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Dampak Keterlibatan BAPPEDA dalam Rangka Pengembangan Kapasitas SKPD Lintas Sektor bagi Perencanaan dan Penganggaran Program Kesehatan Ibu dan Anak di Provinsi Papua Deni Harbianto; Laksono Trisnantoro; Tiara Marthias; Muhammad Faozi Kurniawan; Likke Prawidya Putri; Deswanto Marbun
Jurnal Kebijakan Kesehatan Indonesia Vol 5, No 2 (2016)
Publisher : Center for Health Policy and Management

ABSTRACTBackground: Maternal and child mortality rate in Indonesia is still high. Indonesia is also expected not to reach the target of MDG 4 and 5 in 2015. In an effort to improve the health status of mothers and children in the context of decentralization, planning and budgeting at the district health is an important element of the health system. Evidence-Based Budgeting Planning Approach (EBP/PPBB), is a planning approach models that use data and academic health evidence in the framework of program decision-making as a references. Objectives: Describe the impact results of the PPBB KIA implementation in order to analyze, the impact of BAPPEDA involvement in maternal and child health planning advocacy through coordination across sectors.Research Methods: This study is a descriptive-correlative study that analyze the impact of BAPPEDA involvement in cross- sectoral planning for MCH programs, that are carried out in accordance with bottleneck analysis of the existing health system, using 66 interventions based continuum of care.Results: Cross-sectoral involvement in the planning and budgeting for MNCH brings a positive impact on the district health work plan. Bappeda involvement is crucial to coordinate cross-sectoral program for MNCH.Conclusions: Capacity of district planning staff is limited and should be improved, lack of evidence in planning is due to lack of health data, and the cross sector advocacy for health budgeting is insufficient. PPBB approach can improve capacity on planning on evidence-based and integrated planning for MNCH across-sectoral. Key Word: Planning, Maternal and Child Health, Cross Sectoral ABSTRAKLatar Belakang: Angka kematian ibu dan anak di Indonesia masih tinggi. Indonesia juga diprediksi tidak dapat mencapai target MDG 4 dan 5 pada tahun 2015. Dalam upaya peningkatan status kesehatan ibu dan anak dalam konteks desentralisasi, perencanaan dan penganggaran kesehatan di kabupaten merupakan elemen sistem kesehatan yang penting. Pendekatan Perencanaan Penganggaran Berbasis Bukti (PPBB) KIA, merupakan bentuk model perencanaan yang menggunakan bukti data dan referensi akademis dalam rangka pengambilan keputusan program kesehatan.Tujuan: memaparkan hasil implementasi PPBB-KIA dalam rangka melihat hubungan keterlibatan Bappeda dalam advokasi perencanaan perencanaan kesehatan ibu dan anak melalui koordinasi lintas sektor.Metode Penelitian: Kajian ini secara deskriptif-korelatif keterlibatan Bappeda dalam perencanaan lintas sector untuk progam KIA yang dilakukan sesuai dengan sumbatan sistem kesehatan yang ada dan berdasarkan 66 intervensi berbasis continuum of care.Hasil: Keterlibatan lintas sektor dalam perencanaan dan penganggaran KIA membawa dampak positif terhadap rencana kerja. Peran Bappeda semakin kuat dan memberikan kontribusi positif dalam kegiatan ini. Keterlibatan Bappeda terlihat berpengaruh dalam koordinasi program KIA untuk lintas sektor. Kesimpulan: Peningkatan kapasitas staf perencanaan kabupaten yang masih terbatas, kurangnya data kesehatan, peran advokasi lintas sektor ke Pemda yang belum kuat untuk meningkatkan pembiayaan kesehatan. Pendekatan PPBB dapat meningkatkan kapasitas perencanaan KIA secara berbasis bukti nyata terpadu dan terintegrasi dan lintas sektor di daerah. Kata Kunci: Perencanaan, Kesehatan Ibu dan Anak, Lintas Sektor

Evaluasi Implementasi Kebijakan Bantuan Operasional Kesehatan di Tiga Puskesmas Kabupaten Ende Provinsi Nusa Tenggara Timur Tahun 2011 Mariane Evelyn Pani; Laksono Trisnantoro; Siti Noor Zaenab
Jurnal Kebijakan Kesehatan Indonesia Vol 1, No 3 (2012)
Publisher : Center for Health Policy and Management

Background: Health Operational Assistance policy is given by the government based on the consideration that operational cost from local government is relatively small and widely used for curative and rehabilitative activities as well as less emphasis on promotive and preventive efforts. BOK fund distribution to Primary Health Care often had administrative obstacles and delays in liquefaction. The purpose of the study: to evaluate the implementation of BOK policy in three Primary Health Cares of Ende district.Methods: The study used a qualitative design with a descriptive case study approach. Results: The BOK funds used in Primary Health Care was utilized based on BOK guidelines that is promotive and preventive in which the utilization is based on the needs in the field with accountability guidelines according to BOK guidelines. The fund was often received late and yet the activity of Primary Health Care was still implemented by using loan or debt system. The role of the head of Primary Health Care in socialization and monitoring as well as the role of staff in the implementation of BOK policy was not yet optimal in Primary Health Care. The coverage program funded by BOK did not showed significant improvement due to limited human resources and lack of oversight in the implementation of BOK policy. Conclusion: The implementation of BOK policy in Primary Health Care was adapted with BOK guidelines for administration purposes, and for the completeness of SPJ without paying attention on the impact toward community. The delayed funds in Primary Health Care due to the fund was given late to the district level and delay in submitting POA so that the activity of Primary Health Care was implemented with credit system. The role of the head of Primary Health Care was not yet optimum in the socialization and monitoring of BOK policy implementation in Primary Health Care. BOK policy has no impact on the program improvement due to the lack of human resources and oversight in the implementation of BOK. Latar belakang: Kebijakan Bantuan Operasional Kesehatan (BOK) diberikan oleh pemerintah berdasarkan pertimbangan bahwa biaya operasional dari pemerintah daerah relatif kecil dan banyak digunakan untuk kegiatan kuratif dan rehabilitatif serta kurang menitikberatkan pada upaya promotif dan preventif. Distribusi dana BOK ke puskesmas sering mengalami kendala administratif dan keterlambatan dalam waktu pencairan. Tujuan penelitian adalah untuk mengevaluasi implementasi kebijakan BOK di tiga puskesmas Kabupaten Ende Metode: Penelitian ini menggunakan rancangan kualitatif, dengan pendekatan studi kasus deskriptif. Hasil: Dana BOK di puskesmas dimanfaatkan sesuai juknis BOK yakni untuk upaya kesehatan promotif dan preventif secara administratif, dimana pemanfaatannya disesuaikan dengan kebutuhan di lapangan dengan pertanggungjawabannya disesuaikan dengan juknis BOK. Dana terlambat diterima namun kegiatan di puskesmas tetap terlaksana dengan menggunakan sistem pinjam ataupun hutang. Peran kepala puskesmas dalam sosialisasi dan monitoring serta peran staf dalam pelaksanaan kebijakan BOK belum optimal di puskesmas. Cakupan program yang dibiayai BOK tidak menunjukan peningkatan secara signifikan. yang disebabkan terbatasnya SDM dan kurangnya pengawasan dalam pelaksanaan kebijakan BOK. Kesimpulan: Implementasi kebijakan BOK di puskesmas disesuaikan dengan juknis BOK untuk tertib administrasi, untuk kelengkapan SPJ tanpa memperhatikan dampak bagi masyara- kat. Keterlambatan dana di puskesmas disebabkan dana yang diberikan terlambat sampai ke tingkat kabupaten dan keterlam- batan dalam memasukan POA sehingga kegiatan di puskesmas dijalankan dengan sistem pinjam. Peran kepala puskesmas belum optimal dalam sosialisasi dan monitoring pelaksanaan Kebijakan BOK di puskesmas. Kebijakan BOK tidak berdampak pada pe- ningkatan program secara signifikan yang disebabkan kurangya SDM dan pengawasan dalam pelaksanaan kebijakan BOK.

ANALISIS KEBIJAKAN DESA SIAGA DI KABUPATEN SLEMAN YOGYAKARTA Reni Merta Kusuma
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 3 (2013)
Publisher : Center for Health Policy and Management

Background: Mortality rate is one of indicators andrepresentations of welfare of an area. In order to solve highmortality rate problem, the government of Daerah IstimewaYogyakarta (DIY), including District of Sleman, is carrying outthe policy of alert village.Method: The study used literature review based onreferences and field data which were issued by Health Office.Result: The policy of alert village has less positive impact indecreasing maternal mortality rate and neonatal mortality rate,because health assurance scheme still does not meet theneeds of the people, both physical and non-physical. Thedegree of health still has not improved significantly. The policyof alert village needs inter-sectoral financial support. Financialallocation is still mistargeting. People needs vary from onevillage to another, so it is necessary to have competent andsmart health workers as the implementing agents of HealthDepartment. The policy of alert village is still not able to satisfyall stakeholders (government, health workers, and people),because the concept of satisfaction is closely related to theprinciple of justice.Conclusion: The policy of alert village is an effort to empowerthe people to be independent in overcoming their healthproblems. But, in District of Sleman the policy of alert village isclassified into unsuccessfull policy. This failure is caused byinsufficiet support in implementating the policy.Keyword: Policy of alert village, Health Office of District Sleman

Integrasi bidan praktek swasta dalam program kesehatan ibu dan anak puskesmas: studi kasus implementasi jampersal di pelayanan primer Veronika Evita Setianingrum; Mubasysyir Hasanbasri; Mohammad Hakimi
Jurnal Kebijakan Kesehatan Indonesia Vol 3, No 4 (2014)
Publisher : Center for Health Policy and Management

Pendahuluan: Pemerintah Indonesia meluncurkan program Jampersal pada awal tahun2011. Program ini harus dilaksanakan oleh Puskesmas dan sektoe swasta. Penelitian ini menilai tentang puskesmas yang melakukan inovasi dalam Pelaksanaan Jampersal yang berdasar pada kebutuhan pasien, dimana puskesmas memastikan bahwa ibu hamil mendapatkan pelayanan antenatal yang berkualitas dengan cara pelayanan yang terintegrasi.Metode: Penelitian ini merupakan penelitian kualitatif dengan dengan desain studi kasus. Wwancara mendalam dilaakukan kepada 16 responden, termasuk pejabat kabupaten yang mengampu program Jampersal.Hasil:Puskesmas Moyudan melakukan integrasi pelayanan antenatal care dengan bidan swasta dalam bentuk paket pelayanan yang tidak dipungut biaya apapun. Sebagian besar peserta Jampersal merasa puas dengan pelayanan antenatal care yang terintegrasi ini, namun baru 46,5% ibu hamil di wilayah Moyudan yang sudah memanfaatkan pelayanan ini. Kesimpulan:Meskipun tingkat pemanfaatan program ini baru 46,5% , namun dapat meningkatkan kualitas dan efisiensi dalam pelayanan antenatal. Peran bidan swasta yaitu merujuk ibu hamil peserta Jampersal ke puskesmas untuk mendapatkan paket pelayanann antenatal care dan mengirimkan laporan pelayanan kesehatan ibu dan anak ke puskesmas setiap bulan.Kata kunci: Jampersal, integrasi pelayanan kesehatan, antenatal care, puskesmas, bidan praktek mandiri

Analisis Penetapan Prioritas Program Upaya Kesehatan Dasar (Puskesmas) pada Tingkat Pemerintah Daerah (Studi Eksploratif di Kota Bogor Tahun 2013) Riastuti Kusuma Wardani
Jurnal Kebijakan Kesehatan Indonesia Vol 3, No 4 (2014)
Publisher : Center for Health Policy and Management

Background: A policy is a set of conceptual proposed action in order to achieve certain goals. Some health indicators in Bogor city government has increased but some has decreased or only slightly increased. Method: The study is qualitative methods, and the informants are District health office, Puskesmas, Regional Secretary of Bogor City and Regional Representative Council of Bogor City. We cross check the data by conducting document review and observation . Results: The main actors in setting program priorities are Bogor District health office using evidence-based policy . Support is dominated by an elite group of executive government which is the City Health Office . The elite in legislative also has major effect in the form of budget determination . Overview of the process reveals that any identified problem and issues of the health center depends on the areas of concern. The process of prioritization of primary health care programs in the health center in the city of Bogor using the top-down approach. Furthermore, the Bogor district health office is also coordinating and disseminate at the level of higher government organizers. Prioritization output of primary health care programs in health centers vary in accordance with their respective problems working areas. The program remains in accordance with the basic policy of mandatory basic health centers to run the affairs of primary health care . Conclusions: human resources, support and demand is the necessary input to the priority-setting process, howoever a larger portion of health office still affect prioritization. Bottom- up approach needs to be done on the basis of the data. Kebijakan adalah serangkaian konsep tindakan yang diusulkan dalam rangka mencapai tujuan tertentu. Beberapa indikator pembangunan kesehatan pemerintah daerah Kota Bogor mengalami peningkatan namun ada pula yang mengalami penurunan atau meningkat tetapi tidak signifikan. Metode: metode kualitatif dengan Informan ; Dinkes Kota, Puskesmas, Sekda Kota Bogor, DPRD Kota Bogor. Cross cek data dengan melakukan telaah dokumen dan observasi. Hasil: Input;aktor utama dalam penetapan prioritas program adalah Dinas Kesehatan Kota Bogor dengan evidence base policy. Dukungan didominasi oleh kelompok elit eksekutif pemerintah adalah Dinas Kesehatan Kota. Kelompok elit legislative juga memberikan pengaruh, dalam bentuk penetapan anggaran. Gambaran proses : Identifikasi masalah dan isu tergantung pada permasalahan Puskesmas. Proses penetapan prioritas program pelayanan kesehatan dasar pada Puskesmas di Kota Bogor menggunakan metode top down. Selanjutnya dinas pula yang melakukan koordinasi dan sosialisasi pada level penyelenggara pemerintahan yang lebih tinggi. Output penetapan prioritas program pelayanan kesehatan dasar pada Puskesmas berbeda-beda sesuai dengan permasalahan masing-masing wilayah kerjanya. Program tetap sesuai dengan kebijakan dasar Puskesmas menjalankan urusan wajibnya primary health care. Kesimpulan: SDM, dukungan dan tuntutan merupakan masukan bagi proses penetapan prioritas dengan porsi Dinkes lebih besar mempengaruhi penetapan prioritas. Pendekatan bottom up perlu dilakukan dengan berdasar pada data.

Analisis Anggaran Program Prioritas Kesehatan Ibu dan Anak di Dinas Kesehatan Kabupaten Lingga Propinsi Kepulauan Riau Tahun 2009-2010 Marnaza Yusman; Mubasysyir Hasanbasri; Lutfan Lazuardi
Jurnal Kebijakan Kesehatan Indonesia Vol 1, No 4 (2012)
Publisher : Center for Health Policy and Management

Background: Global commitments for developing countries contained in the Millennium Development Goals (MDGs) by 2015, where the target MMR 102 per 100,000 live births and IMR 23 per 1,000 live births. In connection with this mother and child health program should be a concern. Lingga Health Authority supports the achievement of MDGs with budget support and adequate human resources and the commitment of policy makers. Goal of Research: To find out the budgeting maternal and child health program priorities Lingga Health Authority. Methods of Research: The design of this study using a case study design is descriptive with qualitative methods. Researchers analyzed the budget maternal and child health program in Lingga Health Authority Kepulauan Riau Province 2009-2010. Research Result: The low budget of MCH programs and programs that have not implemented effectively viewed from maternal and child mortality is still high. MPS implementation of the strategy aimed to emergency service only focused on improving access and coverage, while the increase in family and community participation, use of co-operation, and management support is not implemented consistently. There is no prioritization of MCH program activities and budget refers only to the previous year’s budget is based on data or the strengthening of the program. Weak commitment to decision makers and advocacy that have an impact on the budgets MCH program of low. Conclusions: Local builders index is determined by success in reducing maternal mortality. MCH program budget allocation should be based on evidence based and consider the magnitude of maternal mortality can be reduced. Priority setting is needed to determine which program activities over the allocated budget priorities so that more effective. The need for advocacy to local government and is committed to implement the priority programs so that programs are implemented more useful. Latar belakang: Komitmen global bagi negara berkembang tertuang dalam Millenium Development Goals (MDGs) tahun 2015, dimana target AKI 102 per 100.000 kelahiran hidup dan AKB 23 per 1.000 kelahiran hidup. Sehubungan dengan hal itu program kesehatan ibu dan anak harus menjadi perhatian. Dinas Kesehatan kabupaten Lingga mendukung pencapaian target MDGs dengan dukungan anggaran dan sumber daya manusia yang memadai serta komitmen para pembuat kebijakan. Tujuan penelitian: Untuk mengetahui anggaran program prioritas kesehatan ibu dan anak di Dinas Kesehatan Kabupaten Lingga. Metode Penelitian: Rancangan penelitian ini adalah studi kasus yang bersifat deskriptif dengan metode kualitatif. Peneliti menganalisis anggaran dan program prioritas kesehatan ibu dan anak di Dinas Kesehatan Kabupaten Lingga Propinsi Kepulauan Riau Tahun 2009-2010. Hasil Penelitian: Rendahnya anggaran program KIA dan program yang telah dilaksanakan tidak efektif dilihat dari angka kematian ibu dan anak yang masih tinggi. Penerapan strategi MPS yang diarahkan untuk pelayanan kegawatdaruratan hanya terfokus pada peningkatan akses dan cakupan pelayanan, sedangkan peningkatan partisipasi keluarga dan masyarakat, pemanfaatan kerjasama, dan manajemen support tidak dilaksanakan dengan konsisten. Tidak ada penetapan prioritas untuk kegiatan program KIA dan penyusunan anggaran hanya mengacu pada anggaran tahun sebelumnya tidak berdasarkan data atau penguatan dari program. Lemahnya komitmen dan advokasi pengambil keputusan yang berdampak pada anggaran program KIA rendah. Kesimpulan: Indeks pembangun daerah sangat ditentukan oleh keberhasilan dalam menurunkan angka kematian ibu. Pengalokasian anggaran program KIA harus berdasarkan evidence based dan mempertimbangkan besaran angka kematian ibu dapat diturunkan. Penetapan prioritas sangat perlu dilakukan untuk menentukan kegiatan program yang lebih prioritas sehingga anggaran yang dialokasikan lebih efektif. Perlunya advokasi terhadap pemerintah daerah dan mempunyai komitmen untuk melaksanakan program prioritas sehingga program yang dilaksanakan lebih bermanfaat.

STUDI EFEKTIVITAS PENERAPAN KEBIJAKAN PERDA KOTA TENTANG KAWASAN TANPA ROKOK (KTR) DALAM UPAYA MENURUNKAN PEROKOK AKTIF DI SUMATERA BARAT TAHUN 2013 Nizwardi Azkha
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 4 (2013)
Publisher : Center for Health Policy and Management

Background: Area free from tobacco (AFT) policy is the onlyeffective and inexpensive way to protect the public from thedangers of second hand smoke. In West Sumatra there arethree cities that have local regulation on this, namely Padang,Panjang Padang, and Payakumbuh, but in reality the policy hasnot been able to reduce the active smokers. This study aims todetermine the effectiveness of AFT policy in reducing smokersactive beside its effectiveness to protect the public from thedangers of second hand smoker in West Sumatera.Methods: The study was conducted with the method, a mixof quantitative and qualitative research with explanatory design.Data collection was conducted in the city of Padang, PadangPanjang and Payakumbuh. Quantitative data from 100 personswere collected using a questionnaire, while the qualitativedata was collected through in-depth interviews. Informants ineach city are representatives of Department of Health,professional organizations, community leaders, smokers andfocus group discussions. Some secondary data are obtainedthrough documents review related to the implementation ofAFT. The quantitative data is analysed using univariate analysis,and the qualitative data is analysed using content analysis.Results: Based on the quantitative data it can be seen that inthree cities in West Sumatera the smoker rate are 59%. InPadang Panjang, the regulation has been proceeded succesfulydue to the commitment of the Mayor and the legislative parlementin implementing the policies that there should not be any tobaccoadvertising as well as sanctions for smokers, especially foremployees who smoke at the office or at school, according tothe law no. 8/2009; suf ficient funds are available forsocialization and supervision AFT, a total of Rp75.000.000,00collected from tobbacco fundation and Rp24.000.000,00 fromthe budget. In Payakumbuh there is also the commitment of theMayor and the support of the Health Department according tothe Regulation of Area Free tobbacco no 15/2011. Establishmentof Supervisory Team for AFT with funds allocated forsocialization and supervision, a total amount ofRp341.278.129,00. Padang has not yet applying the AFT policyin government offices and schools, only in private sector suchas bank. Tobacco advertising still exists and there is no sanctionfor smokers despite the existing Regulation No. AFF 14/2011with accompanying funds provided Rp85.000.000,00.The study shows that the majority (60%) public opinion supportthe implementation of AFT. Some (51%) of the public say thatAFT is effective enough to reduce active smoker, over half ofrespondents thought AFT should apply to a particular location.According to 59% of respondents, smoking in public placesshould be given sanction. In Padang Panjang there is amonitoring service via SMS and phone to report breach of theregulation so that the Mayor may impose sanctions. InPayakumbuh a similar system exist through reports and spotchecks. Violaters of the regulation are given sanction by themayor. In Padang city, sanctions have not been given. Thelocal government regulation in banning advertising andpromotion of cigarettes is implemented in two cities, the city ofPadang Panjang and Payakumbuh. Some factors that affectthe implementation of AFT are dependent on the commitmentand the role of District mayor, as well as the need for communityempowerment..Conclusion: It is concluded that the AFT policy without thecommitment and support of all parties to the implementation ofAFT difficult. AFT can be effective to protect the second handsmokers and it has potential to reduce active smokers.Keywords: Effective, AFT Policy, Reducing active smokers.

Analsis Biaya Terapi Penyakit Diabetes Melitus Pasien Jaminan Kesehatan Nasional di RS PKU Muhammadiyah Yogyakarta - Perbandingan Terhadap Tarif INA CBGs Endang Yuniarti; Amalia Amalia; Tri Murti Handayani
Jurnal Kebijakan Kesehatan Indonesia Vol 4, No 3 (2015)
Publisher : Center for Health Policy and Management

Background: Diabetes Mellitus is a chronic disease whose prevalence is high enough at RS PKU Muhammadiyah Yogyakarta, particularly since National Health Insurance was launched on 2014. Prospective payment system with INA CBGs rates has to be calculated thoroughly in order to enable the hospital to provide a quality health care. This research aims to determine the cost component that has the greatest impact to the cost of illness Diabetes Mellitus, and to determine whether there are significant differences Alt the direct medical costs of DM with and without complication, and to calculate the difference between the real cost of illness and INA CBGs rates. METHOD This research was conducted at PKU Muhamadiyah Hospital with non experimental analytic and cross-sectional study. Data retrospectively retrieved from secondary data of all National Health Insurance patients who was diagnosed Diabetes Mellitus based on ICD 10 code. The cost calculated was the direct medical costs (hospital perspective). The bivariate correlation test was used to determine the relationship of component costs and the cost of illness Diabetes Mellitus disease. The independent sample t-test was used to test differences in the average cost of DM with and without complications. RESULTS Cost of illness DM type 1 for outpatient was Rp 563.817, higher than INA CBGs rates which is Rp 165.400 (Q-5-44-O, Other Chronic Disease). Cost of illness DM type 2 for outpatient was Rp 374.197, higher than INA CBGs rates of Rp 165.400 (Q-5-44-O, Other Chronic Disease). Cost difference between cost of illness DM for inpatient and INA CBGs (code E-4-10-I Diabetes Mellitus and Nutrition/ Metabolic light disorder) rates was Rp 445.748 lower than INA CBGs rates (Class III ward), Rp 2.250.000 lower than INA CBGs rates (Class II ward), and Rp 1.125.000,- is higher than INA CBGs rates (Class I ward). There is no significant difference between the average cost of illness Diabetes Mellitus with and without complication. CONCLUSIONThere is a difference between the cost of illness Diabetes Mellitus (hospital perspective) and INA CBGs rates which could decrease quality of care for outpatient with type 1 and type 2 Diabetes Mellitus. PENDAHULUAN Diabetes Melitus merupakan salah satu penyakit kronis yang prevalensinya cukup tinggi di RS PKU Muhammadiyah Yogyakarta apalagi sejak diluncurkannya program Jaminan Kesehatan Nasional pada th 2014 yang lalu sebagai implementasi Undang-Undang No 40 tahun 2004 tentang Sistem Jaminan Sosial Nasional. Sistem pembayaran prospective payment system dengan tarif INA CBGs yang diberlakukan memerlukan perhitungan yang valid agar tidak merugikan pemberi pelayanan dan menurunkan kualitas pelayanan itu sendiri. METODE Penelitian ini dilakukan di RS PKU Muhammadiyah Yogyakarta menggunakan metode analitik non eksperimental dengan rancangan cross sectional study. Data yang digunakan untuk penelitian ini adalah data biaya terapi semua pasien JKN yang didiagnosa Diabetes Mellitus berdasarkan kode ICD 10. Biaya yang diperhitungkan adalah biaya medik langsung (direct medical cost) meliputi biaya administrasi, biaya obat dan alat medik habis pakai, jasa pelayanan medik, biaya tindakan medik, biaya penunjang medik serta biaya akomodasi, khusus untuk pasien rawat inap. Data diambil secara retrospektif, kemudian dianalisis secara deskriptif dan perbedaan biaya terapi per episode antara DM dengan komplikasi dan DM tanpa komplikasi diuji secara statistik. Biaya terapi yang diperoleh kemudian dibandingkan dengan tarif INA CBGs untuk melihat selisih yang terjadi. HASIL Biaya terapi penyakit DM tipe 1 per episode rawat jalan sebesar Rp 563.817 + 255.080, dan yang masuk dalam paket sebesar Rp 247.200,- , lebih tinggi Rp 81.400,- dari tarif INA CBGs yang telah ditetapkan dalam PMK 59 th 2104 yaitu sebesar Rp 165.400,- (kode Q-5-44-O, Penyakit Kronis kecil lain-lain). Untuk penyakit DM tipe 2, biaya terapi per episode rawat jalan sebesar Rp 374.197 + 323.237, dan yang masuk dalam paket sebesar Rp 185.376,- , selisih Rp 19.976,- lebih tinggi dari tarif INA CBGs yang telah ditetapkan dalam PMK 59 th 2104 yaitu sebesar Rp 165.400,- (kode Q-5-44-O, Penyakit Kronis kecil lain-lain). Selisih biaya terapi pasien DM per episode rawat inap dengan Tarif INA CBGs (kode E-4-10-I Penyakit Kencing Manis dan Gangguan Nutrisi/Metabolik Ringan), untuk kelas III selisih positif Rp 445.748,-. untuk kelas II selisih positif Rp 2.250.000,- dan untuk kelas I selisih negatif Rp 1.125.000,-. Tidak terdapat perbedaan yang signifikan secara statistik antara biaya terapi DM tanpa komplikasi dengan biaya terapi DM dengan komplikasi. Hampir seluruh obat yang digunakan adalah obat DM yang masuk dalam FORNAS. KESIMPULAN Terdapat selisih biaya terapi penyakit DM pasien JKN antara tarif Rumah Sakit PKU Muhammadiyah Yogyakarta dengan tarif INA CBGs yang berpotensi menimbulkan kerugian bagi RS PKU Muhammadiyah Yogyakarta serta berpotensi menurunkan kualitas pelayanan untuk pasien rawat jalan baik DM tipe 1 maupun DM tipe 2.

EVALUASI PENERAPAN KEBIJAKAN BADAN LAYANAN UMUM DAERAH DI RSUD UNDATA PROPINSI SULAWESI TENGAH Surianto Laksono Trisnantoro
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 1 (2013)
Publisher : Center for Health Policy and Management

Background: One of the important things forchange is a sequentialcharacteristic or the phase of time for a change. Suchas the change stipulated by BLUD (Publis Service Agency)policy of the State Regional Hospital (RSUD) to become BLUD.The implementation of BLUD in the regional public hospital(RSUD) of Undata is generally based on the regulation of TheDepartement of Internal Affairs No 61 year 2007. The newparadigm as BLUD must be balancedof both the “Enterprisingthe Goverment” and the “Public Service Oriented”. The backgroundof Undata Hospital before becoming BLUD were theproblem of health care cost was getting expensive whilst thetariffs imposed had to be competitive, and the demand of goodquality of services to care for the patients. All of this could beachieved if Undata hospital applies the financial managementsystem of the regional public service agency (PPK-BLUD).Method Of Research:Thisresearch uses a descriptive analysiswith the case study design. The samplings conducted inthis research are purposive sampling. Method of data colectionobtained through in depth interview, observation, utilization ofdocuments.Research Result: The implentation of regional public serviceagency (BLUD) based on the result of evaluation study inUndata hospital and in the health departement of CentralSulawesi Province shows that: The implementation based onthe standard, namely governance, business strategy plan,and the report of financial management has been implementedwell. Whereas the implementation which is not in accordanceyet with the BLUD criteria is the minimum service standardrelated to indicator and criteria of SPM. Also the role of healthdepartement as the supervisory board has yet to be implementedbecause there is no supervisory board.Conclusion: It shows the governance, business strategyplan and financial report are already in accordance with standard,set while the minimum service standard and the supervisoryboard have not run optimally within the standard andcriteria set.Key words: PPK-BLUD, implementation of BLUD, Hospital,Stakeholders

Desentralisasi dan Pengambilan Keputusan Kebijakan Peningkatan Gizi Balita di Kota Depok dan Kota Bogor Propinsi Jawa Barat Candra Dewi Purnamasari; Dumilah Ayuningtyas; Riastuti Kusumawhardani
Jurnal Kebijakan Kesehatan Indonesia Vol 3, No 3 (2014)
Publisher : Center for Health Policy and Management

Background: Heywood and Choi ( 2010) found that there is only a slight increase of health system performance post decentralization. Low performance in decentralization of the health sector can be inferred from the high incidence of poor nutrition for U5 (under five) in the city of Bogor in West Java. However the city of Depok has a different situation in which they have successfully reduced poor U5 nutrient to 0% . Performance in a decentralized health system is affected by policy decisions that are influenced by decison space, institutional capacity and accountability of local government . Objective: This study aims to describe the decision-making processes for U5 nutrition based on decision space, capacity and accountability of local government institutions in the city of Depok and city of Bogor in West Java Province . Methods: This study is a qualitative case study design . In- depth understanding of the decision-making on health policy in the era of decentralization will be traced by means of in-depth interviews . Informants in this study include the Head of Department , Mayor , Chief Health Center and Head of Nutrition at the Provincial Health Office , Head of Bappeda. Results: Post Decentralization, nutrition policy decision-making process at the level of the city of Bogor and Depok conducted by larger decision space, the accountability of policy decisions in both regions showed an increase , but the capacity of public institutions and the level of participation of non- government actors as well as the institutional capacity is higher in the city of Depok than in the city of Bogor . Conclusion: Decentralization increases the decision space and accountability in health policy decision-making process. Increased institutional capacity, especially the capacity of human resources and increased levels of participation and non-government actors are needed to produce a more responsive policy decisions. Latar Belakang: Heywood dan Choi (2010) dalam studinya menemukan bahwa secara umum hanya terjadi sedikit pening- katan kinerja sistem kesehatan pasca desentralisasi. Rendahnyakinerja desentralisasi pada sektor kesehatan dapat dilihat dari masih tingginya kasus gizi balita buruk diKotaBogor Propinsi Jawa Barat.Kondisi yang berbeda terjadi di Kota Depok yang telah berhasil menekan gizi Balita buruk menjadi 0% . Kinerja sistem kesehatan dalam era desentralisasi dipengaruhi oleh pengambilan keputusan kebijakan yang dipengaruhi oleh decison space kapasitas institusional dan akuntabilitas pemerintah daerah. Tujuan: Penelitian ini bertujuan menggambarkan proses pengambilan keputusan kebijakan Gizi Balita berdasarkan decision space, kapasitas institusidan akuntabilitas pemerintah daerah diKota Depok dan Kota Bogor Propinsi jawa Barat. Metode: Penelitian ini merupakan penelitian kualitatif dengan rancangan studi kasus. Pemahaman secara mendalam menge- nai pengambilan keputusan pada penyusunan kebijakan kese- hatan pada era desentralisasi akan ditelusuri dengan cara melakukan wawancara mendalam (indepth interview). Informan dalam penelitian ini meliputi Kepala Dinas, WaliKota, Kepala Puskesmas dan Kepala Bagian Gizi di Dinas Kesehatan Propinsi, kepala Bappeda. Hasil: Setelah Desentralisasi, proses pengambilan keputusan kebijakan Gizi di tingkat Kota Bogor dan Kota Depok dilaksana- kan dengan Decision spaceyang lebih besar, akuntabilitas pengambilan keputusan kebijakan pada kedua daerah menun- jukkan adanya peningkatan, namun kapasitas institusi dan tingkat partisipasi masyarakat maupun aktor diluar pemerintah Kota Depok lebih tinggi dibanding Kapasitas Institusi di Kota Bogor. Kesimpulan: Desentralisasi meningkatkan decision space dan akuntabilitas pada proses pengambilan keputusan kebi- jakan kesehatan. Peningkatankapasitas institusi terutama kapa- sitas sumberdaya manusia dan peningkatan tingkat partisipasi masyarakat dan aktor diluar pemerintah sangat dibutuhkan untuk menghasilkan keputusan kebijakan yang lebih responsive.

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Shita Dewi

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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