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INDONESIA
Jurnal Kebijakan Kesehatan Indonesia
Published by Universitas Gadjah Mada
ISSN : 2089 2624     EISSN : 2620 4703     DOI : -
Core Subject : Health,
Public Health
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Articles 436 Documents
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Telaah Kebijakan Mitigasi Kesehatan Kelompok Rentan Pasca Pandemi dan Keadaan Luar Biasa Lain Anung Ahadi Pradana; Lina Anisa Nasution; Casman Casman
Jurnal Kebijakan Kesehatan Indonesia Vol 10, No 3 (2021)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.62692

Abstract

 Kondisi pandemi dan Keadaan Luar Biasa (KLB) memiliki efek negatif bagi kesehatan masyarakat dan kelompok rentan secara khusus. Efek negatif yang dialami oleh kelompok rentan pada periode pasca KLB dapat memanjang hingga beberapa tahun setelah kejadian. Penelitian ini bertujuan untuk menemukan penanganan kesehatan pasca-KLB pada kelompok rentan menggunakan metode studi literatur sederhana. Pencarian artikel didapatkan dari beberapa beberapa database diantaranya Cumulative Index to Nursing and Allied Health Literature (CINAHL), ScienceDirect, ProQuest dan PubMed antara tahun 2010 hingga 2020. Peran yang dapat dilakukan antara lain: mempersiapkan masyarakat dalam kesiapsiagaan terhadap kejadian KLB lain yang terjadi di masa depan, pemaksimalan fungsi pelayanan kesehatan terhadap kelompok rentan, Peningkatan peran tenaga kesehatan di pelayanan primer melalui proses Konseling, Informasi, dan Edukasi (KIE) serta sistem surveilans di masyarakat. Peran pemerintah dan tenaga kesehatan profesional menjadi sangat penting dalam membantu kelompok rentan dalam mencegah efek negatif khususnya di bidang kesehatan selama periode pasca-KLB.Kata kunci: Anak, Ibu Hamil, Keadaan Luar Biasa, Lansia, Pandemi. AbstractPandemic conditions and extraordinary circumstances (KLB) have a negative effect on the health of the public and particularly vulnerable groups. The negative effects experienced by vulnerable groups in the post-outbreak period can extend to several years after the event. This study aims to find post-outbreak health care in vulnerable groups using a simple literature study method. The search for articles was obtained from several databases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ScienceDirect, ProQuest and PubMed between 2010 and 2020. The roles that can be carried out include: preparing the community to be prepared for other outbreaks that occur in the future. in the future, maximizing the function of health services for vulnerable groups, Increasing the role of health workers in primary services through the process of Counseling, Information and Education (IEC) and surveillance systems in the community. The role of government and health professionals is very important in assisting vulnerable groups in preventing negative effects, especially in the health sector, during the post-outbreak period.Keywords: Children, Elderly, Extraordinary Circumstances, Pandemic, Pregnant Women.
Evaluation Managed Care Policy, Fraud Prevention and Commitment-Based Capitation in the Era of National Health Insurance in Bengkulu Province Used Realist Evaluation Susilo Wulan
Jurnal Kebijakan Kesehatan Indonesia Vol 10, No 3 (2021): Special Issues
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.63482

Abstract

Regulations related to health service quality policies in the era of National Health Insurance are needed to evaluate the effectiveness of programs based on sufficient evidence to become local as well as national policies. This research is important to do to support Universal Health Coverage (UHC) as issued by WHO. This study aims to evaluate the implementation of health service quality policy regulations and identify mechanisms of change and contextual factors that affect the implementation of regulations. Evaluation is carried out using a realist evaluation approach and analyzed in the form of a context, mechanism, and outcome configuration. The research was conducted in Bengkulu Province in 2018-2019 with the research subjects consisting of the director of the hospital, TKMKB, the fraud prevention team, the Health Office and the head of the Puskesmas. The sample selection used purposive sampling and data collection was carried out through in-depth interviews. Quality control and cost control (KMKB) programs, fraud prevention and Commitment-Based Capitation (KBK) are running in Bengkulu province. KMKB operates because of the SK which is always updated by BPJS Kesehatan every year, support from BPJS Kesehatan in the form of operational facilitation, coordination and incentives. The anti-fraud team in Bengkulu province in general has been formed at the district / city health office and hospital level, but not yet at the provincial level, this is because there is another team that has similar duties to the anti-fraud team at the provincial health office while at the health office district / city they are aware of the importance of the anti-fraud team. The KBK program shows that in general the target indicator for non-specialist referrals in Bengkulu province is achieved, namely 5%, but there are also city districts that have not been achieved, this is achieved because the Puskesmas has doctors in Bengkulu province, the competence of doctors is sufficient, adequate facilities and infrastructure, staff to receive capitation fund incentives, there is a JKN Monev team that is always active in conducting socialization, monitoring and evaluation at all Puskesmas, especially those that do not reach the target non-specialized referral indicator This study provides an overview of aspects of the context, mechanisms and outputs of health service quality policy regulations in the JKN era. 
Task Shifting dalam Pendistribusian Obat di Rumah Sakit Darurat Penanganan Covid-19 Wisma Atlet Kemayoran Dandung Ruskar; Mochamat Helmi; IDK Widana; Tjahja Nurrobi; Tugas Ratmono
Jurnal Kebijakan Kesehatan Indonesia Vol 10, No 3 (2021)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.63834

Abstract

Pandemi COVID-19 yang terjadi saat ini menyebabkan surge of capacity termasuk dalam jumlah tenaga kefarmasian. Rumah Sakit Darurat Penanganan COVID-19 Wisma Atlet Kemayoran (RSDC WAK) mempunyai kapasitas menampung pasien dengan jumlah yang cukup besar sehingga membutuhkan perhatian khusus dalam ketersediaan tenaga farmasi. Akibat dari keterbatasan jumlah tenaga farmasi di RSDC WAK membuat Task Shifting dalam pelayanan kefarmasian menjadi penting untuk dapat dilakukan. Dalam hal ini pendistribusian obat kepada pasien COVID-19 yang seharusnya dilakukan oleh tenaga farmasi dilimpahkan kepada tenaga perawat. Apabila sistem ini tidak disertai dengan pembekalan, pengetahuan dan keterampilan khusus, tidak menutup kemungkinan akan terjadi kesalahan dalam pendistribusian obat yang akan berpotensi menurunkan mutu pelayanan kesehatan. Kajian ini memberikan gambaran tentang Task Shifting yang terjadi di RSDC WAK, kemudian melalui analisa literatur untuk menjelaskan bagaimana implementasi yang sebaiknya terjadi.
Pola Pelayanan Penderita Hipertensi Peserta JKN di FKRTL Provinsi Jawa Barat Tahun 2015-2016 Wulan Fitrian; Yulia Sofiatin; Irvan Afriandi
Jurnal Kebijakan Kesehatan Indonesia Vol 10, No 3 (2021)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.64161

Abstract

Tekanan darah tinggi merupakan faktor risiko independen penyakit kardiovaskular. Hipertensi di Jawa Barat masih menjadi masalah dengan angka kejadian yang terus meningkat. Beberapa kasus hipertensi harus dirujuk ke Fasilitas Kesehatan Rujukan Tingkat Lanjut (FKRTL) untuk mendapatkan pelayanan spesialis/sub spesialis. Penelitian ini bertujuan untuk mengetahui Pola Pelayanan Penderita Hipertensi Peserta Jaminan Kesehatan Nasional (JKN) di Fasilitas Kesehatan Rujukan Tingkat Lanjut (FKRTL) Provinsi Jawa Barat Tahun 2015-2016. Penelitian  menggunakan desain deskriptif kuantitatif. Data yang digunakan merupakan data tersier yaitu data sampel BPJS Kesehatan tahun 2015-2016. Subyek penelitian ini merupakan penderita hipertensi yang menerima pelayanan di Fasilitas Kesehatan Rujukan Tingkat Lanjut (FKRTL) Provinsi Jawa barat tahun 2015-2016. Seluruh data yang memenuhi syarat dan sebagian besar variabelnya terisi lengkap diikutsertakan dalam analisis dengan menggunakan pembobotan yang disediakan dalam data sampel. Proporsi penderita hipertensi yang dilayani di FKRTL sebanyak 6,3%. Kelompok yang paling banyak ditangani di FKRTL adalah kasus hipertensi primer (53,8%), usia >64 tahun (31,2%), perempuan (63,9%), dan orang yang sudah menikah (72,3%). Hipertensi yang dikelola di FKRTL lebih banyak diberikan kepada kelas premi I (43,8%) dan segmen pekerja bukan penerima upah (33,6%). Jenis fasilitas kesehatan rujukan tingkat lanjut yang dikunjungi paling banyak adalah rumah sakit (99,9%), fasilitas kesehatan asal rujukan paling banyak adalah puskesmas (51,8%), dan klinik yang melayani pasien hipertensi terbanyak adalah klinik penyakit dalam (44,4%). Jenis pelayanan yang diberikan kepada penderita hipertensi terbanyak adalah rawat jalan (81,3%) dan status pulang terbanyak pada penderita hipertensi dengan rawat inap adalah sehat (93%). Sebagian besar pasien hipertensi adalah hipertensi primer, berusia >64 tahun, berjenis kelamin perempuan, status sudah menikah, segmen PBPU, dan kelas premi I. Hipertensi paling banyak terdiagnosis di rumah sakit, dilayani pada klinik penyakit dalam, dan dirujuk dari puskesmas. Jenis pelayanan yang diberikan kepada penderita hipertensi terbanyak adalah rawat jalan dan sebagian besar penderita hipertensi dengan rawat inap pulang dalam keadaan sehat. High blood pressure is an independent risk factor for cardiovascular disease. Hypertension in West Java is still a problem with increasing incidence. Some cases of hypertension must be referred to Advanced Level Health Facilities (FKRTL) for specialist/sub-specialist services. This study aims to describe the pattern of services for hypertension patients who participate in the National Health Insurance (JKN) at the Advanced Level Health Facility (FKRTL), West Java Province in 2015-2016. This research used  quantitative descriptive design. The data used is tertiary data, BPJS Health sample data 2015-2016. The subjects of this study were hypertensive patients who received services at the Advanced Level Health Facility (FKRTL) in West Java Province in 2015-2016. Data that meet the requirements and most of the variables filled in completely are included in the analysis using weights provided in the data sample. The proportion of hypertensive patients served at the FKRTL was 6.3%. The groups managed by FKRTL the most were primary hypertension (53.8%), age> 64 years (31.2%), women (63.9%), and married people (72.3%). Hypertension that is managed in FKRTL is mostly given to premium class I (43.8%) and non-wage worker (33.6%). Types of advanced level health facilities visited the most were hospitals (99.9%), health facilities from which the most referrals originated were puskesmas (51.8%), and clinics that served the most hypertensive patients were internal medicine clinics (44.4 %). Most of the services provided to hypertensive patients were outpatient (81.3%) and most patients with hypertension who hospitalized were healthy (93%). Most hypertensive patients are primary hypertension,> 64 years old, female, married, PBPU segment, and premium class I. Hypertension is most diagnosed in hospitals, served at internal medicine clinics, and referred from puskesmas. Most types of services provided to hypertensive patients are outpatient and most hypertensive patients with hospitalization go home in good health.
Analisis Kesiapan Klinik Pratama Akbid Muhammadiyah Cirebon dalam Menghadapi Pembayaran Kapitasi Berbasis Kinerja Ari Nurfikri
Jurnal Kebijakan Kesehatan Indonesia Vol 10, No 3 (2021)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.65318

Abstract

Performance-based capitation payments complement capitation payments based on the fulfillment of service commitments, which in principle will make adjustments to the capitation received if it does not meet the predetermined indicators. The Primary Clinic Akbid Muhammadiyah Cirebon requires a performance-based analysis of the readiness to face capitation payments. The purpose of this study was to simulate income before and after performance-based capitation adjustments and to see the readiness of the Primary Clinic Akbid Muhammadiyah Cirebon in facing performance-based capitation payments in terms of information, authority, staff, and infrastructure. This research uses an explanatory sequential mixed-method approach. In the first phase, data from primary care in 2020 is simulated so that income is known after adjustment by looking at three indicators. The qualitative phase is carried out by in-depth interviews with clinic leaders, medical support and service coordinators, management coordinators, and medical record staff to analyze the clinic's readiness to face performance-based capitation payments. The results showed that the clinic had not been able to meet all performance-based capitation payment indicators so that the income decreased by Rp. 23,178,200. Preparation from the information side by optimizing the JKN Mobile application as a telemedicine service, in terms of authority with regulations governing non-specialized referrals, from infrastructure side with the repair of computers and internet networks, from the staff side with training in both educational materials and innovative delivery media. The study concluded that the clinic requires system improvements in terms of information, authority, infrastructure, and staff to meet indicators of contact rates, non-specialist outpatient referral ratios, and prolanis participant ratio. Keywords: Contac number, Referral, Prolanis 
Ketanggapan Pemerintah Daerah terhadap Sasaran Tata Kelola Roadmap Jaminan Kesehatan Nasional Tahun 2014 – 2019 di Provinsi Kalimantan Timur Rahmat Bakhtiar; Hilda Hilda; Krispinus Duma
Jurnal Kebijakan Kesehatan Indonesia Vol 10, No 3 (2021)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.66042

Abstract

Peta Jalan Jaminan Kesehatan Nasional 2014-2019 merupakan wujud komitmen Pemerintah untuk mengintegrasikan perencanaan program pembangunan nasional untuk mengimplementasikan program jaminan kesehatan dalam mencapai kepesertaan menyeluruh program jaminan kesehatan. Sebanyak 24 stakeholder potensial diwawancarai secara mendalam dan  dianalisa secara deskriptif dalam aspek kebijakan dan ketanggapan sesuai dengan peran masing masing.  Hasil evaluasi  peta jalan di provinsi Kalimantan Timur menunjukkan sasaran tata kelola yaitu sasaran 1, 5 dan 8  belum sepenuhnya tercapai. Jumlah kepesertaan belum mencapai target UHC (93,64%). Keterbukaan akses terhadap data diawal periode peta jalan mengakibatkan Pemerintah Daerah dan BPJS kesulitan mencapai target universal health coverage. Ketanggapan Pemerintah Daerah terlihat meningkatnya intensifitas koordinasi stakeholder dengan  BPJS serta adanya aturan sinkronisasi kegiatan yang dibuat secara bersama.  Memperbaiki tata kelola dan dukungan stakeholder program JKN-KIS diperlukan dalam upaya memeratakan pelayanan kesehatan dan mencapai target universal health coverage.
Evaluation of National Health Insurance Program Implementation in Jakarta Province, Indonesia Evi Susanti Sinaga; Ika Rahma Ginting; Rina K Kusumaratna; Tiara Marthias
Jurnal Kebijakan Kesehatan Indonesia Vol 10, No 3 (2021): Special Issues
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.66063

Abstract

The implementation of National Health Insurance in several regions in Indonesia faces challenges, such as health service providers, health insurance management , and the community. The outcome that occurs may vary depending on the implementation of different aspects of governance, equity or social justice, and aspects of service quality. Therefore, research was conducted by evaluating the implementation of the national health insurance in DKI Jakarta Province. The evaluation is carried out based on the 2019 JKN road map target indicators, grouped into three aspects: including governance, achievement of equal distribution of health services (equity), and quality of service. This research used a mixed-methods design that combined the approach of quantitative and qualitative elements. Quantitative data were collected from secondary data from Health Social Security Agency (BPJS Kesehatan), the National Social Security Council Monitoring and Evaluation System (Sismonev DJSN). The qualitative data comes from in-depth interviews with selected informants using the purposive sampling technique. The result was that DKI Province had achieved the JKN membership target. There are still JKN participants who are inactive / in arrears from participants in the government and private wage-earning segments. Health facilities and human health resources have met the standards, but related to the package of benefits for heart diseases services, the availability of cardiac specialists and cath lab facilities has not been evenly distributed, especially in the Seribu Islands. Patient preferences in choosing the desired health service resulted in implementing a tiered referral system and back-referral still having problems in health facilities. 
ANALISIS IMPLEMENTASI LAYANAN JANTUNG PROGRAM JKN DI PROVINSI NTT TAHUN 2019 (Analysis of cardiovascular services utilization in the JKN program in NTT Province in 2019) Edit Oktavia Manuama; Stevi Ardianto Nappoe; Tri Aktariyani; M. Faozi Kurniawan; Laksono Trisnantoro
Jurnal Kebijakan Kesehatan Indonesia Vol 10, No 3 (2021): Special Issues
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.66583

Abstract

Keterbatasan fasilitas kesehatan dan tenaga kesehatan yang terjadi di NTT berdampak pada penyerapan dana JKN yang semakin kecil. Adanya ketimpangan rasio dokter juga berpengaruh terhadap mutu layanan kesehatan. Artikel ini bertujuan untuk melihat implementasi JKN di NTT dilihat dari: 1) tata kelola; 2) sisi ketersediaan dan mutu layanan jantung. Penelitian ini merupakan penelitian evaluative dengan design mix methods di mana menggabungkan design kualitatif dan kuantitatif. Hasil penelitian menunjukan bahwa kelompok PBI yang menjadi sasaran program JKN sudah dapat menggunakan layanan. Namun secara umum, jika dilihat dari angka absolut penggunaan layanan mungkin masih jauh dari kebutuhan. Data BPS menunjukkan bahwa 84% kematian terjadi di rumah. Selain itu, pada aspek tata kelola, transparansi dalam JKN belum terwujud. Implementasi JKN dari aspek tata kelola dan ekuitas khusus pada layanan jantung di Provinsi NTT belum berjalan optimal The limitations of health facilities and health workers in NTT province have an impact on the limited absorption of JKN funds in this region. The ratio of doctor specialist also affects the quality of health services. This is an analysis of the utilization of cardiovascular services in NTT. Using a mixed-method study, this study aims to evaluate the implementation of JKN in a rural area in terms of governance, availability, and quality of cardiovascular services.  This study found that the PBI groups (poor), the main target of the JKN program, has been able to access cardiovascular services. However, based on the absolute figures, underutilization of cardiovascular care services is recorded which is likely far below the actual needs.  Transparency in JKN policy remains a significant issue. In conclusion, the implementation of JKN  has not run optimally to achieve its objective to promote good governance and equity in cardiovascular in NTT province.  
EVALUASI KEPESERTAAN DAN PEMERATAAN LAYANAN JAMINAN KESEHATAN NASIONAL DI PROVINSI DIY Tri Aktariyani
Jurnal Kebijakan Kesehatan Indonesia Vol 10, No 3 (2021): Special Issues
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.66762

Abstract

Capaian kepesertaan program JKN DIY belum pernah mencapai 100%.  Peta jalan JKN yang dibuat tahun 2012-2019 menetapkan target-target yang perlu dicapai oleh pemangku kepentingan terkait. Kajian ini bertujuan untuk mengidentifikasi tantangan dan peluang dalam mencapai target-target peta jalan tersebut, khusus pada kepesertaan, pemerataan dan mutu layanan penyakit jantung di Provinsi DIY. Penelitian menggunakan metode deskriptif dengan pendekatan kualitatif. Sumber data dalam penelitian yaitu data primer dan data sekunder.Hasil penelitian menunjukan bahwa persoalan penuruan kepesertaan di Provinsi DIY adalah imbas dari belum jelasnya target peserta program JKN-KIS. Selain itu, program JKN sebagian besar dinikmati oleh segmen PBPU atau penduduk dengan stratifikasi ekonomi mampu dan berada di wilayah perkotaan.
Analisis Capaian Peta Jalan JKN di Provinsi Sumatera Utara Juanita Juanita
Jurnal Kebijakan Kesehatan Indonesia Vol 10, No 3 (2021): Special Issues
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.66946

Abstract

Jaminan Kesehatan Nasional (JKN) sudah diimplementasikan sejak tanggal 1 Januari 2014. Berdasarkan Peta Jalan JKN ada 8 sasaran yang harus dicapai pada tahun 2019. Provinsi Sumatera Utara merupakan salah satu provinsi yang juga telah mengimplementasikan JKN. Kabupaten/kota yang ada sangat bervariasi baik dari sisi kondisi geografis maupun ketersediaan sarana dan prasarana kesehatan. Penelitian ini bertujuan untuk menganalisis capaian Peta Jalan JKN tersebut. Penelitian ini menggunakan metode deskriptif. Data kuantitatif diperoleh dari data sekunder Dashboard Sistem Kesehatan (DaSK), data sampel JKN,  dan Sismonev DJSN. Hasil penelitian : menunjukkan bahwa dari aspek Tata kelola, JKN belum mencapai sasaran yang diharapkan. BPJS Kesehatan belum beroperasi dengan baik, dapat dilihat dari terjadinya defisit di beberapa kabupaten/kota di Provinsi Sumatera Utara 2016. Defisit terjadi karena jumlah kapitasi yang dibayarkan ke FKTP dan klaim yang dibayarkan ke FKTL lebih besar dari iuran yang diterima. Equity pelayanan kesehatan masih belum tercapai. Cakupan kepesertaan tahun 2019 sebesar 76,18 %, walaupun ada beberapa kabupaten/kota yang sudah mencapai lebih dari 90 %, namun ada juga yang masih 65 %.  Utilisasioleh segmen PBI masih sangat rendah dibandingkan dengan segmen PBPU dan PPU. Ketersediaan SDM kesehatan dan fasilitas kesehatan masih belum merata dan terdistribusi secara merata sesuai dengan kebutuhan di 33 kabupaten/kota. Mutu pelayanan kesehatan belum optimal, salah satunya disebabkan belum berperan secara maksimal tim fraud atau tim monev, hingga masih ditemukannya iur biaya yang dikenakan pada pasien. Rekomendasi :1) Pemerintah daerah tidak hanya fokus pada capaian kepesertaan namun juga harus memperhatikan ketersediaan layanan kesehatan; 2) BPJS Kesehatan memberikan kompensasi bagi daerah yang masih kurang sarana dan prasarana kesehatannya.

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