January 2014 Regulation No.3 about smoke-free zone is issued. Recommendation: There are many challenges ahead after the issuance of regulation smoke-free zone. The regulation should be implemented effectively, with the involvement of relevant stakeholders, also society (citizens-based smoke- free zone enforcement). In addition, cross-sectoral cooperation in the application of smoke-free zone regulation needs to be improved. Ministry of Health as a driving force of smoke-free zone policies should support the necessary monitoring and evaluation. LatarBelakang: Jumlah perokok di Indonesia masih tinggi dan tanpa adanya perhatian serius pemerintah maka permasalahan ini akan menjadi bom waktu di masa depan. Hasil penelitian terdahulu sudah membuktikan berbagai penyakit terkait konsumsi rokok. Kota Medan sebagai ibukota Provinsi Sumatera Utara sudah sejak tahun 2010 menaruh perhatian terhadap masalah ini dan sudah mengusulkan Ranperda Kawasan Tanpa Rokok. Namun, hingga keluarnya perda KTR ini membutuhkan proses yang cukup lama dan komitmen yang kuat dari peme- rintah daerah. Metode:Desain penelitian ini adalah studi kasus dengan pen- dekatan kualitatif. Informan penelitian ini adalah anggota DPRD Kota Medan yang membidangi kesehatan, perindustrian, ketena- gakerjaan, perdagangan dan pertanian. Pengumpulan data de- ngan menggunakan teknik wawancara mendalam untuk meng- gali pandangan anggota legislatif terkait Perda KTR Kota Medan. Hasil: Tahapan proses pembentukan perda KTR Kota Medan adalah: 1) Tahap inisiasi yang sudah dimulai sejak tahun 2010 dan diprakarsai oleh Dinas Kesehatan Kota Medan dengan didampingi oleh Yayasan Pusaka Indonesia, yang merupakan salah satu NGO yang bergerak dalam perlindungan anak dan wanita. 2) Tahap pembahasan, ranperda yang sudah diusulkan hingga tahun 2011 belum merupakan prioritas bagi parlemen, karena belum ada political will untuk melindungi masyarakat dari bahaya asap rokok. Proses pembahasan suatu ranperda merupakan tahap yang paling krusial untuk mencapai pema- haman yang sama di antara anggota legislatif. 3) Tahap pene- tapan, setelah melalui proses yang panjang maka melalui rapat paripurna dalam rangka pengambilan keputusan dan persetu- juan bersama tasranperda KTR Kota Medan maka ranperda ini disahkan dengan disetujui oleh seluruh fraksi yang ada. 4) Tahap pengundangan, dikeluarkannya Perda No 3 tahun 2014 tentang KTR di Kota Medan, yang terdiri dari 16 bab 47 pasal; dan 5) Tahap Penyebarluasan melalui Seminar Pembela- jaran Implementasi Regulasi KTR di Indonesia. Kesimpulan: Proses terbentuknya Perda KTR di Kota Medan melalui beberapa tahap yang dimulai sejak tahun 2010 dimana Dinas Kesehatan mulai mengadakan kegiatan-kegiatan terkait permasalahan rokok. Pada tahap awal, ranperda KTR belum menjadi prioritas untuk dibahas dalam rapat-rapat di DPRD, karena timbul pro dan kontra terhadap ranperda ini. Adanya komitmen dari pemerintah daerah dan dukungan dari masyarakat agar perdaini segera diproses sehingga pada bulan Desember 2013 dalam rapat paripurna DPRD perdaini disahkan dan pada bulan Januari tahun 2014 telah dikeluarkan Perda KTR No 3 tentang KTR di Kota Medan. Rekomendasi :Tantangan kedepan setelah dikeluarkannya Perda KTR Kota Medan adalah agar perda ini dapat diimple- mentasikan secara efektif, dengan melibatkan para stakeholder terkait juga masyarakat (penegakan KTR berbasis warga). Selain itu juga kerjasama lintas sektoral dalam penerapan Perda KTR perlu ditingkatkan. Dinas Kesehatan sebagai motor penggerak implementasi Perda KTR perlu melakukan monitor- ing dan evaluasi.

Sekilas Gambaran Pelaksanaan JKN Shita Dewi
Jurnal Kebijakan Kesehatan Indonesia Vol 5, No 3 (2016)
Publisher : Center for Health Policy and Management

Selamat berjumpa kembali.Edisi Jurnal Kebijakan Kesehatan Indonesia pada bulan September ini berfokuspada pelaksanaan Jaminan Kesehatan Nasional yang telah berlang- sung sejak 2014. Jaminan Kesehatan Nasional (JKN) membayar fasilitas kesehatan (dokter praktik, klinik, rumah sakit) secara prospektif sehingga hal ini mengubah sistem kesehatan Indonesia secara me- nyeluruh. Dalam system seperti ini, kendali biaya dan sumber daya lain sangat diperlukan. Bahasan mengenai JKN merupakan topik-topik utama dalam berbagai kongres, symposium mau pun seminar di tingkat daerah maupun nasional. Hal ini mengingat pentingnya memastikan keberlangsungan sistem JKN yang efektif dan efisien untuk melindungi masyakarat dari biaya kesehatan yang tinggi dan memastikan akses ke pelayanan kesehatan yang bermutu.Oleh karena itu, bahasan mengenai pelaksana- an JKN tidak pernah ada habis-habisnya. Tinjauan dapat dilakukan dari berbagai sudut, misalnya pem- biayaannya, keanggotaannya, kesiapan fasilitas, kerjasama dengan pihak swasta, dan sebagainya. Telah banyak pula penelitian dilakukan untuk meng- evaluasi sampai sejauh mana pelaksanaan JKN di berbagai daerah, untuk mengidentifikasi tantangan dan peluang penguatannya.Artikel-artikel kali ini akan sejalan dengan se- mangat untuk membangun system JKN yang lebih kuat, transparan dan akuntabel. Topik bahasan meli- puti misalnya berbagai temuan dari hasil kajian litera- ture sampai sejauh ini tentang JKN, pelaksanaa JKN di daerah, pola pemanfaatan JKN untuk kelompok peserta mandiri, pengelolaan dan pemanfaatan danakapitasi, dan analisis efisiensi teknis dari dana kapitasi.Walau pun ini hanya merupakan sebagian kecil dari gambaran pelaksanaan JKN di Indonesia, namun artikel-artikel ini akan membuka wawasan dan pe- mahaman kita secara lebih mendalam pada topik- topik yang diangkat. Utamanya, artikel-artikel ini mengidentifikasi beberapa tantangan yang masih dirasakan dan memberikan saran-saran perbaikan ke depan. Namun tentu saja perbaikan tidak otoma- tis akan terjadi tanpa ada pergerakan yang berarti dari arah komunitas kebijakan dan para pelaksana- nya.Hal ini hendaknya menjadi pengingat bagi kita semua, para peneliti kebijakan, bahwa penelitian yang kita lakukan hendaknya tidak sekedar dilaku- kan demi menghasilkan sebuah publikasi. Publikasi merupakan hal yang positif karena ini membuka ke- sempatan bagi kalangan yang lebih luas untuk ter- papar dengan informasi dan temuan-temuan peneli- tian kita. Namun, untuk sungguh-sungguh memper- kuat system JKN sesuai dengan yang kita harapkan, rekomendasi penelitian kita hendaknya ditindaklan- juti hingga menjadi perubahan pelaksanaan kebijak- an atau bahkan perubahan kebijakan.Ini merupakaan pe-er besar bagi kita semua, dan bukan merupakan pe-er yang mudah. Namun, justru karena itulah kita hendaknya termotivasi untuk menghasilkan rekomendasi-rekomendasi yang ap- plicable dan mampu menggerakkan tindak lanjut dari target audience kita.Selamat membacaShita Dewi - Pusat Kebijakan dan Manajemen Kesehatan

MANAJEMEN PERUBAHAN DI LEMBAGA PEMERINTAH: STUDI KASUS IMPLEMENTASI KEBIJAKAN PELAKSANAAN PPK-BLUD DI RUMAH SAKIT JIWA PROVINSI NTB Julastri Rondonuwu Laksono Trisnantoro
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 4 (2013)
Publisher : Center for Health Policy and Management

Background: NTB Mental Hospital as the only major referralcenter for mental health services in NTB was required to servethe community, to develop and be self-sufficient, while at thesame time must be able to compete in providing quality andaffordable services to the community. In order to fulfill thesedemands, since January 29, 2011 NTB Mental Hospital hasreceived full endorsement as a Mental Hospital with FinancialManagement Patterns of Local Public Service Agency (PPKBLUD).Therefore, indepth review of the implementation ofPPK-BLUD policy in NTB Provincial Mental Hospital (RSJP) isrequired.Objectives: To explore the transformation process andimplementation of PPK-BLUD policy in RSJP.Methods: The design of this study is a qualitative researchcase study to describe the dynamics of the change processand implementation of PPK-BLUD policy in RSJP.Results and Discussion: The phase of transformationprocess was not running as expected. The implementation ofPPK-BLUD policy is not optimal because some flexibility as ahospital privileges with BLUD financial pattern have not beenimplemented yet. The f inance manager was hesitant toimplement the flexible financial management and still followingthe local government financial management mechanisms. Forexternal stakeholders, the implementation of PPK-BLUD policyimplementation in RSJP did not harm local fiscal policy becausethe revenue of RSJP was still counted as revenue for localgovernment, as opposed to independent PPK-BLUD. A surveywas conducted, consisting of community satisfaction towardsthe services in RSJP, data of revenue and budgettingmanagement and distribution of fee services to employees inRSJP. The survey result described that the implementation ofPPK-BLUD policy in RSJP gives positive impacts on financial,services and benefits performances to RSJP. The positiveimpacts were an increase in the number of income, increasedof service indicators measurement and increased incentive toall employees.Conclusion: Management changes in the transformationprocess were not running optimal so that the PPK-BLUD policyin RSJP is not fully implemented, although there were someperceived positive results.Keywords: Local Public Service Agency, policy, changemanagement.

Analisis Biaya dengan Metode Activity Based Costin (ABC) pada Pemeriksaan Radio Diagnostik di Instalasi Radiognostik RSUD Linggajati Kuningan Jawa Barat Cecep Heriana; Afif Kosasih; Doni Kusuma Anjasmara
Jurnal Kebijakan Kesehatan Indonesia Vol 4, No 3 (2015)
Publisher : Center for Health Policy and Management

Backgroud: Tariffs for radiodiagnostic examination in radiology installation Linggajati Public Hospital Kuningan based on PERDA number 9 of 2012 on Health Care Levy who still use traditional accounting system, so the calculation is still less likely giving an exact cost in setting the charges. Costing is sometimes pose a problem. It is necessary to do cost analysis for radiognostic. The problem is to determine what is the unit cost and other considerations that applied in determining tariff for radiognostic services at Linggajati Public Hospital Kuningan. The aim of this research is to find out the cost unit and determine radiognostik service cost at Linggajati Public Hospital Kuningan. Methods: This was observational research using descriptive method through performing case study at Linggajati Public Hospital Kuningan. A calculation of cost unit was carried out by using the method Activity Based Costing (ABC), and analysis was done using content analysis after performing Focus Group Discussion (FGD). Results: Result of calculation using ABC method shows that cost unit of radiognostic service per unit for activities of administrative services registration is Rp 11,478,545,-. Cost unit for Activity radiodiagnostic examination Rp. 29.999.900,-. film processing activity. 24.677.100,- Activity for reading results is Rp. 2,400,000, Radiology Equipment Maintenance is Rp. 3,500,000. The total cost of the activity charged in radiology installation 72,055,545 divided by the number of days 365 days, so the charges rate is Rp. 197 412. Conclusion: The use of activity based costing as compared with the existing radiodiagnostic examination rate used by the hospitals shows the difference of Rp. 150 412. We suggest that hospitals should know and understand the activity based costing method to be able to make an accurate calculation of rates. Latar Belakang: Pemberlakuan tarif pelayanan pemeriksaan radiodiagnostik di instalasi radiologi RSUD Linggajati Kuningan berdasarkan PERDA Kabupaten Kuningan nomor 9 tahun 2012 tentang Retribusi Pelayanan Kesehatan yang masih mengguna- kan sistem akuntansi tradisional, sehingga hasil perhitungannya masih kurang memberikan gambaran yang tepat dalam pembe- banan tarifnya. Penetapan biaya ini kadang kala menimbulkan masalah. Untuk itu perlu dilakukan analisis biaya pelayanan pemeriksaan radiognostik. Permasalahan yang ada adalah berapa unit cost dan berapa biaya yang tepat berdasarkan unit cost serta pertimbangan- pertimbangan lain yang diberlakukan dalam penetapan tariff pelayanan pemeriksaan radiognostik di RS Linggajati. Tujuan penelitian ini adalah mengetahui besarnya biaya satuan (unit cost) dan menetapkan besarnya biaya pelayanan instalasi radiognostik di RSUD Linggajati Kuningan. Metode: Jenis penelitian ini adalah penelitian observasional diskriptif dengan melakukan studi kasus di RSUD Linggajati. Perhitungan unit cost dilakukan dengan metode Activity Based Costing (ABC), penetapan biaya lebih lanjut dilakukan content analysis setelah dilakukan Focus Group Discussion, serta pertimbangan-pertimbangan lainnya. Hasil: Aktivitas pelayanan administrasi pendaftaran Rp. 11.478.545, Aktivitas pemeriksaan radiodiagnostik Rp. 29.999.900, Aktivitas pengolahan film Rp. 24.677.100, Aktivitas pembacaan hasil Rp. 2.400.000, Pemeliharaan Alat Radiologi Rp. 3.500.000, Total biaya aktivitas dibebankan di instalasi radiologi 72.055.545 dibagi jumlah hari 365 hari maka tarif pemeriksaan Rp. 197.412. Kesimpulan: Perhitungan tarif pemeriksaan radiodiagnostik dengan menggunakan activity based costing, dilakukan melalui dua tahap. Dari perhitungan tarif pemeriksaan radiodiagnostik dengan menggunakan metode activity based costing. Penggunaan activity based costing apabila dibandingkan dengan tarif pemeriksaan radiodiagnostik yang digunakan oleh rumah sakit saat ini memberikan hasil yang lebih besar dengan selisih Rp. 150.412. Saran agar RSUD Linggajati Kuningan sebaiknya mengetahui dan memahami metode activity based costing ini agar bisa membuat perhitungan tarif yang akurat.

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Abstract

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Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Shita Dewi

Contact Email -

Phone -

Journal Mail Official jkki.fk@ugm.ac.id

Editorial Address -

Location Kab. sleman, Daerah istimewa yogyakarta INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Shita Dewi

Contact Email
-

Phone
-

Journal Mail Official
jkki.fk@ugm.ac.id

Editorial Address
-

Location
Kab. sleman,

Daerah istimewa yogyakarta

INDONESIA