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https://jurnal.ugm.ac.id/index/oai
oai:jurnal.ugm.ac.id:article/3068
2013-12-31T03:10:33Z
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EDISI PERTAMA JURNAL KEBIJAKAN KESEHATAN INDONESIA
Trisnantoro, Laksono
Edisi ini merupakan penerbitan pertama Jurnal
Kebijakan Kesehatan Indonesia yang berdiri tahun
2012. Mengapa diperlukan jurnal ini? Pada pertemuan
nasional II Jaringan Kebijakan Kesehatan Indonesia
di Makassar tahun 2011, telah disepakati
penerbitan Jurnal Kebijakan Kesehatan Indonesia.
Jurnal yang mengambil bentuk e-journal dan cetak
(dua versi) akan dikelola oleh Jaringan Kebijakan
Kesehatan Indonesia, bekerja sama dengan Program
Studi Ilmu Kesehatan Masyarakat, Minat Kebijakan
dan Manajemen Pelayanan Kesehatan Universitas
Gadjah Mada. Pertemuan di Makassar memandang
perlu adanya sebuah jurnal yang fokus pada pengembangan
kebijakan kesehatan di Indonesia.
Apa materi jurnal ini? Dengan berfokus pada
kebijakan kesehatan maka materi akan berada pada
proses penyusunan kebijakan, mulai dari penyusunan
ide dan agenda sampai ke evaluasi pelaksanaan
kebijakan. Terkait dengan penyusunan kebijakan,
ada dua kelompok topik yang dapat dicermati. Pertama
adalah kelompok topik yang sudah mempunyai
kebijakan publik. Kebijakan publik tersebut dapat
berada di level pusat dalam bentuk Undang-Undang,
Peraturan Pemerintah, Peraturan Presiden, Peraturan
Menteri Kesehatan, dan sebagainya. Di level propinsi
adalah Peraturan Daerah, Peraturan Gubernur
dan sebagainya. Demikian pula di level kabupaten/
kota. Contoh topik kebijakan di kelompok ini adalah
UU SJSN di tahun 2004 dan UU BPJS di tahun 2011.
Kelompok kedua, adalah berbagai topik kesehatan
yang belum mempunyai kebijakan. Sebagai gambaran
adalah topik “medical-tourism” yang belum
mempunyai kebijakan publik sama sekali. Kelompok
ini juga studi mengenai persiapan penyusunan
kebijakan publik di level Peraturan Pemerintah
sebagai perintah dari sebuah UU.
Berbagai kebijakan di level internasional yang
perlu dicermati ada kebijakan yang mengikat seperti
Treaty, namun juga ada berbagai kebijakan di level
internasional yang lebih banyak menghimbau.
Kebijakan formal yang dapat dilihat berdasarkan tata
hukum nasional dan internasional, dikenal pula
berbagai kebijakan lokal yang informal. Gambaran
kebijakan informal diberbagai kelompok masyarakat
yang menolak vaksinasi merupakan hal menarik
untuk ditulis dalam jurnal ini. Kecocokan, dan ketidak
cocokan antara kebijakan kesehatan formal dan informal
di berbagai tempat merupakan isu penelitian
yang menarik.
Pertanyaan yang sering muncul adalah siapa
yang akan membaca jurnal ini? Pertanyaan
berikutnya adalah: siapa yang akan menulis di jurnal
ini? Diperkirakan pembaca jurnal ini adalah
pengambil kebijakan kesehatan di Indonesia yang
berada di Kementerian Kesehatan dan berbagai
kementerian terkait kesehatan. Adanya kebijakan
desentralisasi, tentunya ada ribuan pengambil
kebijakan di propinsi dan kabupaten yang diharapkan
membaca jurnal ini. Dengan mengambil kriteria
pembaca adalah level kepala bidang ke atas, maka
diperkirakan akan ada 2500 pembaca di daerah dan
sekitar 300 di pusat. Ada pengajar dan peneliti
kebijakan kesehatan di berbagai universitas dan
lembaga penelitian yang akan membaca dan
sekaligus menulis artikel-artikel penelitian. Edisi
pertama ini kami menghimbau para calon penulis
untuk mengirimkan naskah ke Jurnal Kebijakan
Kesehatan Indonesia. Topik-topik naskah tersebut
tentunya terkait dengan proses kebijakan yang sudah
di bahas di atas. Kami tunggu naskahnya. (Laksono
Trisnantoro, )
Center for Health Policy and Management
2013-12-31 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3068
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 1, No 1 (2012)
eng
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oai:jurnal.ugm.ac.id:article/3069
2013-12-31T03:10:33Z
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EVALUASI PROGRAM SKRINING STATUS TETANUS TOXOID WANITA USIA SUBUR DI JEMBER TAHUN 2010
Ahmad Falih, Abu Khoiri, Dewi Rokhmah,
Background: Cases and deaths due to Tetanus Neonatorum
(TN) in Jember District within the period of 2005 to 2009 with a
Case Fatality Rate (CFR) were greater than 50%. CFR with a
rate of more than or equal to 50% indicates a high share of
deaths. Jember District Health Office implemented a screening
program for childbearing women’s TT status in early 2010.
However, not until the end of 2010 there were already 6 cases
and 3 deaths due to TN (CFR = 50%). This suggested that the
implementation of the screening program had already been
running but not optimal; thus, an evaluation for this program
needed conducting.
Objective: To evaluate the screening program for childbearing
women’s TT status by describing the capacity and motivation
of personnel, implementation and results of the screening
program in Jember District in 2010.
Method: This was a descriptive-evaluation study. It was
conducted in January-February 2011 in five health centers of
Jember District. The population was midwives as persons in
charge of implementing the screening program.
Result: Most respondents (59%) had a moderate level of
capacity. Most respondents had a high level of intrinsic and
extrinsic motivation, namely 71% and 53%, respectively. The
screening implementation for childbearing women’s TT status
by the respondents had not been in accordance with the two
operational procedures. The results of the screening program
showed that five health centers were still experiencing the
same problem, i.e., not identified TT status of all women and
unmet target coverage of T5 childbearing women and T2 plus
pregnant women.
Conclusion: Technically, some obstacles in the implementation
of the screening program are still present; therefore, there is a
need for conducting training procedures for the personnel of
the screening program for childbearing women’s TT status
and conducting an evaluation for the program periodically and
continuously.
Keywords: evaluation, tetanus toxoid, childbearing women
Center for Health Policy and Management
2013-12-31 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3069
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 1, No 1 (2012)
eng
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oai:jurnal.ugm.ac.id:article/3070
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PELAKSANAAN KEBIJAKAN BANTUAN OPERASIONAL KESEHATAN DI KABUPATEN OGAN ILIR, SUMATERA SELATAN
Ainy, Asmaripa
ABSTRACT
Introduction: The Ministry of Health of Indonesia Republic
has issued a policy on health operational fund (BOK) to increase
the access of service in health centers based on a decree of
the Minister of Health Number 494/Menkes/SK/IV/2010 updated
through the regulation of the Minister of Health Number 210/
Menkes/Per/I/2011 dated 31st January 2011 on the technical
guidelines for BOK. Ogan Ilir District has supported that policy
through a decree issued by the head of health office Number
440/337/DKES/III/2011 and 440/22/DKES/III/2011, which each
regulates the forming of the management of Jamkesmas,
Jampersal, and BOK as well as budget managers. This study
aimed to analyze the implementation of BOK policy in Ogan Ilir
District.
Methods: This study was an analysis of policy. The primary
data were obtained through direct observation and in-depth
interviews to 4 informants: Head of Ogan Ilir Health Office,
management staff at Ogan Ilir Health Office, Head of Indralaya
Health Center and management staff at Indralaya Health Center.
The secondary data were obtained through review of BOK
documents.
Results: BOK in Ogan Ilir had been implemented in 2010 through
the social assistance and in April 2011 by co-administration by
the health office. The organizing of BOK referred to the
technical guideline from the Ministry of Health. Financial
management referred to the financial management guideline
from the Directorate General of Nutrition and Maternal and
Child Health. Disbursement of BOK began from proposing Plan
of Actions (POA) from health centers to health office to verify
the funds and then proposing disbursement to KPPN. The fund
for implementing program could be taken from BOK treasurer.
The allocation of BOK at health centers was adjusted for the
number of working areas, population, program coverage and
geographical conditions. BOK was prioritized for health
promotion such as: maternal and child health, nutrition, body
mass index measurement, and communicable diseases. Per
April-June 2011, the fund for secretariat had been disbursed
about 40% used for dissemination, training and transport for
health center treasurer. Reporting of BOK conducted from
health center to health office was on every date 5 then
forwarded to the province and to the Ministry of Health every
month via online, as well as a written report to KPPN.
Conclusion: The implementation of BOK in Ogan Ilir referred
to the policy of the Ministry of Health and was followed up
with the policy of district health office. POA proposal is decisived
in the disbursement of BOK so it is recommended to the head
of Ogan Ilir District Health Office to routinely ensure
dissemination about BOK and guide all health centers in
preparation of POA for implementing policy effectively.
Keywords: financing policy, health operational fund, health
center
Center for Health Policy and Management
2013-12-31 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3070
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 1, No 1 (2012)
eng
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oai:jurnal.ugm.ac.id:article/3071
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ANALISIS PEMBIAYAAN PROGRAM KESEHATAN IBU DAN ANAK BERSUMBER PEMERINTAH DENGAN PENDEKATAN HEALTH ACCOUNT
Sigit Riyarto, Dominirsep Dodo, LaksonoTrisnantoro,
Background: The degree of Maternal and Child Health (MCH)
is still a major problem in health development in Indonesia. One
factor that may be an obstacle in solving this problem is the
limited cost. In this context, planning and cost utilization are
essential to improve so that they can produce a great impact
for the improvement of MCH. Therefore, in-depth information
about the MCH financing situation in regions as an input to
develop efficient activities in improving MCH status is needed.
Objective: To analyze health financing situation of MCH program
in 2010 which sourced from government and to make policy
recommendations related to the program in Sabu Raijua District,
East Nusa Tenggara Province. The situation in question is
availability, budget planning process, expenditure accuracy,
and fund flow rate.
Method: This was a descriptive research with a case study
strategy.
Result: The total cost of MCH program was IDR 450,787,500.
It was not sufficient to provide basic health services for
pregnant women from early pregnancy until postpartum period.
The budget proportion from the central, provincial, and district
governments amounted to 79.63%, 3.56%, and 16.78%,
respectively. Cost allocation of the district budget was 0.80%.
Planning activities of MCH program was from the district budget
through the development planning meeting (Musrenbang).
Proposed activities in Musrenbang were dominated by physical
activities. The cost of MCH program was spent more on direct
activities and operational cost in villages and sub districts. The
implementation of the activities was not supported by facilities
and adequate human resources. The MCH fund disbursement
from the central government was conducted in October-
November while from the provincial and district governments
were in July to August.
Conclusion: The government’s commitment was still low in
financing MCH program as a priority program due to budget
decentralization. Musrenbang activities had not demonstrated
significant impacts on quality activities improvement and budget
allocations from the district budget. Availability of personnel
and health facilities greatly affected the performance of MCH
program. Delays in funds disbursement disrupted the
implementation of activities and provided opportunities for
corruption. Therefore, the supervision function must be
improved both internal and external.
Keywords: financing, maternal and child health program,
health account, budget, government.
Center for Health Policy and Management
2013-12-31 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3071
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 1, No 1 (2012)
eng
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oai:jurnal.ugm.ac.id:article/3072
2017-10-09T15:46:11Z
jkki:ART
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KEBIJAKAN PEMERINTAH DAERAH DALAM MENINGKATKAN SISTEM RUJUKAN KESEHATAN DAERAH KEPULAUAN DI KABUPATEN LINGGA PROVINSI KEPULAUAN RIAU
Luti, Ignasius
http://orcid.org/0000-0003-2972-6916
Hasanbasri, Mubasysyir
https://scholar.google.co.id/citations?user=cNLJ2XAAAAAJ&hl=id http://orcid.org/0000-0003-2972-6916
Lazuardi, Lutfan
Ignasius Luti1, Mubasysyir Hasanbasri2, Lutfan Lazuardi2
1 Dinas Kesehatan Kabupaten Lingga, Kepulauan Riau
2 Program Studi Ilmu Kesehatan Masyarakat, Fakultas Kedokteran,
Universitas Gadjah Mada, Yogyakarta
ABSRACT
Background: One of the critical issues in the development of
national health care is the limited accessibility to health services.
Such problems also occur in Linga District of Kepulauan
Riau Province. It is caused by many factors, such as geographical
location, cost, number of health personnel and condition
of health care facilities, such as health centers and their
networks which are not accessible to the public. Several attempts
have been made, for example, by improving the status
of sub-health centers to be health centers, health centers to
be treatment centers, assinging health workers both medical
and paramedical, improving health financing and making budget
policies. However, its implementation has not been maximal.
In accordance with the above background, it would require
a study on the role of local government policy in improving
the referral system which is useful to know the problems
in the field, so that in the future a variety of improvement can
be done.
Objective: To determine the referral system in the islands
area of Linga District.
Methods: This was a case-study research. The research
subjects were head of health centers / health center doctors,
nurses/midwife assistants, ambulance drivers/sea ambulance
drivers, patient families, community figures, jamkesmas/
Jamkesda managers, head of health care section/head of
health office, director of local hospital/mobile hospital and emergency
room nurses. The variables in this study were independent
variable (referral system) and dependent variable (ambulance
service). The research location was in Linga District
of Kepualauan Riau Province.
Results: The results showed that policy efforts of the Linga
Government District in improving the referral system had existed.
The existing financing policy had encompassed two
aspects both from the demand side (medical expenses) and
from the supply side (a system that supported health care).
The process of referral from primary care to advanced services
had been going well although there was still lack as the
unavailability and completeness of services. Most of the health
workers had received training; there were also specialist doctors
(in collaboration with the faculty of medicine), but networking
in the referral process was done partially and not
integrated.
Conclusion: The health referral system in Linga District had
run pretty well, but did not fully involve community participation
in an integrated service system. The local government in this
case Linga District Health Office needs to revitalize as well as
accelerate the development of Desa Siaga (alert villages) readiness
to increase community participation in the development
of a referral system.
Keywords: policy, referral systems, islands, ambulance service
Center for Health Policy and Management
2013-12-31 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3072
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 1, No 1 (2012)
eng
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oai:jurnal.ugm.ac.id:article/3073
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EFEKTIFITAS DAN EFISIENSI PEMANFAATAN DANA BANTUAN OPERASIONAL KESEHATAN DENGAN PENERAPAN METODE ANALYTIC HIERARCHY PROCESS
Makkasau, Kasman
Background: Millennium Development Goals (MDGs) is a global
commitment that must be realized by all countries by 2015,
to accelerate the goal then the health ministries of Bantuan
Operasional Kesehatan (BOK) in helping the distric implement
appropriate health services by improving the performance of
SPM Puskesmas and networks as well as Upaya Kesehatan
Bersumber Masyarakat (UKBM) in carrying out preventive and
promotive health services. Utilization of funds is an authority
of the BOK clinic, it is necessary for an effective method in
determining program priorities. Along with the progress of science
and technology in the field of public health and medicine,
has provided a wide range of alternatives that can be used to
solve the health problems that occur in the community today.
Objective: to determine the utilization of funds BOK intervention
is most effective, with metodogi analitic using a model
system of decision makers using AHP.
Methods: Analytic Hierarchy Process (AHP) is a model approach
that provides an opportunity for planners and program
managers in health to be able to build the ideas or the ideas
and define problems that exist in a way to make assumptions
and then get the desired solution.
Results: Based on the analysis by using the AHP model, it can
produce an alternative to the use of program funds BOK highly
effective in community health centers. By using the AHP model
then any program that will be implemented with clearly defined
priorities, compared to using Hanlon, Delbeq and PEARL which
has been used by the manager of health programs in Province
West Sulawesi in Indonesia.
Conclusion: It is recommended to use the AHP method in
determining the intervention/program BOK utilization of funds
and benefit the most effective and acceptable to all stakeholders.
Keywords: Analytic Hierarchy Process, Program BOK
Center for Health Policy and Management
2013-12-31 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3073
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 1, No 1 (2012)
eng
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oai:jurnal.ugm.ac.id:article/3074
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KOORDINASI PELAKSANAAN PEMBIAYAAN PROGRAM KESEHATAN IBU DAN ANAK DI KABUPATEN LOMBOK TENGAH PROVINSI NUSA TENGGARA BARAT TAHUN 2011
Tudiono, Lalu Najmul Erpan, Laksono Trisnantoro,
Background: Health financing provided by the government
greatly helps the implementation of health system in the decentralized
era. General Allocation Fund and Local Revenue
and Expenditure Budget are apparently inadequate to finance
health service. Some efforts have been made to finance health
service such as Community Health Insurance (Jamkesmas),
Childbirth Insurance (Jampersal), and Health Operational Fund
(Bantuan Operasional Kesehatan/BOK). These are meant to
achieve Millennium Development Goals in 2015. The practice
of coordination from planning to implementation and stakeholders’
commitment can affect the process of maternal and child
health service. Coordination is definitely needed to run the
program policy and prevent the overlapping financing in order
that the objective of the program can be achieved.
Objective: To evaluate coordination of planning, implementation
and stakeholders’ commitment in relation to maternal and
child health (MCH) service in Lombok Tengah District.
Method: This was a descriptive-analytical study with a qualitative
approach and a case-study design. Samples were taken
purposively. The data were obtained through in-depth interview,
observation and documentation analysis.
Result: The planning coordination of MCH health financing
had not been optimal, even despite the involvement of cross
sector and program. However, the organizations of health
professionals were not involved in program planning. The coordination
of health financing implementation had not been optimal
as well. Even though there was no overlapping financing
from some different sources, in the policy implementation there
was cost sharing for referral and drugs. Private sectors were
not involved in the implementation of Jampersal. Stakeholders’
commitment was relatively optimum as reflected from the policy
and action in health development acceleration particularly MCH.
The process of MCH service at both primary and secondary
level could run well.
Conclusion: Coordination of MCH financing implementation in
Lombok Tengah District through BOK, Jampersal, Jamkesmas,
Community Empowerment National Program of Healthy and
Smart Generation and Local Revenue and Expenditure Budget
had not been optimal; therefore, it needed to be improved to
eliminate cost sharing. Professional organizations and private
health providers were not yet involved in the program planning
and implementation.
Keywords: coordination, stakeholders’ commitment, health
financing, maternal and child health, program evaluation
Center for Health Policy and Management
2013-12-31 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3074
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 1, No 1 (2012)
eng
Copyright (c)
oai:jurnal.ugm.ac.id:article/3075
2013-12-31T03:10:34Z
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KEBIJAKAN DAN IMPLEMENTASI BANTUAN LUAR NEGERI AUSAID DI TIMOR LESTE: EVALUASI TERHADAP PROYEK DUKUNGAN RENCANA STRATEGIK SEKTOR KESEHATAN
Retna Siwi Padmawati, Manuela Pereira, Yodi Mahendradhata,
Background: The Ministry of Health of Timor-Leste has realized
that they should work together with other stakeholders to
achieve their vision and mission due to insufficient human
resources and budget. Therefore, the Ministry of Health has
established collaboration with AusAid and other development
partners through mechanism of coordination. However, the
mechanism is not yet implemented fully.
Objective: To evaluate foreign aid policy in coordinating AusAid
donor and development partners to fund human resource development
program (in the HSSP-SP project) through the mechanism
of coordination in the Ministry of Health of Timor-Leste.
Method: This was a qualitative study with a case-study design.
The respondents were 16 people, consisting of 13 persons
from the Ministry of Health and 3 persons from AusAid,
World Bank and development partners.
Result and Discussion: The Department of Partnership Management
had not been optimum in managing and controlling the
project/program and activities of the donors and working partners.
The approved action plan and budget were relevant
with the proposal made by the Ministry of Health but planning
for human resource development was unclear and was not
based on the work force gap faced and priority in human
resource development. The project had impact on human resource
development but the process of staff re-placement
was not in line with the principle of the right man on the right
place. Regular consultative meeting could facilitate the approval
of action plan and budget for human resource development.
However, the mechanism of coordination was less effective
because there was no specific instrument or mechanism
to do alignment and harmonization and it only focused on
collective gain and there was too much pressure and demand
to staff from both the Ministry of Health and partners. Constraints
and challenges from political aspect and human resource
capacity had hampered the process of coordinating
AusAid and working partners.
Conclusion: The implementation of foreign aid policy to coordinate
AusAid and development partners to fund human resource
development (in HSSP-SP project) following the mechanism
of coordination in the Ministry of Health of Timor-Leste
had run well enough but still received lack of support from
human resource development planning based on institutional
development.
Keywords: policy evaluation, mechanism of coordination,
human resource development, donor agency
Center for Health Policy and Management
2013-12-31 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3075
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 1, No 1 (2012)
eng
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oai:jurnal.ugm.ac.id:article/3199
2014-01-17T04:14:34Z
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SINERGI KEBIJAKAN UPAYA PENGHEMATAN ANGGARAN BELANJA JAMINAN KESEHATAN DI PERANCIS
Dewi, Shita Listya
Menjelang diberlakukannya Jaminan Kesehatan
Semesta 2014, Indonesia menghadapi berbagai tantangan
terkait kesiapannya. Walaupun prioritas pemerintah
saat ini adalah pada perluasan cakupan/
kepesertaan, berbagai isu terkait selayaknya tetap
menjadi perhatian kita. Isu seperti 1) seberapa dalam
manfaat pelayanan kesehatan yang akan dijamin,
2) seberapa besar proporsi urun biaya yang masih
harus dikeluarkan oleh peserta jaminan kesehatan
ketika mendapatkan manfaat, 3) bagaimana kesiapan
kuantitas dan kualitas sistem pelayanan kesehatan,
fasilitas dan SDM kesehatan serta pemerataan
distribusinya di berbagai daerah, 4) bagaimana
kebijakan dan regulasi diperkuat untuk mendukung
sistem jaminan kesehatan semesta, 5) bagaimana
evaluasi dan monitoring dilakukan, 6) bagaimana
mengajak sektor swasta untuk berperan serta, dan
banyak hal lain masih tetap perlu dikaji dan dicermati.
Bahkan di negara lain dimana sistem jaminan
kesehatan semesta telah dijalankan, isu-isu seperti
di atas tetap menjadi perhatian dan terus menerus
diawasi. Pada beberapa editorial yang lalu telah dibahas
bagaimana sistem jaminan kesehatan semesta
dijalankan di Perancis. Menjelang akhir tahun, pemerintah
mengevaluasi berbagai dimensi pelaksanaan
jaminan kesehatan semestanya misalnya kualitas
pelayanan, distribusi SDM, besarnya anggaran, dll
serta proposal yang diajukan untuk upaya perbaikannya.
Bulan September lalu, pengelola jaminan kesehatan
semesta di Perancis mengajukan laporan tahunan
termasuk proposal upaya penghematan senilai
2,48 milyar euro untuk menekan pertumbuhan anggaran
belanja jaminan kesehatan dikisaran 2,4%
(pertumbuhan anggaran pada tahun 2012 adalah
2,5% sementara pada tahun 2013 adalah 2,7%). Situasi
perekonomian Eropa telah menekan berbagai
negara termasuk Perancis untuk melakukan penghematan
anggaran belanja, sehingga wacana penghematan
anggaran belanja kesehatan merupakan isu
yang cukup disorot.
Anggaran belanja kesehatan di Perancis adalah
sekitar 12% dari GDP, dan beberapa tahun terakhir
mengalami defisit lebih besar dari yang diproyeksikan.
Pada awal tahun 2013, misalnya, defisit diperkirakan
sebesar 11,4 juta euro, tetapi laporan tahunan
2013 menyatakan bahwa riil defisitnya adalah 14,7
juta euro. Hal ini juga disebabkan oleh tekanan situasi
ekonomi yang membuat sekelompok peserta jaminan
yang tadinya termasuk di dalam peserta dengan
urun biaya berubah menjadi peserta tanpa urun biaya
(ditanggung penuh pemerintah) karena kehilangan
pekerjaan. Diperkirakan jumlah peserta tanpa urun
biaya ini akan lebih besar pada tahun-tahun mendatang
selama krisis ekonomi di Eropa belum berakhir.
Oleh karena itu, pemerintah sangat berkepentingan
untuk memastikan kecukupan anggaran untuk menyediakan
pelayanan bagi mereka.
Proposal penghematan yang diajukan mencakup
kebijakan harga untuk berbagai obat (diharapkan
akan menghasilkan penghematan senilai 750juta
euro), serta kebijakan yang membatasi dokter dalam
meresepkan obat mahal/branded dan menggantinya
dengan obat generik (diharapkan akan menghasilkan
penghematan senilai 600juta euro), dan kebijakan
yang membatasi transportasi untuk rujukan yang
tidak perlu, dan kebijakan yang mendorong perluasan
one-day surgery untuk menghindari biaya rawat
inap. Salah satu target dari kebijakan one-day surgery
ini adalah operasi katarak yang merupakan salah
satu operasi yang paling sering dilakukan di
Perancis (sekitar 700,000 di tahun 2012) yang sebelumnya
tidak dilakukan sebagai one-day surgery.
Penghematan juga akan dilakukan dalam bentuk
strategic purchasing untuk peralatan kesehatan
misalnya insulin pumps, prostheses, respirators, dll.
Diharapkan dengan kebijakan strategic purchasing
ini penghematan yang dihasilkan adalah senilai 220
juta euro (untuk level rumah sakit) dan 150juta euro
(untuk level klinik/fasilitas kesehatan primer). Yang
menarik adalah bagaimana proposal ini didukung
oleh berbagai kebijakan yang mengikutinya. Dokter,
misalnya, diharuskan untuk menulis setidaknya 25%
bagian dari resepnya berupa formula kimia dari molekul
aktif obat, dan bukan brand name-nya. Hal ini
dilakukan untuk mendongkrak penjualan obat generik
di Perancis yang saat ini masih berkisar 14%
(dalam nilai uang) atau 26% (dalam kuantitas) pada
tahun 2012 lalu. Sebagai perbandingan, share penjualan
obat generik di Jerman atau Inggris adalah
sekitar 50%.
Kebijakan lain yang juga terkait adalah
kebijakan redistribusi ketersediaan tenaga medis,
seperti yang telah dibahas pula pada editorial lalu.
Hasilnya ternyata cukup menggembirakan. Secara
keseluruhan, jumlah dokter bertambah 0.9 % namun
secara riil jumlah dokter di beberapa tempat yang
telah padat berkurang (misalnya di region Center
berkurang 2.3 %, dan di region Ile- de- France berkurang
4.2%) dan sebaliknya meningkat di daerah yang
sebelumnya kekurangan (misalnya di region Paysde-
Loire meningkat 4.7% dan di region Rhône –
Alpes meningkat 4.5%). Ketersediaan tenaga medis
di daerah-daerah yang kekurangan diharapkan dapat
mengurangi unnecessary referral antar-region dan
mengurangi biaya transpor rujukan.
Selain kebijakan yang mendukung, proses
evaluasi yang dilakukan terhadap fasilitas kesehatan
(klinik dan rumah sakit) di Perancis baik fasilitas
pemerintah maupun swasta juga mencerminkan
dukungan terhadap upaya penghematan anggaran
kesehatan seperti yang diusulkan. Dari beragam
komponen penilaian dan evaluasi tersebut misalnya
juga dimasukkan variabel rendahnya LOS di rumah
sakit dan seberapa banyak ambulatory care dilakukan.
Hasil dan ranking penilaian untuk seluruh rumah
sakit ini, baik rumah sakit pemerintah maupun swasta,
diumumkan setiap tahun sehingga masyarakat
dapat secara terbuka melihat ranking dari rumah
sakit di daerahnya. Dengan demikian rumah sakit
dan klinik dipacu untuk mengembangkan layanan
one-day surgery yang lebih cost-effective dan
mengurangi LOS.
Dari cerita singkat di atas dapat ditarik pelajaran
bahwa pemerintah Indonesia pun perlu melihat
sistem kesehatannya secara utuh dan mencari
sinergi antar kebijakan agar saling mendukung. Hal
ini khususnya menjadi semakin penting di era
jaminan kesehatan semesta. Apabila sinergi antar
kebijakan ini belum terjadi maka perlu dicari solusi
atau alternatif kebijakannya. Apabila telah ada
kebijakan yang digulirkan, maka perlu pula dikaji
sejauh mana efektifitas pelaksanaannya di lapangan.
Di sinilah letak pentingnya kajian kebijakan dan
evaluasi kebijakan dalam memainkan peran sebagai
‘feeder’ terhadap komunitas kebijakan khususnya
pengambil kebijakan. Selaras dengan itu, berbagai
artikel dalam JKKI kali ini akan berupaya menyoroti
berbagai implementasi kebijakan dan memberikan
rekomendasi perbaikan. Selamat membaca.
Center for Health Policy and Management
2014-01-17 00:00:00
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Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 4 (2013)
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MANAJEMEN PERUBAHAN DI LEMBAGA PEMERINTAH: STUDI KASUS IMPLEMENTASI KEBIJAKAN PELAKSANAAN PPK-BLUD DI RUMAH SAKIT JIWA PROVINSI NTB
Laksono Trisnantoro, Julastri Rondonuwu
Background: NTB Mental Hospital as the only major referral
center for mental health services in NTB was required to serve
the community, to develop and be self-sufficient, while at the
same time must be able to compete in providing quality and
affordable services to the community. In order to fulfill these
demands, since January 29, 2011 NTB Mental Hospital has
received full endorsement as a Mental Hospital with Financial
Management Patterns of Local Public Service Agency (PPKBLUD).
Therefore, indepth review of the implementation of
PPK-BLUD policy in NTB Provincial Mental Hospital (RSJP) is
required.
Objectives: To explore the transformation process and
implementation of PPK-BLUD policy in RSJP.
Methods: The design of this study is a qualitative research
case study to describe the dynamics of the change process
and implementation of PPK-BLUD policy in RSJP.
Results and Discussion: The phase of transformation
process was not running as expected. The implementation of
PPK-BLUD policy is not optimal because some flexibility as a
hospital privileges with BLUD financial pattern have not been
implemented yet. The f inance manager was hesitant to
implement the flexible financial management and still following
the local government financial management mechanisms. For
external stakeholders, the implementation of PPK-BLUD policy
implementation in RSJP did not harm local fiscal policy because
the revenue of RSJP was still counted as revenue for local
government, as opposed to independent PPK-BLUD. A survey
was conducted, consisting of community satisfaction towards
the services in RSJP, data of revenue and budgetting
management and distribution of fee services to employees in
RSJP. The survey result described that the implementation of
PPK-BLUD policy in RSJP gives positive impacts on financial,
services and benefits performances to RSJP. The positive
impacts were an increase in the number of income, increased
of service indicators measurement and increased incentive to
all employees.
Conclusion: Management changes in the transformation
process were not running optimal so that the PPK-BLUD policy
in RSJP is not fully implemented, although there were some
perceived positive results.
Keywords: Local Public Service Agency, policy, change
management.
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3200
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 4 (2013)
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STUDI EFEKTIVITAS PENERAPAN KEBIJAKAN PERDA KOTA TENTANG KAWASAN TANPA ROKOK (KTR) DALAM UPAYA MENURUNKAN PEROKOK AKTIF DI SUMATERA BARAT TAHUN 2013
Azkha, Nizwardi
Background: Area free from tobacco (AFT) policy is the only
effective and inexpensive way to protect the public from the
dangers of second hand smoke. In West Sumatra there are
three cities that have local regulation on this, namely Padang,
Panjang Padang, and Payakumbuh, but in reality the policy has
not been able to reduce the active smokers. This study aims to
determine the effectiveness of AFT policy in reducing smokers
active beside its effectiveness to protect the public from the
dangers of second hand smoker in West Sumatera.
Methods: The study was conducted with the method, a mix
of quantitative and qualitative research with explanatory design.
Data collection was conducted in the city of Padang, Padang
Panjang and Payakumbuh. Quantitative data from 100 persons
were collected using a questionnaire, while the qualitative
data was collected through in-depth interviews. Informants in
each city are representatives of Department of Health,
professional organizations, community leaders, smokers and
focus group discussions. Some secondary data are obtained
through documents review related to the implementation of
AFT. 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 in
three cities in West Sumatera the smoker rate are 59%. In
Padang Panjang, the regulation has been proceeded succesfuly
due to the commitment of the Mayor and the legislative parlement
in implementing the policies that there should not be any tobacco
advertising as well as sanctions for smokers, especially for
employees who smoke at the office or at school, according to
the law no. 8/2009; suf ficient funds are available for
socialization and supervision AFT, a total of Rp75.000.000,00
collected from tobbacco fundation and Rp24.000.000,00 from
the budget. In Payakumbuh there is also the commitment of the
Mayor and the support of the Health Department according to
the Regulation of Area Free tobbacco no 15/2011. Establishment
of Supervisory Team for AFT with funds allocated for
socialization and supervision, a total amount of
Rp341.278.129,00. Padang has not yet applying the AFT policy
in government offices and schools, only in private sector such
as bank. Tobacco advertising still exists and there is no sanction
for smokers despite the existing Regulation No. AFF 14/2011
with accompanying funds provided Rp85.000.000,00.
The study shows that the majority (60%) public opinion support
the implementation of AFT. Some (51%) of the public say that
AFT is effective enough to reduce active smoker, over half of
respondents thought AFT should apply to a particular location.
According to 59% of respondents, smoking in public places
should be given sanction. In Padang Panjang there is a
monitoring service via SMS and phone to report breach of the
regulation so that the Mayor may impose sanctions. In
Payakumbuh a similar system exist through reports and spot
checks. Violaters of the regulation are given sanction by the
mayor. In Padang city, sanctions have not been given. The
local government regulation in banning advertising and
promotion of cigarettes is implemented in two cities, the city of
Padang Panjang and Payakumbuh. Some factors that affect
the implementation of AFT are dependent on the commitment
and the role of District mayor, as well as the need for community
empowerment..
Conclusion: It is concluded that the AFT policy without the
commitment and support of all parties to the implementation of
AFT difficult. AFT can be effective to protect the second hand
smokers and it has potential to reduce active smokers.
Keywords: Effective, AFT Policy, Reducing active smokers.
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3201
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 4 (2013)
eng
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IMPLEMENTASI KEBIJAKAN SUBSIDI PELAYANAN KESEHATAN DASAR TERHADAP KUALITAS PELAYANAN PUSKESMAS DI KOTA SINGKAWANG
Lutfhan Lazuardi, R. Hendri Apriyanto Tjahjono Kuntjoro
Background: Health sector is inseparable from the
decentralized system of local autonomy. Health sector is a
responsibility of the local government, even though it is
frequently included in the political policies of a leader. The
direction of healthcare service development, particularly at
the level of Health Center, has been maintained in the Mayor's
Decree of Singkawang No. 82/2009 on the subsidiary of
healthcare in Kota Singkawang.
Objective: To find out the quality of healthcare at the Health
Centers in relation to the primary healthcare subsidy based on
the perception of society, control/supervision of Local Health
Office, management, service time, service capacity/type, and
attitude of the health center staffs.
Method: A descriptive research with case study design was
conducted in three Health Centers: Singkawang Tengah, Singkawang
Timur, and Singkawang Utara Health Centers. Subjects
of the research were 15 health staffs and 111 patients.
The data were collected using questionnaire, observation, and
interviews.
Results: The research found a score of 3.3 for the healthcare
in Singkawang Tengah, Singkawang Timur, and Singkawang
Utara Health Centers. It means that the Health Center provided
relatively high quality healthcare. From the Reliability dimension,
a score of 2.92 was found for Point 2 quick examination
service with reference to the standard procedure and a score
of 2.97 for Point 5, the timeliness of healthcare. From the Responsiveness
dimension, a score of 2.77 was found for Point 3
– the patients did not wait long to get the healthcare service –
and a score of 2.94 for Point 4 – the working hour of the Health
Center. Qualitative analysis showed that the Local Health Office
controlled/supervised the Health Centers by means of utilization/
visit reports and management. It was found that service
time was frequently ignored and that service type/capacity at
the Health Centers was constrained by the availability of reagents
and medication. The health staffs tended to ignore service
quality and time and there was an indication of deviation in
the utilization/visit reports sent by the Health Centers.
Conclusion: The Local Health Office did not have adequate
tools to control/supervise the Health Centers, as evident from
the aspect of management, service time, service type/capacity,
and health staff attitude. Procurement of healthcare supplies
was hampered by bidding process and the health staffs need
continuous training and development.
Keywords: Health Office, Health Centers, Public Perception,
and Healthcare quality
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3202
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 4 (2013)
eng
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PROBLEM DAN TANTANGAN PUSKESMAS DAN RUMAH SAKIT UMUM DAERAH DALAM MENDUKUNG SISTEM RUJUKAN MATERNAL DI KABUPATEN KARIMUN PROVINSI KEPRI TAHUN 2012
Siti Noor Zaenab, Zulhadi Laksono Trisnantoro
Background: Strengthening referral system is a method to
accelerate decrease of maternal mortality rate. The main factors
affecting referral system are facilities, staff, team work, and
budget that need seroius attention from all stakeholders
involved in the program of maternal health. By strengthening
the system of maternal health the problem and the challenge of
health center to support of maternal referral can be addressed.
Objective: The study aimed to evaluate referral system of
maternal health at District of Karimun Province of Kepulauan
Riau.
Method: This was a qualitative case study undertaken at
Karimun Hospital and 2 health centers with high maternal and
infant mortality rate, i.e. Meral and Moro Health Center that
were located at both urban and rural areas. Data were obtained
through in-depth interview, focus group discussion,
observation, checklist and document study.
Result: The result of the study showed there was limitation of
resources at primary health service such as facilities and
equipments and hospital limited ability to provide comprehensive
emergency neonatal and obstetric management despite being
operated 24 hours. There were lack of team coordication
across referral levels involving district health office, hospital
and health centers, incomplete standard operating procedures,
weak information system and bypassing referral procedure.
Community participation in referral system was very high
though some labor was assisted by traditional childbirth
attendants. This condition was mainly due to cultural factors/
reasons.
Conclusion: There are some problems and challenges in both
primary health service and hospitals to support maternal
referral system in Karimun District. Some policies are required
as a first step toward better referral system in Karimun District,
for instance accelerating a functioning CMOC hospital,
strengthening the teamwork across referral system, and
establishing SOP for maternal cases including its referral
procedures.
Keywords: Problem, Challenge, Maternal referral system,
Health Center, Distric Goverment Hospital.
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3203
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 4 (2013)
eng
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DETERMINAN KINERJA PELAYANAN KESEHATAN IBU DAN ANAK DI RUMAH SAKIT PEMERINTAH INDONESIA (ANALISIS DATA RIFASKES 2011)
Ernawati, Demsa Simbolon Djazuli Chalidyanto
Background: The hospital has quite an important role in
reducing IMR and MMR because hospitals as providers of
plenary personal health services including maternal and child
health (MCH). However, until now the IMR and MMR Indonesia
is still high compared to other ASEAN countries. The main
causes of maternal mortality are obstetric complications or
disease as a complication that arises during pregnancy, childbirth
and postpartum. This factor was experienced by approximately
20% of all pregnant women, while complication cases that
were treated well are less than 10%.
Objective: The research aims to identify the effect of hospital
characteristics, management of MCH services, human
resources for MCH, MCH services, and MCH equipment on the
performance of MCH services in government hospitals in
Indonesia.
Methods:Research is using secondary data of Health Facilities
Research 2011 (RIFASKES) with a cross sectional study.
Population and sample is the entire Indonesian government
hospitals (685 hospitals). The research variables were
identified from the available variables in the questionnaire
RIFASKES. Performance measurement of the composite
variable proportion of maternal deaths due to hemorhage d”
1%, d” 10% pre-eclampsia, sepsis d” 0.2%, d” 20% secaria
section, the proportion of stillborn d” 4%, and the proportion of
LBW handling 100% based SPM hospital. Multivariate logistic
regression was used to obtain a model determinants of
performance MCH services.
Results: The majority (66.3%) government hospitals in
Indonesian has less than optimal performance. As the
determinant is unaccredited status (OR = 2.99: 1.43 to 6.28),
the hospital is not a vehicle of education (OR = 1.78; 1.11 to
2.85), team PONEK is incomplete (OR = 1.89; 1.27 to 2.82),
there is no PONEK-trained doctor in the ER (OR = 1.89; 1.27 to
2.82), there is no team ready to perform the operation or task
though on call (OR = 2.16; 1.32 to 3.53). The most dominant
factor is the unaccredited status.
Conclusions: Suboptimal performances of MCH at Indonesian
government hospitals are influenced by the low hospital service
characteristics and incomplete of human resources. The
Ministry of Health needs to support improvement in all types of
services to complete an accredited hospitals (16 types of
services), not just 5 or 12 services. They also need to make
the government hospital as a vehicle of education, increase
the quantity and quality of human resources are trained in
PONEK-skill, ensure availability of PONEK-trained doctor in
emergency, provide the team that are ready to perform the
operation or task though on call, and increase organizational
commitment to overall performance improvement.
Keywords: Performance, Maternal and Child Health Services,
Government Hospital
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3204
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 4 (2013)
eng
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HUBUNGAN ANTARA REALISASI DANA BANTUAN OPERASIONAL KESEHATAN DENGAN INDIKATOR GIZI KIA DI KABUPATEN/KOTA PROVINSI JAWA TENGAH TAHUN 2012
Malik Cahyadin, Ulma Putri Septyantie
Background: Health Operational Fund (HOF) is a grant from
central government through the Ministry of Health. The goal is
to help local governments for implementing health services
based on Minimum Service Standards (MSS) in the field of
health to accelerate the achievement of the Millennium
Development Goals (MDGs). Health development policies in
2010-2014 are directed to enable availability of fundamemntal
helalth access that cheap and affordable especially for the
lower-middle gorups. This is indicated by increasing life
expectancy, infant mortality and maternal mortality. One of the
health priority programs is Nutrition Program and the Maternal
and Child Health (MCH).
Methods: This research is quantitative research. Analysis
method uses a simple regression. Research data are secondary
data in 2012 of 35 districts/cities in Central Java Province.
Results: The realization of Health Operational Fund (HOF) is
significant ( Sig.0,000 < ±=1%) on neonatus first visit/KN1, the
realization of Health Operational Fund (HOF) is significant (
Sig.0,000 < ±=1%) on assistance by skilled health personnel/
Pn, and the realization of Health Operational Fund (HOF) is
significant ( Sig.0,000 < ±=1%) on children weighing or D/S.
Coefficient of determination (r ²) is 0.629 for the effect of HOF
on KN1, 0.636 for the effect of HOF on Pn, and 0.690 for HOF
on D/S. The result of classical assumptions shows that residual
variables are normally distributed, despite heteroscedasticity
and despite autoccorelation.
Conclusion: HOF has positive effect and significant on KN1,
HOF has positive effect and significant on Pn, and HOF has
positive effect and significant on D/S
Key Words: HOF, MCH Nutrition, Simple Regression, Central
Java
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3205
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 4 (2013)
eng
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DAPATKAH KITA BERPERAN SERTA MENJAWAB TANTANGAN KEBUTUHAN KEBIJAKAN BERBASIS BUKTI?
Dewi, Shita Listya
Para pembuat kebijakan perlu mempertimbangkan
banyak faktor untuk membuat kebijakan sistem
kesehatan (misalnya, hambatan kelembagaan, konflik
kepentintangn para pemangku kepentingankepentingan
yang dipengaruhi oleh suatu kebijakan,
dan nilai-nilai serta preferensi publik), namun hasil
penelitian empiris juga dapat membantu. Hasil penelitian
empiris dapat menyediakan dukungan bukti
atas apa yang efisien dan efektif dan apa yang tidak
efisien dan tidak efektif serta strategi apa yang direkomendasikan
untuk mengatasinya. Dengan kata
lain, hasil penelitian empiris akan memberitahu mereka
untuk memperkuat atau memperbaiki secara
terus menerus upaya reformasi sistem kesehatan
agar mencapati efektivitas dan efisiensi program,
layanan, dan obat-obatan secara optimal untuk masyarakat
target yang membutuhkan. Harapannya,
kebijakan yang dihasilkan dengan mendapat
masukan dari penelitian empiris akan merupakan
kebijakan berbasis bukti.
Oleh karena itu, para pembuat kebijakan dan
para stakeholder memerlukan akses langsung ke
berbagai jenis penelitian empiris untuk mengambil
keputusan berdasarkan informasi yang lengkap tentang
berbagai pertanyaan dan masalah yang mereka
miliki mengenai sistem kesehatan, tata kelola dan
strategi implementasi. Di lain pihak, para peneliti
kebijakan dan lembaga penelitian perlu mendukung
dan mengupayakan penggunaan hasil penelitian
empiris pada tingkat masyarakat, penyedia, organisasi,
dan pembuat kebijakan. Namun, adanya hasil
penelitian empiris dan adanya akses terhadap hasil
penelitian empiris tidak serta merta menjawab kebutuhan
para pengambil kebijakan. Ketepatan waktu
dari hasil penelitian adalah salah satu dari dua faktor
yang penting. Para peneliti dan lembaga penelitian
perlu secara sistematis mengidentifikasi gap di
dalam pengetahuan dan literature tentang sistem
kesehatan kemudian melakukan serta menghasilkan
masukan penelitian baru sesuai dengan konteksnya
dan tepat waktu.
Faktor kedua yang juga penting adalah: para
pembuat kebijakan akan menilai seberapa banyak
kepercayaan dapat mereka tempatkan terhadap
kualitas dari penelitian tersebut, local applicabilitynya,
serta nilai tambah (value added) dari hasil penelitian
tersebut dibanding penelitian-penelitian sejenis
lain atau sebelumnya.
Dengan demikian, upaya lebih besar harus diarahkan
pada beberapa prioritas untuk meningkatkan
kegunaan dari penelitian tentang sistem kesehatan
dan dukungan yang diperlukan oleh para pembuat
kebijakan dan para pemangku kepentingan. Pertama,
ada kebutuhan untuk mendukung upaya-upaya
sistematis untuk melakukan penelitian kontekstual
yang tepat waktu secara teratur. Kedua, perlunya
upaya advokasi hasil penelitian empiris untuk
memastikan bahwa para pembuat kebijakan dan para
stakeholder memiliki akses ke terbaru terhadap hasil
penelitian empiris. Ketiga, ada kebutuhan untuk meningkatkan
kualitas dari penelitian itu sendiri. Terakhir,
ada kebutuhan untuk ketersediaan serangkaian
berbagai topik-topik yang berhubungan dengan
tata kelola, keuangan dan pelayanan di dalam sistem
kesehatan termasuk topik-topik yang selama ini masih
kurang ‘disentuh’ misalnya pelayanan long term
care, geriatric, dsb, serta strategi implementasi yang
dapat mendukung perubahan dalam sistem
kesehatan.
Sepanjang tahun 2012-2013 ini, Pusat Kebijakan
dan Manajemen Kesehatan telah melangsungkan
pelatihan berbasis web bagi para peneliti kebijakan
kesehatan. Penelitian telah berlangsung untuk beberapa
angkatan. Pelatihan mencakup pengenalan
terhadap konsep penelitian kebijakan, perspektif penelitian
kebijakan, serta advokasi hasil penelitian
kebijakan. Dari setiap angkatan yang mengikuti pelatihan
ini, telah dipilih lima peserta yang mendapatkan
dukungan dana untuk melakukan penelitian
kebijakan sesuai proposal yang disusunnya. Para
pemenang kemudian disaring lagi untuk menentukan
siapa yang memperoleh beasiswa untuk mempresentasikan
hasil penelitiannya di Forum Nasional
IV Jaringan Kebijakan Kesehatan Indonesia di Kupang
pada bulan September 2013. Namun, bagi yang
belum terpilih untuk melakukan presentasi, tetap diberi
sarana untuk mendiseminasikan hasil penelitian
mereka yaitu melalui edisi JKKI kali ini dan edisi
berikutnya.
Walau pun masih jauh dari sempurna, namun
ini merupakan sebagian kecil dari sumbangsih untuk
menjawab empat tantangan yang telah diuraikan sebelumnya, dengan cara (1) mendukung dilakukannya
penelitian kontekstual yang tepat waktu, (2) menyediakan
sarana untuk diseminasi dan advokasi
hasil penelitian kebijakan, (3) berupaya meningkatkan
kualitas penelitian kebijakan, dan (4) memastikan
tersedianya berbagai ragam topik penelitian
kebijakan. Semoga terselenggaranya kegiatan ini
mendorong dan memotivasi para peneliti kebijakan
dan lembaga penelitian kesehatan untuk terus memperjuangkan
upaya perbaikan sistem kesehatan.
Selamat membaca.
Center for Health Policy and Management
2014-01-17 00:00:00
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https://jurnal.ugm.ac.id/jkki/article/view/3206
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 3 (2013)
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IMPLEMENTASI KEBIJAKAN KESEHATAN “LIBAS 2+” SEBAGAI UPAYA MENURUNKAN ANGKA KEMATIAN IBU DAN BAYI DI KABUPATEN SAMPANG
Imron, Ali
Introduction: The issue of MDGs 4 and 5 that targets reducing
the AKI and AKB by three-quarters between 1990 and 2015
seems difficult to achieve if there are no immediate concrete
steps. Areas with the highest AKI and AKB are Sampang
Regency. Looking at the empirical conditions, it is necessary to
identify the factors that led to the high AKI and AKB in Sampang
Regency. There is an existing health policy in Sampang district
through LIBAS (Lima Bebas) 2+, but it needs to be monitored
and evaluated to ensure policy implementation went well. This
study aims to assess the implementation of the Libas programs
and identify socio-cultural factors that influence health policy
implementation.
Methods: This study used qualitative methods that took place
at the Puskesmas Camplong, Sampang Regency. Informants
were selected purposively. The research data was collected
by participating observation, in-depth interviews, and focus
group discussions. The finding was analyzed using descriptive
analysis.
Results: Sociologically, the implementation of policy to reduce
AKI and AKB in Sampang Regency is one of which is influenced
by the shaman midwife partnerships, especially in the delivery
process. Increasing public confidence in midwives indicates
strengthening social relations. 5T programs (weigh, tension,
tablet Fe, weigh abdominal size, and height) is helpful to control
the development of maternal pregnancy. “Healthy Babies 24
Hours” SMS number serves as a control and monitoring in
delivery care. Nonetheless, culturally, traditional cultural
construction of Madura, particularly the coastal communities,
still entrenched so that the construction of knowledge about
reproductive health is still weak. Shaman massage, herbal
medicine, pregnancy myths, and charismatic central figure
are prominent. Social relation between local actors is still weak,
so is the local actors support.
Conclusion: Strong local culture values and weak social
relationship and support of local actors as a result of program
implementation LIBAS2+ reduce AKI and AKB efforts in
Sampang Regency had not been effective.
Keywords: health policy, LIBAS 2+, social relationship, local
culture
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3207
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 3 (2013)
eng
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oai:jurnal.ugm.ac.id:article/3208
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ANALISIS IMPLEMENTASI KEBIJAKAN JAMINAN PERSALINAN DALAM MENINGKATKAN CAKUPAN PERSALINAN TENAGA KESEHATAN DI KABUPATEN SITUBONDO TAHUN 2013
Putro, Gurendro
Background:The policy of Maternity Benefit for the Uninsured
(Jampersal) is based on the philosophy to reduce maternal
mortality and infant. The Minister of Health Regulation number
2562/Menkes/Per/XII/2011 on A Maternity Benefit for the
Uninsured Persons’s Technical Guidelines ensures that the
government provides services to pregnant women with
antenatal care (ANC), parturition and post-parturition for free,
including the use of contraceptives post parturition.
Objective:To know the confidence’s level of pregnant women
in seeking help for parturition from the health provider, the
provider commitment to Jampersal policy, and Jampersal
socialization in the community.
Methods: Cross-sectional and purposive sampling are used
for descriptive analysis. Data collection is conducted with
interview using a questionnaire to 40 mothers and 40 midwives
in the district Situbondo. Data is also collected through
secondary data from the district health office Situbondo and
hospital.
Results: From the 40 respondents that had been interviewed,
92.5% ask for help to providers, but as much as 7.5% ask for
partus help from traditional birth attendants. In addition, the
Jampersal still charged costs to maternal care to as many as
12 people (30%). This is non-conforming to Jampersal policy
of giving free maternal care. In Jampersal implementation in
Situbondo, 50% of midwives have good commitment. While
27.5% showed medium commitment and the remaining 22.5%
is less committed. The magnitude of this commitment varies.
Respondents with the age of 30-39 years shows excellent
commitment ( 55%), and those who work for 1-9 years are
committed (50%). Socialization of Jampersal policy hasn’t been
optimal. Jampersal is still not known by all pregnant women
yet. The term “free treatment” is confused with the health card
policy.
Conclusion: There is a high trust level in pregnant women
who asks for partus help (92.5%). Commitment of provider in
running the Jampersal policy is still high. Jampersal socialization
hasn’t reached the optimal level because people still do not
understand the conditions of Jampersal.
Suggestion: Since birth delivery by the traditional birth attendants
is still common, the midwife should work with traditional
birth attendants in terms of infant care such as bathing, and
give incentives when collaborating in handling after partus.
There is a need to improve midwife skills in detecting the risk
of pregnancy and childbirth. Socialization Jampersal need to
involve community leaders, and religion leaders.
Keywords: Jampersal, pregnant women’ trust, Provider Commitment.
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3208
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 3 (2013)
eng
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oai:jurnal.ugm.ac.id:article/3209
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ANALISIS KEBIJAKAN PEMERINTAH DAERAH DALAM PENGEMBANGAN ‘JAMINAN SOSIAL KESEHATAN SUMATERA SELATAN SEMESTA’ MENYAMBUT UNIVERSAL HEALTH COVERAGE
Misnaniarti, Misnaniarti
Background: The ‘Jamsoskes Sumsel Semesta’ is a local
program that offered free medical treatment for health services
for the people of South Sumatra who do not have health
insurance. Meanwhile, starting in 2014, the national Government
will implement the Universal Health Coverage as mandated by
the Social Security Law. As insurance have a principle of
indemnity where there should not be a duplicate social security,
there should be no society that is assured by the two programs
with the aim of speculating to make a profit. This study aims to
explore the implementation of the expansion plan of ‘Jamsoskes
Sumsel Semesta’ to pave the way to Universal Health Coverage
in 2014 in South Sumatera.
Methods: This study was a qualitative policy research with
exploratory design. The focus are policy content, context,
actors, and policy processes. Data were collected by in-depth
interviews and observation. Sources of information obtained
from five informants from the institution of Provincial Health
Office, Planning and Regional Development Agency of South
Sumatra, and Provincial Government who selected by
purposive technique based on considerations of participation
in Jamsoskes. The analysis used is the analysis of policy.
Results and Discussion: Based on the results of study it is
found that the South Sumatra provincial government will
continue to provide the Jamsoskes program in 2014 as it is,
managed by the Health Office. Some of the considerations are
for efficiency and flexibility and that it does not include all the
people. Also, in the Presidential Decree No. 12 of 2013, the
national government still provides opportunities for local scheme
to grow until 2019. Some development is done in Jamsoskes
including improving the quality and quantity of health care
providers. Preparations are coordinated with Social Security
Agency about number of contribution beneficiaries. One of
the challenges is that the community rather go to the hospital
directly so it can interfere with the referral system.
Conclusion: There has not been a lot of development effort
undertaken by local government onJamsoskes in preparation
for the 2014 to welcome Universal Health Coverage. The South
Sumatra provincial government should develop further the
services under Jamsoskes as adjustments in welcoming the
implementation of the second phase of the National Health
Insurance.
Keywords: Policy, Health Insurance, Jamsoskes, Efficiency
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3209
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 3 (2013)
eng
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oai:jurnal.ugm.ac.id:article/3210
2014-01-17T04:14:19Z
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ANALISIS KEBIJAKAN DESA SIAGA DI KABUPATEN SLEMAN YOGYAKARTA
Kusuma, Reni Merta
Background: Mortality rate is one of indicators and
representations of welfare of an area. In order to solve high
mortality rate problem, the government of Daerah Istimewa
Yogyakarta (DIY), including District of Sleman, is carrying out
the policy of alert village.
Method: The study used literature review based on
references and field data which were issued by Health Office.
Result: The policy of alert village has less positive impact in
decreasing maternal mortality rate and neonatal mortality rate,
because health assurance scheme still does not meet the
needs of the people, both physical and non-physical. The
degree of health still has not improved significantly. The policy
of alert village needs inter-sectoral financial support. Financial
allocation is still mistargeting. People needs vary from one
village to another, so it is necessary to have competent and
smart health workers as the implementing agents of Health
Department. The policy of alert village is still not able to satisfy
all stakeholders (government, health workers, and people),
because the concept of satisfaction is closely related to the
principle of justice.
Conclusion: The policy of alert village is an effort to empower
the people to be independent in overcoming their health
problems. But, in District of Sleman the policy of alert village is
classified into unsuccessfull policy. This failure is caused by
insufficiet support in implementating the policy.
Keyword: Policy of alert village, Health Office of District Sleman
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3210
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 3 (2013)
eng
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oai:jurnal.ugm.ac.id:article/3211
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STUDI PELAKSANAAN KEBIJAKAN PERATURAN DAERAH JAMINAN KESEHATAN DAERAH SUMATERA BARAT SAKATO DALAM MENGHADAPI UNDANG-UNDANG SISTEM JAMINAN SOSIAL NASIONAL DAN UNDANGUNDANG BADAN PENYELENGGARA JAMINAN SOSIAL TAHUN 2013
Ernawati, Tuty
ABSTRACT
Background: Local health insurance (Jamkesda) is an effort
made by the Government of West Sumatra province to improve
the accessibility of health services for the poor or near poor
who are not accommodated in the quota of public health
insurance (Jamkesmas). Jamkesda was implemented at the
start of 2007 until in 2011 using Governor Regulation West
Sumatera Number 40 and Number 41 in 2007. After running
for five years, there are still many problems in the
implementation. Later in 2011, the provincial parliament of West
Sumatera exercised its rights of initiative and enacted Local
Legislation Number 10 year 2011 regarding the implementation
of the Health Insurance West Sumatra Sakato. Afterwards,
the implementation of Jamkesda West Sumatera Sakato refers
to these regulations. The purpose of this study is to evaluate
the implementation of the new regulation of the Jamkesda West
Sumatera Sakato in 2013.
Methods : This study is a descriptive analysis with a qualitative
using case study. Data collection is done at the Provincial
Health Office / District Health Office / City selected, PT Health
Insurance, regional planning agency (Bappeda), and health
provider. Qualitative data were collected through in-depth
interviews, and secondary data were collected through
document review.
Result: The results of the study shows that implementation of
health insurance on West Sumatra Sakato still had not been
optimal, namely how the selection of the participants; a low
premium that is Rp.6.000/month/member by sharing funding
between provincial and district budgets / City budgets; the
benefits are not yet comprehensive enough; health providers
is still limited in the region of West Sumatra province and only
in public facilities; health workers has not been evenly
distributed; the team is still not functioning well; the monitoring
and evaluation at every level Administrative as well as
socialization of Jamkesda are not optimal; and the existing
policy has not referred to higher level policy.
Conclusion: Implementation of Jamkesda West Sumatra
Sakato does not go according to the existing policy. Among
others, the selection of membership, quality of health care,low
premiums, health facilities are limited, health workers have not
been evenly distributed, and the monitoring and evaluation
team has not been established as per the guidelines.
Suggestion: There is a need to evaluate Jamkesda West
Sumatera Sakato policy so that the policies are not
contradicting. There is a need to form a Monev Team for
Jamkesda so that all parties have a sense of shared
responsibility.
Keywords: Local Regulation of Jamkesda, health financing,
Provider Jamkesda.
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3211
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 3 (2013)
eng
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oai:jurnal.ugm.ac.id:article/3212
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EVALUASI KEBIJAKAN JAMINAN PERSALINAN DI PROVINSI DAERAH ISTIMEWA YOGYAKARTA TAHUN 2012
Khair, Ummul
Background: The Ministry of Health made a breakthrough
through delivery care scheme as one solution to reducing the
MMR and IMR called Jampersal. This policy is a delivery
assurance scheme intended for all pregnant women and new
mothers in Indonesia who are not covered by any insurance
yet. Delivery care assurance scheme consist prenatal care,
postnatal care including family planning postpartum and
newborn care. This program also applied in the special region
of Yogyakarta as one of the program in improving the health of
mothers and children. During the implementation in Yogyakarta,
the program still has some obstacles.
Objective: This study aimed to evaluate the delivery care
assurance policy in the province of Yogyakarta.
Methods: The research design used case study design. The
research was conducted in the province of Yogyakarta. which
The sampling technique used was stratified sampling. The unit
of analysis in this study is the health districts / municipalities,
general hospitals, health centers and private practice midwives
who administer Jampersal. Data collected by in-depth
interviews.
Results: The result of this research shows that there are
many problems in terms of input, process and output. In terms
of input, the problems are related to human resources, financial,
means and policy. In terms of process, the problems are related
to socialization, regulations of patient, process of claiming,
referral system and funding. In terms of output, the problem is
related to overcrowding, patient refusal, and complains from
the consumer.
Conclusion: This program is a good program for reduction of
infant and maternal mortality rates, but still needs some
improvement. Improvements are needed in terms of
strengthening cross-sector coordination, socialization of the
program should be optimized, stregthening the electronic-based
referral system, strengthening the commitment and motivation
of personnel and improvement of health infrastructures.
Keywords: Delivery Care Assurance Policy, Policy Evaluation.
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3212
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 3 (2013)
eng
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oai:jurnal.ugm.ac.id:article/3213
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ANALISIS KEBIJAKAN JAMINAN KESEHATAN KOTA BENGKULU DALAM UPAYA EFISIENSI DAN EFEKTIFITAS PELAYANAN DI PUSKESMAS
Yandrizal, Yandrizal
Anita, Betri Anita
Suryani, Desri
Background. Mayor of Bengkulu Regulation Number 13 Year
2012 on The Implementation Guidelines for State Health
Insurance Assistance Costs (Jamkeskot) in Bengkulu city is
managed by the Secretariate of the Government of Community
Welfare Section in Bengkulu. The cost of referral health care
in Provincial General Hospital could be made more efficient by
optimizing the role of community health centers as a curative,
preventive and promotive health services. It is hoped to reduce
the number of visits for treatment and referral to hospital. The
purpose of this study is to analyze the City Health Insurance
policies in an effort to improve the efficiency and effectiveness
of primary health care and public health efforts to reduce the
number of visits for treatment and referral to hospital.
Method: The type of research is non-experimental research,
or also called qualitative research. It is an exploratory research
to find a new role of the city government and Administering
Agency to improve the efficiency and effectiveness of health
services at the health center.
Unit of Analysis: 1) Community Health Center Unit 20, 2)
organizing: PT. Askes 2 person and Community Welfare section
2 person, 3) the City: Head of the Community Welfare Section
1 person, Bengkulu City Health Office 2 person. Data is collected
using interview using questionnaire as the instrument, and
documents review.
Results: Bengkulu Jamkeskot policies have not applied the
principle of insurance in which the organizers serves to control
the quality and cost of health care provided in both basic
services/primary and referral services. Most of the health
centers tend to refer patients (67%) that are still within their
authorization to provide care. The reason being: the health
centers have limited equipment and drugs, and some patients
demanded to be referred due to perceived bad quality of service
at the health centers. The Community Welfare section has not
coordinated with the City Health Office to conduct training for
the health center in an effort to increase the effectiveness of
services.
Recommendation: The City Government is to establish a
team to conduct technical guidance supervision to health
centers to ensure that the health centers play the role of
gatekeeper and only refer patients that need complex care,
providing medical equipment and drugs to the health centers
with proposed funding from Bengkulu City budget and provincial
budget. The Health Centers are to provide routine counseling
on healthy behavior and IEC on nutrition and hygiene to every
posyandu. The City Health Office provides technical guidance
in drafting POA for promotive and preventive activities to have
more focus in efforts to control the causes of disease. Improve
policy management of Jamkeskot by submitting the management
to an administering body, so that the Jamkeskot can apply the
insurance principles where the strong help the weak, the
healthy help the sick, the rich help the poor; and also can
control the quality and cost of service.
Keywords: Health Policy, Health Insurance, Gatekeeper
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3213
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 3 (2013)
eng
Copyright (c)
oai:jurnal.ugm.ac.id:article/3214
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SISTEM PEMBIAYAAN DAN KEBIJAKAN PENGENDALIAN BIAYA
Dewi, Shita
Dalam edisi kali ini beberapa artikel menyajikan
penelitian mengenai kebijakan berobat gratis dan implikasinya.
Disebutkan bahwa dampak positifnya berupa
peningkatan utilisasi pelayanan, namun diduga
mengakibatkan moral hazard dan penurunan motivasi
di sisi para penyedia layanan. Masalah utama
utama yang ditemui biasanya adalah sustainability
dari sistem berobat gratis karena kurang diperhitungkannya
kebutuhan anggaran dan lemahnya mekanisme
pengendalian biaya. Apakah kebijakan berobat
gratis hanya suatu kebijakan yang bersifat politis
untuk memenuhi ‘janji pemilu’ yang justru merugikan
sistem kesehatan, ataukah merupakan kebijakan
yang aplikatif? Bila itu merupakan kebijakan yang
aplikatif, sistem seperti apa yang harus ada untuk
mendukungnya?
Jelas bahwa menyediakan perlindungan kesehatan
bagi masyarakat harus mempertimbangkan
banyak hal dari sisi demand mau pun dari sisi supply.
Terlebih lagi, mekanisme pembiayaan dan pengendalian
biaya harus diperhitungkan secara serius.
Pada kesempatan ini kita akan melihat bagaimana
sistem pembiayaan kesehatan dan sistem pengendalian
biaya dilakukan di Perancis. Seperti telah
disinggung pada edisi lalu, sistem kesehatan di
Perancis adalah salah satu yang terbaik di Negaranegara
OECD. Sistem sécurité sociale berlaku di
Perancis, khusus untuk kesehatan sistem disebut
Couverture Maladie Universelle (CMU). Sistem ini
me-reimburse sebagian besar biaya perawatan, sisanya
biasanya di-reimburse oleh asuransi pribadi (private
insurance atau mutuelles) yang kita miliki yaitu
assurance complémentaire santé atau top-up voluntary
insurance.
Selain itu sistem CMU ini juga mengharuskan
kita menunjuk seorang dokter keluarga untuk menjadi
médecin traitant kita. Caranya adalah dengan pergi
ke dokter tersebut dan meminta beliau mengisi formulir
untuk didaftarkan sebagai médecin traitant
yang kita pilih. Sistem CMU ini dikelola oleh Caisse
d’Assurance Maladie lokal dimana kita terdaftar
sebagai penduduk. Kita harus menyerahkan bukti
bahwa kita merupakan penduduk setempat (carte
de séjour), bukti pendapatan tahunan (taxable income)
dan nomor rekening bank, dan dokumen
pendukung lain. Kita harus pula menyerahkan formulir
yang telah ditandatangani médecin traitant kita
kepada Caisse d’Assurance Maladie. Caisse d’Assurance
Maladie kemudian akan menerbitkan Carte Vitale
(kartu sehat) bagi kita, dilengkapi foto kita dan
chip berisi data registrasi kita di dalam sistem CMU.
Kartu ini harus selalu dibawa apabila kita pergi ke
dokter atau membeli obat, apabila kita ingin mendapatkan
reimbursement dari CMU. Dengan menggunakan
carte vitale, kita akan menerima reimbursement
langsung di rekening bank kita dalam waktu
kurang lebih seminggu sejak transaksi dilakukan.
Biaya yang di-reimburse oleh sistem sécurité
sociale melalui CMU adalah tariff pelayanan resmi.
Tariff pelayanan resmi ini ditetapkan berdasarkan
DRG dan merupakan hasil negosiasi antara asosiasi
profesi kesehatan dengan pemerintah/CMU. Besarnya
reimbursement CMU adalah 70% dari tariff pelayanan
resmi, 65% dari obat yang diresepkan (hanya
obat generik yang di-reimbursed), dan 80% - 95%
untuk pelayanan di rumahsakit. Reimbursement
100% akan diberikan untuk layanan X-rays atau
scans, laboratory tests tertentu, persalinan, sterilisasi
dan biaya rawat inap di atas 31 hari. Agar dapat
di-reimburse, semua tindakan/perawatan ini harus
dilakukan di daerah setempat dimana Caisse d’Assurance
Maladie kita berada. Otoritas kesehatan setempat
bertanggungjawab dalam melakukan health
technology assessment dan juga melakukan investment
planning misalnya dalam hal jumlah tempat
tidur serta jumlah dan jenis alat kesehatan (termasuk
MRI, CT-scan, dll) yang harus tersedia di daerahnya,
untuk menghindari overcrowding atau sebaliknya
under-utilized.
Para provider yang mengikuti tariff resmi disebut
sectuer 1. Saat ini sekitar 85% dokter keluarga dan
65% dokter spesialis berada dalam secteur 1. Selisih
antara tariff yang dikenakan dengan tariff pelayanan
resmi disebut dépassements, biasanya berkisar antara
€5-€30 lebih mahal dari tariff pelayanan resmi.
Para dokter yang memiliki tariff di atas tariff pelayanan
resmi berada dalam secteur 2. Di luar kantor
dokter selalu tertulis apakah dokter ini termasuk
dalam secteur 1 atau secteur 2, begitu pula tertera
secara jelas tariff untuk setiap jenis pelayanan yang diberikan. Tidak semua top-up voluntary insurance
akan me-reimburse secara penuh dépassements ini.
Reimbursement tidak akan diberikan sama sekali
oleh top-up voluntary insurance bila kita langsung
pergi ke dokter spesialis (atau ke rumah sakit) tanpa
adanya rujukan dari médecin traitant. Sementara
sistem sécurité sociale hanya akan me-reimburse
40% dari tariff pelayanan resmi bila kita langsung
pergi ke dokter spesialis atau ke rumah sakit tanpa
adanya rujukan dari médecin traitant. Dengan
demikian, ada disinsentif ganda bagi kita/pasien jika
mem-bypass sistem rujukan.
CMU sebenarnya adalah sistem asuransi wajib
berbasis kontribusi. Artinya, seseorang harus berkontribusi
sebesar 8% dari net income tahunannya
dengan memperhitungkan threshold CMU. Batas/
threshold CMU ini adalah sebesar €9,356 per tahun.
Jadi, seandainya pendapatan tahunan kita adalah
€20,000 maka kita boleh mengurangkan dengan ketentuan
threshold sebesar €9,356. Dengan demikian
didapat angka €10,644 sebagai dasar penghitungan
8% kontribusi untuk CMU, atau iur premi sebesar
€851 per tahun. Selain itu kontribusi juga harus dilakukan
oleh perusahaan tempat kita bekerja. Pembayaran
premi dilakukan per kuartal dan dibayarkan
ke URSSAF. Kita dapat mengakses www.urssaf.fr
untuk memahami lebih lanjut bagaimana kontribusi
ini diperhitungkan dan di-submit, bergantung dari
jenis pekerjaan kita. Untuk pekerja sector informal
(misalnya pertanian) dan mandiri/self-employed,
sebagian kontribusi ditanggung oleh pemerintah.
Adakah pelayanan yang 100% gratis di Perancis?
Tentu ada, dengan beberapa kondisi tertentu.
Pihak-pihak yang berhak atas pelayanan 100% gratis
adalah (a) mereka yang memiliki penyakit kronis
(affection de longue durée misalnya penderita
kanker), (b) ibu hamil dan bayi baru lahir hingga usia
30 hari, (c) mereka yang berada di dalam sistem
sebagai penerima invalidity benefits (karena memiliki
disability tertentu), dan (d) mereka yang berada di
dalam sistem CMU-Complémentaire. Terhadap kelompok-
kelompok ini, penyedia layanan hanya diperbolehkan
untuk mengenakan tariff layanan resmi
(secteur 1).
CMU-Complémentaire (CMU-C) adalah sistem
dimana orang dengan pendapatan di bawah pendapatan
minimum, atau mereka yang tidak memiliki
pekerjaan sama sekali, berhak atas sistem CMU
tanpa membayar kontribusi. Besarnya pendapatan
minimum tahunan dihitung dari jumlah anggota keluarga,
mulai dari €7,934 (untuk 1 orang) sampai
€19,835 (untuk 5 orang). CMU-C adalah sistem yang
dibiayai berbasis pajak, jadi berbeda sama sekali
dengan sistem CMU. Berbeda dengan sistem CMU
yang merupakan sistem reimbursement, sistem
CMU-C merupakan sistem free of charge at the point
of service. Dengan demikian, penyedia layanan kesehatan
yang bertanggungjawab untuk memproses
reimbursement dari pemerintah bagi mereka/institusi
mereka sendiri. Apabila kita dikenai biaya tambahan
apa pun, kita harus melaporkan hal ini kepada CMUC,
dan pihak yang mengenakan biaya tambahan tersebut
akan dikenai sanksi denda mau pun administrative
oleh pemerintah. CMU-C dikelola oleh institusi
yang berbeda yaitu Caisse Primaire d’Assurance
Maladie, namun memiliki ketentuan yang sama
dalam hal kita harus mendaftarkan diri di Caisse
Primaire d’Assurance Maladie lokal dimana kita tercatat
sebagai penduduk, dan memiliki bukti pendapatan
dibawah pendapatan minimum serta bukti
bank. Besarnya pendapatan minimum ini di-review
setahun sekali. Implikasinya, kita harus selalu meregistrasi
ulang setiap tahun untuk dinilai eligibilitasnya.
Dengan sekilas membaca bagaimana sistem
pembiayaan dan sistem pengendalian biaya dilakukan
di Perancis, semoga pembaca dapat mencatat
hal-hal bermanfaat yang bisa dicontoh.
Center for Health Policy and Management
2014-01-17 00:00:00
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PELAKSANAAN KEBIJAKAN OBAT GENERIK DI APOTEK KABUPATEN PELALAWAN PROVINSI RIAU
Suryani, Aini
Hasanbasri, Mubasysyir
https://scholar.google.co.id/citations?user=cNLJ2XAAAAAJ&hl=id http://orcid.org/0000-0003-2972-6916
Priyatni, Nunung
Background: Medicine is an integral part of community health
service. Therefore it must be available in sufficient quantity,
types and adeqaute quality, properly distributed and accessible
for community when its needed. In order to meet the
community’s need for medicine and to guarantee medicine
accessibility, the government released generic medicine policy.
Although the price of the generic medicine has already been
set up and fixed by government, there are variety of the price
still can be found on implementation of the generic medicine
sold in the pharmacy store or in the market, and can cause
price uncertainty for community in finding medicine they need.
That is why a research needs to be conduct toward
implementation of the generic medicine price policy on the
distribution channel especially at the pharmacy store.on
Pelalawan District in Riau Province.
Method: This research is non experimental/observational
research with qualitative and quantitative method using cross
sectional design, data analyzed descriptively.
Result: Research result indicates that access to generic
medicine at pharmacy store for available medicine are 99,3%,
for un available medicine are 0,7% and for replaced medicine
are 0,5%. Average availability of the medicine at the pharmacy
store are 4-7,3 months. Highest availability rate for medicine is
Hidrocortison cream 2,5% for 7,3 months and the lowest is
Pirazinamid tablet 500 mg for 4 months. Pharmacy store that
have an expired medicine are PR (0,7%) and KH (2%). Every
pharmacy store have no damaged medicine, 0% percentage.
Almost all pharmacy store experiencing out of supply for
medicine between 4 to 90 days. Price of the medicine sold
averagely increasing from its pharmacy store Highest Retail
Price (HRP). But there are several medicine that sold under the
HRP The highest price medicine that are sold higher than its
HRP is Clorfeniramin Maleat (CTM) tablet by 515,4% increase
and Dexametason tablet is the lowest price sold under HRP by
65,2%. Even so they are Alopurinol, Digoksin, and Ranitidin.
From in depth interviews with patients, can be learn that they
have a purchase ability for generic medicine.
Conclusion: Implementation of generic drug price on Pelalawan
district is good. It can be seen from generic medicine access
by community that are high after the release of regulation from
Health Department of Republic Indonesia, the level of availability
of generic medicine on pharmacy store at Pelalawan District
are low but there are no expired or damaged medicine. The
price of generic medicine at Pelalawan District are variable but
the community still can afford to buy them.
Keyword: Generic medicine, availability and affordability.
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3215
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 2 (2013)
eng
Copyright (c)
oai:jurnal.ugm.ac.id:article/3216
2017-05-16T15:45:03Z
jkki:ART
oai:jurnal.ugm.ac.id:article/3217
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EVALUASI KEBIJAKAN BEROBAT GRATIS DI KABUPATEN TANJUNG JABUNG TIMUR PROPINSI JAMBI
Juanita, Hendriyanto Julita Hendrartini
Background: In the decentralized era, local government has
wider authority to decide policies relevant with local needs.
For this reason the Regent of Tanjung Jabung Timur District in
2005 issued a decree on free medication at the health center
and secondary health center. However there are problems
with the sources and allocation of budget to support the decree.
Besides, there is also a problem with target of the program
funded by the government. Therefore there should be an
evaluation to find out facts for future improvement.
Objective: The study aimed to identify mechanisms of funding,
relevance of target and efficiency of the policy.
Method: This was an explanatory case study which used
quantitative and qualitative approaches. Analysis units of the
study were local government, health center and secondary
health center; and the subject were members of local
parliament, head of health office, head of local planning council,
head of health centers, staff of health centers/secondary health
centers and the community. The size of samples to measure
target relevance was determined using stratified sampling;
qualitative method was determined using purposive sampling.
Data were obtained through questionnaire, in-depth interview
and document checklist. Data were analyzed qualitatively and
quantitatively in proportion.
Result: Local government of Tanjung Jabung Timur allocated
budget in the form of operational fund of health centers, drug
allocation and incentives. The realization of budget was delayed
so that health centers used alternative financial resources,
i.e. budget of health insurance for poor community. Operational
fund did not give much support for free medication when there
was no clear cut distinction between users of health insurance
for poor communities and free medication. This caused overlap
in budgeting which might end in inefficiency. The authority did
not do monitoring and supervision appropriately. Users of free
medication were mostly non poor communities. Poor
communities utilized free medication at secondary health
centers more frequently than at health centers.
Conclusion: The local government of Tanjung Jabung Timur
District had not implemented good health insurance principles
in health financing to support free medication policies. There
was misallocation of funding because more non – poor
communities used the service. This increased the potential of
inefficiency in government budget utilization.
Keywords: free medication policy, health financing, budget
efficiency
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3217
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 2 (2013)
eng
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oai:jurnal.ugm.ac.id:article/3218
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ANALISIS UNTUK PENERAPAN KEBIJAKAN: ANALISIS STAKEHOLDER DALAM KEBIJAKAN PROGRAM KESEHATAN IBU DAN ANAK DI KABUPATEN KEPAHIANG
Iswarno, Iswarno
Hasanbasri, Mubasysyir
https://scholar.google.co.id/citations?user=cNLJ2XAAAAAJ&hl=id http://orcid.org/0000-0003-2972-6916
Lazuardi, Lutfan
Background: Maternal, neonatal and child health (MNCH)
program is a national priority programs in health development.
In 2006 the Ministry of Health to provides the largest budget
allocation to the KIA programs. This policy was taken in order
to accelerate the decline in maternal mortality and infant through
the implementation of the making pregnancy safer strategy
(MPS) with focus on some activities that are considered to be
cost effective. MNCH sustainability of the program depends
on political commitment and support from stakeholders in the
region. Therefore, stakeholder analysis is important for the
implementation of policy to support the MNCH program.
Objectives:Assessing the political commitment of the local
government to MNCH program in Kepahiang Regency.
Methods: This research is a descriptive, qualitative design
with a case study. Unit of analysis is a research MNCH program
stakeholder. How do the data with the brainstorming, depth
interviews, reports and documents, and direct observation.
Results: Political commitment of the local government to
maternal, neonatal and child health program is still low, this is
evidenced by the lack of budget allocation maternal, neonatal
and child health program. Essentially all stakeholders agree
and support the program. The involvement of local stakeholders
in the process of planning and budgeting programs is still lacking.
Coordination among health agencies with key stakeholders in
the planning and budgeting also are not running well, so often
there are differencesin understanding the program. Besides
the quality planning activities are still considered low, and there
is still weak advocacy capacity of health district office.
Conclusion: The small budget allocation for the program
shows the commitment to maternal, neonatal and child health
program of the local government is still low. This problem was
more due to the quality of the program planning (design) that is
not well-developed. Also the role and involvement of
stakeholders in the planning process is still lacking.
Keywords: Stakeholder, MNCH policy
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3218
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 2 (2013)
eng
Copyright (c)
oai:jurnal.ugm.ac.id:article/3219
2017-10-09T15:45:15Z
jkki:ART
"130606 2013 eng "
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Evaluasi kebijakan pembangunan puskesmas pembantu di Propinsi Kalimantan Tengah
Winarno, Kus
Hasanbasri, Mubasysyir
https://scholar.google.co.id/citations?user=cNLJ2XAAAAAJ&hl=id http://orcid.org/0000-0003-2972-6916
Sunjaya, Deni Kurniadi
health care politics; corruption; bribery; health bureaucracy; Indonesia; kickback money
Background: The objective of health development is improving community health status through increasing public access to health services. One of strategy is by supporting facilities for
health service by developing auxiliary health center for all remote district at Central Kalimantan Province. Central Kalimantan Province with 1,9 million of population, consisted of 14 district, 1348 villages, 805 auxiliary health center. It means that only 59% village have facilities for health service such as auxiliary health center.
Objectives: This research aimed to know how formulation process and implementation of policy of developing auxiliary health center by using provincial funds.
Method: It was descriptive case study using mainly method qualitative designed by semi structured in-depth interview and document study. Research subject is stakeholder at level
province and chosen district. This research executed in Province Public Health Service of Central Kalimantan and one chosen district.
Result: Development of secondary health center in Central Kalimantan Province is the realization of Central Kalimantan Province local decree number 12 and 13 year 2005 fulfilment
on RPJPD and RPJMD. Initially, the budgeting concept was planned by Tugas Pembantuan mechanism, but this mechanism was not agreed. This scheme was a top down program from
province government. Problems occurred in the implementation are 1). Bad monitoring, 2). Lack of reporting by developer, 3). Remote location of, 4). Varieties in cost of production, 5). Shortage health care workforce, 6). Equipments unmatched the need of health care provider. Evaluation is executed, but only concerning physical progress problem. In the meantime, there was increased allocation of DAK fund in each district.
Conclusion: Development of auxiliary health center in Central Kalimantan Province which funded by province fund, is not required by district. There was no agenda surrounding development of auxiliary health center. The role of stakeholder in compilation of agenda setting for this policy was only a normative role.
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3219
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 2 (2013)
eng
Copyright (c) 2013
oai:jurnal.ugm.ac.id:article/3220
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DAMPAK KEBIJAKAN PELAYANAN KESEHATAN GRATIS TERHADAP KEPUASAN PASIEN DALAM MENERIMA PELAYANAN KESEHATAN PUSKESMAS DI KOTA AMBON
Lutfan Lazuardi, Lintje Sintje Corputty Hari Kusnanto
Background: The Mayor of Ambon City, in order to improve
the welfare of society especially the health sector has made a
policy too free basic health services costs at health centers
and its network for all communities. In implementing this policy,
there are many problems both tecnical and operational.
Objectives: The objective of this research was to determine
the performance of officers in providing free health services
to the public in accordance with the level of satisfaction in
terms of free health care.
Methods: This research is descriptive analysis with a
qualitative approach and conducted at five sub district
coordinator public health services.Research data obtained by
in-depth interviews and focused group discussion.For data
analysis,qualitative techniques were used, that is, narrative
interpretations, conclusions and data validation by triangulation
techniques.
Results: The results show that on giving free services,officer
does not show any improvement in their performance. This
was the result of the absence of incentives or special
compensation for them. Material and non material compensation
is expected to increase work motivation. Supporting facilities
such as logistics and health facilities should be prepared to
improve provision of free services, thus in turn increasing
patient’s satisfaction.
Keywords: Free Health Services Policy, Performance,
Incentive and Compensation, Patient Satisfaction.
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3220
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 2 (2013)
eng
Copyright (c)
oai:jurnal.ugm.ac.id:article/3221
2017-10-09T15:45:25Z
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KEBIJAKAN UNTUK DAERAH DENGAN JUMLAH TENAGA KESEHATAN RENDAH
Dewi, Shita Listya
Ketidakmerataan distribusi tenaga kesehatan
(khususnya, namun tidak terbatas pada dokter dan
dokter spesialis) di Indonesia merupakan salah satu
hambatan dalam upaya peningkatan akses terhadap
layanan kesehatan. Tenaga kesehatan menumpuk
di daerah urban sementara Daerah Terpencil, Perbatasan
dan Kepulauan (DTPK) mengalami resesi tenaga.
Pemerintah Indonesia telah mencoba mengatasi
hal ini dengan berbagai kebijakan. Situasi ini sebenarnya
tidak hanya terjadi di Indonesia. Di Negara
maju seperti Prancis pun, fenomena ini terjadi.
Menteri Kesehatan Perancis menyebut beberapa
daerah di region-region pedalaman Perancis
mengalami “les déserts médicaux” (gurun pasir tenaga
kesehatan). Secara keseluruhan jumlah dokter
di Perancis memang bertambah 30% dalam 20 tahun
terakhir, ratio saat ini adalah 337 dokter per 100,000
penduduk. Perancis memiliki sistem gatekeeping
yang ketat dan sistem kesehatan difokuskan pada
akses terhadap dokter umum. Rata-rata jarak yang
ditempuh untuk menemukan dokter umum adalah 5
km (8 menit dengan kendaraan). Hanya di region
pedalaman tertentu saja (biasanya di daerah pegunungan)
dibutuhkan waktu tempuh 15 menit berkendara
untuk menemukan dokter umum, misalnya di
region Alps atau Pyrenees.
Namun tidak berarti Perancis bebas dari isu
distribusi tenaga medis. Densitas tertinggi ada di
region urban Île-de-France (367 dokter per 100,000
penduduk), sementara terendah ada di pedalaman,
misalnya di region Eure (118 dokter per 100,000 penduduk).
Perbandingannya rata-rata adalah 1:2 untuk
dokter umum (1 dokter di daerah pedalaman, 2
dokter di daerah urban), dan 1:8 untuk dokter
spesialis (1 dokter spesialis di daerah pedalaman,
8 dokter spesialis di daerah urban). Akibatnya adalah
tingginya antrian untuk konsultasi di daerah yang
termasuk dalam les déserts médicaux, dibutuhkan
waktu tunggu 18 hari untuk konsultasi dengan dokter
anak, 40 hari untuk konsultasi dengan dokter obsgyn,
dan 133 hari untuk dokter mata.
Hal ini diperparah dengan dua fakta, bahwa: 1)
25% dari jumlah dokter saat ini akan pensiun dalam
5 tahun ke depan, dan 2) hasil riset di kalangan mahasiswa
kedokteran menunjukkan 63% mahasiswa
kedokteran tidak berniat untuk bekerja di daerah
pedalaman. Pada bulan Desember 2012 lalu, Menteri
Kesehatan Perancis mengumumkan bahwa pemerintah
sedang membuat beberapa kebijakan baru untuk
mengatasi hal ini. Pengumuman ini disampaikan dihadapan
asosiasi walikota Perancis (AMF). Beberapa
kebijakan lama yang bersifat binding dikoreksi
dan akan diganti oleh kebijakan baru yang bersifat
memberi insentif. Misalnya: 1) Tersedia alokasi untuk
200 dokter pemula yang akan ditempatkan di
daerah pedalaman dengan gaji bersih €55,000/tahun
untuk kontrak dua tahun (bandingkan dengan gaji
bersih dokter pemula di rumah sakit yang adalah
€40,645/tahun), 2) Pengunaan véhicules santé pluriprofessionnels
yaitu tim multiprofesi (dokter umum,
ophthalmologists, cardiologists, perawat, physiotherapists)
yang akan melayani daerah-daerah dengan
akses terbatas, 3) Menciptakan profesi baru: Agent
Management And Interface (AGI) sebagai tenaga
administrative/kesekretariatan yang mengambil alih
beban administrasi dari dokter di pedalaman. Tenaga
AGI ini akan dibiayai sebagian oleh sécurité sociale
dan sebagian oleh dokter, dan 4) Pembentukan komite
nasional telemedicine untuk mendukung pelayanan
di daerah pedalaman.
Pengumuman ini mendapat sambutan baik dari
AMF. Sambutan baik juga datang dari berbagai asosiasi
profesi dan asosiasi mahasiswa kedokteran,
yang disampaikan melalui media social termasuk
akun twitter milik Menteri Kesehatan. Beberapa
minggu setelah itu, Menteri Kesehatan mengundang
berbagai asosiasi profesi dan asosiasi mahasiswa
kedokteran untuk melakukan dialog dan brainstorming
mengenai rumusan kebijakan tersebut. Dialog
tersebut, telah terkumpul beberapa usulan, antara
lain: 1) Usulan untuk disediakannya insentif bagi dokter
senior yang tertarik untuk pensiun di daerah pedalaman.
Beberapa dokter senior telah mengemukakan
keinginan mereka untuk memiliki kualitas hidup lebih
baik di pedalaman, karena mereka ingin mengurangi
beban kerja dan sudah tidak ingin lagi melayani 60-
70 pasien per hari, 2) Usulan untuk mendelegasikan
wewenang tindakan ke profesi tenaga kesehatan lain;
hal ini mengantisipasi kesulitan menempatkan 1
dokter di setiap desa, dan 3) Usulan perbaikan kondisi perumahan untuk dokter di daerah pedalaman,
dan fasilitas di rumah sakit daerah yang perlu
ditingkatkan (diusulkan untuk setara dengan rumah
sakit pendidikan).
AMF juga menekankan keinginan mereka untuk
dilibatkan dalam rencana implementasinya untuk
lebih me’lokal’kan beberapa pendekatan yang terdapat
dalam kebijakan nasional. AMF mengakui perlunya
peran mereka dalam meningkatkan perekonomian
lokal untuk lebih meluaskan lapangan kerja sehingga
suami/istri dokter bisa memperoleh pekerjaan
di daerah. Di sisi lain, AMF juga mengusulkan untuk
lebih membatasi kebebasan dokter di daerah perkotaan
untuk memilih skema dua (tariff di luar ambang
reimbursement oleh sécurité sociale) untuk mengurangi
kesenjangan pendapatan dokter di perkotaan
dan dokter di pedalaman.
Sebagai catatan, tarif yang dikenakan dokter
dan rumah sakit di Perancis untuk pelayanan apa
pun terdiri dari tiga pilihan: 1) skema 1, yaitu tarif
yang ditetapkan oleh sécurité sociale, artinya, pasien
akan menerima full reimbursement dari biaya yang
dikeluarkannya, 2) skema 2, yaitu tarif di atas ambang
yang ditetapkan oleh sécurité sociale, artinya,
pasien harus ditanggung sebagian oleh sécurité
sociale dan sebagian lagi oleh asuransi pribadi, dan
3) skema 3, yaitu tarif private, artinya, pasien tidak
menerima reimbursement apa pun dari sécurité
sociale. Kebebasan dokter untuk memilih skema 2
dibatasi oleh beberapa persyaratan yang telah ditetapkan
pada tahun 1998, tidak semua dokter diperbolehkan
mengenakan skema 2. Sebagai gambaran,
92.3% dari dokter umum berada di skema 1, 6,8%
berada di skema 2, dan hanya kurang dari 1% yang
berada di skema 3 (di luar sistem sécurité sociale).
Pada sisi lain, pemerintah juga akan mengambil
beberapa kebijakan pada tingkat Nasional untuk
memperbaiki sistem sécurité sociale di tahun 2013
ini. Sebagai contoh, harga obat dan pemeriksaan
lab akan turun sekitar 7%. Sécurité sociale juga mendorong
dokter dan rumah sakit untuk lebih banyak
menggunakan obat generik, dan one-day surgery.
Peningkatan anggaran untuk Sécurité Sociale akan
diambil dari kenaikan pajak tembakau dan pajak
miras. Pada awal bulan Februari 2013, muncul rekomendasi
pokja yang dibentuk di Senat untuk membahas
kebijakan mengatasi les déserts médicaux.
Rekomendasi tersebut bertolakbelakang dengan
usulan yang disampaikan oleh Menteri Kesehatan
pada bulan Desember 2012 lalu. Rekomendasi pokja
lebih mengambil pendekatan ‘coercive’, yaitu: 1)
Membatasi praktek pribadi dokter yang telah melebihi
jumlah tertentu di suatu daerah. Hal ini telah
diterapkan untuk profesi medis lain (perawat, farmasi,
fisioterapis, bidan, dll) dan telah terbukti meningkatkan
penempatan perawat di daerah sebanyak 30%
dalam 3 tahun terakhir, 2) Menetapkan wajib kerja
di daerah selama minimal 2 tahun untuk dokter spesialis
yang baru lulus, dan 3) Mulai mensosialisasi
kepada mahasiswa kedokteran bahwa mereka akan
menjalani wajib kerja di daerah apabila masalah les
déserts médicaux tidak teratasi.
Pada Minggu lalu, Perdana Menteri Perancis
telah menegaskan kembali komitmennya untuk
mengambil kebijakan mengatasi masalah les déserts
médicaux ini. Dari sudut pandang analisis kebijakan,
dinamika dan dialog kebijakan yang terjadi di Perancis
dalam hal ini cukup menarik untuk diikuti. Kita
melihat berbagai aktor yang terlibat dalam mencoba
mengatasi masalah les déserts médicaux di daerah
pedalaman. Menarik pula untuk melihat spectrum
kebijakan yang diambil dan saran yang diberikan
oleh para aktor kebijakan ini.
Pada edisi Jurnal Kebijakan Kesehatan Indonesia
(JKKI) kali ini, beberapa artikel membahas
kebijakan untuk penempatan tenaga kesehatan di
daerah terpencil. Topik ini pula menjadi salah satu
topik yang diangkat dalam Annual Scientific Meeting
(ASM) di Fakultas Kedokteran Universitas Gadjah
Mada. Jelaslah bahwa kita semua menyadari pentingnya
mengambil langkah strategis untuk mengatasi
masalah ini.
*) Semua data diolah dari situs Kementrian Sosial
dan Kesehatan Perancis, dan dari Direction de la
recherche, des études, de l’évaluation et des
statistiques (DREES).
Center for Health Policy and Management
2014-01-17 00:00:00
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eng
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Pelatihan seperti apa yang dapat mendukung implementasi kebijakan: perspektif peserta - evaluasi training manajer mid-level untuk imunisasi di Kota Banda Aceh
Munthe, Alfian R
Hasanbasri, Mubasysyir
Jurusan Ilmu Kesehatan Masyarakat, Fakultas Kedokteran, Universitas Gadjah Mada https://scholar.google.co.id/citations?user=cNLJ2XAAAAAJ&hl=id http://orcid.org/0000-0003-2972-6916
Kusnanto, Hari
Jurusan Ilmu Kesehatan Masyarakat, Fakultas Kedokteran, Universitas Gadjah Mada
Background: Training is an effort to develop knowledge and
skills and change attitudes through learning experiences to
achieve effective perfomance in an activity or range of
activities. Tsunami disaster on December, 26th 2004 attacked
Aceh Province, in 2007-2009, the Ministry of Health in
collaboration with UNICEF/PATH conducted mid level
management training on immunization in Aceh Province with
the main objective to improve performance of health workers
who served as manager in implementing the policy of national
program on immunization service at the provincial level, district/
city and clinic.
Research: This is a case study design using descriptive
qualitative and quantitative analysis. The unit of analysis is the
managers of the immunization in District Health Office and in
the health centres that have been trained in Banda Aceh. The
methods of data collection are brainstorming, in-depth
interviews, focus group discussions, reports and documents,
and assesment.
Result: Immunization managers have a good knowledge of
management and type of the vaccine, vaccine logistics, place
and schedule of vaccinations. The number of cases of
diseases preventable by immunization have decreased and
results coverage of routine immunization has been increasing
after mid-level management training.
Conclusion: Trainees have a positive reaction to training,
results of immunization coverage and knowledge were
increased and behavioral change occured.
Keywords: Evaluation, Training Mid Level Management,
Immunization.
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3222
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 1 (2013)
eng
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oai:jurnal.ugm.ac.id:article/3223
2014-01-17T06:18:59Z
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EVALUASI KEBIJAKAN PENEMPATAN TENAGA KESEHATAN DI PUSKESMAS SANGAT TERPENCIL DI KABUPATEN BUTON
Mubasysyir Hasanbasri, Herman Laksono Trisnantoro
Background: One of the important elements and very
determining and expected can become innovator in the effort
of increasing the quality of health service is health force. The
placement of health force especially in the very remote public
health center is meant for the equalization of access to health
service, but in fact the placement of health force policy in the
very remote public health center in Buton Regency is not yet
fully implemented. Besides, the interest and motivation of those
who are placed in the very remote areas are very low, although
they are placed, they will not stay for long. We observe the
high demand for request to transfer to the urban area, resulting
in the accumulation of health force in the urban public health
center.
Method: It is a descriptive research, with qualitative method
to evaluate the placement of health force policy in the very
remote public health center in Buton Regency.
Result: The placement policy is influenced by geographical
factor and the intervention of stakeholders in the Regency.
Doctor, nurse and midwife forces placed in the very remote
public health center do not have high retention rate to stay and
work in the very remote public health center. The small income
produced due to unavailability of additional incentive, the unclear
carrier development pattern and lack of appreciation for those
who work in the very remote public health center are the main
reason to request for a transfer. The transfer is conducted to
the other public health center in the same region or to the other
regency. The provision of supporting facilities policy is not
able to make the health forces have motivation to stay and
work in the very remote public health center.
Conclusion: The placement of health force policy can not
overcome the lack of health force in the very remote public
health center yet. The unavailability of incentives and unclear
carrier development and lack of appreciation are the main
reason why the health forces do not stay for long, resulting in
low health force number in the very remote public health center.
Keyword: Placement policy, financial, supporting facilities,
retention
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3223
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 1 (2013)
eng
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ANALISIS KEBIJAKAN DALAM MENGATASI KEKURANGAN BIDAN DESA DI KABUPATEN NATUNA
Kristiani, Imam Syafari Dwi Handono Sulistyo
Background: Geographical condition of Natuna Islands which
is not in accordance with health development affects the
quantity and availability of midwives distributed in villages in
the District of Natuna. In fact, the ratio between the number of
villages and the number of midwives in the district has not met
the standard proposed by the Ministry of Health. Unfortunately,
there are still around 13 villages from 51 villages that have no
midwives serving in those villages. The location of 13 villages
are separate Island, and it caused lack of provide access to
quality health care services. One of efforts done by the local
government is to attract midwives’ interest through a variety
of strategies and policies in several fields such as financing,
incentive, regulation, organization, and stakeholders’ behaviors.
Method: This was a descriptive study with study-case design
by using qualitative method. Study case in this study was a
single holistic study case. The informants were head of health
office, head of health empowerment and promotion division,
head of general affairs and employment sub division, head of
BKD, head of Local Development Planning Agency, the
Commission Two of Local Legislative, heads of community
health centers, and village midwives. The study case design
aimed to know policies in overcoming the lack of midwives in
the District of Natuna.
Results: The local government financing policy allocated the
budget or health less than 15%, which was only 3-4% used
for improving the health workers’ capacity. The incentive giving
for midwives was relatively small compared to the incentive
regulated by the Ministry of Health. There was no specific
regulation from the local government, so that the policy was
considered not optimal. In the organizational level, the role of
stakeholders was in accordance with their duty and provision;
however, the f inal decision was dependent upon Local
Legislative and the local government’s leader. Lastly, midwives’
low interest to work in Natuna was caused by its geographical
condition.
Conclusion: Local government’s policy in the field of financing,
incentive, organization, regulation, and behavior in overcoming
the lack of village midwives was considered not optimal
because of the absence of specific policy from the local
government in this matter. In addition, midwives’ low interest to
work in Natuna contributed the lack of midwives in this district.
Keywords: policy analysis, the lack of village midwives
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3224
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 1 (2013)
eng
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SITUASI PERAWAT PEGAWAI TIDAK TETAP DI DAERAH TERPENCIL PEGUNUNGAN MERATUS KABUPATEN HULU SUNGAI TENGAH – SEBUAH EVALUASI TERHADAP IMPLEMENTASI KEBIJAKAN
Dwi Handono Sulistyo, Rahmatullah Laksono Trisnantoro
Background: The operation of mobile health center activities
is currently unable to increase the coverage and provide equal
distribution of basic health service for people in isolated areas.
The cost for mobile health center activities is relatively
high; it needs lots of staff and the service hours are limited. As
the budget for mobile health center operation is limited, the
frequency of mobile health center activities is relatively low.
Further consequence is that the implementation of survaillance
and priority program is constrained. To improve health service
for people living in isolated areas of Meratus Mountain the
District Government of Hulu Sungai Tengah in 2002 issued a
policy on Non Permanent Staff Nurses. This policy is aimed to
provide continuous and accessible basic health service for
the community whenever they need it.
Method: This was a descriptive qualitative study that used a
case study design and was carried out at 4 villages that got
allocation of non permanent staff nurses with as many as 14
informants. Primary data were obtained from indepth interview
whereas secondary data were obtained from document
search particularly documents at Hulu Sungai Tengah district
health office and health centers. Observation was also made
to get information not covered in indepth interview.
Result: The result shows improvement in availability of basic
services to the community. On the other hand limited facilities
are made available to the non permanent staff nurses, along
with inadequate equipment, supplies, and vehicle to do their
work. Also there is lack of additional incentive and regular
monitoring to support them.
Conclusion: Basic health service was available more continuously
and more accessible for people at isolated areas.
However, findings also suggest that the policy of non permanent
staff nurses for isolated areas of Meratus Mountain, District
of Hulu Sungai Tengah had not been fully supported by
necessary facilities, equipment, additional incentives and monitoring.
Keywords: policy evalution, non permanent staff nurses, isolated
areas,
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3225
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 1 (2013)
eng
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oai:jurnal.ugm.ac.id:article/3226
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EVALUASI PENERAPAN KEBIJAKAN BADAN LAYANAN UMUM DAERAH DI RSUD UNDATA PROPINSI SULAWESI TENGAH
Laksono Trisnantoro, Surianto
Background: One of the important things forchange is a sequential
characteristic or the phase of time for a change. Such
as 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 The
Departement of Internal Affairs No 61 year 2007. The new
paradigm as BLUD must be balancedof both the “Enterprising
the Goverment” and the “Public Service Oriented”. The background
of Undata Hospital before becoming BLUD were the
problem of health care cost was getting expensive whilst the
tariffs imposed had to be competitive, and the demand of good
quality of services to care for the patients. All of this could be
achieved if Undata hospital applies the financial management
system of the regional public service agency (PPK-BLUD).
Method Of Research:Thisresearch uses a descriptive analysis
with the case study design. The samplings conducted in
this research are purposive sampling. Method of data colection
obtained through in depth interview, observation, utilization of
documents.
Research Result: The implentation of regional public service
agency (BLUD) based on the result of evaluation study in
Undata hospital and in the health departement of Central
Sulawesi Province shows that: The implementation based on
the standard, namely governance, business strategy plan,
and the report of financial management has been implemented
well. Whereas the implementation which is not in accordance
yet with the BLUD criteria is the minimum service standard
related to indicator and criteria of SPM. Also the role of health
departement as the supervisory board has yet to be implemented
because there is no supervisory board.
Conclusion: It shows the governance, business strategy
plan and financial report are already in accordance with standard,
set while the minimum service standard and the supervisory
board have not run optimally within the standard and
criteria set.
Key words: PPK-BLUD, implementation of BLUD, Hospital,
Stakeholders
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3226
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 1 (2013)
eng
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oai:jurnal.ugm.ac.id:article/3227
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KEBIJAKAN NASIONAL DALAM KONTEKS LOKAL: TANTANGAN IMPLEMENTASI KEBIJAKAN DESA SIAGA DAN RUJUKAN PELAYANAN KESEHATAN DI KABUPATEN KEPULAUAN YAPEN PAPUA
Maing, Yosef
Supriyati, Supriyati
Sunjaya, Deni Kurniadi
Background:One of the policies in health to achieve Indonesia
Sehat 2010 was the development of desa siaga that was
based on Decree of Ministry of Health number 564/MENKES/
SK/VIII/2006 regarding the guidance on the implementation of
Desa Siaga. Desa Siaga is a community based health effort
that involved community self funding agency such as PKK,
religious organization, and private sector.
Method:This was a qualitative descriptive research that used
explanatory analysis with case study design. The research
informant was district government, health office, community
leaders and public figure as well as health care provider. The
data was collected with interview, observation and
documentation. Data analysis was conducted with case study
analysis.
Result: This research showed that the implementation of Desa
Siaga was with top–down method that used social mobilization
approach. The district government and community was very
much supporting the policy of Desa Siaga. Difficult geographic
location, limited human resources in health and limited funding
were the main obstacles in the implementation of Desa Siaga
policy and health service referral. The main problem of referral
implementation was transportation and funding. The readiness
of community and village aparatur to assist the poor community
was still very minimum.
Conclusion: This research proven that Desa Siaga program
was very important for community in the district of Yapen
archipelago. Nevertheless, difficulties in geographiccondition,
limited human resources in health as well as limited funding
has resulted in difficulties in the implementation of Desa Siaga
policy and health service referral in the district of Yapen
archipelago. The regional and central government have not
been able to respond to the needs of Desa Siaga.
Keyword: Policy Implementation, Desa siaga, Papua.
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/3227
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 1 (2013)
eng
Copyright (c)
oai:jurnal.ugm.ac.id:article/5367
2018-07-19T05:08:38Z
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Widiasih, Eny Setyo
Zahrulfa, Arrosianti
Rustamaji, Rustamaji
Suryawati, Sri
Background: The incidence of damaged medicine and expired medicine always occurred in every mechanism of medicine management. The write-off procedure of damaged medicine and expired medicine as a regional owned goods was not established specially yet. The amount of damaged and expired medicine value, the burden of their management technically, the write-off process considered from administrative aspects as a inventory, considering that there was no legal formal aspect become particular problem for the Health Office of Yogyakarta Municipality. Objectives: The objective of the study was to give administrative and legal base for procedure to write-off of damaged and expired medicine as regional owned goods in the Health Office of Yogyakarta Municipality. Methods: This was observational study by case study design with descriptive analytic approach. Results: The damaged and expired medicine that was stocked in Public Health Center was sent back to UPT Farmakes to be write-off and destroyed. The write off and destroying of damaged and expired medicine have been completed for 2009, 2010 and 2011 in 2012 by Health Office of Yogyakarta Municipality. The write off of damaged and expired medicine should be appropriate to the regulation on the prevailed regulation on the write off of regional owned goods, though that regulation was not specified for medicine. Conclusion: The write-off of damaged and expired medicine referred to Regulation by Ministry of Internal Affairs Number. 17 of 2007 on Technical Guidelines on the management of Regional Owned Goods and Mayor Regulation of Yogyakarta Municipality, Number. 54 in 2011 on Guidelines on the Management of Reserve Goods in the governance of Yogyakarta Municipality. However, the necessary and administration efforts to ease the process of write-off of damaged and expired medicine.
ABSTRAK
Latar Belakang: Kejadian obat rusak dan kadaluwarsa selalu ada di setiap mekanisme pengelolaan obat. Prosedur penghapusan obat rusak dan obat kadaluwarsa sebagai barang milik daerah belum ditetapkan secara khusus. Besarnya nilai obat rusak dan kadaluwarsa dan beban pengelolaannya secara teknis, proses penghapusan ditinjau dari aspek administrasi sebagai persediaan, belum adanya aspek legal formal menjadi permasalahan tersendiri bagi Dinas Kesehatan Kota Yogyakarta. Tujuan: Tujuan penelitian ini untuk memberikan dasar administrasi dan legal untuk prosedur penghapusan obat rusak dan obat kadaluwarsa sebagai barang milik daerah di Dinas Kesehatan Kota Yogyakarta. Metode: Penelitian ini merupakan jenis penelitian observasional dengan desain penelitian studi kasus yang bersifat deskriptif analitik. Pengumpulan data kuantitatif berupa nilai obat rusak dan kadaluwarsa. Data kualitatif diperoleh dengan cara inventarisasi data prosedur administrasi dan aspek legal penghapusan obat rusak dan kadaluwarsa serta wawancara mendalam. Hasil: Obat rusak dan kadaluwarsa yang ada di Puskesmas dikembalikan ke UPT Farmakes untuk dilakukan penghapusan dan pemusnahan bersama. Telah dilaksanakan pemusnahan dan penghapusan obat rusak dan kadaluwarsa tahun 2009, 2010, 2011 pada tahun 2012 oleh Dinas Kesehatan Kota Yogyakarta. Penghapusan obat rusak dan kadaluwarsa harus sesuai ketentuan penghapusan barang milik daerah yang berlaku, meskipun ketentuan itu belum dikhususkan untuk obat. Kesimpulan: Penghapusan obat rusak dan kadaluwarsa di Dinas Kesehatan Kota Yogyakarta mengacu kepada Permendagri No. 17 Tahun 2007 tentang Petunjuk Teknis Pengelolaan Barang Milik Daerah dan Perwali Kota Yogyakarta No. 54 Tahun 2011 tentang Pedoman Pengelolaan Barang Persediaan di Lingkungan Pemerintah Kota Yogyakarta. Namun demikian diperlukan terobosan / upaya administrasi untuk memudahkan proses penghapusan obat rusak dan kadaluwarsa.
Center for Health Policy and Management
2018-07-19 12:08:38
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/5367
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 7, No 1 (2018)
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Copyright (c) 2018 Jurnal Kebijakan Kesehatan Indonesia : JKKI
oai:jurnal.ugm.ac.id:article/6760
2018-12-02T14:39:44Z
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ISABELA, MARIA
Latar belakang: Jaminan pembiayaan persalinan disediakan bagi ibu bersalin yang ditolong oleh tenaga kesehatan di fasilitas kesehatan. Di Kabupaten Rote Ndao masih ada 492(28%) ibu yang melahirkan ditolong oleh non Nakes dan 598(27%) ibu melahirkan di rumah, ini mengakibatkan Jaminan Persalinan yang disediakan oleh pemerintah tidak digunakan/dimanfaatkan. Aksesibilitas pelayanan kesehatan merupakan faktor yang berhubungan dengan pemanfaatan jaminan persalinan tersebut, seperti yang terjadi di Ghana bahwa ibu yang tinggal jauh dari fasilitas kesehatan membutuhkan lebih banyak waktu dan upaya untuk mencapai fasilitas kesehatan.
Tujuan Penelitian: Tujuan Umum dalam penelitian ini adalah untuk mengevaluasi pemanfaatan Jampersal di Kabupaten Rote Ndao. Sedangkan Tujuan khususnya adalah mengetahui hubungan antara aksesibilitas pelayanan kesehatan dengan pemanfaatan Jampersal dan faktor-faktor lain yang turut mempengaruhi hubungan tersebut.
Metode: Penelitian observasional analitik dengan rancangan cross sectional dan metode kuantitatif didukung dengan kualitatif. Sampel penelitian adalah ibu bersalin tahun 2013 di 6 wilayah Puskesmas di Kabupaten Rote Ndao. Penentuan sampel merupakan perpaduan dari rancangan proportional stratified random sampling dan simple random sampling.
Analisis Data: Analisis kuantitatif yaitu univariat, bivariat dengan uji chi-square, serta multivariat dengan uji regresi logistik berganda dengan tingkat kemaknaan p<0,05 dan CI95%. Analisis kualitatif untuk mendukung hasil kuantatif.
Hasil : Analisis menunjukkan bahwa ada hubungan antara aksesibilitas pemanfaatan Jampersal dengan pemanfaatan Jampersal. Ibu yang memiliki aksesibilitas mudah berpeluang memanfaatkan Jampersal sebesar 8,45 kali dibandingkan dengan ibu yang memiliki aksesibilitas sulit setelah mengontrol tingkat pendidikan ibu dan status ANC.
Kesimpulan : Ibu yang memiliki aksesibilitas mudah berpeluang untuk memanfaatkan Jampersal dibandingkan ibu yang aksesibilitasnya sulit. Faktor lain yang turut berhubungan yaitu pendidikan ibu, status ANC, tingkat sosek dan pengetahuan ibu tetang Jampersal sedangkan kepemilikan askes/jamkes tidak berhubungan dengan pemanfaatan Jampersal.
Kata Kunci: Evaluasi Jaminan Persalinan, Pemanfaatan Jampersal, Aksesibilitas
Pelayanan Kesehatan.
Center for Health Policy and Management
2018-12-02 21:39:44
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https://jurnal.ugm.ac.id/jkki/article/view/6760
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 7, No 3 (2018)
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oai:jurnal.ugm.ac.id:article/9235
2018-01-30T05:14:02Z
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Giamto, Kristian Wongso
Background: Malaria is one of high burden infectious diseases for tropical-subtropical areas worldwide, such as Indonesia, especially in the eastern Indonesia. Malaria eradication once failed in late 1960s, now re-emerge after a commitment statement of Bill Gates in 2007. Now, Indonesia also targeting malaria elimination in 2030. Objective: To determine the feasibility of Malaria Elimination Program 2030, especially in Indonesia with existing modalities to combat malaria. Methods: This paper uses data, ranging 2000-2016, which selected from MEDLINE journal portal and other sources, which found to be relevant with topics, yet reliable. Results and Discussion: Malaria eradication can not be equalized to smallpox's, which has characteristics those very supportive in putting it to be eradicated (such as no subclinical infection and do not involve vector). Until now, issues of fake antimalarial drugs, forest malaria, financing commitment and healthcare service in rural parts of Indonesia remain unanswered and managed optimally. It also appears that medical advances can not contribute optimally without being supported by strategic policies. Conclusion and Suggestions: With existing modalities and situation, malaria control still difficult to be achieved in Indonesia. This will cause malaria eradication program in 2030 as less realistic target. Malaria eradication as a target may be worth to be reconsidered. Malaria control as target may be a more realistic alternative. More advanced studies regarding obstacles in managing malaria in Indonesia and its solutions are mandatory.
Center for Health Policy and Management
2018-01-22 15:26:13
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Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 4 (2017)
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Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/9917
2018-12-14T07:38:57Z
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Andiyanto, Budi
Trinantoro, Laksono
Kurniawan, Muhammad Faozi
Latar belakang : Penyelenggaraan pelayananan kesehatan RSUD Prof. DR. H.M. Chatib Quzwain Kabupaten Sarolangun masih jauh dari harapan, salah satunya penyebabnya masih minimnya anggaran yang diberikan pemerintah daerah untuk membiayai kebutuhan dalam menjalankan tugasnya sebagai pusat rujukan pelayanan kesehatan. Perubahan status RSUD Prof. DR. H.M. Chatib Quzwain menjadi Badan Layanan Umum Daerah (BLUD) secara penuh melalalui Keputusan Bupati Sarolangun No.367/RSUD/2013, memberikan kemudahan berupa fleksibilatas pengelolaan keuangan. Disisi lain ada pendapat yang over estimate dari pemerintah daerah terhadap keberadaan BLUD, Pemerintah daerah beranggapan dengan adanya perubahan menjadi BLUD, rumah sakit akan benar-benar mandiri dan lepas dari beban pembiayaan pemerintah daerah, termasuk belanja modal bahkan pembayaran gaji pegawai. Menurut Trisnantoro (2009) Perubahan menjadi BLU bersifat public good, bukan private good, Rumah sakit BLU mempunyai pelayanan yang menjadi tanggung jawab negara Sehingga diperlukan subsidi yang berkelanjutan.
Tujuan:Tujuan penelitian ini adalah menganalisis kebijakan Subsidi di RSUD Prof. DR. H.M. Chatib Quzwain setelah menjadi Badan Layanan Umum Daerah (BLUD) Tahun 2015.
Metode: Penelitian ini merupakan riset kebijakan secara kualitatif dengan rancangan studi kasus untuk menganalisis kebijakan, yang difokuskan pada aktor kebijakan, konteks, isi, dan proses kebijakan.
Hasil: Subsidi yang diterima di RSUD Prof. DR. H.M. Chatib Quzwain setelah menjadi Badan Layanan Umum Daerah (BLUD), berupa biaya opersasional dan belanja pegawai;Stakeholder di Kabupaten Sarolangun yang berperan aktif dalam proses kebijakan Subsidi di RSUD Prof. DR. H.M. Chatib Quzwain sesuai dengan tugas, pokok dan fungsinya masing-masing; Faktor konteks kebijakan yang mempengaruhi adalah perubahan status RSUD Prof. DR. H.M. Chatib Quzwain menjadi BLUD dengan status Penuhdan faktor ekonomi yang dipengaruhi oleh kemampuan keuangan daerah Kabupaten Sarolangun; Konten/isi kebijakan Subsidi di RSUD Prof. DR. H.M. Chatib Quzwain hingga saat ini belum ada.Proses kebijakan kebijakan Subsidi di RSUD Prof. DR. H.M. Chatib Quzwain dilakukan secara top down dari Pemerintah Daerah.
Kesimpulan: kebijakan Subsidi di RSUD Prof. DR. H.M. Chatib Quzwain setelah menjadi Badan Layanan Umum Daerah (BLUD) sebaiknya diberikan berkelanjutan karena rumah sakit merupakan pelayanan publik yang sifatnya public goods.
Kata Kunci : Analisis Kebijakan, Subsidi, Rumah Sakit
Center for Health Policy and Management
2018-12-14 14:38:57
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Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 7, No 4 (2018)
ind
Copyright (c) 2018 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/10013
2018-07-19T05:08:38Z
jkki:ART
"180301 2018 eng "
2620 4703
2089 2624
dc
Jairani, Eka Nenni
Hartriyanti, Yayuk
Nurdiati, Detty S.
Hasanbasri, Mubasysyir
Background: The coverage of exclusive breastfeeding in Indonesia is still not satisfactory. Based on data from Riskesdas in 2010, exclusive breastfeeding coverage 31,0% and 30,2% in 2013. As for the less than an hour process of breastfeed in 2010 amounted to 29.3% and 34.5% in 2013. Some policies those concerning about exclusive breastfeeding and early initiation of breastfeeding has been established. The established policies at the central level should be implemented and under surveillance in order to have an impact and achieve the goals set. There are many factors that influence the process of implementation including implementing perception, communication, budget, resources, facilities and infrastructure, bureaucratic structures, and unclear technical implementation guidelines. Objective: This research aimed to obtain a representation of the implementation of exclusive breastfeeding policy at Binjai city North Sumatera as well as surveillance and the factors that influence its implementation. Methods: This research use a qualitative method with case study approach. Data collected by indepth interviews, focus groups discussion, observation and document study. Results: Implementation of exclusive breastfeeding policy is still not implemented. This can be seen by inexistence of surveillance to the policy implementation and there are different interpretations in implementing the policy by the policy implementers. Moreover, there is no communication channel, basic quantity of budget, the training for midwives, facilities and supporting infrastructure, bureaucratic structure, as well as the guidelines of technical implementation in this implementation of policy. Conclusion: The implementation of exclusive breastfeeding policy should be initiated with the establishment of derivative policies at the local level so that there are clear regulations in the implementation.
ABSTRAK
Latar Belakang: Cakupan ASI eksklusif di Indonesia masih belum memuaskan. Berdasarkan data Riskesdas 2010 cakupan ASI eksklusif sebesar 31,0% dan 30,2% pada tahun 2013. Sedangkan untuk proses menyusu kurang dari satu jam (IMD) pada tahun 2010 sebesar 29,3% dan pada tahun 2013 sebesar 34,5%. Beberapa kebijakan mengenai ASI eksklusif dan Inisiasi Menyusu Dini (IMD) telah ditetapkan pemerintah. Kebijakan yang telah ditetapkan dengan baik di tingkat pusat seharusnya diimplementasikan dan dilakukan pengawasan dalam proses implementasinya, agar mempunyai dampak dan mencapai tujuan yang telah ditetapkan. Ada banyak faktor yang mempengaruhi proses implementasi diantaranya persepsi pelaksana, komunikasi, anggaran, sumber daya, sarana dan prasarana, struktur birokrasi, dan pedoman pelaksanaan teknis yang kurang jelas. Tujuan: Penelitian ini bertujuan untuk memperoleh gambaran implementasi kebijakan ASI Eksklusif di Kota Binjai Sumatera Utara serta pengawasannya dan faktor-faktor yang mempengaruhi implementasinya. Metode: Penelitian ini menggunakan metode kualitatif dengan pendekatan studi kasus. Penelitian dilaksanakan di Puskesmas Binjai Kota pada bulan Mei-Juni 2015. Pengumpulan data dilakukan dengan indepth interview, focus group discussion, observasi, dan studi dokumen. Hasil: Implementasi kebijakan ASI Eksklusif masih belum dilaksanakan dengan baik. Tidak adanya pengawasan terhadap implementasi kebijakan, penafsiran yang berbeda dalam mengimplementasikan kebijakan oleh implementer kebijakan. Selain itu tidak adanya saluran komunikasi, besaran anggaran, pelatihan bagi bidan, sarana dan prasarana pendukung, struktur birokrasi, serta pedoman pelaksanaan teknis, menyebabkan belum tercapainya tujuan kebijakan yang diharapkan. Kesimpulan: Implementasi kebijakan ASI Eksklusif sebaiknya diawali dengan dibuatnya kebijakan turunan di tingkat daerah sehingga ada regulasi yang jelas dalam pelaksanaannya.
Center for Health Policy and Management
2018-07-19 12:08:38
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/10013
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 7, No 1 (2018)
ind
Copyright (c) 2018 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/12090
2018-12-02T14:39:44Z
jkki:ART
"180901 2018 eng "
2620 4703
2089 2624
dc
Wijayani, Rina Wahyu
Implementasi Program Jaminan Kesehatan Nasional (JKN) memberikan kemudahan masyarakat dalam menikmati layanan kesehatan yang disediakan oleh Pemerintah dan bertujuan mewujudkan Universal Health Coverage bagi seluruh rakyat Indonesia. JKN membawa perubahan sistem pembiayaan kesehatan dari Fee For Service Payment (FFS) menjadi Prospective Payment System (PPS) dengan sistem paket INA CBG’s. Ketakutan bahwa JKN merugikan Rumah Sakit tidak berlaku untuk 31 Rumah Sakit Vertikal Kementerian Kesehatan. setelah implementasi JKN terjadi kenaikan pada pendapatan khususnya pendapatan layanan secara rata-rata pada 31 Rumah Sakit Vertikal Kementerian Kesehatan. Terjadi penurunan yang drastis juga pada masa penagihan piutang. Likuiditas Rumah Sakit Vertikal Kementerian Kesehatan sangat tinggi terlebih setelah JKN diimplementasikan. Likuiditas tinggi belum tentu baik karena dapat diartikan lemahnya manajemen kas.
Center for Health Policy and Management
2018-12-02 21:39:44
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/12090
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 7, No 3 (2018)
ind
https://jurnal.ugm.ac.id/jkki/article/download/12090/23725
Copyright (c) 2018 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/12186
2018-07-19T05:08:38Z
jkki:ART
"180719 2018 eng "
2620 4703
2089 2624
dc
Situmeang, Lena Elfrida
Hidayat, Budi
Background: Indonesia’s health development geared to achieve national health insurance scheme (JKN). However, funding of health in Indonesia is still dominated by domestic funding through out-of-pocket (OOP). Objective: Catastrophic health expenditure of households will disrupt household consumption and can lead to poverty. Using secondary data of the National Social Surveys 2 (Susenas) 2012, this study aims to prove health insurance ownership lowers catastrophic health expenditure of households in Indonesia in 2012. Methods: This study used a cross-sectional study design with models probit and bivariate probit. Results: The results found that the health insurance ownership lowers catastrophic health expenditure amounted 12.97% at the threshold 10% of total expenditure and amounted 18.42% at 20% of total non-food expenditure. Conclutions: Health insurance ownership provides protection for catastrophic health expenditure in Indonesia in 2012.
ABSTRAK
Latar Belakang: Pembangunan kesehatan Indonesia diarahkan untuk mencapai Jaminan kesehatan Nasional (JKN). Namun, sebagian besar pendanaan kesehatan masih didominasi oleh rumah tangga melalui out-of-pocket (OOP). Pengeluaran biaya kesehatan katastrofik rumah tangga akan mengganggu konsumsi rumah tangga dan dapat mengakibatkan kemiskinan. Tujuan: Menggunakan data sekunder Survei Sosial Nasional (Susenas) tahun 2012, penelitian ini bertujuan membuktikan bahwa kepemilikan jaminan kesehatan menurunkan belanja kesehatan katastrofik rumah tangga di Indonesia tahun 2012. Metode: Penelitian dengan desain studi potong lintang ini, menggunakan pendekatan ekonometrik dengan model probit dan bivariat probit. Hasil: Hasil penelitian menunjukkan bahwa kepemilikan jaminan kesehatan menurunkan belanja kesehatan katastrofik sebesar 12.97% pada ambang batas 10% dari total pengeluaran dan sebesar 18.42% pada ambang batas 20% total pengeluaran non-makanan. Kesimpulan: Kepemilikan jaminan kesehatan memberikan perlindungan terhadap belanja kesehatan katastrofik di Indonesia pada Tahun 2012.
Center for Health Policy and Management
2018-07-19 12:08:38
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/12186
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 7, No 1 (2018)
ind
Copyright (c) 2018 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/12194
2018-07-19T05:08:38Z
jkki:ART
"180301 2018 eng "
2620 4703
2089 2624
dc
Sugiharto, Fitria
Achadi, Anhari
Background: As the consequence of Competency-Based Curriculum (KBK) implementation, Indonesia Medical Internship Program (PIDI) has been conducted since 2010 as a continuation of the medical education. In practice, a number of pros and cons emerges from the various parties among students, education institutions, professional organizations , and the general public. Objective: This study aimed to analyze the policy of PIDI Methods: through a retrospective approach. Results: The results showed the stage of agenda-setting and policy formulation has been relatively well conducted but not optimal in the legitimacy and implementation phases. Conclusion: The role of policy actors have not been clearly delegated with the strong legal protection and details of functions. Therefore, it is recommended to do a comprehensive evaluation of the implementation of PIDI involving the key stakeholders.
Abstrak
Latar Belakang: Program Internsip Dokter Indonesia (PIDI) diimplementasikan sejak tahun 2010 sebagai kelanjutan pendidikan profesi setelah diimplemetasikannya kurikulum berbasis keompetensi (KBK) di Indonesia. Dalam pelaksanaannya, sejumlah pro-kontra muncul dari berbagai pihak di antaranya mahasiswa, institusi pendidikan, organisasi profesi, dan masyarakat umum. Tujuan: Penelitian ini bertujuan untuk menganalisis kebijakan PIDI Metode: melalui pendekatan retrospektif. Hasil: Hasil penelitian menunjukkan tahapan pengagendaan kebijakan dan formulasi yang relatif baik namun kurang optimal pada saat legitimasi dan implementasi kebijakan. Kesimpulan: Peran aktor kebijakan terpotret belum terdelegasi dengan payung hukum dan rincian fungsi yang kuat. Oleh karenanya, direkomendasikan untuk dilakukan evaluasi komprehensif terhadap pelaksanaan PIDI yang melibatkan stakeholder kunci.
Center for Health Policy and Management
2018-07-19 12:08:38
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/12194
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 7, No 1 (2018)
ind
Copyright (c) 2018 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/13282
2017-05-27T05:00:37Z
jkki:ART
oai:jurnal.ugm.ac.id:article/17620
2018-10-01T07:27:15Z
jkki:ART
"180711 2018 eng "
2620 4703
2089 2624
dc
Rahmah, Miftahul Jannati
Latar Belakang: Indonesia merupakan negara penyumbang perokok terbesar diantara Negara-Negara di ASEAN, 53 % dari seluruh perokok di ASEAN ada di Indononesia, dengan 67,4% adalah perokok laki-laki dan 4.5% adalah perokok wanita. Dari berbagai penelitian, perokok wanita memiliki risiko kesehatan lebih banyak dari pada perokok laki-laki, terutama pada wanita yang memiliki usia subur. Karena, bahaya yang ditimbulkan tidak hanya untuk dirinya namun untuk anak yang akan dilahirkannya juga. Banyak determinan yang mempengaruhi perilaku merokok pada wanita di Indonesia, salah satunya adalah faktor predisposisi yang didalamnya berisi tentang faktor sosiodemografis dan faktor enabling salah satunya adalah kepuasan hidup. Penelitian ini bertujuan untuk mengetahui determinan sosiodemografis pada perilaku merokok wanita usia subur
Metode: Penelitian ini merupakan penelitian kuantitatif menggunakan analisis data sekunder Indonesian Family Life Survey (IFLS) 2014 dengan unit kebiasaan merokok pada wanita dan desain cross sectional. Data IFLS 2014 diambil dari 13 provinsi.
Hasil: Wanita yang tidak menikah memiliki peluang lebih tinggi menjadi perokok (OR=2,3;95%CI=1,52-3,35). Wanita yang berada di Desa lebih rentan menjadi perokok (OR=1,41; 95%CI=1,12-1,73). Wanita bekerja memiliki peluang lebih rendah menjadi perokok (OR=0,65; 95%CI=0,52-0,82). Dan wanita yang merasa puas terhadap hidupnya memiliki peluang lebih tinggi menjadi perokok (OR=2,3 ;95% CI=1,77-2,97)
Kesimpulan: Penelitian ini menemukan adanya hubungan yang kuat antara status marital, status pekerjaan, domisili dan kepuasan hidup dengan perilaku merokok pada wanita usia subur.
Center for Health Policy and Management
2018-10-22 13:07:42
https://jurnal.ugm.ac.id/jkki/article/view/17620
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 7, No 2 (2018)
ind
Copyright (c) Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/17936
2018-07-19T05:08:38Z
jkki:ART
"180301 2018 eng "
2620 4703
2089 2624
dc
Usman, Nazmi
Indonesia dengan wilayah yang luas dan jumlah penduduk yang terus berkembang menyebabkan kebutuhan akan kesehatan, termasuk perbekalan kesehatan, juga meningkat, ditambah dengan adanya program Jaminan Kesehatan Nasional (JKN). Salah satu kebutuhan perbekalan kesehatan yang kebutuhannya meningkat adalah alat kesehatan. Akan tetapi, saat ini alat kesehatan yang beredar di Indonesia 90% merupakan alat kesehatan impor. Terus meningkatnya kebutuhan dan besarnya pasar alat kesehatan serta program Pemerintah dalam mewujudkan kemandirian ekonomi dengan menggerakkan sektor-sektor strategis ekonomi domestik, maka Pemerintah menetapkan industri alat kesehatan sebagai salah satu industri prioritas untuk dikembangkan
Penelitian ini dilakukan dengan metode penelitian kualitatif dimana informasi didapatkan dengan cara wawancara mendalam dan pengumpulan data. Informan yang diwawancara berasal dari kementerian Kesehatan, Kementerian Perindustrian, ASPAKI, FKUI dan PERSI.
Implementasi kebijakan pengembangan industri alat kesehatan dalam negeri ini sudah berjalan cukup baik, antara lain dalam hal komunikasi dan koordinasi serta komitmen pemerintah untuk melaksanakan kebijakan tersebut. Akan tetapi, implementasi ini juga belum optimal karena dalam implementasi kebijakan tersebut masih banyak kekurangan atau hambatan dalam pelaksanaannya antara lain dari segi SDM dan kepercayaan masyarakat terhadap produk alat kesehatan dalam negeri.
Center for Health Policy and Management
2018-07-19 12:08:38
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/17936
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 7, No 1 (2018)
ind
Copyright (c) 2018 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/18051
2018-12-02T14:39:44Z
jkki:ART
"180901 2018 eng "
2620 4703
2089 2624
dc
Rahman, Ngabila Salama
Puskesmas Duren Sawit mengalami peningkatan kunjungan pasien hipertensi peserta JKN yang kemudian dirujuk ke fasilitas kesehatan tingkat lanjut. Tujuan penelitian untuk mengevaluasi efektivitas Puskesmas Duren Sawit sebagai gatekeeper dalam penanganan pasien hipertensi peserta JKN. Penelitian ini menggunakan metode kualitatif dengan melakukan wawancara mendalam kepada petugas terkait dan FGD kepada pasien hipertensi. Kerangka pikir dasar penelitian dengan menganalisis unsur fasilitas kesehatan dan unsur pasien. Hasil penelitian menunjukkan puskesmas belum melakukan penanganan pasien JKN penderita hipertensi secara komprehensif. Hal ini ditunjukkan dengan belum adanya poliklinik khusus PTM, SOP khusus penanganan hipertensi, kurangnya promosi kesehatan terkait hipertensi di luar dan di dalam gedung, serta belum memanfaatkan sistem informasi manajemen dalam penanganannya. Penelitian ini menyimpulkan bahwa keputusan merujuk pasien didasari adanya komplikasi pasien, kurangnya ketersediaan obat, sarana pendukung yang kurang optimal, dan kurangnya promosi kesehatan. Diharapkan puskesmas dapat mengembangkan skema penanganan pasien hipertensi lebih komprehensif, BPJS kesehatan dapat memberikan reward kepada puskesmas bila melakukan penanganan penderita hipertensi secara kontinu, dan dinas kesehatan mampu berkomitmen untuk mengembangkan program KPLDH.
Center for Health Policy and Management
2018-12-02 21:39:44
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/18051
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 7, No 3 (2018)
ind
https://jurnal.ugm.ac.id/jkki/article/download/18051/0
https://jurnal.ugm.ac.id/jkki/article/download/18051/35973
Copyright (c) 2018 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/19093
2018-09-28T14:50:09Z
jkki:ART
"180711 2018 eng "
2620 4703
2089 2624
dc
Nadiyah, Husnun
Program JKN bertujuan memberikan perlindungan kesehatan dalam bentuk manfaat pemeliharaan kesehatan untuk memenuhi kebutuhan dasar kesehatan. Jumlah kepesertaan JKN tahun 2015 di Kota Samarinda saat ini sebanyak 398.135 atau 40,25% dari jumlah penduduk Kota Samarinda tahun 2015
Center for Health Policy and Management
2018-10-22 13:07:42
https://jurnal.ugm.ac.id/jkki/article/view/19093
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 7, No 2 (2018)
ind
Copyright (c) Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/25038
2018-04-14T04:18:46Z
jkki:ART
"120901 2012 eng "
2620 4703
2089 2624
dc
Hasanbasri, Mubasysyir
https://scholar.google.co.id/citations?user=cNLJ2XAAAAAJ&hl=en http://orcid.org/0000-0003-2972-6916
Jika mempelajari policy making process, kita belajar tentang rational choice theory - bahwa setiap individu dalam organisasi akan mengutamakan kepentingan pribadi mereka. Dalam implementasi, kepentingan dari penduduk sering dikalahkan oleh kepentingan pribadi dari penyelenggara layanan. Jadi implementasi kebijakan sering gagal karena adanya kepentingan pribadi dari penyelenggara layanan. Implementasi kebijakan bagian penting dari policy analysis. Jika kebijakan berhasil dibuat dengan susah payah, tidak selalu berarti kebijakan itu akan terimplementasi begitu saja. Ada banyak tantangan yang membuat kebijakan itu tidak berarti apa-apa - kebijakan di atas kertas - tidak ada implementasinya. Kebijakan yang gagal jika implementasinya tidak ada. Kegagalan implementasi adalah termasuk kegagalan kebijakan. Implementasi adalah ranah dari manajer program. Jika kebijakan ingin berhasil, ia membutuhkan manajer yang efektif. Mereka membuat kebijakan menjadi operasional dan dapat menyajikan layanan kepada penduduk yang membutuhkannya.
Center for Health Policy and Management
2012-10-14 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/25038
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 1, No 3 (2012)
ind
Copyright (c) 2012 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/25041
2017-10-09T15:46:00Z
jkki:ART
"120416 2012 eng "
2620 4703
2089 2624
dc
Suryati, Siti
Hasanbasri, Mubasysyir
https://scholar.google.co.id/citations?user=cNLJ2XAAAAAJ&hl=en http://orcid.org/0000-0003-2972-6916
Padmawati, Retna Siwi
Rumah sakit pada umumnya bergerak kearah sistem manajemen berdasarkan konsep usaha yang mengarah pada mekanisme pasar dan prinsip efisiensi. Kepedulian terhadap para pelanggan ditunjukkan dengan adanya mekanisme untuk mengenali apa yang dipersyaratkan oleh pelanggan dan ditujukkan dalam perilaku pemberi layanan yang mencerminkan tata nilai yang berlaku dalam organisasi. Indikator pelayanan (BOR) di RSUD Panembahan Senopati Bantul 89,28%, hal ini menunjukkan bahwa pemanfaatan tempat tidur sudah melebihi standar yang ada. Kondisi demikian ini apabila tidak disertai dengan pelayanan yang bermutu baik dari sisi sarana dan prasarana termasuk pengelolaan manajemennya, bukan tidak mungkin akan mengalami hal-hal yang tidak diinginkan.
Tujuan penelitian ini adalah untuk mengetahui strategi penanganan keluhan pelanggan dan bagaimana keluhan pelanggan dikelola dalam rangka pelaksanaan sistem manajemen mutu di RSUD Panembahan Senopati Bantul
Penelitian studi kasus dengan subyek penelitian pelanggan rawat jalan dan rawat inap dipilih secara purposive sampling dan wawancara terhadap manajemen meliputi direktur, kepala bagian pengembangan, humas, serta melakukan observasi. Analisa data dilakukan secara deskriptif dan kualitatif.
Pemerintah Kabupaten dan direksi telah mengimplementasikan Total Quality Management, walaupun belum dilaksanakan secara optimal. Prosedur tetap dan tim khusus yang menangani keluhan belum semuanya ada. Berbagai macam fasilitas untuk menyampaikan keluhan telah tersedia antara lain melalui kotak saran, SMS center, telephone, web, email, dialog melalui radio maupun televisi, dan media cetak. Pelanggan eksternal lebih menyukai penyampaian langsung apabila ada keluhan, namun kenyataannya pelanggan eksternal lebih banyak menyampaikan keluhan melalui SMS center. Cara penanganan keluhan yang sudah ditetapkan oleh direktur belum dilaksanakan secara totalitas terutama dalam hal tindak lanjut.
Agar pengelolaan keluhan pelanggan dapat dilaksanakan secara optimal maka perlu ada tim khusus atau unit yang menangani keluhan dilengkapi dengan prosedur tetap dan pelaksanaan prosedur tetap tersebut di semua lini.
Center for Health Policy and Management
2012-04-16 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/25041
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 1, No 2 (2012)
ind
Copyright (c) 2012 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/25042
2018-04-14T04:18:46Z
jkki:ART
"180414 2018 eng "
2620 4703
2089 2624
dc
Rejeki, Lucia Sri
Hasanbasri, Mubasysyir
https://scholar.google.co.id/citations?user=cNLJ2XAAAAAJ&hl=en&oi=sra http://orcid.org/0000-0003-2972-6916
Sanjaya, Guardian Yoki
https://scholar.google.co.id/citations?user=ZQ32ALkAAAAJ&hl=en
Health Center’s Role Alert Village’s Development in Bantul Regency
Background: Alert village is a village where the residents have the readiness of resources, the ability, and the intention to independently prevent and overcome health problems or threats, disaster, and emergency. Health center has a duty as the facilitator of the alert village’s development, where besides providing basic medical care, health center is expected to be able to carry out the mobilization and the community empowerment. If the facilitation process succeeded, it can evoke intentions and community independence in health, so that alert village’s liveliness comes from community’s initiative and is not from health center. This kind of development strategy leads to community development. Objective: This research aims to review the role of health center within alert village’s development, especially towards the facilitation of alert village’s development. Method: This research uses the qualitative descriptive method along with a case study design, to describe health center’s perception towards alert village’s development and health center’s role as the alert village’s facilitator. The subjects of this research are the heads of health centers and midwife coordinators, as well as the community leaders: the heads of the public’s welfare affair and the chief of village’s women organization. The datas are collected through in-depth interviews. Results: This research showed various activities of Community-Based Health Efforts as the form of alert village’s implementation. The facilitation which health center provides to actualize active alert village had not showed community development, but rather a social mobilization. The obstructions are that health center has not been provided with facilitation techniques and the community’s culture is less independent in health. Conclusion: Alert village’s development towards community development has not been utterly well responded by the community.
Keywords: Facilitation, Alert village, Community development.
Latar Belakang: Pengembangan masyarakat menjadi salah satu topik yang paling populer didalam konteks intervensi ke- sehatan masyarakat. Di Indonesia, Desa Siaga merupakan ben- tuk pengembangan masyarakat di bidang kesehatan. Desa Sia- ga adalah desa yang penduduknya memiliki kesiapan sumber- daya dan kemampuan serta kemauan untuk mencegah dan mengatasi masalah/ancaman kesehatan, bencana dan kega- watdaruratan secara mandiri. Puskesmas memiliki tugas seba- gai fasilitator pengembangan desa siaga, dimana selain mem- berikan pelayanan medis dasar, diharapkan mampu melaksana- kan tugas penggerakan dan pemberdayaan masyarakat. Fasili- tasi pengembangan desa siaga ini tergantung kemampuan pus- kesmas, disini diharapkan puskesmas mampu menerapkan prin- sip-prinsip fasilitasi yang efektif. Apabila proses fasilitasi ber- hasil akan menumbuhkan kemauan dan kemandirian masya- rakat di bidang kesehatan, sehingga keaktifan desa siaga ber- asal dari inisiatif masyarakat bukan dari puskesmas. Fasilitasi pengembangan seperti ini mengarah pada community devel- opment. Tujuan: Penelitian ini bertujuan untuk melakukan kajian terha- dap peran puskesmas dalam fasilitasi pengembangan desa siaga. Metode: Penelitian ini menggunakan metode deskriptif kualitatif dengan rancangan studi kasus, untuk mendeskripsikan peran puskesmas sebagai fasilitator desa siaga. Subyek penelitian adalah kepala puskesmas dan bidan koordinator, serta tokoh masyarakat : kepala bagian kesejahteraan rakyat desa, ketua Tim Penggerak PKK desa, dan kader kesehatan. Data dikumpul- kan melalui wawancara mendalam dan observasi. Hasil: Desa siaga telah dilaksanakan dengan berbagai kegiatan Upaya Kesehatan Bersumberdaya Masyarakat (UKBM), namun belum semuanya berjalan seperti yang diharapkan. Puskesmas telah berupaya dalam mendampingi pengembangan desa siaga, namun fasilitasi yang dilakukan puskesmas belum mewujudkan community development, melainkan lebih kearah mobilisasi sosial. Kesimpulan: Pengembangan desa siaga kearah community development belum terwujud dalam masyarakat.
Kata Kunci : Fasilitasi, Desa siaga, Community development.
Center for Health Policy and Management
2012-10-14 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/25042
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 1, No 3 (2012)
ind
Copyright (c) 2012 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/25043
2017-10-09T15:45:15Z
jkki:ART
"130516 2013 eng "
2620 4703
2089 2624
dc
Tambun, Elfrida
Hasanbasri, Mubasysyir
https://scholar.google.co.id/citations?user=cNLJ2XAAAAAJ&hl=en http://orcid.org/0000-0003-2972-6916
Latar belakang: Faktor ekonomi merupakan salah satu faktor yang menghambat akses masyarakat dalam pemanfaatan pelayanan kesehatan. Dalam upaya menjamin akses masyarakat miskin terhadap pelayanan kesehatan pemerintah menyelenggarakan jaminan kesehatan masyarakat. Adanya keterbatasan jam kerja puskesmas mengakibatkan jam pelayanan terbatas. Mengatasi hal ini pemerintah menetapkan praktek bidan swasta salah satu pelayanan kesehatan yang dapat digunakan masyarakat miskin dengan biaya pelayanan ditanggung oleh pemerintah. Kebijakan pemerintah ini belum berhasil meningkatkan cakupan pertolongan persalinan oleh tenaga kesehatan. Untuk itu perlu dilakukan suatu evaluasi untuk mengetahui fenomena yang terjadi di masyarakat agar dapat dicarikan pemecahan masalah dalam upaya perbaikan pelayanan kesehatan di masa mendatang.
Tujuan Penelitian: Untuk mengetahui gambaran implementasi kebijakan pertolongan persalinan bagi masyarakat miskin oleh bidan swasta di Kota Tanjungpinang.
Metode: Jenis penelitian ini adalah penelitian deskriptif dengan pendekatan kualitatif dengan rancangan studi kasus. Subjek penelitian adalah bidan PNS yang melakukan praktek kebidanan, Kepala Puskesmas, Kepala Dinas Kesehatan, Kepala Bidang Kesehatan Keluarga, dan ibu bersalin pengguna kartu askeskin. Pemilihan responden untuk bidan dan ibu bersalin digunakan tehnik purposive sampling. Jenis data yang dikumpulkan meliputi data primer yang diperoleh dari hasil wawancara mendalam dengan menggunakan panduan wawancara, sedangkan data sekunder diperoleh dengan telaah dokumen. Data dianalisis secara kualitatif.
Hasil: Kebijakan persalinan masyarakat miskin di Kota Tanjungpinang belum mendapat dukungan secara optimal dari pemerintah daerah. Plafon biaya yang kecil membuat tidak semua bidan bersedia menolong pasien askeskin dengan klaim biaya ke puskesmas. Bidan praktek swasta melakukan iur biaya dari pasien askeskin. Tidak ada perbedaan jenis pertolongan yang diberikan bidan praktek swasta antara pasien askeskin dan masyarakat umum. Pasien askeskin merasa puas dengan pelayanan yang diberikan bidan praktek swasta.
Kesimpulan:
Bidan praktek swasta tidak semuanya bersedia memberikan pelayanan pertolongan persalinan bagi masyarakat miskin dengan mengajukan klaim ke puskesmas. Dukungan Pemerintah Kota Tanjungpinang terhadap implementasi askeskin diwujudnyatakan dengan pengembangan dua unit puskesmas menjadi puskesmas perawatan. Pelayanan pertolongan persalinan bagi masyarakat miskin yang diberikan bidan praktek swasta tidak berbeda dengan pasien umum. Plafon klaim biaya jasa persalinan bagi masyarakat miskin dinilai para bidan praktek swasta terlalu minim dan mengakibatkan adanya iur biaya dari pasien. Pengajuan klaim biaya jasa pertolongan persalinan oleh bidan praktek swasta cepat dan mudah.
ABSTRACT: BIrth delivery practices for the poor in Tanjung Pinang Indonesia: evaluation of private midwife practitioners
Background: Economy factor is one of the factors that could hampered community’s access in the utilization of health service. In the guarantee effort of poor community access toward health service, the government was conducted managed program. The limitation of working hours in primary health care was causing limited service hours. Therefore, in order to solve the problem, the government stated that private midwife practice as one of the health services could be utilized by poor community with budget that was covered by government. The government’s policy has not yet able to improve the coverage of delivery attendant by health care provider. Hence, an evaluation to find out the phenomenon occurred in the community is necessary to solve this problem in order to improve the health service in the future.
Objective: This research was aimed to find out the description of delivery assistance policy implementation for poor community by private midwife in Tanjungpinang Municipality.
Method: This was a descriptive research that used qualitative approach with case study design. The research subject was civil servant midwife who had midwifery practice, head of primary health care, head of health office, head of family health division, and mothers who delivered and had askeskin (health insurance for poor community) card. The selection for midwife and mothers who delivered was using purposive sampling technique. Furthermore, the data was collected by using primary data that was obtained from indepth interview result that used interview guidance, while the secondary data was obtained from document observation, and the data will be analysed qualitatively.
Result: The policy of delivery for poor community in Tanjungpinang Municipality has not yet obtained optimal support.The small bugdet availability affected not all of the midwives were willing to assist askeskin patient with cost claim to primary health care. Private practice midwife asked for fee from askeskin patient. There was no difference the treatment given between askeskin patient and common people. However, askeskin patient was satisfied with the service given by private practice midwife.
Conclusion: The implementation of delivery policy for poor community by private practice midwife has not yet optimal as there was a lack of support from municipality government, administratively or financially.
Center for Health Policy and Management
2014-01-17 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/25043
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 2, No 2 (2013)
ind
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/25044
2017-05-31T18:40:29Z
jkki:ART
"150416 2015 eng "
2620 4703
2089 2624
dc
Wirawan, Widodo
Hasanbasri, Mubasysyir
https://scholar.google.co.id/citations?user=cNLJ2XAAAAAJ&hl=en http://orcid.org/0000-0003-2972-6916
Hakimi, Mohammad
ABSTRACT Background: Government limitations in the implementation of health care becomes an obstacle to modify individual factors in utilizing community MCH services. The private setor, such as private hospitals, has their own role in MCH services. This role can not be ignored because the number of private hospitals is more than the number of public hospital and the growth is also faster.. Objectives: This study was conducted to explore and understand the participation of the private hospitals in the government’s MCH program through case studies in Yogyakarta Islamic Hospital PDHI, and exploring the feasibility of private hospitals as a service provider of the MCH program.. Method: The study used a qualitative method with case study design. The variables measured were the resources, participation, barriers and challenges, as well as the strategic value. Data is collected through in-depth interviews to respondents from PDHI Foundation board, directors, manager, medical staffs, and the patient or their family, as well as field observations, and document tracking. Result: Private hospital has a major role in government MCH program through MCH services its self, facilities and infrastructure, and resources doctors and paramedics. Private hospitals encountered the obstacles in implementing MCH programs, such as the amount of government insurance payments that are not in accordance with the cost of private hospital services and there is tariff discrimination based on hospital class. The government also is not optimal in socializing MCH program guideline in private hospitals, while the referral systems between health facilities are still not smooth. Conclusion: The participation of the private hospitals in the MCH program is not optimal, influenced by financing for MCH programs, weak referral systems, and government lack of facilitation for the infrastructure development and medical personnel, and lack of socialization MCH program guideline
Center for Health Policy and Management
2015-04-16 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/25044
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 4, No 1 (2015)
ind
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/25045
2017-05-28T01:51:35Z
jkki:ART
oai:jurnal.ugm.ac.id:article/25334
2017-05-25T00:38:38Z
jkki:ART
"170525 2017 eng "
2620 4703
2089 2624
dc
Firmana, Andri Satriadi
Hasanbasri, Mubasysyir
https://scholar.google.co.id/citations?user=cNLJ2XAAAAAJ&hl=en http://orcid.org/0000-0003-2972-6916
Irawati, Susi
ABSTRACT
Background: 2015 is known as the last year from the worldwide agenda called Millennium Development Goals (MDGs). One of amongst MDGs pledge is to ensure environmental sustainability, which aimed to reduce the proportion of the population without sustainable access to safe drinking water and basic sanitation to halves (Goal 7, Target 7C). The condition in West Sumbawa Regency shows that the implementation of Community-Based Total Sanitation had not fulfilled its five pillars due to limited funding resources.
Goals: To understand the funding mechanism of Community- Based Total Sanitation program under the Health Department of West Sumbawa Regency
Research Method: This research classified as descriptive research with qualitative method and the case study design to describe the program financing of the Community-Based Total Sanitation Program under the Health Department of West Sumbawa Regency. The sampling is purposive sampling method and; in depth interview and document review are used to collect the data.
Result: The STBM program under the Health Department are successfully conducted, as shown by the 100% realization of the funds utilization in which most of the fund allocated to the triggering workshop. The establishment of program priority based on the health department’s strategic plan, minimum service standard (IPM), and MDGs whereas the program related to people’s life expectancies to increase the regency’s Human Development Index. The commitment of the regency’s health department was well realized, however the commitments of regency’s inter-related department to CBTS are lacking. The program coverage until this research published, is dwelling on first pillar with ownership of toilet beyond 70% and access to toilet reached 90%.
Conclusion: Coordination between related departments needed further enhancement despite the different nature of task, function and program given; in which designed to resolve sanitation and environmental problem in West Sumbawa Regency.
Keywords: Health Financing, Community Based Total Sanitation (STBM)
ABSTRAK
Latar Belakang: Tahun 2015 adalah akhir dari agenda program Millenium Development Goal (MDGs). Salah satu tujuan dari kesepakatan MDGs adalah menjamin keberlanjutan lingkungan, dimana salah satu sasaran utamanya megurangi separuh dari proporsi penduduk yang belum memiliki akses terhadap air minum dan sanitasi dasar (tujuan 7 target 10). Pelaksanaan STBM di Kabupaten Sumbawa Barat belum tercapai sampai lima pilar, disebabkan oleh keterbatasan dana pembiayaan program.
Tujuan: Untuk mengetahui pembiayaan program sanitasi total berbasis masyarakat di Dinas Kesehatan Kabupaten Sumbawa Barat.
Metode: Penelitian ini menggunakan jenis penelitian deskriptif dengan metode kualitatif dan rancangan studi kasus untuk menggambarkan Pembiayaan Program Sanitasi Total Berbasis Masyarakat di Dinas Kesehatan Kabupaten Sumbawa Barat. Pengambilan sampel pada penelitian ini dilakukan secara purposive sampling. Metode pengumpulan data diperoleh dengan wawancara mendalam (in depth interview), dan Telaah Dokumen.
Hasil: Program STBM di Dinas Kesehatan sudah berjalan dengan baik, hal ini terlihat dari pemanfaatan pembiayaan yang terealisasi 100% dan sebagian besar digunakan untuk pelatihan pemicuan. Penetapan prioritas program mengacu kepada renstra dinas kesehatan dinas kesehatan, juga SPM dan MDGs yang dimana programnya berkaitan dengan Umur Harapan Hidup untuk meningkat IPM Kabupaten. Komitmen di dinas kesehatan sudah berjalan dengan baik, akan tetapi komitmen dengan dinas yang terkait STBM masih kurang baik. Cakupan program STBM sampai dengan saat ini masih di Pilar I dengan kepemilikan melebihi 70% dan akses terhadap penggunaan jamban mencapi 90%.
Kesimpulan: Koordinasi yang ada antara dinas terkait harus ditingkatkan dan dibangun lebih baik lagi meskipun tugas dan fungsi dan program yang dilaksanakan berbeda, tetpai mempunyai tujuan yang sama yaitu untuk memperbaiki sanitasi dan lingkungan di Kabupaten Sumbawa Barat.
Kata Kunci: Pembiayaan Kesehatan, Program Sanitasi Total Berbasis Masyarakat.
Center for Health Policy and Management
2017-05-25 07:38:38
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/25334
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 1 (2017)
ind
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/25486
2018-07-19T05:08:38Z
jkki:ART
"180301 2018 eng "
2620 4703
2089 2624
dc
Molyadi, Molyadi
Trisnantoro, Laksono
Background: Public health care accreditation is one of Ministry of Health’s strategic plans in 2015-2019 to improve equity of access and service quality in public health center. Although many efforts have been done in order to implement accreditation policy including in 4 PHCs of Kubu Raya District, many constraints and variation are found in the process. The purpose of this study is to identify important factors that influencing the effectiveness of policy implementation in the 4 PHCs and observing its results. Methods: This research is a qualitative research with single embedded case study design. Subjects of the study are 36 respondents including accreditation program manager of District’s Health Office and accreditation team from 4 PHCs interviewed about their experience in preparing for accreditation. Consolidated framework for implementation research (CFIR) used to guide data collection and qualitative analysis process. Construction with greatest effect towards accreditation effectively identified with cross case study and ranked accordingly. Results: Among 25 CFIR constructions, data analysis result shows that accreditation effectiveness in PHC A, B, C, and D are influenced factors such as network and communication, aims and feedback, involvement of leader and resources availability (strongly differentiate), also organization culture and planning (weakly differentiate). While still facing challenges, all respondents report positive acceptance of accreditation policy because of the benefits it give and standard accreditation structure fit to be guidance for work performance especially to develop quality control system and improving quality control in public health center. Conclusion: Public health center accreditation policy in Kubu Raya District generally are well implemented, especially in PHC A and C, on the contrary are still weak in PHC B and D. Therefore, improvement on the performance is needed.
Abstrak
Latar Belakang: Akreditasi Puskesmas merupakan salah satu strategi kebijakan Kementerian Kesehatan pada tahun 2015-2019 yang bertujuan meningkatkan pemerataan akses dan mutu pelayanan kesehatan di Puskesmas. Berbagai upaya untuk menerapkan kebijakan akreditasi telah dilakukan termasuk di empat Puskesmas Kabupaten Kubu Raya, banyak variasi dan hambatan yang dirasakan oleh setiap Puskesmas dalam proses pelaksanaannya. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor penting yang mempengaruhi efektivitas pelaksanaan kebijakan akreditasi di empat Puskesmas Kabupaten Kubu Raya dan mengetahui hasil pelaksanaannya. Metode: Penelitian ini merupakan penelitian kualitatif dengan rancangan studi kasus tunggal terjalin (embeded). Subyek penelitian sebanyak tiga puluh enam orang terdiri dari pengelola program akreditasi di Dinas Kesehatan Kabupaten dan tim akreditasi di empat Puskesmas diwawancarai tentang pengalaman mereka mempersiapkan akreditasi. Kerangka Konsolidasi Riset Implementasi (CFIR) di gunakan untuk memandu pengumpulan dan analisis data kualitatif. Konstruksi yang paling kuat mempengaruhi efektivitas pelaksanaan akreditasi Puskesmas diidentifikasi melalui perbandingan lintas kasus dan diberi peringkat. Hasil: Dari dua puluh lima konstruksi CFIR yang dinilai, hasil analisis data menunjukkan bahwa tingkat efektivitas pelaksanaan kebijakan akreditasi di Puskesmas A, B, C, dan D di pengaruhi oleh jaringan dan komunikasi, tujuan dan umpan balik, keterlibatan kepemimpinan dan sumberdaya yang tersedia (kuat sangat membedakan) serta budaya organisasi dan perencanaan (lemah membedakan). Meskipun menghadapi beberapa tantangan, seluruh responden melaporkan penerimaan secara positif adanya kebijakan akreditasi karena banyak memberikan manfaat dan keuntungan serta isi struktur standar akreditasi cocok dijadikan pedoman kerja terutama untuk pengembangan sistem manajemen mutu dan upaya perbaikan kinerja pelayanan di Puskesmas. Kesimpulan: Pelaksanaan kebijakan akreditasi Puskesmas di Kabupaten Kubu Raya berjalan cukup baik pada Puskesmas A dan C dan sebaliknya pada Puskesmas B dan D perlu upaya perbaikan kinerja pelaksanaannya di masa mendatang.
Center for Health Policy and Management
2018-07-19 12:08:38
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/25486
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 7, No 1 (2018)
ind
Copyright (c) 2018 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/25531
2017-05-31T18:53:36Z
jkki:ART
"140601 2014 eng "
2620 4703
2089 2624
dc
Setianingrum, Veronika Evita
Hasanbasri, Mubasysyir
https://scholar.google.co.id/citations?user=cNLJ2XAAAAAJ&hl=en http://orcid.org/0000-0003-2972-6916
Hakimi, Mohammad
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
Center for Health Policy and Management
2014-09-01 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/25531
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 3, No 4 (2014)
ind
Copyright (c) 2014 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/25532
2017-05-31T18:53:36Z
jkki:ART
"170601 2017 eng "
2620 4703
2089 2624
dc
Priyatmoko, Heri
Lazuardi, Lutfan
Hasanbasri, Mubasysyir
https://scholar.google.co.id/citations?user=cNLJ2XAAAAAJ&hl=en http://orcid.org/0000-0003-2972-6916
Determinants of specialist availability in public hospitals: analysis of 2011 Rifaskes
ABSTRACT 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
Center for Health Policy and Management
2014-09-01 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/25532
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 3, No 4 (2014)
ind
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/26186
2018-01-30T05:14:02Z
jkki:ART
"180123 2018 eng "
2620 4703
2089 2624
dc
Cahyadi, Ade Muhammad
Lusmilasari, Lely
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.
Center for Health Policy and Management
2018-01-22 15:26:13
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/26186
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 4 (2017)
ind
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/26235
2017-10-09T15:46:00Z
jkki:ART
"120706 2012 eng "
2620 4703
2089 2624
dc
Kismoyo, Christina Pernatun
Hasanbasri, Mubasysyir
https://scholar.google.co.id/citations?user=cNLJ2XAAAAAJ&hl=en http://orcid.org/0000-0003-2972-6916
Hakimi, Mohammad
Basic emergency maternal care at public health center: are they effective
Background: Every pregnancy and birth is a risky event; therefore, every pregnant woman and maternity must be located as close as possible to the basic emergency obstetric care. As a health care unit, near and reachable health centers are expected to provide basic emergency neonatal and obstetric care (PONED or EmOC in primary health level). In Bantul District, there are six PONED health centers. Health centers in their implementation need an evaluation to improve or maintain a mechanism to measure whether they are good or not good. This study aimed to determine the implementation of PONED in the health centers of Bantul District.
Method: This was a qualitative descriptive study. The analysis unit was service providers such as doctors, midwives, nurses, laboratory and driver as well as the head of Bantul District Health Office. The research instrument was the researcher and the tools used were cameras, tape recorders, checklists and interview guides.
Results: PONED health centers were viewed more as a routine work because the service provider had not been able to understand the purpose of a good service. Emergency obstetric and neonatal care had not been fully able to be served at six health centers. Sewon I Health Center was the only PONED health center with available support system, but the availability of the service such as tools, medicine and infrastructure had not yet fully available. This was because of the rare cases of obstetric and neonatal complications handled so that the drugs and equipment available were expired and damaged. Management of emergency obstetric and neonatal referral had not been going well according to the case; thus, early referral was frequently preferable.
Conclusion: The management of PONED health center’s services was more on the bureaucracy not based on the setting of emergency obstetric and neonatal care, so that the orientation of service providers was seen as a routine job. Support from the government and incentives were still very influential on service providers’ work motivation.
Keywords: evaluation, PONED health center, maternal mortality rate
Latar belakang: Setiap kehamilan dan persalinan merupakan kejadian berisiko, oleh karena itu setiap ibu hamil dan bersalin harus berada sedekat mungkin dengan pelayanan obstetrik emergensi dasar. Unit pelayanan kesehatan yang dekat dan mampu terjangkau oleh masyarakat puskesmas diharapkan mampu memberikan pelayanan obstetrik neonatal emergensi dasar. Di Kabupaten Bantul ada 6 puskesmas mampu PONED. Puskesmas dalam pelaksanaannya perlu adanya suatu langkah evaluasi guna meningkatkan ataupun mempertahankan suatu mekanisme yang sudah baik atau kurang baik.Tujuannya adalah untuk melihat implementasi pelayanan puskesmas mampu kegawatdaruratan Obstetrik dan Neonatal Dasar (PONED) di Kabupaten Bantul.
Metode: Penelitian diskriptif kualitatif dengan unit analisis adalah petugas (dokter, bidan, perawat, laboran dan sopir) serta kepala Dinas Kesehatan Kabupaten Bantul. Instrumen penelitian adalah peneliti sendiri, alat yang digunakan kamera, tape recorder, daftar tilik, dan pedoman wawancara.
Hasil: Puskesmas PONED lebih dipandang sebagai pekerjaan rutinitas karena provider pelayanan belum mampu memahami tujuan pelayanan dengan baik. Pelayanan kegawatdaruratan obstetrik dan neonatal belum seluruhnya dapat dilayani di 6 puskesmas hanya Sewon I. Sistem pendukung pelayanan PONED tersedia, namun ketersediaan pelayanan belum seluruhnya tersedia yakni; alat, obat dan infrastruktur. Hal ini karena jarangnya kasus komplikasi obstetri dan neonatus yang ditangani sehingga obat dan alat yang tersedia kadaluarsa serta rusak. Pengelolaan rujukan kasus kegawatdaruratan obstetri dan neonatal belum berjalan dengan baik sesuai dengan kasus, cenderung melakukan rujukan dini.
Kesimpulan: Manajemen pelayanan puskesmas PONED lebih pada birokrasi belum berdasarkan pada setting pelayanan kegawatdaruratan obstetrik dan neonatal, sehingga orientasi petugas pelayanan dipandang sebagai pekerjaan rutinitas. Dukungan pemerintah dalam support insentif sangat berpengaruh pada motivasi kerja petugas pelayanan.
Center for Health Policy and Management
2012-04-16 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/26235
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 1, No 2 (2012)
ind
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/26409
2018-12-14T07:38:57Z
jkki:ART
"181214 2018 eng "
2620 4703
2089 2624
dc
Manihuruk, Melita
Nadjib, Mardiati
ABSTRACT
Posbindu elderly is an integrated post for old age service at the kelurahan level within the working area of the puskesmas. Based on the data of puskesmas bintara in 2016, the coverage of elderly visit only 34% is still below the target of 70% SPM. The purpose of this research is to know factors related to elderly visit to posbindu elderly in work area of Puskesmas of Kelurahan Bintara Kota Bekasi year 2017 with variable of a g e, gender, education, occupation, knowledge, family su p port , health officer support, access and need. Quantitative research with cross sectional study with a sample size of 70 elderly people aged 45-69 years, data were collected through interviews with questionnaires and qualitative approaches t o eld e rly visiting and never visiting respondents. The results of the study known 85.2% of elderly who know the benefits of visiting the posbindu elderly. Related factors are knowledge, family support, health care support and need factors. Results of interviews with visiting informants already know the benefits of visiting Posbindu Elderly. Based on these results should be puskesmas m ake e fforts to improve counseling related to elderly health so understand about health problem and want to visit posb i ndu e lderly.
ABSTRAK
Posbindu lansia merupakan pos pembinaan terpadu lanjut usia di tingkat kelurahan dalam wilayah kerja puskesmas. Berdasarkan data puskesmas Bintara tahun 2016 cakupan kunjungan lansia hanya 34% masih dibawah target SPM 70%. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kunjungan lansia ke posbindu lanjut usia di wilayah kerja Puskesmas Bintara Kota Bekasi tahun 2017 dengan variabel umur, jenis kelamin, pendidikan, pekerjaan, pengetahuan, dukungan keluarga, dukungan petugas kesehatan, akses dan kebutuhan. Penelitian kuantitatif dengan studi potong lintang dengan jumlah sampel 70 orang lansia yang berusia 45-69 tahun, data dikumpulkan melalui wawancara dengan kuesioner dan pendekatan kualitatif kepada responden lanjut usia yang berkunjung dan tidak pernah berkunjung. Hasil penelitian diketahui 85,2% lanjut usia yang mengetahui manfaat berkunjung ke posbindu lanjut usia. Faktor-faktor yang berhubungan adalah pengetahuan, dukungan keluarga, dukungan petugas kesehatan dan faktor kebutuhan. Hasil wawancara dengan informan yang berkunjung sudah mengetahui manfaat berkunjung ke Posbindu Lansia. Berdasarkan hasil tersebut hendaknya puskesmas melakukan upaya-upaya untuk meningkatkan penyuluhan yang berkaitan dengan kesehatan lansia sehingga lansia mengerti masalah kesehatan dan mau berkunjung ke posbindu lansia.
Center for Health Policy and Management
2018-12-14 14:38:57
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/26409
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 7, No 4 (2018)
ind
Copyright (c) 2018 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/26438
2018-01-30T05:14:02Z
jkki:ART
"181201 2018 eng "
2620 4703
2089 2624
dc
Dharmawan, Indra Rachmad
This study aims to find out how the reflection of the implementation of national health insurance (JKN) in dentistry services at first-rate health facilities (FKTP) Tangerang City in 2017. The condition of awareness of Indonesian people for oral health is still not good, thus requiring process improvement, and The concept of better service. Such improvements can be implemented in the form of dental services in FKTP. This research uses qualitative method that aims to know the implementation of dental services in health insurance, in accordance with the rules, conditions and regulations that apply. The research was conducted in FKTP of Tangerang City Health Office, 15 Puskesmas and 15 pratama clinics in collaboration with BPJS health. The results showed the presence of dentists in each FKTP has been fulfilled as well as the condition of dental infrastructure facilities is sufficient. In terms of utilization of dentistry services, JKN participants in Puskesmas are very low. There are still differences in the number of JKN participants in each FKTP. Dentistry services in JKN are still many kinds of service in serving JKN participants, the highest number of dental disease cases in the community in JKN not all can be served in primary service so there are still many references.
Center for Health Policy and Management
2018-01-22 15:26:13
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/26438
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 4 (2017)
ind
Copyright (c) 2018 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/26480
2019-09-27T04:08:08Z
jkki:ART
"180901 2018 eng "
2620 4703
2089 2624
dc
Dora, Dora
Sulistiadi, Wachyu
Self Assessment Effectiveness of Free of Corruption Area/Clean and Serve Bureaucratic Area Evaluation in The Health Ministry in The Aim of Bureaucracy Reform Policy
Background: Implementation of Bureaucratic Reform has an important role in supporting the implementation of national development in the field of health. Strengthening Bureaucracy Reform aims to improve public services because bureaucrats are public servant. Evaluation towards WBK / WBBM is a small form of Bureaucracy Reform applied to a minimum work unit of echelon 3. Evaluation to WBK / WBBM was conducted through self assessment by Internal Assessment Team at Ministry of Health level, which will be futher evaluate by National Assessment Team from Ministry of Empowerment of State Apparatus and Bureaucracy Reform. There is a significant difference between the evaluation results conducted by TPI and TPN. Purpose: The purpose of this study is to determine the effectiveness of self assessment in the evaluation of WBK / WBBM conducted by Itjen Kemenkes in accelerating the achievement of Bureaucracy Reform in the Ministry of Health. Method: This research is a descriptive study with qualitative analysis method by conducting in-depth interviews with 9 informants and document tracking. Results: The study was conducted in May - June 2017, located in DKI Jakarta area. The result of the research stated that the regulation is not yet complete, the communication of the evaluation implementation clear, the leader has not fully understand about WBK / WBBM, there is still conflict of interest, there are differences of work unit characteristic, there is still difference of motivation, perception and human resource competence become a factors that influence effectiveness of the evaluation towards WBK / WBBM in the Ministry of Health. Conclusion: Self Assessment implementation towards WBK / WBBM evaluation in Ministry of Health have not effective so require evaluation and further improvement.
Keywords: Bureaucracy Reform, Free Area of Corruption, Clean and Serve Bureaucratic Area
Latar Belakang: Pelaksanaan Reformasi Birokrasi memiliki peran yang penting dalam mendukung mendukung pelaksanaan pembangunan nasional di bidang kesehatan. Penguatan Reformasi Birokrasi bertujuan untuk memperbaiki pelayanan publik karena birokrat adalah pelayan kepentingan masyarakat. Evaluasi menuju WBK/WBBM adalah bentuk kecil dari Reformasi Birokrasi yang diterapkan kepada satuan kerja minimal setingkat eselon 3. Evaluasi menuju WBK/WBBM dilakukan secara penilaian mandiri oleh Tim Penilai Internal di tingkat Kementerian Kesehatan, yang pada tahap lanjut akan dilakukan oleh Tim Penilai Nasional dari Kementerian Pendayagunaan Aparatur Negara dan Reformasi Birokrasi. Terdapat perbedaan yang cukup signifikan antara hasil evaluasi yang dilakukan oleh TPI dengan TPN. Tujuan: Tujuan penelitian ini untuk mengetahui efektivitas penilaian mandiri dalam evaluasi WBK/WBBM yang dilakukan Itjen Kemenkes dalam mempercepat tercapainya Reformasi Birokrasi di Kementerian Kesehatan. Metode: Penelitian ini merupakan studi deskriptif dengan metode analisis kualitatif dengan melakukan wawancara mendalam terhadap 9 informan dan penelusuran dokumen. Hasil: Penelitian dilakukan pada bulan Mei - Juni 2017, berlokasi di wilayah DKI Jakarta. Hasil penelitian menyebutkan bahwa regulasi belum lengkap, komunikasi pelaksanaan evaluasi sudah jelas, pemimpin belum memahami sepenuhnya mengenai WBK/WBBM, masih terdapat benturan kepentingan, terdapat perbedaan karakteristik satuan kerja, masih terdapat perbedaan motivasi, persepsi dan kemampuan sumber daya manusia menjadi faktor yang berpengaruh dalam efektifitas pelaksanaan evaluasi menuju WBK/WBBM di Kementerian Kesehatan. Kesimpulan: Pelaksanaan Penilaian mandiri evaluasi menuju WBK/WBBM di Kementerian Kesehatan belum efektif sehingga memerlukan evaluasi dan perbaikan lebih lanjut.
Center for Health Policy and Management
2019-09-27 11:08:08
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/26480
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 8, No 3 (2019)
ind
Copyright (c) 2019 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/26493
2018-01-30T05:14:02Z
jkki:ART
"171201 2017 eng "
2620 4703
2089 2624
dc
Diniarti, Isnaeni
Iljanto, Sandi
Background: The growth of Indonesian traditional medicine exports during 2009-2013 period increased by 6.49% per year. In Indonesia, the Traditional Medicine Industry (IOT) is one of the means that play a role in producing and developing traditional medicines are safe, quality and useful. IOT as an industry is driving the national economy. Objective: Analyze the description of the factors that affect the competitiveness of IOT, providing an alternative strategy in improving the competitiveness of IOT. Method: This research is a descriptive study with qualitative analysis method to conduct in-depth interviews, Focus Group Discussion (FGD), tracking documents. Results: factor conditions; demand conditions; related and supporting industries; firm and strategy rivalry, government roles and opportunity factors are linked and mutually supportive. SWOT identification to develop alternative strategies to enhance IOT competitiveness. Conclusion: The competitiveness of IOT is still lacking, lack of support of factor conditions (capital), related and supporting industries, government roles, firm and strategy rivalry. The role of government affects all components. Enhanced coordination of academia, entrepreneurs, government, and society is needed.
Center for Health Policy and Management
2018-01-22 15:26:13
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/26493
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 4 (2017)
ind
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/26899
2018-02-19T05:53:27Z
jkki:ART
"171201 2017 eng "
2620 4703
2089 2624
dc
Ramsar, Ulfayani
Trisnantoro, Laksono
Putri, Likke Prawidya
Background: The Chronic Disease Management Program (Prolanis) is a system of health services and proactive approach, implemented in an integrated manner involving participants, health facilities and BPJS Health in order to maintain health for BPJS Health participants who suffer from chronic diseases to achieve optimal quality of life With the cost of effective and efficient health services. Prolanis program is to improve the quality of life of BPJS participants who suffer from chronic diseases, especially diabetes mellitus (DM) type II and hypertension. This prolanis is implemented by a government-owned first-level health facility (FKTP). Aims: to describe the influence of external factors, internal and individual character to the scope of implementation of prolanis program in kendari city. Method: The research type is descriptive research with qualitative method by using single case study design. Informants in this study are stakeholders who play a role in the Implementation of Chronic Disease Management Program (Prolanis) at Poasia Health Center of Kendari City which consists of 12 informants. The way data collection is done is by observation, in-depth interviews, and document review. This research was conducted in April-May 2017. It was analyzed with qualitative abalisa. Result: From the result of the research, it is obtained from the external influences in this case the health service fully supports the prolanis activity. On the internal factors obtained puskesmas poasia is good enough to carry out prolanis. And on the character factor of the invidu still the lack of knowledge and understanding of the health personnel involved in the implementation of prolanis. Conclusion: improving the knowledge and understanding of health personnel involved in the prolanis program.
Center for Health Policy and Management
2018-01-22 15:26:13
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/26899
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 4 (2017)
ind
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/26922
2017-07-25T13:25:53Z
jkki:ART
"170725 2017 eng "
2620 4703
2089 2624
dc
Diana, Nana
Hasanbasri, Mubasysyir
https://scholar.google.co.id/citations?user=cNLJ2XAAAAAJ&hl=en http://orcid.org/0000-0003-2972-6916
Hakimi, Mohammad
ABSTRACT
Background: The growing number of infant mortality is one of the challenging problems in distric health offi ce. One of the causes of this problem is the recurring mistakes in the system. Learning organization is a strategic step to continuously learn and determine proper solution. However, there are learning disabilities in the organization that interfere with the learning organizationin maternal and infant mortality.
Objective: This study was aimed to explore learning organizationin emergency care unit by midwifes in the perspective of organizational learning in three organization level: distric health office, community health center, and midwifes.
Method: This was a case study with multi cases design in the working area of Distric Health Offi ce of Kepahiang Region from September to October 2015. Study subjects were secretary of distric health offi ce, director of Planning division, director and officers of maternal and infant health division, coordinator of midwifes, and midwifes. Three strategic steps of conducting qualitative studies were preparing and organizing data, reducing data into themes, and presenting data.
Result: There were four learning disabilities that often occurred in organization, which were: I am my position, the enemy is out there, the illusion of taking charge and the myth of team management.
Conclusion: Learning disabilities interfered with implementation of learning organization. Improving the role of maternal and perinatal audit were strategic opportunities to optimize learning organization process.
Keywords: Learning organization, organizational learning,midwives, emergency care unit.
ABSTRAK
Latar Belakang: Kasus kematian bayi yang terus meningkat setiap tahun merupakan permasalahan yang belum mampu tertangani oleh dinas kesehatan. Ada kesalahan berulang yang terjadi, namun dinas kesehatan belum mampu mengambil pelajaran dari kesalahan tersebut. Learning organization merupakan langkah yang strategis untuk senantiasa belajar dan menentukan langkah penanganan yang tepat. Tetapi ada learning disabilities yang terjadi dalam organisasi sehingga proses learning organization dalam kasus kematian ibu dan bayi tidak mampu berjalan sebagaimana yang diharapkan.
Tujuan: Tujuan dari penelitian ini adalah mengeksplorasi bagaimana learning organization dalam layanan kegawat daruratan oleh Bidan Desa ditinjau dari Perspektif organizational learning pada tiga level organisasi yaitu Dinas Kesehatan, Puskesmas dan Bidan Desa.
Metode: Penelitian ini adalah studi kasus dengan desain multi kasus di wilayah Kerja Dinas Kesehatan Kabupaten Kepahiang mulai bulan September sampai dengan Oktober 2015, subjek penelitian adalah sekretaris dinas kesehatan, kepala seksi perencanaan, kepala seksi KIA, staff KIA, bidan koordinator dan bidan desa. Ada tiga langkah strategis dalam melakukan analisis data kualitatif: menyiapkan dan mengorganisasikan data, untuk analisis mereduksi data menjadi tema, dan menyajikan data.
Hasil: Ada empat learning disabilities yang sering terjadi dalam organisasi meliputi I am my position, the enemy is out there, the illusion of taking charge dan the mytm of team management.
Kesimpulan: Learning disabilities merupakan hambatan dalam menerapkan learning organization. Penguatan peran audit maternal dan perinatal merupakan peluang strategis untuk mengoptimalkan proses learning organization.
Kata Kunci: Learning organization, organizational learning, Bidan desa, Layanan kegawatdaruratan.
Center for Health Policy and Management
2017-07-25 20:25:53
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/26922
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 2 (2017)
ind
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/26926
2018-04-14T04:18:46Z
jkki:ART
"180414 2018 eng "
2620 4703
2089 2624
dc
Heru, Retno
Hasanbasri, Mubasysyir
https://scholar.google.co.id/citations?user=cNLJ2XAAAAAJ&hl=en http://orcid.org/0000-0003-2972-6916
Hakimi, Mohammad
Counseling for Pregnant Women at Midwife Practice and Community Health Center in Bantul District
Background: One of the factors of Maternal and Neonatal Mortality is the lack of knowledge on the cause and how to deal with important complications during pregnancy, labor, and post natal. Counseling is an effort to dig and give useful information in order to help pregnant mother to take decisions. Midwife practice and Community Health Center is an organization which aims at giving service to pregnant mother including counseling. Midwife practice an independent organization which is managed privately, whereas Community Health Center is an organization which belongs and runs by the government. Objectives: The objective of the research is to find out the implementation of counseling on pregnant mother which includes, time, places, instruments, materials, problem solving, training efforts, and form of teaching counseling skill on midwife practice and Community Health Center in Bantul district. Method: Research method used in this research is qualitative research method with case study and descriptive method. The analysis unit is the pregnant mother, midwife in charge in midwife practice and in Community Health Center. The data was taken using purposive sampling through interview, observation and library study. Result: Counseling implementation in midwife practice and Community Health Service is done through giving information. The time done for counseling is under the standard which was below 20 minutes. The counseling process is undergone in one place along with the other services, and there are many patients in the room. The instruments used for counseling is just KIA book and there are no other instruments, the information given is merely on the problems which are shared by the pregnant mother. If the pregnant mother doesn’t share her problem, the midwife will not give counseling. The problem which is often faced by the midwife is that pregnant mother has difficulties in intrepreting information given. Problem solving is done through the participation of the husband during the counseling service. Training efforts to increase the counseling skill has not been done officially. The efforts taken so far is by reading books or learn from other coleagues. The form of teaching counseling skill is using roleplay, done in pairs and not more than 45 minutes. Conclusion: The implementation of counseling for pregnant mother is done inappropriately, which is not the same as it is stated in the Standart Service of Midwifery. It makes pregnant mother doesn’t have the necessary information dealing with the pregnancy.
Keywords: Counseling, Pregnancy, Midwife
Latar Belakang: Salah satu penyebab tingginya Angka Kematian Bayi dan Angka Kematian Ibu adalah karena kurangnya pengetahuan tentang penanggulangan dan komplikasi-komplikasi penting dalam kehamilan, persalinan, dan nifas. Konseling adalah upaya menggali dan memberikan informasi guna mendapatkan apa yang dibutuhkan dan membantu ibu hamil dalam mengambil keputusan. Bidan Praktik Swasta dan Puskesmas adalah organisasi pelayanan kesehatan yang memberikan pelayanan pada ibu hamil termasuk konseling. BPS adalah organisasi pelayanan kesehatan swasta yang dikelola secara mandiri, sedangkan Puskesmas adalah organisasi pelayanan kesehatan yang di kelola oleh pemerintah. Tujuan: Tujuan penelitian ini adalah untuk mengetahui pelaksanaan konseling pada ibu hamil yang meliputi: praktik konseling, waktu, tempat, alat bantu, materi, cara mengatasi hambatan, upaya peningkatan ketrampilan, dan bentuk pengajaran ketrampilan konseling di pendidikan di BPS dan puskesmas di Kabupaten Bantul. Metode: Metode penelitian adalah metode kualitatif dengan rancangan studi kasus dan bersifat deskriptif. Unit analisis adalah ibu hamil, bidan pelaksana di BPS dan puskesmas. Data diambil secara purposive sampling melalui wawancara mendalam dan lembar pengamatan konseling serta penelusuran dokumen. Hasil: Praktik konseling di BPS dan puskesmas dalam bentuk pemberian informasi. Waktu yang digunakan dalam proses konseling masih kurang yaitu di bawah 20 menit. Tempat yang digunakan untuk proses konseling menjadi satu dengan tempat yang digunakan untuk periksa kehamilan, dan banyak orang yang ada dalam ruangan periksa. Alat bantu yang digunakan untuk konseling sebatas buku KIA dan belum menggunakan alat bantu yang lain. Informasi yang diberikan sebatas pada keluhan yang disampaikan oleh ibu hamil. Jika ibu hamil tidak menyampaikan keluhan, bidan tidak berusaha menggali permasalahan atau memberikan informasi. Hambatan yang paling sering ditemui bidan adalah sulitnya ibu hamil memahami informasi yang diberikan bidan. Cara penyelesaian hambatan dengan cara melibatkan suami dalam proses konseling. Upayapeningkatan ketrampilan konseling secara resmi seperti pelatihan-pelatihan belum ada. Upaya yang dilakukan selama ini adalah dengan membaca buku-buku dan belajar dari teman. Bentuk pengajaran ketrampilan konseling di pendidikan dengan metode roleplay, dilaksanakan dikelas, dan dilakukan dengan teman sendiri. Kesimpulan: Proses konseling pada ibu hamil yang dilakukan oleh bidan pada umumnya tidak berjalan sebagaimana mestinya, yaitu tidak sesuai dengan pedoman yang ada dalam standar pelayanan kebidanan. Dampaknya adalah ibu hamil belum paham dengan segala hal yang berkaitan dengan kehamilan.
Kata Kunci: Konseling, Kehamilan, Bidan
Center for Health Policy and Management
2012-10-14 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/26926
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 1, No 3 (2012)
ind
Copyright (c) 2012 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/28809
2017-10-12T08:16:34Z
jkki:ART
oai:jurnal.ugm.ac.id:article/28904
2017-07-25T13:25:53Z
jkki:ART
"170601 2017 eng "
2620 4703
2089 2624
dc
Analisis Pelaksanaan Rujukan Berjenjang Fasilitas Kesehatan Tingkat Pertama Kasus Kegawatdaruratan Maternal Peserta Badan Penyelenggara Jaminan Sosial di 3 Puskesmas Perawatan Kota Bengkulu
Hidayati, Putri
Dinas Kesehatan Profinsi Bengkulu
Hakimi, Mohammad
Program Studi Ilmu Kesehatan Masyarakat, Fakultas Kedokteran Universitas Gadjah Mada
Claramita, Mora
Pendidikan Kedokteran Fakultas Kedokteran Universitas Gadjah Mada
Tiered referral, maternal emergency, National Health Insurance
ABSTRACT
Background: Indonesia National Health Insurance also regulates referral system, which is intended to increase effectiveness and efficiency of resources. There is a need to optimize tiered referral system: primary, secondary, and tertiary so that it runs effectively and efficiently. Tiered referral for maternal cases are still frequently done in Bengkulu City, especially on emergency cases that cannot be handled by primary health center, a lot of expectant mother are aged <20 and >35 which become risk factor in pregnancy, and patients’ wish to undergo USG exam which is unavailable at PHC. The high frequency of referral among National Health Insurance participants will cause an increase on referral facility utilization, which in turn will increase cost in referral health facility.
Objective: To analyze implementation of tiered referral system on maternal cases in National Health Insurance participants in 3 PHC of Bengkulu City.
Methods: This study use quantitative design using case studies. Study use primary and secondary data. Primary data collected from observation and in depth interview with medical staff in PHC and patients.
Results: From observation and direct interview with medical staffs, patients, and management or doctors from 3 PHC used as sample, 4 aspects among other are found, including staffs perception about health workers availability, drugs availability, medical instrument availability, and availability of health facility are often become obstacle, proven by observation of medicines and instruments that available in PHC. Meanwhile no obstacle found in severity level and access to hospital.
Conclusion: Perception of medical staffs in terms of understanding of diagnosis and severity level and also access to hospital is not the main factors. On the contrary, staffs’ perception about human resources, drug, instruments, and health facilities still need support from involved parties in addressing these obstacles found in primary health center.
Keywords: Tiered referral, maternal emergency, National Health Insurance
ABSTRAK
Latar Belakang: Didalam BPJS diatur juga system rujukan kesehatan, yang merupakan manajemen utilisasi pelayanan kesehatan untuk meningkatkan efektifitas dan efisiensi sumber daya, dapat ditinjau dari penyedia kesehatan maupun penerima kesehatan. Perlunya optimalisasi kepatuhan pelaksanaan sistem rujukan berjenjang: primer, sekunder dan tersier agar efektifitas dan efisiensi berjalan optimal. Proses rujukan berjenjang pada pasien maternal di kota Bengkulu masih tinggi, terutama kasus kegawatdaruratan maternal hal ini tidak dapat ditangani oleh fasilitas kesehatan tingkat pertama dan masih adanya ibu hamil yang berusia < 20 tahun dan ibu-ibu hamil usia> 35 tahun yag menjadi resiko tinggi dari kehamilan tersebut dan juga keinginan dari pasien untuk melakukan USG yang tidak tersedia di puskesmas. Tingginya rujukan pasien BPJS akan berdampak pada peningkatan pemanfaatan fasilitas pelayanan tingkat lanjutan, maka akibatnya akan terjadi pembengkakan biaya pelayanan kesehatan pada fasilitas kesehatan lanjutan.
Tujuan: Menganalisis pelaksanaan rujukan berjenjang FKTP kasus kegawatdaruratan maternal peserta BPJS Kesehatan pada 3 Puskesmas perawatan di Kota Bengkulu.
Metode: Rancangan penelitian yang digunakan adalah kualitatif bersifat case studies. Penelitian ini menggunakan data primer dan data skunder. Data primer diperoleh melalui observasi dan wawancara mendalam (in-depth interview) kepada petugas medis di puskesmas dan pasien. Aspek yang dikaji pada penelitian ini yaitu Severity level, ketersediaan sumber daya manusia kesehatan, ketersediaan obat-obatan, ketersediaan alat-alat medis, ketersediaan fasilitas kesehatan dan akses menuju rumah sakit.
Hasil: Dari hasil observasi dan wawancara langsung dengan petugas medis, pasien dan pihak manajemen atau dokter dari 3 puskesmas menjadi tempat penelitian di peroleh informasi bahwa dari ke 6 (enam) aspek tersebut ada 4 aspek antara lain persepsi petugas tentang ketersediaan sumber daya manusia kesehatan, ketersediaan obat-obatan, ketersediaan alat-alat medis, ketersediaan fasilitas kesehatan menjadi kendala yang sering dan di buktikan oleh hasil observasi obat-obatan dan alat-alat yang tersedia di puskesmas. Sedang kan pada aspek severity level dan Akses menuju RS tidak ditemukannya kendala.
Kesimpulan: Persepsi petugas medis dilihat dari pemahaman diagnosa dan severity level dan akses menuju RS tidak mengalami kendala. Sedangkan pada persepsi petugas mengenai SDM, Ketersediaan obat-obatan, ketersediaan alat- alat kesehatan dan Fasilitas kesehatan masih diperlukan adanya bantuan dari berbagai pihak yang terkait dalam memperbaiki untuk melengkapi kendala dihadapi di fasilitas kesehatan tingkat pertama.
Kata Kunci : Rujukan berjenjang, Kegawatdaruratan maternal, BPJS
Center for Health Policy and Management
2017-07-25 20:25:53
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/28904
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 2 (2017)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/28931
2017-07-25T13:25:53Z
jkki:ART
"170601 2017 eng "
2620 4703
2089 2624
dc
Faktor-Faktor yang Berhubungan dengan Kepesertaan Program JKN di Wilayah Kerja Puskesmas Remaja Kota Samarinda
Nadiyah, Husnun
Fakultas Kesehatan Masyarakat Universitas Mulawarman, Samarinda
Subirman, Subirman
Fakultas Kesehatan Masyarakat Universitas Mulawarman, Samarinda
S, Dina Lusiana
Fakultas Kesehatan Masyarakat Universitas Mulawarman, Samarinda
Health Insurance, Membership, Knowledge
ABSTRACT
Background: National health insurance program aims to provide health protection in health care benefits to fill basic health needs. In 2015 the number of membership of a JKN in Samarinda city is 398.135 or 40,25% of the total population of the city, membership are divided into subsidized member (PBI) of 89.876 and non subsidized member (Non PBI) of 308.259 people. It shows that 59.74% of the population is not yet not covered by health insurance.
Aim: The purpose of this research to asses the factors related to the participation of the JKN program in working area Remaja Health Center Samarinda.
Method: This study used analytic survey method with cross sectional approach. Population of the study was head of household in the district of Temindung Permai, Bandara, and Gunung Lingai with a sample of 371 respondents using purposive sampling. Data were analyzed descriptively with a frequency table using coefficient kontingency test and coefficientn corelated Phi.
Result: This study showed 47% of respondents are not participants JKN and 53% of respondents are JKN participants, 75% of respondents with good knowledge of JKN, 93% of respondents with positive attitudes towards JKN, 78% of respondents trust the JKN service, and 70% of respondents have the support of family. The results of the bivariate analysis showed there was correlation between knowledge (p value 0.006), respondents attitude (p value 0.031), family support (p value 0,000) and there was no relationship of trust (p value 0.226) with membership of JKN program.
Conclusion: There is a need to increasing public knowledge about the program JKN and improving the quality of health services.
Keywords: Health Insurance, Membership, Knowledge
ABSTRAK
Latar belakang: Program JKN bertujuan memberikan perlindungan kesehatan dalam bentuk manfaat pemeliharaan kesehatan untuk memenuhi kebutuhan dasar kesehatan. Jumlah kepesertaan JKN tahun 2015 di Kota Samarinda saat ini sebanyak 398.135 atau 40,25% dari jumlah penduduk Kota Samarinda tahun
2015, terdiri dari peserta Penerima Bantuan Iuran sebanyak 89.876 jiwa dan peserta Non Penerima Bantuan Iuran sebanyak
308.259 jiwa. Jumlah tersebut menunjukkan bahwa sebanyak 59,74% penduduk Kota Samarinda belum terlindungi oleh Jaminan Kesehatan.
Tujuan: Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kepesertaan program JKN di wilayah kerja Puskesmas Remaja Kota Samarinda.
Metode: Metode yang digunakan dalam penelitian ini adalah metode penelitian survei analitik dengan pendekatan cross sectional. Populasi dalam penelitian ini adalah kepala keluarga yang tinggal di Kelurahan Temindung Permai, Kelurahan Bandara, dan Kelurahan Gunung Lingai dengan sampel sebanyak 371 responden yang dipilih secara purposive sampling. Data dianalisis secara deskriptif dengan tabel frekuensi dengan menggunakan uji Koefi sien Kontingensi dan Koefi sien Korelasi Phi.
Hasil: Dalam penelitian ini diperoleh 47% responden bukan peserta JKN dan 53% responden peserta JKN, 75% responden berpengetahuan baik, 93% responden bersikap positif, 78% responden percaya terhadap pelayanan JKN, dan 70% responden mendapatkan dukungan dari keluarga terdekat. Hasil analisis bivariat menunjukkan terdapat hubungan pengetahuan (p value 0,006), sikap responden (p value 0,031), dukungan keluarga (p value 0,000) dan tidak ada hubungan kepercayaan (p value 0,226) dengan kepesertaan program JKN.
Kesimpulan: Dalam hal ini, perlunya peningkatan pengetahuan masyarakat mengenai program JKN dan peningkatan mutu pelayanan kesehatan.
Kata Kunci: Jaminan Kesehatan, Kepesertaan, Pengetahuan
Center for Health Policy and Management
2017-07-25 20:25:53
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/28931
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 2 (2017)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/28932
2017-07-25T13:25:53Z
jkki:ART
"170601 2017 eng "
2620 4703
2089 2624
dc
Evaluasi Paradigma Fungsi Ekonomi pada Rumah Sakit Elim Rantepao
Gasong, David Nakka
Fakultas Kedokteran dan Ilmu Kesehatan Unversitas Kristen Satya Wacana Salatiga
Trisnantoro, Laksono
Program Studi, Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta
Evaluation, Paradigm; Economic Function; Social Function.
ABSTRACT
Background: Head of Toraja Church and Church Health Foundation tend to maintain religious social function on management of Elim hospital. Meanwhile, low income and high operational costs followed by limited funding support from donors forced managers to think of their economic functions. There is lack of developing strategy, while hospital management still follow strategy set by Zending at the beginning of hospital establishment.
Aim: Providing information as comparison to determine strategy from re-evaluation of the old strategy to decision making. To provide comparison information to determine vision, mission, objectives and strategy of Elim Hospital.
Method: The type of research was observasional by survey approach. Evidence, data and information are obtained through observation, indepth interview using interview guideline and checklist. Data obtained from head of church and foundation, hospital director and document.
Result and Discussion: About 38% of Toraja Church leaders expect hospital revenue will be bigger than expenditure. About 62% believe that hospital income should be equal with expenditure. The church leaders expect to develop public perception related to excelence service (23%), but 77% did not want this. About 31% believe that expenditure is expected financed by owner’s equity and loans.
Conclusion: Hospital management based on economic principle is only expected by minority of leader, especially hospital director; while the majority of Toraja Church Leaders and foundation did not expected transformation of hospital management based on economic principle.
Keyword: Evaluation, Paradigm, Economic Function, Social Function.
ABSTRACT
Latar belakang: Dikalangan Pimpinan Gereja Toraja dan Yayasan Kesehatan Gereja Toraja cenderung mempertahankan fungsi sosial keagamaan dalam pengelolaan rumah sakit Elim. Sementara, rendahnya pendapatan dan tingginya biaya operasional serta terbatasnya dukungan dana dari donor memaksa pengelola memikirkan fungsi ekonomi. Langkah- langkah ke arah pengembangan kurang diperhatikan dan berusaha mengelolah rumah sakit dengan menggunakan strategi yang ditetapkan oleh Zending pada awal berdirinya.
Tujuan: Sebagai informasi pembanding bagi pengambil keputusan dalam memilih strategi guna menilai kembali strategi masa lalu Pihak Gereja melalui Yayasan sebagai pemilik rumah sakit Elim memperoleh informasi pembanding dalam menentukan visi, misi, tujuan dan strategi rumah sakit Elim.
Metode: Penelitian ini adalah jenis observasi dengan menggunakan pendekatan survey. Data, fakta dan informasi diperoleh melalui pengamatan, dan wawancara mendalam dengan menggunakan pedoman pertanyaan semacam chek-list. Data diperoleh melalui Pimpinan Gereja & Yayasan, Direktur, dan dokumen.
Hasil: Dari hasil penelitian, pandangan Pimpinan Gereja Toraja, 38% menginginkan pendapatan rumah sakit lebih besar dari pengeluaran, agar rumah sakit memperoleh laba. 62% pendapatan rumah sakit sama dengan pengeluaran. Dalam hal citra didinginkan, 23% menginginkan agar membangun persepsi masyarakat akan keunggulan pelayanan 77% tidak menginginkan demikian. Dalam hal penciptaan produk baru, 77% tidak menginginkan modifikasi bentuk pelayanan baru. Kemudian pembelanjaan kegiatan, 31% menginginkan apabila pembelanjaan dibiayai dari modal sendiri dan pinjaman. Namun 69% tidak sesuai harapannya.
Kesimpulan: Hasil penelitian menunjukkan bahwa, mayoritas pimpinan Gereja Toraja, Yayasan tidak menginginkan pengelolaan rumah sakit Elim berdasakan fungsi ekonomi. Minoritas pimpinan, khususnya direktur menghapkan pengelolaan rumah sakit Elim berdasarkan fungsi ekonomi.
Kata Kunci: Evaluasi, paradigma, fungsi ekonomi, fungsi sosial
Center for Health Policy and Management
2017-07-25 20:25:53
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/28932
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 2 (2017)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/28934
2017-07-25T13:25:53Z
jkki:ART
"170601 2017 eng "
2620 4703
2089 2624
dc
Evaluasi Implementasi Program Jaminan Kesehatan Nasional terhadap Pasien Stroke di RSUP Dr. Sardjito
Dahlan, Muhammad
Mahasiswa Magister Manajemen Rumah Sakit, Fakultas Kedokteran, Universitas Gadjah Mada
Setyopranoto, Ismail
Bagian Neurologi, Fakultas Kedokteran, Universitas Gadjah Mada
Trisnantoro, Laksono
Program Studi Ilmu Kesehatan Masyarakat, Fakultas Kedokteran, Universitas Gadjah Mada
Universal health coverage, stroke, quality care, implementation research
ABSTRACT
Background: Since 2014, Indonesia has implemented universal health coverage. In Indonesia, it was named as Jaminan Kesehatan Nasional or JKN. “Quality control and cost control” is the tagline of these program. Health provider such as doctors, nurses and the others health provider must control the quality and the cost of the patient’s treatment. Stroke, as one of the disease which needed such a complex treatment, must be treated as effective as possible.
Aim: The aim of this study is evaluating the implementation of the JKN in stroke care especially in Central hospital. Measuring the quality of the care in stroke unit is compulsory in implementation research. Knowing acceptability and fidelity of the rules from JKN by the doctors must be described.
Method: This study is mixed method with sequential explanatory design. The qualitative research was a cross sectional research which began in June 15th-July 31st. Interview from three doctors in stroke unit Sardjito General Hospital were performed to know the acceptability of the program.
Result: The quality of care in Unit Stroke RSUP Dr. Sardjito from the doctors are good. Rationalization of the drugs and safety of the patients were prioritized. From that conditions the unit got a debt condition. The financial performance from one patient could get debt up to eleven million rupiahs. From the qualitative research, the acceptability of the national formulation slightly didn’t accept by the doctors. Neuro protector and another kind of drugs isn’t on the list. rtPA which can be found in the list is too expensive. Reimbursement from the BPJS was too low. Homecare as one the rehabilitation isn’t covered by BPJS. Back referral system to general practitioner isn’t accepted by the neurologist because of the lack of the facility in puskesmas or PPK I. Research and education in academic hospital didn’t do well because of the lack of patients.
Conclusion: National formularies are needed to revised based on the patients need. Reimbursement from BPJS should be higher than before. Homecare patients should be guaranteed by BPJS.
Keywords: Universal health coverage, stroke, quality care, implementation research
ABSTRAK
Latar Belakang: Era baru program asuransi kesehatan nasional mulai 1 Januari 2014 yang diselenggarakan oleh BPJS Kesehatan yang mempunyai target bahwa seluruh masyarakat telah menjadi peserta BPJS pada tahun 2019. Apresiasi diberikan kepada pemerintah atas usahanya melaksanakan JKN. Dalam pelaksanaannya, evaluasi perlu dilakukan terhadap program ini. Stroke sebagai salah satu penyakit mematikan dan perlu manajemen yang menyeluruh patut untuk dievaluasi. Penerimaan penyedia pelayanan kesehatan dalam hal ini dokter perlu diidentifikasi.
Tujuan: 1) Mengukur kinerja pelayanan; 2) Mengukur kinerja keuangan; 3) mengetahui penerimaan dan ketaatan pemberi pelayanan terhadap aturan
Metode: mixed method dengan desain sekuensial ekplanasi. Penelitian kualitatif merupakan cross sectional dimulai 15 Juni–31 Juli. Interview dengan tiga dokter di Unit Stroke Rumah Sakit Umum Pusat Sardjito dilakukan untuk menggambarkan penerimaan.
Hasil: Mutu pelayanan penyakit stroke sudah sesuai dengan mutu standar. Rasionalisasi obat, maupun pemulangan pasien tetap sesuai standar. Performa keuangan dari Unit Stroke mengalami kerugian. Penerimaan dari para dokteer terkait beberapa aturan seperti sistem rujukan dan standar tarif belum diterima sepenuhnya
Kesimpulan: Permasalahan program Jaminan Kesehatan Nasional masih terjadi. Perbedaan persepsi antara pembuat aturan dengan pemberi pelayanan masih menonjol. Performa keuangan dari unit stroke mengalami kerugian walaupun mutu pelayanan sudah dilakukan secara optimal. Sistem rujukan terutama rujuk balik belum dapat dirasa layak oleh para dokter karena keterbatasan di PPK I. Pelayanan home care yang biasa digunakan tidak dapat optimal karena peserta asuransi belum mendapatkan jaminan untuk memperoleh pelayanan home care.
Kata Kunci: jaminan kesehatan nasional, stroke, quality care, implementation research
Center for Health Policy and Management
2017-07-25 20:25:53
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/28934
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 2 (2017)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/28935
2017-07-25T13:25:53Z
jkki:ART
"170601 2017 eng "
2620 4703
2089 2624
dc
Partisipasi Masyarakat dalam Proses Penyusunan Peraturan Daerah (Studi Kasus Peraturan Daerah Provinsi Bengkulu Nomor 12 Tahun 2013 tentang Perbaikan Gizi)
Hidayati, Alfina
Ilmu Kesehatan Masyarakat Fakultas Kesehatan Masyarakat Universitas Indonesia
Sulistiadi, Wahyu
Ilmu Kesehatan Masyarakat Fakultas Kesehatan Masyarakat Universitas Indonesia
Public Participation, Academic Manuscript, Regional Regulation
ABSTRACT
Background: There are some problems concerning the quality of legislation, and the involvement of community participation in the process of drafting and design of a regulation being in the concern.
Purpose: The purpose of this study to obtain information on the public participation in the formulation of the Regional Regulations.
Method: This is a qualitative research that conduct analysis based on the stages in the preparation of Regulation No. 12 of 2013, namely Definition, Aggregation, Organitation, Representation, Agenda Setting, Formulation and Legitimation last stage.
Result: The process of drafting Regulation No. 12 of 2013 is not a meaningful public participation, except in some seminar were the number of participants is limited. The availability of academic paper is a starting material containing ideas of urgency, approach, scope and substance of a regional regulation.
Conclusion: It is advisable to increase community participation in every decision-making process, which can be done with advocacy to community groups that carried out by universities, community organizations and local government. There should be local regulations that regulate and ensure people’s participation in any decision-making process, as well as the need to support it with adequate human resources, adequate funding and adequate time so that the academic paper worthy of reference in the process of drafting a regional regulation.
Keywords: Public Participation, Academic Manuscript, Regional Regulation
ABSTRAK
Latar belakang: Permasalahan produk legislasi yang menyangkut kualitas, maupun pelibatan partisipasi masyarakat di dalam proses penyusunan dan perancangan suatu Perda sedang menjadi sorotan.
Tujuan: Tujuan penelitian ini untuk memperoleh informasi mengenai partisipasi masyarakat dalam proses penyusunan Peraturan Daerah menggunakan pendekatan kualitatif.
Metode: Berdasarkan analisis bahwa tahapan-tahapan dalam penyusunan Perda no 12 tahun 2013 telah melakukan semua tahapan dari tahap Definition, Aggregation, Organitation, Representation, Agenda Setting, Formulation dan terakhir tahapLegitimation.
Hasil: Proses penyusunan Perda No 12 tahun 2013 belum melibatkan partisipasi masyarakat kecuali dalam seminar uji publik yang jumlah pesertanya terbatas. Kedudukan naskah akademik merupakan bahan awal yang memuat gagasan-gagasan tentang urgensi, pendekatan, ruang lingkup dan materi muatan suatu Peraturan Daerah.
Kesimpulan: Disarankan untuk meningkatkan partisipasi masyarakat dalam setiap proses penyusunan Perda dapat dilakukan dengan advokasi kepada kelompok masyarakat yang dilakukan oleh Perguruan Tinggi, organisasi masyarakat maupun pemerintahan daerah Provinsi Bengkulu sendiri, memiliki produk hukum daerah yang mengatur dan menjamin partisipasi masyarakat dalam setiap proses penyusunan Perda, serta perlu dukunganan sumber daya manusia yang memadai, dana yang cukup dan waktu yang lebih banyak sehingga Naskah Akademik yang dihasilkan layak dijadikan acuan dalam proses penyusunan suatu peraturan daerah.
Kata kunci: Partisipasi Masyarakat, Naskah Akademik, Peraturan Daerah
Center for Health Policy and Management
2017-07-25 20:25:53
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/28935
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 2 (2017)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/28998
2018-01-19T07:37:52Z
jkki:ART
oai:jurnal.ugm.ac.id:article/29000
2017-05-25T00:38:38Z
jkki:ART
"170301 2017 eng "
2620 4703
2089 2624
dc
Evaluasi Pengelolaan Sampah di Rumah Sakit Umum Daerah (RSUD) Hadji Boejasin Pelaihari Kabupaten Tanah Laut Kalimantan Selatan
Rahman, Fadhilah
Rumah Sakit Umum Daerah Hadji Boejasin Kabupaten Tanah Laut
Sarto, Sarto
Departemen Teknik Kimia Fakultas Teknik Universitas Gadjah Mada
Iravati, Susi
Departemen Ilmu Kesehatan Masyarakat Fakultas Kedokteran Universitas Gadjah Mada
Pengelolaan sampah, RSUD
ABSTRACT
Background: The hospital was a health-care facility for public services, a gathering place for sick people or healthy people who allowed environmental pollution, health problems or may be spread of disease transmissions. The existence of health care facilities also can have negative impacts on the environment and surrounding communities, especially when the waste/garbage service facilities was not maintained properly. According to the annual report of the General Hospital of Hadji Boejasin Pelaihari in 2010, the number of patients has increased significantly which will also affect the amount of waste generated either medical waste or waste nonmedical.
Objectives: To evaluate the existing waste management activities at the General Hospital of Hadji Boejasin Pelaihari.
Methods: Descriptive research on qualitative and quantitative approach with the main objective to create an objective overview of waste management situation objectively. Data analysis was done by using annotations, all data/sources examined and evaluated together so that all of the findings in this study was combination of a different variety of information. Data analysis was performed by analysis of transcript questionnaires, followed by analysis of the observation checklist.
Results: Waste management activities in the operational techniques were that phase segregation still existed on where medical waste contents mixed with a kind of other trash, garbage collected to inpatient, transporting medical waste and garbage nonmedical combined with three-wheel motorcycle to the polls, medical waste that was collected on the spot temporary shelter while nonmedical trash dumped into landfills. Cleaners who has not been trained about hospital waste management, as well as fixed procedures (SOP), did not exist in a guideline for the janitor on waste management.
Conclusion:The waste management and disposal in General Hospital Hadji Boejasin has been in accordance with applicable regulations, so it required reformation to make better.
Keywords: Pengelolaan sampah, RSUD
ABSTRAK
Latar Belakang: Rumah sakit merupakan sarana pelayanan kesehatan untuk pelayanan umum, tempat berkumpulnya orang sakit maupun orang sehat yang memungkinkan terjadinya pencemaran lingkungan, gangguan kesehatan atau dapat menjadi tempat penyebaran penularan penyakit. Adanya sarana
layanan kesehatan juga dapat menimbulkan dampak negatif bagi lingkungan dan masyarakat sekitar, terutama bila limbah/ sampah sarana layanan tersebut tidak dikelola dengan benar. Peningkatan jumlah pasien di Rumah Sakit Umum Daerah Hadji Boejasin Pelaihari akan mempengaruhi jumlah timbulan sampah yang dihasilkan baik itu sampah medis maupun sampah nonmedis.
Tujuan:Untuk mengevaluasi kegiatan pengelolaan sampah yang ada di Rumah Sakit Umum Daerah Hadji Boejasin Pelaihari.
Metode: Jenis penelitian deskriptif dengan metode pendekatan kualitatif dan kuantitatif. Analisa data dilakukan dengan teknik penjelasan. Data dievaluasi disajikan dengan narasi maupun dalam bentuk tabel. Selanjutnya dianalisa untuk mengetahui sejauhmana kesesuaian antara keadaan seharusnya dengan kenyataan yang didapat pada pengelolaan sampah yang ada di RSUD Hadji Boejasin.
Hasil Penelitian: Kegiatan pengelolaan sampah pada teknik operasional yaitu tahap pemilahan masih ada tempat sampah medis yang isinya bercampur dengan jenis sampah lain, sampah dikumpulkan diantara ruang rawat inap, pengangkutan sampah medis dan sampah nonmedis digabung dengan menggunakan kendaraan roda tiga ke TPS, sampah medis dikumpulkan pada tempat penampungan sementara sedangkan sampah nonmedis dibuang ke tempat pembuangan akhir. Tenaga kebersihan yang ada belum pernah dilatih tentang pengelolaan sampah rumah sakit,begitu juga dengan prosedur tetap (SOP) yang merupakan pedoman bagi petugas kebersihan dalam pengelolaan sampah belum ada.
Kesimpulan: Pengelolaan dan penanganan sampah yang ada di RSUD. Hadji Booejasin secara umum masih belum sesuai dengan peraturan yang berlaku, sehingga masih perlu pembenahan yang lebih baik lagi.
Kata kunci: Pengelolaan sampah, RSUD
Center for Health Policy and Management
2017-05-25 07:38:38
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/29000
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 1 (2017)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/29001
2017-05-25T00:38:38Z
jkki:ART
"170301 2017 eng "
2620 4703
2089 2624
dc
Pengelolaan Sisa Lebih Dana Kapitasi di Fasilitas Kesehatan Tingkat Pertama Milik Pemerintah (Monitoring dan Evaluasi Jaminan Kesehatan Nasional di Indonesia)
Kurniawan, M Faozi
Pusat Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Universitas Gadjah Mada
Siswoyo, Budi Eko
Grup Penelitian dan Pengembangan, BPJS Kesehatan Pusat
Novelira, Aulia
Grup Penelitian dan Pengembangan, BPJS Kesehatan Pusat
Sulistiawan, Dedik
Grup Penelitian dan Pengembangan, BPJS Kesehatan Pusat
Aisyah, Wan
Grup Penelitian dan Pengembangan, BPJS Kesehatan Pusat
Gadistina, Welly
Grup Penelitian dan Pengembangan, BPJS Kesehatan Pusat
Kurniawati, Golda
Grup Penelitian dan Pengembangan, BPJS Kesehatan Pusat
nutilized fund, capitation, JKN
ABSTRACT
Background: During the two years of implementation of the National Health Insurance (JKN), many national and district regulations have been published and revised. However, there is no clear regulation in the management of unutilized capitation fund. The high actual capitation in line with the low utilization ratio, which means it could potentially lead unutilized capitation. Financial management in the district that has not been integrated with unutilized capitation become a challenge for the Puskesmas to accommodate the operational requirements of service.
Objective: To analyze the potential and the management of unutilized capitation of JKN program at the Puskesmas and its determinant factors
Method: This is a case study using cross sectional design and implementation research approach. A total of 492 samples in 13 regionals and 26 districts were selected using multistage random sampling. Primary data were collected through series of interviews and FGDs using a standardized questionnaire. Variables that become secondary data (2014-2015) were collected from Puskesmas and BPJS Kesehatan database. Qualitative data were analyzed using thematic approach and quantitative data were analyzed descriptively and analytically using test for comparison and correlation.
Result: Allocation in the utilization of capitation funds, distribution of membership, geographical aspects, service time, the ratio of doctors to the participants, contact rate, total revenue from the Puskesmas have correlation to the unutilized capitation and performance indicators. Planning, budgeting, and disbursement of unutilized capitation follow the budget mechanism of APBD, either early budget document or the mid-year budget document; so it can not be used directly by Puskesmas without submission, reconciliation, and the budget approval from the district government. Nevertheless, the majority of Puskesmas do not manage unutilized capitation because there are no local regulations and technical guidelines for managing unutilized capitation fund.
Conclusion: Intervention should consider the variables that had a significant correlation value, both on unutilized capitation and performance indicators. It is necessary to evaluate the fund channeling; and also the strengthening of the regulation should also be followed by optimizing the role BPJS Kesehatan, Health Office, and other stakeholders to support the implementation of the concept of strategic purchasing.
Keywords: unutilized fund, capitation, JKN
ABSTRAK
Latar Belakang: Selama dua tahun penyelenggaraan program Jaminan Kesehatan Nasional (JKN), banyak regulasi nasional dan daerah yang telah diterbitkan dan direvisi. Walaupun demikian, belum ada kejelasan regulasi dalam pengelolaan sisa lebih kapitasi. Tingginya kapitasi aktual sejalan dengan rendahnya rasio utilisasi yang pada akhirnya berpotensi menimbulkan sisa lebih kapitasi. Belum terintegrasinya pengelolaan keuangan daerah dan sisa lebih dana kapitasi menjadi tantangan Puskesmas untuk mengakomodir kebutuhan operasional pelayanan.
Tujuan: Menganalisis potensi dan pengelolaan sisa lebih kapitasi JKN di Puskesmas beserta faktor-faktor determinannya.
Metode: Studi kasus dengan rancang bangun cross sectional ini menggunakan pendekatan riset implementasi. Sejumlah 492 sampel dari 13 regional dan 26 kabupaten/ kota ditentukan secara multistage random sampling. Data primer dikumpulkan melalui serangkaian wawancara dan FGD menggunakan kuesioner terstandar. Variabel yang menjadi data sekunder (2014-2015) dikumpulkan dari Puskesmas dan BPJS Kesehatan. Data kualitatif dianalisis dengan pendekatan tematik, sementara data kuantitatif dianalisis secara deskriptif dan analitik menggunakan uji komparasi dan uji korelasi.
Hasil: Alokasi pemanfaatan dana kapitasi, distribusi kepesertaan, aspek geografis, waktu pelayanan, rasio dokter terhadap peserta, angka kontak, total penerimaan Puskesmas berkorelasi terhadap sisa lebih dana kapitasi dan capaian indikator komitmen pelayanan. Perencanaan, penganggaran, dan pencairan sisa lebih dana kapitasi mengikuti mekanisme APBD baik induk maupun perubahan; sehingga tidak dapat digunakan secara langsung oleh Puskesmas tanpa pengajuan, rekonsiliasi, dan pengesahan dokumen anggaran dari Pemda. Walaupun demikian, sebagian besar Puskesmas belum mengelola sisa lebih dana kapitasi karena tidak ada Peraturan Daerah dan pedoman teknis pelaksanaan.
Kesimpulan: Intervensi dapat mempertimbangkan variabel yang memiliki nilai korelasi signifikan, baik terhadap sisa lebih dana kapitasi dan capaian komitmen pelayanan. Selain perlu adanya evaluasi fund channeling; penguatan regulasi sebaiknya juga diikuti dengan optimalisasi peran BPJS Kesehatan, Dinkes, dan stakeholder lainnya untuk mendukung penerapan strategic purchasing.
Kata Kunci: sisa lebih, kapitasi, JKN
Center for Health Policy and Management
2017-05-25 07:38:38
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/29001
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 1 (2017)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/29002
2017-05-25T00:38:38Z
jkki:ART
"170301 2017 eng "
2620 4703
2089 2624
dc
Persepsi Bidan Praktek Mandiri terhadap Paket Persalinan Badan Penyelenggara Jaminan Sosial (BPJS) dalam Keberlanjutan Kerjasama menjadi Provider dalam Jejaring Dokter Keluarga di Kota Bengkulu
Solekah, Siti
Mahasiswa Minat KPMAK Program Studi Ilmu Kesehatan Masyarakat, Fakultas Kedokteran Universitas Gadjah Mada
Hakimi, Mohammad
Program Studi Ilmu Kesehatan Masyarakat, Fakultas Kedokteran Universitas Gadjah Mada
Claramita, Mora
Pengajar pada Program Magister Kesehatan Masyarakat, Universitas Gadjah Mada
Independent Midwife Practice, Delivery Package, BPJS
ABSTRACT
Background: Maternal deaths as a global public health problem and urgent to be addressed through the launch of the Safe Motherhood program. UN Resolution on universal health coverage (Universal Health Coverage) is an important resolution and urged all countries to develop a health system with equitable access and affordable cost. This is one of the programs to reduce MMR and IMR. Based on research in three countries, namely Burkina Faso, Ghana and Tanzania also had a strong effort to improve the quality of maternal and neonatal health (MNH) In addition, these three countries are also striving to improve the performance and motivation of the provider. In Indonesia, according to Ministry of Health Decree No. 59 Year 2014 About the standard of health care, require midwives in cooperation with BPJS through a network of family doctors who have been appointed to make the deal as one of the Government's aim to improve maternal and child health (MCH).
Methods: This study is a qualitative research design of phenomenology. Data collection is carried out by the method of in depth review or directly using the guidelines of unstructured interviews, and open questions midwives practice independently as a unit of analysis. Samples or informants taken up to a certain saturation or have reached sufficient number until there is no more data that needs to be explored. Triangulation of data include interview with the chairman of the Indonesian Midwives Association (IBI). Midwife verifiers and family doctor.
Results: The results showed that midwives have a bad perception of the delivery package BPJS today. The reason is partly that the mechanism of the claims made package, complicated claim procedures and disbursement process long and low birth rates. So the motivation BPM in cooperation with the current BPJS is relatively small. The phenomenon that researchers have found that there are several midwife, although still tied to cooperation with BPJS but not serving patients with BPJS. Other phenomena that is the BPM want to directly contracted by with BPJS without a network of family doctors. This is due to lack of socialization of BPJS for strengthening primary care program that is currently being initiated by the government.
Conclusions: The perception of Independent Midwife Practice against BPJS delivery package is still bad. Although the objective of the government is quite good, but there is still need for evaluation and dissemination as an effort to strengthen the primary care for BPM in the sustainability of cooperation in networks of family doctors in the hope that the package delivery mechanism is not paid in package and increase of the delivery service tarif rates between 800 thousand to 1.5 million IDR.
Keywords: Independent Midwife Practice, Delivery Package, BPJS
ABSTRAK
Latar Belakang: Kematian ibu sebagai masalah kesehatan masyarakat global dan mendesak untuk segera ditanggulangi melalui peluncuran program Safe Motherhood. Resolusi PBB pada cakupan kesehatan universal (Universal Health Coverage) pada bulan desember 2012, yang menggaris bawahi bahwa UHC merupakan resolusi yang penting dan mendesak pada semua negara untuk mengembangkan system kesehatan dengan akses yang adil dan biaya yang terjangkau. Hal ini merupakan salah satu program untuk menurunkan AKI dan AKB. Berdasarkan penelitian di tiga Negara yaitu Burkina Faso, Ghana dan Tanzania juga memiliki upaya yang kuat untuk meningkatkan kualitas kesehatan ibu dan bayi (MNH) Selain itu ketiga negara tersebut juga berjuang untuk meningkatkan kinerja dan motivasi para provider. Di Indonesia, berdasarkan Keputusan Menteri Kesehatan Nomor 59 Tahun 2014 Tentang standar pelayanan kesehatan, mewajibkan para bidan bekerjasama dengan BPJS melalui jejaring dokter keluarga yang telah ditunjuk untuk membuat kesepakatan sebagai salah satu tujuan pemerintah untuk meningkatkan pelayanan kesehatan ibu dan anak (KIA).
Metode: Penelitian ini merupakan penelitian kualitatif dengan rancangan fenomenologi,. Pengambilan data dilaksanakan dengan metode wawancara mendalam secara langsung menggunakan pedoman wawancara tidak terstruktur, dan pertanyaan terbuka kepada para bidan praktek mandiri sebagai unit analisis. Sampel atau informan di ambil sampai dengan saturasi tertentu atau telah mencapai kecukupan hingga tidak ada lagi data yang perlu digali. Sebagai triangulasi yang dipilih antara lain ketua IBI, Bidan Koordinator/verifikator dasar dan Dokter keluarga.
Hasil: Dari hasil penelitian menunjukkan bahwa para bidan memiliki persepsi yang buruk terhadap paket persalinan BPJS saat ini. Meskipun jumlah paketnya lebih besar dari Jampersal, namun tidak semua paket bisa diklaimkan. Penyebabnya antara lain yaitu mekanisme klaim yang dibuat perpaket, prosedur klaimnya rumit dan proses pencairannya lama serta rendahnya tarif persalinan. Sehingga motivasi Bidan Praktek Mandiri (BPM) didalam kerjasama dengan BPJS saat ini relatif kurang. Fenomena yang peneliti temukan yaitu ada beberapa bidan yang meskipun masih terikat kerjasama dengan BPJS tetapi tidak melayani pasien persalinan dengan BPJS. Hal ini terkait dengan rumitnya prosedur paket persalinan BPJS sehingga bidan enggan untuk mengklaim ke BPJS. Fenomena lainnya yaitu para BPM ingin bisa langsung bekerjasama dengan BPJS tanpa melalui jejaring dokter keluarga. Hal ini akibat kurangnya sosialisasi dari BPJS untuk program penguatan layanan primer yang saat ini sedang dicanangkan oleh pemerintah.
Kesimpulan: Persepsi Bidan Praktek Mandiri terhadap paket persalinan BPJS masih buruk. Untuk keberlanjutan menjadi provider di dalam jejaring dokter keluarga para BPM masih ingin tetap melanjutkan namun dengan harapan agar mekanisme paket persalinan tidak di buat perpaket dan ada peningkatan tarif persalinan antara 800 ribu sampai 1.5 juta rupiah.
Kata Kunci: Persepsi, Bidan Praktek Mandiri, Paket Persalinan, BPJS
Center for Health Policy and Management
2017-05-25 07:38:38
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/29002
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 1 (2017)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/29003
2017-05-25T00:38:38Z
jkki:ART
"170301 2017 eng "
2620 4703
2089 2624
dc
Evaluasi Program Penanggulangan Kejadian Luar Biasa Infeksi Daerah Operasi Pasca SC di Departemen Obsgin RSCM
Hakim, Surahman
Program Studi Ilmu Kesehatan Masyarakat Fakultas Kedokteran Universitas Gajah Mada Yogyakarta
IDO, context, mechanism, outcome, realist evaluation
ABSTRACT
Background: Surgical Site Infection (SSI) is one of the complication of surgery that disturbing, both in the patient nor the doctor and the hospital as a health care provider. There is an increased incidence of SSI post-Cesarian Section in the Department of Obstetric and Gynecology in August 2014 ie from the range of 0.16% - 0.33% to 2.32%, whereas RSCM standard should not be more than 2%. The hospital has made several efforts in the prevention program of outbreak SSI post-Cesarian Section by some parties concerned, namely the Committee on Hospital Infection Prevention (PPIRS) by IPCN (Infection Prevention Control Nurse).
Method: This study uses a realist evaluation with context, mechanism, and outcome. The data is collected by interviews and focus group discussions with related parties as well as conducting a document review and observations. The results of the study were analyzed using content analysis.
Result. Using the hypothesis of C-M-O, that the context is correct, however IPCN and infrastructure in operating rooms also provide a big influence in overcoming the problem of IDO, to decrease the incidence of SSI and increased compliance. Conclusion. The program succeeded in reducing the incidence of SSI with an improved C-M-O.
Keywords: Surgical Site Infection (SSI), context, mechanism, outcome, realist evaluation
ABSTRAK
Latar belakang: Infeksi Daerah Operasi (IDO) merupakan salah satu komplikasi tindakan operasi yang sangat mengganggu, baik dari sisi pasien maupun dokter dan rumah sakit sebagai penyedia layanan kesehatan. Terjadi peningkatan insiden IDO pasca-SC di Departemen Obstetri dan Ginekologi pada bulan September 2014 yaitu dari kisaran 0,16% - 0,33% menjadi 2,32%, sedangkan ambang di RSCM tidak boleh lebih dari 2%. Rumah sakit telah melakukan beberapa upaya dalam program penanggulangan KLB IDO pasca-SC oleh beberapa pihak yang terkait, yaitu Panitia Penanggulangan Infeksi di Rumah Sakit (PPIRS) oleh IPCN (Infection Prevention Control Nurse).
Metode: Penelitian ini menggunakan metode realist evaluation dengan pola context, mechanism, dan outcome. Pengumpulan data dilakukan dengan wawancara dan FGD kepada pihak terkait serta melakukan telaah dokumen dan observasi. Hasil penelitian dianalisis menggunakan analisis isi.
Hasil: Dengan menggunakan hipotesis C-M-O, bahwa context sudah tepat, mechanism selain peran IPCN, sarana dan prasarana di ruang-ruang operasi juga memberikan andil yang cukup besar dalam penanggulangan masalah IDO, dan
outcome terjadi penurunan angka kejadian IDO dan peningkatan kepatuhan.
Kesimpulan: Program berhasil menurunkan kejadian IDO dengan C-M-O yang sudah disempurnakan.
Kata Kunci: IDO, context, mechanism, outcome, realist evaluation
Center for Health Policy and Management
2017-05-25 07:38:38
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/29003
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 1 (2017)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/29005
2017-05-25T00:38:38Z
jkki:ART
"170301 2017 eng "
2620 4703
2089 2624
dc
Faktor-Faktor yang Mempengaruhi Rawat Inap Ulang Pasien Skizofrenia pada Era Jaminan Kesehatan Nasional di Rumah Sakit Jiwa Grhasia Pemda DIY
Pratiwi, Suri Herlina
Mahasiswa Pasca Sarjana Ilmu Kesehatan Masyarakan, Fakultas Kedokteran Universitas Gadjah Mada
Marchira, Carla Raymondalexas
Bagian Psikiatri, Rumah Sakit Sardjito, Yogyakarta
Hendrartini, Julita
Pasca Sarjana Ilmu Kesehatan Masyarakat, Fakultas Kedokteran, Universitas Gadjah Mada
schizophrenia, readmission, medication adherence, caregiver level of knowledge, national health insurance
ABSTRACT
Background: The implementation of National Health Insurance (JKN) applies a quality and cost control system services aimed at improving the efficacy and effectivity of health insurance with managed care principle. Readmission is used as an indicator for effectivity and technical competence of a hospital. The increasing cases of readmission, specifically in schizophrenia patients, leads to an increase in health care costs in the hospital. The aim of this study is to know the determinant factors of readmission of schizophrenia patients.
Methods: This study was a non-experimental research using a case control study plan. The study was conducted in Grhasia Mental Hospital. The samples were 53 groups of readmission and 53 group of non-readmission. The respondents were the schizophrenia patients and their caregivers. The data collecting used questionnaire and in-depth interview.
Result: Bivariate analysis showed the incidence of readmission of schizophrenia patients to some risk factors as follows: (1) Marriage OR 2.822; CI95% 1.082 – 7.630; p-value 0.018; (2) Work OR 2.709; CI95% 1.063 – 7.106; p-value 0.021; (3) Medication Adherence OR 14.692; CI95% 5.245 – 42.221; p-value <0.001; (4) Caregiver Level of Knowledge OR 8.571; CI95% 2.213 – 47.927; p-value 0.0003. Multivariate analysis showed that risk factors affecting incidence of readmission of schizophrenic patients are medication adherence (OR13.556, CI95% 5.037 - 36.480; p-value <0.001) and caregiver level of knowledge (OR 7.175; CI95% 1.628 – 31.605; p-value 0.009).
Conclusion: Determinant factors of the readmission of schizophrenia patients are the lack of medication adherence of the patients and caregiver’s lack of knowledge. Demographic factors (age, gender, marital status, education, and job) and ownership of health insurance are not statistically significant to the readmission of schizophrenia patients.
Keywords: schizophrenia, readmission, medication adherence, caregiver level of knowledge, national health insurance
ABSTRAK
Latar Belakang: Implementasi Jaminan Kesehatan Nasional (JKN) menerapkan sistem kendali mutu dan biaya pelayanan bertujuan untuk meningkatkan efisiensi dan efektifitas jaminan kesehatan dengan prinsip managed care. Readmission sebagai dimensi mutu efektivitas dan kompetensi teknis rumah sakit. Meningkatnya kasus readmission pasien skizofrenia di rumah sakit meningkatkan biaya pelayanan kesehatan. Tujuan penelitian ini adalah mengetahui faktor-faktor yang mempengaruhi rawat inap ulang (readmission) pada pasien skizofrenia.
Metode: Penelitian ini merupkan studi non eksperimental menggunakan rancangan case control study. Penelitian dilakukan di RSj Grhasia. Jumlah sampel 53 pasien kelompok readmission dan 53 pasien pada kelompok non readmission. Responden penelitian ini adalah pasien skizofrenia dan caregiver. Pengumpulan data dengan kuesioner dan wawancara mendalam.
Hasil: Analisis bivariat menunjukkan kejadian readmission terhadap faktor resiko perkawinan diperoleh nilai OR 2,822, CI 95% 1,082-7,630, p-value 0,018; pekerjaan diperoleh nilai OR 2,709, CI 95% 1,063-7,106, p-value 0,021; kepatuhan minim obat diperoleh nilai OR 14,692, CI 95% 5,247-42,221, p-value <0,001; tingkat pengetahuan caregiver diperoleh nilai OR 8,571, CI 95% 2,213-47,927, p-value 0,0003. Hasil analisis multivariat menunjukkan bahwa faktor resiko yang berpengaruh terhadap kejadian readmission pasien skizofrenia adalah kepatuhan minum obat (OR 13,556, CI 95% 5,037-36,480, p-value <0,001) dan tingkat pengetahuan caregiver (OR 7,175, CI 95% 1,628- 31,605, p-value 0,009).
Kesimpulan: Faktor-faktor yang mempengaruhi readmission pasien skizofrenia adalah kepatuhan minum obat dan tingkat pengetahuan caregiver. Faktor demografi (usia, jenis kelamin, status perkawinan, pendidikan dan pekerjaan) tidak bermakna secara statistik terhadap readmission pasien skizofrenia.
Kata Kunci: skizofrenia, readmission, kepatuhan minum obat, pengetahuan caregiver, jaminan kesehatan.
Center for Health Policy and Management
2017-05-25 07:38:38
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/29005
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 1 (2017)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/29152
2017-10-09T15:39:00Z
jkki:ART
"161201 2016 eng "
2620 4703
2089 2624
dc
Audit Mutu Layanan Rujukan Primer Guna Mengurangi Jumlah Rujukan ke Layanan Sekunder. Studi Kasus pada Provinsi DKI Jakarta
Hardhantyo, Muhammad
Pusat Kebijakan dan Manajemen Kesehatan Fakultas Kedokteran Universitas Gadjah Mada
Armiatin, Armiatin
Pusat Kebijakan dan Manajemen Kesehatan Fakultas Kedokteran Universitas Gadjah Mada
Utarini, Adi
Pusat Kebijakan dan Manajemen Kesehatan Fakultas Kedokteran Universitas Gadjah Mada
Djasri, Hanevi
Pusat Kebijakan dan Manajemen Kesehatan Fakultas Kedokteran Universitas Gadjah Mada
Referral and conultation, gate keeper, quality assurance
ABSTRACT
Background: Cost control care was sensitive issue in Universal Health Coverage (UHC) era. Some assume it could be achieved by reduce the quality given or service fee for functional staff. However, optimizing primary care services to avoid hospitalization could be another form of cost controlled care
Method: Retrospective audit was performed to 1025 medical record from 15 primary health office in DKI Jakarta Province. Sample was patient referred to hospital from Januari 1st until June 30th 2015. W e monitored percentage of complete documentation, accuracy and quality of referred patient specifically for four diagnosis which Diabetes Melitus, Severe Pre Eclamcia, Hypertension and Dengue Fever. Selection of those diagnose was made based on high patient referred with low quality (60,2%). Result of audit was use to made effective refferal system guidance that contained referral manual for four case and revision of referral form.
Result: Patient referred were 0-87 year old. Majorly range from 60-70 year old (25,9%), 43,2% were men and 56,8% were woman, and most of them 54,5% used universal health coverage BPJS PBI. Medical record audit showed there is only 69,5% (SD ± 13.26) patient deserved to be referred to hospital from primary health office. After implementation the re-audit result showed significant improvement of referral quality, from 69,5% become 83,4% (SD ± 13.67, P<0.05), including its complete documentation, accuracy, and quality of the referral system.
Conclutsion: The innovation for improving quality of referral system need support from various stakeholder. Referral form changes need approval from BPJS because its function not merely for administation, it is a way to communicate between primary doctors and specialist in hospital. Some component was missing in referral form today. Referral guidance revision from Ikatan Dokter Indonesia also needed for 155 cases in primary health office. Cost controlled care in universal health coverage could be achieved by optimizing the function of doctor in primary health office.
Keyword: Referral and conultation, gate keeper, quality assurance
ABSTRAK
Latar Belakang: Kendali biaya merupakan suatu hal yang sensitif di era Jaminan Kesehatan Nasional saat ini, banyak yang beranggapan bahwa kendali biaya berarti menurunkan mutu pelayanan atau jasa medis untuk staf fungsional. Padahal salah satu bentuk dari kendali biaya adalah optimalisasi peran dokter primer dengan menurunkan angka rujukan yang tidak perlu dari puskesmas.
Metode: Audit dilakukan secara restrospektif, kami mengambil sampel sebanyak 1025 rekam medis pasien yang di rujuk dari 15 puskesmas di Provinsi DKI Jakarta selama periode Januari hingga Juni 2014. Audit rekam medis dilakukan untuk melihat aspek kelengkapan, ketepatan, serta mutu rujukan terutama pada empat kasus khusus yakni Diabetes Melitus, Pre Eklamsia, Hipertensi dan Demam Dengue. Pemilihan kasus tersebut didasarkan pada tingginya angka rujukan disertai dengan rendahnya kualitas rujukan pada empat kasus tersebut (60,2%). Hasil audit kemudian dijadikan acuan guna penyusunan sistem rujukan efektif yang terdiri dari manual rujukan, perbaikan form rujukan serta pedoman rujukan primer pada empat kasus.
Hasil: Pasien yang dirujuk berusia antara 0 hingga 87 tahun (mean ± SD, 46.78 ± 19.15) dengan rentang usia terbesar adalah 60 hingga 70 tahun sebanyak 25,9%, laki-laki 43,2% dan perempuan 56,8%, dengan jaminan kesehatan terbanyak merupakan pengguna kartu BPJS PBI sebanyak 54,5%. Hasil audit menunjukkan bahwa hanya terdapat 69.5% (SD ± 13.26) kasus rujukan yang berkualitas dari 15 puskesmas di Provinsi DKI Jakarta. Pasca adanya implementasi, hasil re-audit menunjukkan peningkatan signifikan kualitas rujukan menjadi 83.4% (SD ± 13.67, P<0.05), baik dari segi kelengkapan, ketepatannya maupun mutunya.
Kesimpulan: Inovasi untuk meningkatkan kualitas sistem rujukan memerlukan dukungan dari berbagai stakeholder. Penggantian form rujukan memerlukan persetujuan dari BPJS karena fungsinya tidak hanya sebagai kelengkapan administrasi tetapi juga sebagai jembatan komunikasi antara dokter umum dengan spesialis di rumah sakit. Saat ini beberapa komponen dalam form masih kurang lengkap. Perbaikan pedoman rujukan bagi 155 kasus yang dapat ditangani di puskesmas perlu disusun oleh Ikatan Dokter Indonesia. Dengan berbagai perbaikan tersebut, kendali biaya di era jaminan kesehatan saat ini dapat tercapai dengan mengoptimalkan fungsi dokter di layanan primer.
Kata Kunci: Rujukan dan Konsultasi, Gate keeper, Jaminan Kualitas
Center for Health Policy and Management
2017-10-09 22:39:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/29152
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 5, No 4 (2016)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/29658
2017-10-09T15:47:21Z
jkki:ART
"170901 2017 eng "
2620 4703
2089 2624
dc
Analisis Kebijakan Pemanfaatan Dana Kapitasi JKN pada FKTP Puskesmas di Kabupaten Bogor Tahun 2016
Hasan, Abdul Gani
Fakultas Kesehatan Masyarakat, Universitas Indonesiam, Depok
Adisasmito, Wiku B.B.
Departemen Administrasi dan Kebijakan Kesehatan, Fakultas Kesehatan Masyarakat Universitas
Indonesia, Depok
kapitasi; FKTP; Puskesmas
Abstract
Background: The purpose of analyzing the policy of utilization of JKN capitation fund at FKTP Puskesmas in Bogor Regency refers to Permenkes 21 year 2016. Method: Qualitative with Rapid Assessment Procedure, in-depth interview on 12 informant, purposive sample, related to research objectives. Results: There is a high disparity of capitation funds for puskesmas covering participants, capitation norms, number of doctors and the ratio of doctors between various puskesmas. In-depth interviews found the difficulty of fulfilling the ideal physician ratio, low capitation norms indicated the low quality of the puskesmas, not all the puskesmas did the proper planning process, the small capitation clinics were difficult in the operational and the overwhelming operational and potentially piled up, Drug fulfillment is constrained by procurement, the potential for overlapping capitation with BOK and the quality of physician services decreases in the ratio of physicians per large participant. Conclusions and suggestions: The ratio of physicians to participants is still below the standard of 1: 5000 participants need equalization effort, 60% capitation portion for services and 40% other opersional, different sufficiency there should be operational fund backups for the less, the disincentives of service need to be reviewed, Capitation of 40% portion can be complementary with BOK, the rest of the budget is advantageous if the activity alternative can be effectively efficient according to society requirement, need improvement of drug procurement mechanism, budget flexibility need to be pushed PPK-BLUD at puskesmas.
Keywords: capitation; FKTP; Puskesmas
Abstrak
Latar Belakang : Tujuan menganalisis kebijakan pemanfaatan dana kapitasi JKN pada FKTP Puskesmas di Kabupaten Bogor mengacu Permenkes 21 tahun 2016. Metode : Kualitatif dengan Rapid Assesment Procedure, wawancara mendalam pada 12 informan, sampel purposive, terkait tujuan penelitian. Hasil : Terdapat disparitas tinggi dana kapitasi puskesmas meliputi peserta, norma kapitasi, jumlah dokter dan rasio dokter antara berbagai puskesmas. Wawancara mendalam didapatkan sulitnya pemenuhan rasio dokter ideal, norma kapitasi rendah menunjukkan kuantitas kualitas puskesmas rendah, belum semua puskesmas melakukan proses perencanaan dengan benar, puskesmas kapitasi kecil sulit dalam operasional dan yang besar berlebih operasional dan berpotensi menumpuk, penentuan poin cukup jauh berbeda antar tenaga, pemenuhan obat-obatan terkendala oleh pengadaan, potensi overlapping kapitasi dengan BOK dan kualitas pelayanan dokter menurun pada rasio dokter per peserta besar. Kesimpulan dan saran : Rasio dokter dengan peserta masih dibawah standar 1:5000 peserta perlu upaya pemerataan, porsi kapitasi 60% untuk Jasa dan 40% opersional lain, ketercukupannya berbeda perlu ada backup dana operasional untuk yang kurang, adanya disinsentif jasa pelayanan perlu dikaji ulang, kapitasi porsi 40% dapat komplementer dengan BOK, sisa anggaran menguntungkan bila alternatif kegiatan mampu efektif efisien sesuai kebutuhan masyarakat, perlu perbaikan mekanisme pengadaan obat, dalam fleksibilitas anggaran perlu didorong PPK- BLUD pada puskesmas.
Kata kunci : kapitasi; FKTP; Puskesmas
Center for Health Policy and Management
2017-10-05 14:15:34
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/29658
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 3 (2017)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/29659
2017-10-09T15:47:21Z
jkki:ART
"170901 2017 eng "
2620 4703
2089 2624
dc
Faktor yang Mempengaruhi Rekrutmen Dokter di Puskesmas Wilayah Kerja Dinas Kesehatan Kabupaten Buol Tahun 2016
Arifandi, Arifandi
Mahasiswa Pascasarjana Ilmu Kesehatan Masyarakat, Fakultas Kedokteran Universitas Gadjah Mada, Yogyakarta
Meliala, Andreasta
Departemen Kebijakan dan Manajemen Pelayanan Kesehatan Fakultas Kedokteran Universitas Gadjah Mada, Yogyakarta
rekrutmen, seleksi, dokter
ABSTRACT
Background: One of the health human resource management functions is to perform recruitments. Recruitment is a practice or activity undertaken by an organization with the primary purposes of identifying and attracting potential workers. Based on the profile data of Public Health Office of Buol by 2015 and 2016 were still lacking of physicians. This suggested that recruitment process conducted by Public Health Office of Buol was ineffective because it didn’t meet the standard of supply. This study aims to determine procedures of physician’s recruitment at Public Health Office of Buol and identify factors affecting the willingness of physicians to be placed at Primary Health Care of Buol. Method: This is descriptive study with qualitative approach. Informants collected were 11 respondents (N=11) consisting of Officers of Public Health Office, Regional Employment Institution, Non-Permanent Physicians working in the District of Buol. Finding: The number of Primary Care Physicians has not met yet the standard of the need and the distribution is not widespread. Factors affecting the willingness of physicians to work in Buol are compensation which is accordance with the standard of salary for the very remote areas and the reward, career path in which physicians have the chance of being civil servants as well as further promotion of education. Inhibiting factors including working condition, workload and environmental factors such as quiet and remote area. Conclusion: Recruitment of physicians of Primary Health Care conducted by Public Health Office of Buol was ineffective yet and need improvement efforts regarding recruitment process and improves factors supporting the willingness of physicians to work in the District of Buol.
Keywords: recruitment, physician, supporting, inhibit.
ABSTRAK
Latar Belakang: Salah satu fungsi manajemen sumber daya manusia kesehatan adalah melaksanakan rekrutmen. Jumlah dokter di Kabupaten Buol masih kurang. Pada tahun 2015, jumlah dokter di Kabupaten Buol adalah sebanyak 15 dokter dengan rincian 9 dokter umum dan 6 dokter gigi, sedangkan standarnya adalah 26 dokter dengan rincian 15 dokter umum dan 11 dokter gigi. Oleh karena itu, ada kekurangan sebanyak 11 dokter dengan rincian 6 dokter umum dan 5 dokter gigi. Pada tahun 2016, jumlah dokter di Kabupaten Buol adalah sebanyak 8 dokter dengan rincian 3 dokter umum dan 5 dokter gigi, sedangkan standarnya adalah 26 dokter dengan rincian 15 dokter umum dan 11 dokter gigi. Oleh karena itu, ada kekurangan sebanyak 18 dokter dengan rincian 12 dokter umum dan 6 dokter gigi. Jumlah dokter di Kabupaten Buol pada tahun 2016 justru semakin berkurang dan semakin jauh dari kebutuhan standar. Kondisi ini menunjukkan bahwa proses rekrutmen yang dilaksanakan tidak efektif karena belum mampu memenuhi jumlah standar kebutuhan. Tujuan: Untuk mengetahui prosedur rekrutmen dokter di Dinas Kesehatan Kabupaten Buol dan mengidentifikasi faktor yang menghambat rekrutmen dokter di Dinas Kesehatan Kabupaten Buol. MetodePenelitian: Jenis penelitian ini adalah penelitian deskriptif dengan penekatan kualitatif. Informan dalam penelitian ini adalah pihak Dinas Kesehatan dan Dokter yang bekerja di Kabupaten Buol. Kesimpulan: Permasalahan yang terjadi dalam rekrutmen dokter di Kabupaten Buol adalah kurangnya jumlah pelamar. Hal ini dapat disebabkan karena kurangnya minat dan kesediaan dokter untuk bekerja di Kabupaten Buol. Faktor yang mendukung kesediaan dokter untuk bekerja di Kabupaten Buol adalah kompensasi yang sudah sesuai dengan standar gaji untuk wilayah terpencil dan penghargaan serta jenjang karir dimana dokter masih memiliki peluang untuk menjadi PNS dan mendapatkan promosi pendidikan lebih lanjut. Faktor yang menghambat kesediaan dokter untuk bekerja di Kabupaten Buol adalah kondisi kerja yang dinilai sangat berat karena kurangnya jumlah dokter pada Puskesmas rawat inap dan Puskesmas non rawat inap di Kabupaten Buol serta faktor lingkungan yang lebih luas yang dirasa sepi dan terpencil dan menjadi hambatan bagi sebagian dokter.
Kata kunci : rekrutmen, seleksi, dokter
Center for Health Policy and Management
2017-10-05 14:15:34
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/29659
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 3 (2017)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/29661
2017-10-09T15:47:21Z
jkki:ART
"170901 2017 eng "
2620 4703
2089 2624
dc
Analisis Pembiayaan Kesehatan Bersumber Pemerintah di Kota Serang Tahun 2014 – 2016
Sitorus, Estherlina
Departemen Administrasi Kebijakan Kesehatan,Fakultas Kesehatan Masyarakat Universitas Indonesia
Nurwahyuni, Atik
Departemen Administrasi Kebijakan Kesehatan,Fakultas Kesehatan Masyarakat Universitas Indonesia
Pembiayaan Kesehatan, DHA, Belanja Kesehatan
ABSTRACT
Background:This study aims to obtain information about health financing based on sources and utilization of funds derived from the government in Serang City year 2014-2016, as well as commitment from the local government of Serang City towards health financing by using approach District Health Account (DHA. The results showed that the total budget for health financing funded by the government in Serang City from 2014-2016 has increased in 2014 amounting to Rp 61,759,128,963, in year 2015 it was amounting to Rp 77,302,110,763 and in year 2016 of Rp 88,278,652,111. The proportion of APBD Serang City in the Year 2014 was 6.02%, Year 2015 was 6.99% and Year 2016 was 7.79%. This shows the commitment of Serang City government to funding the health sector. From the perspective of Health financing by function, the largest percentage is health system governance functions and for curative services. From the perspective of the program, many is allocated for health system strengthening program 59,55% -67,43%. While from the perspective of budget, most is allocated for the operational expense (83.68% -93.57%). With limited resources while increasing health needs, it will require the efficient use of existing resources as well as the selection of effective health program activities, and the need to make health budgeting policy as the basis or reference of health budget planning in Serang City.
Keywords: Health Financing, DHA, Health Expenditure
ABSTRAK
Penelitian ini bertujuan untuk memperoleh informasi tentang pembiayaan kesehatan berdasarkan sumber dan pemanfaatan dana yang berasal dari pemerintah di Kota Serang Tahun 2014- 2016, serta komitmen dari pemerintah Daerah Kota Serang terhadap pembiayaan kesehatannya dengan menggunakan pendekatan District Health Account (DHA). Hasil penelitian menunjukan bahwa total anggaran untuk pembiayaan kesehatan bersumber pemerintah di Kota Serang dari Tahun 2014-2016 mengalami peningkatan yaitu pada Tahun 2014 sebesar Rp 61.759.128.963, Tahun 2015 sebesar Rp 77.302.110.763
dan Tahun 2016 sebesar Rp 88.278.652.111. Jika dilihat dari persentase APBD Kota Serang pada Tahun 2014 sebesar 6,02%, Tahun 2015 sebesar 6,99% dan Tahun 2016 sebesar 7,79%. Hal ini menunjukan komitmen pemerintah Kota Serang terhadap pendanaan sektor kesehatannya. Pembiayaan kesehatan berdasarkan fungsi, persentase terbesar untuk fungsi tata kelola sistem kesehatan dan untuk pelayanan
kuratif. Berdasarkan program, banyak terealisasi untuk program penguatan Sistem kesehatan 59,55%-67,43%, berdasarkan mata anggaran, paling besar untuk belanja operasional (83,68%- 93,57%). Dengan sumber daya yang terbatas sedangkan kebutuhan kesehatan yang terus meningkat, maka diperlukan efisensi penggunaan sumber daya yang ada serta pemilihan program kegiatan kesehatan yang efektif, serta perlunya dibuat kebijakan penganggaran kesehatan sebagai dasar atau acuan perencanaan anggaran kesehatan di Kota Serang.
Kata Kunci: Pembiayaan Kesehatan, DHA, Belanja Kesehatan
Center for Health Policy and Management
2017-10-05 14:15:34
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/29661
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 3 (2017)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/29666
2017-10-09T15:47:21Z
jkki:ART
"170901 2017 eng "
2620 4703
2089 2624
dc
Hubungan Pemanfaatan Dana Bantuan Operasional Kesehatan (BOK) dengan Peningkatan Cakupan Kunjungan Antenatal K4 di Puskesmas Kota Serang Tahun 2014-2016
Laeliyah, Siti Nurul
Departemen Administrasi Kebijakan Kesehatan,Fakultas Kesehatan Masyarakat Universitas Indonesia
Nadjib, Mardiati
Departemen Administrasi Kebijakan Kesehatan,Fakultas Kesehatan Masyarakat Universitas Indonesia
Bantuan Operasional Kesehatan, Puskesmas, Kunjungan Antenatal K4
ABSTRACT
Health Operational Aid Fund (BOK) realization at Serang City Community Health Centers (CHC) through 2014-2016 has always reached 100% mark which more than 30% of the fund was allocated for maternal and children health each year. However the achievement from maternal and children health scope especially on K4 antenatal visit was not proportional with the budget, instead each year a decreasing trend from proposed target (75%) was observed thus the need of evaluation. This study was conducted at regional health agency and four CHCs (Banten Girang, Curug, Sawah Luhur and Serang Kota) with retrospective study case design and considering fund variables and scopes. The result shows lack of human and other resources in managing maternal and children health program; the lack of operational fund for preventive and promotive activities from regional government budget (APBD) and only rely on health operational fund; the lack of supervision in midwife records and reports, also the contract ending of trained cadres as the result of village chief replacement.
Keywords: community health centre, health operational fund, K4 antenatal visit
ABSTRAK
Realisasi dana Bantuan Operasional Kesehatan (BOK) di Puskesmas Kota Serang dari tahun 2014-2016 selalu mencapai 100% dengan alokasi dana untuk kegiatan KIA lebih dari 30% setiap tahunnya, namun tidak berbanding lurus dengan capaian cakupan pelayanan kesehatan ibu dan anak khususnya kunjungan antenatal K4 yang justru semakin tahun menunjukkan penurunan dari target yang ditetapkan (75%) sehingga perlu dievaluasi. Penelitian dilakukan di Dinas Kesehatan dan 4 Puskesmas, yaitu Puskesmas Banten Girang, Curug, Sawah Luhur dan Serang Kota dengan studi kasus bersifat retrospektif dan mempertimbangkan variabel dana serta cakupan. Hasil penelitian menunjukkan bahwa semua Puskesmas kekurangan sumber daya manusia dan sarana prasarana dalam mengelola program KIA, ketersediaan dana operasional untuk kegiatan preventif dan promotif dari APBD tidak ada dan hanya mengandalkan dana BOK, kurangnya pengawasan pencatatan pelaporan bidan, serta putusnya kontak dengan kader yang sudah dilatih sebagai efek pergantian kepala desa.
Kata Kunci: Bantuan Operasional Kesehatan, Puskesmas, Kunjungan Antenatal K4
Center for Health Policy and Management
2017-10-05 14:15:34
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/29666
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 3 (2017)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/29667
2017-10-09T15:47:21Z
jkki:ART
"170901 2017 eng "
2620 4703
2089 2624
dc
Pelaksanaan Kebijakan DAK Non Fisik Bidang Kesehatan untuk Tenaga Kontrak Promosi Kesehatan di Kabupaten Sumbawa dan Kabupaten Sleman Tahun 2016
Yuniati, Yuniati
Mahasiswa Pascasarjana Ilmu Kesehatan Masyarakat, Fakultas Kedokteran Universitas Gadjah Mada, Yogyakarta
Trisnantoro, Laksono
Departemen Kebijakan dan Manajemen Pelayanan Kesehatan, Fakultas Kedokteran Universitas Gadjah Mada, Yogyakarta
Sulistyo, Dwi Handono
Departemen Kebijakan dan Manajemen Pelayanan Kesehatan, Fakultas Kedokteran Universitas Gadjah Mada, Yogyakarta
Implementasi, outcome, kebijakan DAK non Fisik, Tenaga Kontrak promosi kesehatan,Consolidated Framework for Implementation Research
ABSTRACT
Background : In order to support the global commitment in addressing the burden of non-communicable diseases, the government through the Ministry of Health set the one of the targets of the National Development Strategy Plan is the promotion and preventive service through the availability of health promotion personnel at the Puskesmas. To meet these needs the government issued a policy that is the Regulation of the Minister of Health No. 82 of 2015 on Technical Guidance Special Allocation Fund for Health Operational Support where one of financing is for promotive and preventive activities directed to finance one (1) contract health promotion workers. Aims : To analyze the implementation of the policy of Non-Physical Special Allocation Fund of 2016 to recruit Health Promotion Contract Workers for Puskesmas in Sumbawa and Sleman districts. Methods : A single case study study was established using Implementation Research carried out at the Health Office in Sumbawa and Sleman districts. Informants were interviewed using the Consolidated for Implementation Research (CFIR) framework as a guide in collecting and analyzing qualitative data. Result :The most dominant factor of CFIRs affecting the implementation of contract labor policies is the internal communication network, particularly the involvement of the management. Organizational needs are the reasons for implementing a policy, but this is not a major factor in the implementation of a policy. Meeting the needs of the organization is influenced by the involvement factor of the leader of the organization in this case the leadership commitment to the vision of the organization, the implementation is also influenced by the external communication network organization that is: advocacy, coordination and cooperation with cross-related sector. Conclusion : The policy of recruitment of contract workers in Sleman district was successfully implemented because the policy makers and implementers played a good role, while Sumbawa regency did not implement this policy because of the difference perception about the need of health promotion personnel between Puskesmas as implementer of policy and health department as policy maker which supervises the Puskesmas.
Keyword : Implementation, outcome, DAK non-Physical policy, Contract force health promotion, Consolidated Framework for Implementation Research
ABSTRAK
Latar belakang: Isu global tentang beban penyakit tidak menular menjadi salah satu dasar kebijakan nasional di bidang kesehatan. Penyakit tidak menular adalah penyebab 68% kematian di dunia dan sebagian terjadi pada negara berpenghasilan menengah ke bawah. Dalam rangka mendukung komitmen global pemerintah melalui Kementerian Kesehatan menetapkan salah satu sasaran Rencana Strategi Pembangunan Nasional (RPJMN) adalah upaya pelayanan promotif dan preventif dalam rangka menurunkan kejadian penyakit tidak menular yang dalam beberapa tahun terakhir berkembang pesat. Untuk memenuhi kebutuhan tersebut pemerintah melalui Kementerian Kesehatan mengeluarkan kebijakan yaitu Peraturan Menteri Kesehatan Nomor 82 Tahun 2015 tentang Juknis Dana Alokasi Khusus sebagai Bantuan Operasional Kesehatan dimana salah satu pembiayaannya adalah untuk kegiatan promotif dan preventif yang diarahkan untuk membiayai satu (1) orang tenaga kontrak promosi kesehatan. Tujuan untuk menganalisis pelaksanaan kebijakan Dana Alokasi Khusus Non Fisik Tahun 2016 untuk merekrut Tenaga Kontrak Promosi Kesehatan di Kabupaten Sumbawa dan Kabupaten Sleman Metode: Penelitian studi kasus tunggal terjalin dengan strategi pendekatan menggunakan Riset Implementasi ini dilakukan di Dinas Kesehatan di Kabupaten Sumbawa yang belum melaksanakan kebijakan Tenaga Kontrak Promosi Kesehatan dan Kabupaten Sleman yang telah melaksanakanya. Informan diwawancarai dengan menggunakan kerangka kerja The Consolidated for Implementation Research (CFIR) sebagai panduan dalam pengumpulan dan analisis data kualitatif. Partisipasi aktif pembuat keputusan kebijakan baik di Pusat maupun di Daerah ikut dilibatkan selama proses penelitian berlangsung, mulai dari penentuan topik, pertanyaan penelitian sampai pada pelaksanaan penelitian.
Kata kunci: Implementasi, outcome, kebijakan DAK non Fisik, Tenaga Kontrak promosi kesehatan,Consolidated Framework for Implementation Research
Center for Health Policy and Management
2017-10-05 14:15:34
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/29667
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 3 (2017)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/29669
2017-10-09T15:47:21Z
jkki:ART
"170901 2017 eng "
2620 4703
2089 2624
dc
Implementasi Kebijakan Remunerasi di Rumah Sakit Pemerintah
Dakota, Iwan
Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita
Ayuningtyas, Dumilah
Progam Studi Pascasarjana Kajian Administrasi Rumah Sakit, Fakultas Kesehatan Masyarakat, Universitas Indonesia, Depok
Oktarina, Ratih
Progam Studi Pascasarjana Kajian Administrasi Rumah Sakit, Fakultas Kesehatan Masyarakat, Universitas Indonesia, Depok
Misnaniarti, Misnaniarti
Fakultas Kesehatan Masyarakat, Universitas Sriwijaya, Indralaya
Implementasi, kebijakan, remunerasi, rumah rakit
ABSTRACT
Background: Since 2008, Hospital A began implementing remuneration. However, this system gets the refusal of some parties. Therefore, aims this research was to determine the remuneration policy implementation at the Hospital A Jakarta. Method: The study was conducted with a qualitative approach through in-depth interviews and focus group discussions, each with 10 medical personnel involved. Result: The results of this study indicate that aspects of the environment in general have a positive perception of the organization while the relationship between negative perceptions obtained. Negative perceptions are also found on the organization’s resources and budget allocation accuracy especially bureaucratic commitment is relatively low. Meanwhile, the characteristic aspects and capabilities of implementing agencies received a positive perception. Secondary data showed an increase in financial performance and hospital services after the implementation of the remuneration. Conclusion: Implementation of the remuneration policy in Hospital A goes pretty well with a few flaws that need attention. Therefore, the necessary changes to the paradigm of gradual and continuous work culture of employees, improving the quality and quantity of communication between the organization and management of the employees regarding transparency, optimization remuneration policy dissemination and implementation of monitoring and evaluation on a regular basis with the involvement of all stakeholders.
Keyword : Implementation, Policy, Remuneration, Hospital
ABSTRAK
Latar Belakang: Sejak tahun 2008, Rumah Sakit A mulai menerapkan kebijakan remunerasi. Akan tetapi sistem ini mendapat penolakan dari sejumlah pihak. Oleh karena itu, tujuan studi ini adalah untuk mengetahui implementasi kebijakan remunerasi di Rumah Sakit A di Jakarta. Metode: Studi dilakukan dengan pendekatan kualitatif melalui wawancara mendalam dan diskusi kelompok terfokus, masing-masing dengan 10 tenaga medis yang terkait. Hasil: Hasil penelitian ini menunjukkan bahwa aspek kondisi lingkungan secara umum memiliki persepsi positif sedangkan hubungan antar organisasi didapatkan persepsi yang negatif. Persepsi yang negatif juga dijumpai pada sumber daya organisasi khususnya
ketepatan alokasi anggaran dan komitmen birokrasi yang relatif rendah. Sementara, aspek karakteristik dan kapabilitas instansi pelaksana mendapat persepsi positif. Data sekunder menunjukkan adanya peningkatan kinerja pelayanan dan keuangan rumah sakit setelah pelaksanaan remunerasi. Kesimpulan: Impelementasi kebijakan remunerasi di Rumah Sakit A berlangsung cukup baik dengan beberapa kekurangan yang perlu mendapatkan perhatian. Oleh karena itu, diperlukan perubahan bertahap dan berkesinambungan terhadap paradigma budaya kerja karyawan, peningkatan kualitas dan kuantitas komunikasi antar organisasi maupun manajemen dengan karyawan menyangkut tranparansi, pengoptimalan sosialisasi kebijakan remunerasi serta pelaksanaan monitoring dan evaluasi secara berkala dengan melibatkan semua pemangku kepentingan.
Kata kunci: Implementasi, kebijakan, remunerasi, rumah rakit
Center for Health Policy and Management
2017-10-05 14:15:34
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/29669
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 6, No 3 (2017)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/30527
2017-10-09T15:39:00Z
jkki:ART
"161201 2016 eng "
2620 4703
2089 2624
dc
Faktor yang Berhubungan dengan Implementasi Keselamatan Pasien Di RSUD Ajjappannge Soppeng Tahun 2015
Rivai, Fridawaty
Rumah Sakit Fakultas Kesehatan Masyarakat Universitas Hasanuddin
Sidin, A.Indahwaty
Rumah Sakit Fakultas Kesehatan Masyarakat Universitas Hasanuddin
Kartika, Ita
Rumah Sakit Fakultas Kesehatan Masyarakat Universitas Hasanuddin
Implementasi keselamatan pasien, Kepemimpinan, dan Supervisi
ABSTRACT
Backgroud: The incidence of nosocomical in Ajjappannge Soppeng hospital still high ie 2.4 %. Mortality rate of patient still high (1.2%), caused by 0.6% of drug administration error and the lack of use of protecequipment ADP. This indicates that the implementation of patient safety in RSUD Ajjappannge Soppeng.
Objective: This study aims to determine factors related to the implementation of patients safety at RSUD Ajjappannge in 2015.
Methods: This research is an observational with cross- sectional approach and using univariate and bivariate analysis with chi-square test ±=0.05. The population of the study was all inpatient nurses in Ajjappannge Soppeng Hospital. Sampling technique using exhaustive sampling where all the population being sampled by 137 nurses.
Result: The result indicate that the implementation of patient safety include in good category (54,7%). The result also indicate that there is a relationship between leadership (p=0.015), communication (p=0.004) and supervision (p=0,000) with the implementation of patient safety by nurses. Meanwhile teamwork ( p=1) and safety culture variables have not significant relationship with the implementation of patient safety by nurses.
Conclusions: The recommendations are hospital management should disseminate patient safety programs and hold a patient safety training to all hospital staffs.
Keywords: Implementation of Patient Safety, Leadership, and Supervision
ABSTRAK
Latar belakang: Angka kejadian infeksi nosokomial di RSUD Ajjappannge Soppeng, masih tinggi yaitu sebesar 2,4%. Begitupula angka kematian pasien yaitu sebesar 1,2% yang disebabkan oleh 0,6% adanya kesalahan pemberian obat dan kurangnya penggunaan alat pelindung diri APD). Hal ini menunjukkan masih rendahnya implementasi keselamatan pasien di RSUD Ajjappannge Soppeng.
Tujuan: Penelitian bertujuan untuk mengetahui faktor yang berhubungan dengan implementasi keselamatan pasien di instalasi rawat inap RSUD Ajjapangge Soppeng tahun 2015.
Metode: Jenis penelitian observasional dengan pendekatan cross sectional study. Populasi yaitu seluruh perawat pelaksana di unit rawat inap RSUD Ajjappannge Soppeng berjumlah 137 perawat. Pengambilan sampel dengan teknik exhaustive sampling dengan besar sampel 137 perawat. Analisis data yang digunakan adalah univariat dan bivariat, dengan uji chi square dengan ±=0,05. Hasil penelitian menunjukkan bahwa implementasi keselamatan pasien termasuk dalam kategori baik (54,7%).
Hasil: Hasil penelitian juga menunjukkan adanya hubungan kepemimpinan (p=0,015), komunikasi (p=0,004) dan supervisi (p=0,000) dengan implementasi keselamatan pasien oleh perawat pelaksana. Untuk variabel kerjasama tim (p=1) dan budaya keselamatan (p=0,905) tidak memiliki hubungan dengan implementasi keselamatan pasien oleh perawat pelaksana. Kesimpulan: Peneliti menyarankan kepada pihak manajemen rumah sakit untuk mensosialisasikan program keselamatan pasien dan mengadakan pelatihan patient safety kepada seluruh staf rumah sakit.
Kata kunci: Implementasi keselamatan pasien, Kepemimpinan, dan Supervisi
Center for Health Policy and Management
2017-10-09 22:39:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/30527
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 5, No 4 (2016)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/30529
2017-10-09T15:39:00Z
jkki:ART
"161201 2016 eng "
2620 4703
2089 2624
dc
Analisis Keefektifan Kebijakan Pictorial Health Warning pada Kemasan Rokok dalam Menurunkan Perilaku Merokok Siswa Smk se Kabupaten Jember
Sandra, Christyana
Fakultas Kesehatan Masyarakat, Universitas Jember
Pictorial Health Warning, perokok aktif, siswa SMK
ABSTRACT
Background: Smoking is a major factor impacting on lung health. In cigarette smoke there are 4000 harmfull chemicals for health. Two of them are the addictive nature of nicotine and tar which are carcinogenic. The number of novice smokers prevalence in teenagers. But smoking at an early age will increase risks to to health. The increased risk is what pushed the Government to enforce Pictorial Health Warning policies on cigarette packs in 2014.
Methods: The objectives of this study was to analyze the effectiveness of the policy in lowering the smoking behaviour in students of SMK in Jember District. This was descriptive study with SMK student population, study was carried out in Februari to April 2015. Samples was 63 student using random method.
Results: As many as 53,96% from 63 students which are active smokers. All students active smokers that know of any creepy images on cigarette packs but only 70,58% of them know that creepy images is the Government’s policy. As much as 42,86% do not feel scared at the sight of the creepy images, either the first time or after it. 79,41% of active smokers do not feel scared at the sight of creepy images on cigarette packs. Conclution: Pictorial Health Warning policy has not been fully sociallized to the public, only a fraction of the active smokers who feel scared at the sight of the picture has not yet been effectively raises the active smoker’s desire to quit smoking. It is recommended that the Government lists of images that more creepy and vary in order to evoke feelings of fear and disgust so that reduces the interest the student for smoking.
Keywords: Pictorial Health Warning, active smokers, SMK students.
ABSTRAK
Latar Belakang: Rokok merupakan faktor berdampak besar pada kesehatan paru. Dalam asap rokok terdapat 4.000 zat kimia berbahaya untuk kesehatan. Dua diantaranya adalah nikotin yang bersifat adiktif dan tar yang bersifat karsinogenik. Jumlah prevalensi perokok pemula pada remaja semakin meningkat. Padahal merokok pada usia dini akan meningkatkan risiko terhadap kesehatan. Peningkatan risiko inilah yang mendorong pemerintah menerapkan kebijakan Pictorial Health Warning pada kemasan rokok pada tahun 2014.
Metode: Penelitian ini bertujuan untuk menganalisis keefektifan kebijakan tersebut dalam menurunkan perilaku merokok pada siswa SMK se Kabupaten Jember. Penelitian ini merupakan penelitian deskriptif dengan populasi seluruh siswa SMK se Kabupaten Jember, penelitian dilaksanakan pada bulan Februari sampai April 2015. Sampel dalam penelitian ini adalah 63 siswa SMK menggunakan metode sampel acak.
Hasil: Dari 63 siswa SMK diketahui sebanyak 53,96% merupakan perokok aktif dan semua siswa perokok aktif tersebut mengetahui adanya gambar menyeramkan yang ada di kemasan rokok namun hanya 70,58% diantaranya yang mengetahui bahwa gambar menyeramkan tersebut merupakan kebijakan pemerintah. Sebanyak 42,86% tidak merasa takut saat melihat gambar menyeramkan tersebut, baik pertama kali atau setelahnya. 79,41% perokok aktif tidak merasa takut saat melihat gambar menyeramkan pada kemasan rokok.
Kesimpulan: Kebijakan Pictorical Health Warning tersebut belum sepenuhnya tersosialisasikan dengan baik kepada masyarakat dan hanya sebagian kecil dari perokok aktif yang merasa takut saat melihat gambar tersebut namun belum secara efektif menimbulkan keinginan perokok aktif tersebut untuk berhenti merokok. Disarankan pemerintah mencantumkan gambar yang lebih menyeramkan dan bervariasi agar menimbulkan perasaan takut dan jijik sehingga mengurangi minat pelajar untuk merokok.
Kata Kunci: Pictorial Health Warning, perokok aktif, siswa SMK
Center for Health Policy and Management
2017-10-09 22:39:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/30529
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 5, No 4 (2016)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/30532
2017-10-09T15:39:00Z
jkki:ART
"161201 2016 eng "
2620 4703
2089 2624
dc
Penyakit-Penyakit di Bidang Psikiatri yang Harus Dituntaskan di Puskesmas
Idaiani, Sri
Pusat Sumber Daya dan Pelayanan Kesehatan Badan Penelitian dan Pengembangan Kesehatan
Kementerian Kesehatan RI
penyakit dibidang psikiatri, Puskesmas, panduan praktik klinik
ABSTRACT
Background: Since January 1st 2014, Indonesia has imple- mented the national health insurance. Indonesian Doctor Com- petency Standard 2012 and Ministry of Health Regulation No 5 in 2014 about clinical practice guideline of doctor in primary care were applied as reference. The aim of this analysis was to give reccomendation related to psychiatric diseases have to be controlled and completely treated by doctors in primary health care
Methods: This article was a study of health policy, literature review followed by verification from several experts and vis- iting to two primary health centers (PHCs) in Jakarta and Bogor on July to September 2014.
Results: Four psychiatric diseases have to be controlled and completely treated in PHC are insomnia, dementia, mixed anxi- ety depression disorder, and psychosis. In general, patients visiting in PHC have physical, mental and social problems. It was undifferentiated cases and not fulfills the diagnostic cri- teria if examined by psychiatric interview and cause psychiat- ric cases were very limited reported in PHC.
Conclusion and Recommendation: The gap of psychiat- ric cases that were not reported is possibly caused by very strict diagnostic criteria therefore doctor in PHC cannot detect psychiatric disease with low severity. This study suggests the need of special psychiatric diagnostic in PHC considering diagnosis, severity, chronicity, and disability.
Keywords: psychiatric diseases, primary health center, clinical practice guideline.
ABSTRAK
Latar belakang: Sejak tanggal 1 Januari 2014 di Indonesia dilaksanakan Jaminan Kesehatan Nasional (JKN). Sebagai rujukannya diterapkan Standar Kompetensi Dokter Indonesia tahun 2012 dan Permenkes Nomor 5 tahun 2014 tentang Panduan Praktik Klinik dokter di pelayanan primer. Tujuan analisis ini adalah untuk memberikan rekomendasi terhadap penyakit- penyakit dibidang psikiatri yang harus dikuasai dan tuntas ditangani oleh dokter di pelayanan kesehatan primer.
Metode: Artikel ini adalah telaah kebijakan kesehatan, kepus- takaan dilanjutkan dengan verifikasi dengan beberapa narasumber dan kunjungan di dua Puskesmas di Jakarta dan Kota Bogor. Dilaksanakan pada bulan Juli sampai September 2014.
Hasil: Empat penyakit dibidang psikiatri yang harus dapat dituntaskan di Puskesmas adalah insomnia, demensia, gangguan campuran cemas dan depresi, dan psikosis. Pada umumnya pasien Puskesmas mempunyai banyak gejala fisik, psikologik dan masalah sosial. Bila dilakukan pemeriksaan psikiatri, merupakan kasus-kasus yang tidak terdiferensiasi (undifferentiated) dan tidak memenuhi kriteria diagnostik sehingga kasus gangguan jiwa selalu tidak terlaporkan.
Kesimpulan dan Saran: Kesenjangan kasus gangguan jiwa yang tidak terlaporkan di Puskesmas mungkin disebabkan oleh kriteria diagnostik yang sangat ketat sehingga dokter di pelayanan primer tidak mampu mendeteksi gangguan dengan keparahan yang lebih rendah. Hasil telaah ini mengusulkan perlunya kode diagnosis di Puskesmas yang memperhatikan diagnosis, severitas, kronisitas dan disabilitas.
Kata kunci: penyakit dibidang psikiatri, Puskesmas, panduan praktik klinik
Center for Health Policy and Management
2017-10-09 22:39:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/30532
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 5, No 4 (2016)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/30536
2017-10-09T15:39:00Z
jkki:ART
"161201 2016 eng "
2620 4703
2089 2624
dc
Perancangan Sistem Penilaian Kinerja 360º Berdasarkan Metode Kompetensi Spencer Bagian Medis di Rasyidamedan
Lubis, Arfah Mardiana
Departemen Keselamatan dan Kesehatan Kerja Fakultas Kesehatan Masyarakat, Universitas
Sumatera Utara
Salmah, Umi
Departemen Keselamatan dan Kesehatan Kerja Fakultas Kesehatan Masyarakat, Universitas
Sumatera Utara
Syahri, Isyatun Mardhiyah
Departemen Keselamatan dan Kesehatan Kerja Fakultas Kesehatan Masyarakat, Universitas
Sumatera Utara
Penilaian Kinerja 360º, dokter, perawat, hemodialisa, kompetensi Spencer
ABSTRACT
Background: The main product of Rasyida Medan is haemodialysis treatment that is being responsible of Medical Department, which are Medical Manager, HD room head, HD vice room head, Doctor, Nurse, CAPD, CIMINO, Rontgen and USG, so it must be carried out supervision and performance appraisal well. But there are concern over non-objective supervisor assessments and the performance appraisal document is not based competency. While the competencies necessary to describe the knowledge, abilities, skills and other characteristics needed to do the job. Therefore, we need Spencer competency-based 360º Performance Appraisal System design on Medical Department Rasyida Medan.
Objective: To identify competencies of Medical department, so that it has accurate competency mapping, increasing the effectiveness and efficiency of recruitment, education, training and promotion.
Methods: This qualitative research is done on March - September 2013. The 21 person participants are chosen based on theory, employee that have Superior and Average performance (2:1.5) and their supervisor. The data collecting by group interview with thematic analysis.
Results: Each of Medical Department parts has a level of medical competence and weights vary according to the level of interest in the job. The resulting competence poured into Behavioral codebook and the competency- based 360º Performance Appraisal Sheets.
Conclusion: Core competencies are the impact and influence, interpersonal understanding, self-confidence, self-control, organizational commitment, expertise, customer service orientation, teamwork, analytical thinking, conceptual thinking, initiative, flexibility, and directive.
Keywords: 360º Performance appraisal, doctor, nurse, haemodialysis, Spencer competency
ABSTRAK
Latar Belakang: Produk utama klinik Rasyida Medan adalah pelayanan Hemodialisa yang ditanggung jawabi bagian Medis, yaitu Manager Medis, Kepala Ruang HD, Wakil Kepala Ruang HD, Dokter, Perawat, CAPD, CIMINO, Rontgen dan USG, se- hingga harus dilakukan pengawasan dan penilaian kinerja dengan baik. Tetapi muncul kekhawatiran ketidak-objektifan penilaian atasan dan dokumen penilaian tidak berdasarkan kom- petensi. Sedangkan kompetensi perlu untuk menggambarkan pengetahuan, kemampuan, keahlian dan karakteristik lain yang diperlukan untuk mengerjakan pekerjaan. Oleh karena itu perlu dirancang Sistem Penilaian Kinerja 360º Bagian Medis Ber-dasarkan Metode Kompetensi Spencer.
Tujuan: Mengidentifikasi kompetensi bagian Medis, sehingga memiliki pemetaan akurat kompetensi bagian Medis, peningkatan keefektifan dan keefisienan rekrutmen, pendidikan, pelatihan dan promosi.
Metode: Penelitian kualitatif dengan studi kasus intrinsik ini dilakukan pada bulan Maret - September 2013. Partisipan 21 orang dipilih berdasarkan teori, karyawan superior dan average performance (2 : 1,5) dan atasannya. Pengumpulan data wawancara berkelompok dengan analisis tematik.
Hasil : Masing-masing bagian medis memiliki tingkat kompetensi dan bobot yang berbeda-beda sesuai tingkat kepentingan dalam jabatan. Kompetensi yang dihasilkan dituangkan ke dalam Behavioral Codebook dan Lembar Penilaian Kinerja 360º Berdasarkan Metode Kompetensi Spencer.
Kesimpulan: Kompetensi inti Bagian Medis adalah Dampak dan pengaruh, Empati, Percaya diri, Pengendalian diri, Komitmen terhadap organisasi, Keahlian teknikal, Berorientasi kepada pelanggan, Kerja sama kelompok, Berfikir analitis, Berfikir konseptual, Inisiatif, Fleksibilitas, dan Kemampuan mengarahkan/ memberikan perintah.
Kata Kunci: Penilaian Kinerja 360º, dokter, perawat, hemodialisa, kompetensi Spencer
Center for Health Policy and Management
2017-10-09 22:39:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/30536
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 5, No 4 (2016)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/30540
2017-10-09T15:39:00Z
jkki:ART
"161201 2016 eng "
2620 4703
2089 2624
dc
Determinan Pilihan Naik Kelas Perawatan Rumah Sakit dari Kelas I ke Kelas VIP
Palupi, Joys Karman Nike
BPJS Kesehatan Kediri
Wardhani, Viera
Magister Manajemen Rumah Sakit Fakultas Kedokteran Universitas Brawijaya
Andarini, Sri
Magister Manajemen Rumah Sakit Fakultas Kedokteran Universitas Brawijaya
pasien rawat inap, naik kelas rawat, BPJS Kesehatan
ABSTRACT
Background: The decision to upgrade service level in the era of National Health Insurance is a demand arising for health services. There are several factors that influence the demand for health services.
Objectives: The aims of the study are to determine the influence of income level, availability of care classes, hospital common rates, service quality, comfort, privacy, the completeness of facilities and additional insurance against the upgrading service level selection of Healthcare and Social Security Agency (BPJS Kesehatan) inpatients from class I to VIP class and the most dominant factor.
Research Methods: This study was an observational study with cross-sectional design of the 284 respondents were divided proportionally from 6 hospitals in Kediri in collaboration with the BPJS Kesehatan Kediri Branch. The research was conducted by interviewing the respondents using a questionnaire at the time of going home from the hospital or during outpatient control.
Results: The results showed eight independent variables can influence on the model simultaneously. Factors that are statistically significant influence patient choice grade is hospital common rates factor (p=0.001); (²=0.208). This may imply that the choice of grade-patient tends to grow at 20.8% every hospitals common rates reduction.
Conclusions: Hospitals reasonable rates will make patients reconsider their ability to pay. Rates adjusment and standardization of hospital services, monitoring of class availability in hospital, as well as the National Health Insurance premium adjustment is required in order to implement better social security.
Keywords: inpatients, service level upgrading, BPJS Kesehatan
ABSTRAK
Latar belakang: Keputusan untuk memilih naik kelas rawat pada era Jaminan Kesehatan Nasional merupakan permintaan yang timbul terhadap pelayanan kesehatan. Terdapat beberapa faktor yang mempengaruhi dalam permintaan pelayanan kesehatan.
Tujuan: Mengetahui pengaruh faktor tingkat pendapatan, ketersediaan kelas perawatan, tarif rumah sakit, kualitas pelayanan, kenyamanan, privasi, kelengkapan fasilitas dan asuransi tambahan terhadap pilihan pasien rawat inap BPJS Kesehatan naik kelas perawatan dari kelas I ke kelas VIP dan faktor yang paling dominan.
Metode Penelitian: Penelitian ini adalah penelitian observasional dengan rancangan cross-sectional pada 284 responden yang dibagi secara proporsional dari 6 rumah sakit di Kota Kediri yang bekerja sama dengan BPJS Kesehatan Cabang Kediri. Penelitian dilaksanakan dengan melakukan wawancara pada responden menggunakan kuisioner pada saat hendak pulang dari rumah sakit maupun pada saat kontrol rawat jalan.
Hasil: Penelitian menunjukkan kedelapan variabel independen dapat memberikan pengaruh terhadap model secara simultan. Faktor yang secara statistik signifikan mempengaruhi pilihan naik kelas rawat adalah faktor tarif umum rumah sakit (p=0.001); (²=0.208). Hal ini dapat diartikan bahwa pilihan naik kelas rawat cenderung bertambah sebesar 20,8% setiap ada penurunan tarif umum rumah sakit.
Kesimpulan: Tarif rumah sakit yang wajar akan membuat pasien berpikir ulang tentang kemampuannya dalam membayar. Penyesuaian tarif dan standarisasi pelayanan rumah sakit, monitoring ketersediaan kelas rawat di rumah sakit, serta penyesuaian iuran Jaminan Kesehatan Nasional diperlukan dalam rangka pelaksanaan jaminan sosial yang lebih baik.
Kata kunci: pasien rawat inap, naik kelas rawat, BPJS Kesehatan
Center for Health Policy and Management
2017-10-09 22:39:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/30540
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 5, No 4 (2016)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/30546
2017-10-09T15:39:00Z
jkki:ART
"161201 2016 eng "
2620 4703
2089 2624
dc
Analisis Perubahan Kebijakan Peraturan Presiden No.19 Tahun 2016 tentang Jaminan Kesehatan Menjadi Peraturan Presiden No.28 Tahun 2016 tentang Jaminan Kesehatan
Simanjuntak, Julian
Departemen Administrasi dan Kebijakan Kesehatan Fakultas Kesehatan Masyarakat Universitas
Indonesia
Darmawan, Ede Surya
Departemen Administrasi dan Kebijakan Kesehatan Fakultas Kesehatan Masyarakat Universitas
Indonesia
Perubahan, Kebijakan, Peraturan Presiden
ABSTRACK
Background: The rapid change from presidential regulation no. 19 year 2016 on health insurance into presidential regulation no. 28 year 2016 on health insurance get a big attention.
Objectives: This research was purposed to analyze about health insurance policy which changed very quickly. It changed from presidential regulation no.19 year 2016 into presidential regulation no.28 year 2016 on health insurance.
Research Methods: The researcher used qualitative methods.
Results: The analysis from the input processing and output showed that the change of presidential regulation is a responsive form from president when he looked public rejection response for the increase of fee.
Conclusions: The president extended it through the department of health affairs.This change has not been described a process of democracy because there’s still a lack of cross-sectoral coordination role in the discussion. This change of presidential regulation not yet affected to appropriate the fee adequacy on BPJS Implementation. The department of health affairs as a leader of health sector was recommended to increase the cross-sectoral coordination which can manifest the better product of health policy and to complete the policy instrument that yet to be determined. It also used to be concern from the department of health affairs, DJSN and BPJS which explained the increase of fee must be offset by a quality improvement rather than the implementation of national health insurance.
Keywords; change, policy, presidential regulation
ABSTRAK
Latar belakang: Perubahan Peraturan Presiden No.19/2016 tentang Jaminan Kesehatan menjadi Peraturan Presiden No. 28/2016 tentang Jaminan Kesehatan yang sangat cepat menjadi sorotan yang mencolok.
Tujuan: penelitian ini untuk menganalisis perubahan yang begitu cepat tentang kebijakan jaminan kesehatan Peraturan Presiden No.19/2016 tentang Jaminan Kesehatan menjadi Peraturan Presiden No.28/2016 tentang Jaminan Kesehatan
Metode penelitian: pendekatan kualitatif.
Hasil: Berdasarkan analisis bahwa dalam proses input, proses dan output, perubahan Peraturan Presiden ini merupakan bentuk responsif Presiden melalui lembaga pemerintah Kementerian Kesehatan dengan melihat respon penolakan masyarakat akan kenaikan iuran. Proses perubahan ini belum menggambarkan sebuah proses yang demokrasi dikarenakan masih kurangnya koordinasi peran lintas sektoral dalam pembahasannya.
Kesimpulan: Dengan adanya perubahan Peraturan Presiden ini berdampak belum memadainya kecukupan iuran dalam penyelenggaraan BPJS. Peran Kementerian Kesehatan sebagai leader dalam regulasi bidang kesehatan disarankan dapat meningkatkan koordinasi lintas sektoral untuk dapat mewujudkan produk kebijakan kesehatan yang lebih baik serta melengkapi instrument kebijakan yang belum ditetapkan, serta untuk menjadi perhatian sektor terkait Kementerian Kesehatan, DJSN dan BPJS Kesehatan bahwa kenaikan iuran harus dapat diimbangi dengan peningkatan kualitas daripada penyelenggaraan jaminan kesehatan nasional.
Kata kunci: Perubahan, Kebijakan, Peraturan Presiden
Center for Health Policy and Management
2017-10-09 22:39:00
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/30546
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 5, No 4 (2016)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/30648
2017-10-09T15:38:12Z
jkki:ART
"160901 2016 eng "
2620 4703
2089 2624
dc
Kajian Implementasi Jaminan Kesehatan Nasional Lintas Provinsi (Sulawesi Selatan, Sulawesi Tenggara, Sulawesi Barat) Tahun 2014
Maidin, Alimin
Departemen Manajemen Rumah Sakit Fakultas Kesehatan Masyarakat Universitas Hasanundin, Makasar
Palutturi, Sukri
Departemen Administrasi dan Kebijakan Kesehatan Fakultas Kesehatan Masyarakat Universitas Hasanundin, Makasar
JKN, Sulawesi Selatan, Sulawesi Tenggara, Sulawesi Barat
ABSTRACT
Background: Changes in health financing towards Universal Health Coverage (UHC) is to provide benefits, but on the other hand have a negative impact and the risks. Implementation of the National Health Insurance should be monitored in order to achieve the level of satisfaction of 80% against BPJS of health facilities.
Aims: Monitoring and evaluating the implementation and the barriers to formulate policy recommendations on the improvement of the National Health Insurance program (JKN) in the province of South Sulawesi, Southeast Sulawesi and West Sulawesi in 2014; explained various aspects of the progress and challenges on political and institutional transformation program, advocacy and socialization, participation, service infrastructure at health facilities, referral system, Human Resources and Capacity Building; explained various aspects of the progress and challenges of financing, the risk of fraud, and the impact on utilization, satisfaction of participants and providers.
Methods: This study used a qualitative approach. This research was conducted in the Province of South Sulawesi (Makassar City and Jeneponto), South East Sulawesi (Kendari and Konawe) and W est Sulawesi (Mamuju and Majene regency). The selection of respondents was done by using purposive sampling technique. Informants were from different elements: Hospitals, BPJS, Health Center, Health Department, Bappeda, Family Doctor and patient. Data were collected by using indepth interviews and review documents. Analysis of the data was using triangulation techniques either method and source triangulations.
Results: There are still many problems, especially at the initial stage of implementation JKN. Problems related to aspects of political and institutional transformation program, advocacy and socialization of program JKN, membership, service infrastructure at health facilities, referral system and Human Resources and capacity building, aspects of financing, the risk of fraud in the implementation of JKN, and the impact JKN against utilization, satisfaction of participants and providers. Conclusion:Guarantee to quality of service by providers and patients will increase if policies and institutional transformation program, advocacy and socialization of program JKN, JKN membership, service infrastructure at health facilities, referral system and Human Resources and capacity building are strengthened and improved. It also covers aspects of
financing, the risk of fraud in the implementation of JKN and JKN impact on utilization, satisfaction of participants and providers.
Keywords: JKN, South Sulawesi, Southeast Sulawesi, West Sulawesi
ABSTRAK
Latar belakang: Perubahan pembiayaan kesehatan menuju Universal Health Coverage ( UHC) merupakan hal yang menjanjikan namun pada sisi lain mempunyai dampak dan risiko. Pelaksanaan JKN perlu dipantau agar dapat tercapai tingkat kepuasan 80% terhadap BPJS dari fasilitas kesehatan.
Tujuan: Memonitoring dan mengevaluasi pelaksanaan dan hambatan untuk merumuskan rekomendasi kebijakan perbaikan program Jaminan Kesehatan Nasional (JKN) di Provinsi Sulawesi Selatan, Sulawesi Tenggara, dan Sulawesi Barat pada tahun 2014; memaparkan berbagai kemajuan dan tantangan pada aspek kebijakan dan kelembagaan, transformasi program, advokasi dan sosialisasi, kepesertaan, infrastruktur pelayanan pada fasilitas kesehatan, sistem rujukan, SDM dan Capacity Building; memaparkan berbagai kemajuan dan tantangan dari aspek pembiayaan, risiko terjadinya Fraud, dan dampak terhadap utilisasi, kepuasan peserta dan provider.
Metode: Penelitian ini menggunakan pendekatan kualitatif. Penelitian ini dilakukan di Provinsi Sulawesi Selatan (Kota Makassar dan Kabupaten Jeneponto), Provinsi Sulawesi Tenggara (Kota Kendari dan Kabupaten Konawe) dan Provinsi Sulawesi Barat (Kabupaten Mamuju dan Kabupaten Majene). Pemilihan responden dilakukan dengan menggunakan teknik Purposive Sampling. Informan berasal dari berbagai unsur: Rumah Sakit, BPJS, Puskesmas, Dinas Kesehatan, Bappeda, Dokter Keluarga, dan pasien. Pengumpulan data dilakukan dengan menggunakan indepth interview dan telaah dokumen. Analisis data menggunakan teknik triangulasi baik triangulasi metode maupun triangulasi sumber.
Hasil: Masih banyak ditemukan berbagai masalah dalam pelaksanaan JKN terutama pada tahap awal pelaksanaannya. Masalah yang berkaitan dengan aspek kebijakan dan kelembagaan, transformasi program, advokasi dan sosialisasi program JKN, kepesertaan, infrastruktur pelayanan pada fasilitas kesehatan, system rujukan dan Sumber Daya Manusia dan Capacity Building, aspek pembiayaan, risiko terjadinyaFraud pada pelaksanaan JKN, dan dampak JKN terhadap utilisasi, kepuasan peserta dan provider.
Kesimpulan: Jaminan kualitas pelayanan oleh provider dan pasien akan meningkat jika asapek aspek kebijakan dan kelembagaan, transformasi program, advokasi dan sosialisasi program JKN, kepesertaan JKN, infrastruktur pelayanan pada fasilitas kesehatan, system rujukan dan Sumber Daya Manusia dan Capacity Building diperkuat dan ditingkatkan. Selain itu juga mencakup aspek pembiayaan, risiko terjadinya Fraud pada pelaksanaan JKN, dan dampak JKN terhadap utilisasi, kepuasan peserta dan provider.
Kata Kunci: JKN, Sulawesi Selatan, Sulawesi Tenggara, Sulawesi Barat
Center for Health Policy and Management
2017-10-09 22:38:12
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/30648
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 5, No 3 (2016)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/30649
2017-10-09T15:38:12Z
jkki:ART
"160901 2016 eng "
2620 4703
2089 2624
dc
Analisis Pola Pemanfaatan Jaminan Pembiayaan Kesehatan Era Jaminan Kesehatan Nasional Pada Peserta Non PBI Mandiri Di Wilayah Perdesaan Kabupaten Banyumas
Intiasari, Arih Diyaning
Universitas Jenderal Soedirman Purwokerto
Hendrartini, Julita
Prodi Ilmu Kesehatan Masyarakat Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta
Trisnantoro, Laksono
Prodi Ilmu Kesehatan Masyarakat Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta
BPJS Non PBI Mandiri, Adverse Selection
ABSTRACT
Background : There is a suspected tendency of adverse selection during the implementation of JKN typically among Non PBI members (voluntary member) impact on the high rate of claims for services, especially in the outpatient claims level in hospital. It is necessary to study the patterns of utilization of health financing among Non PBI participants to describe determinants that influence it. Policy recommendations for the improvement of public health financing for non-poor informal sector are expected to support the efforts toward the expansion of the universal health coverage
Method: This study design was cross-sectional in the period from June to December 2015. Data collection is using qualitative approach with in-depth interview guide. Informants are some 24 people comprising 12 Non PBI informant participants, 3 the registrar at the health center, 2 nurses in health centers, 3 the registrar at the private hospital and 4 people registrar in General Hospital
Result: There are four patterns of usage by the participants of the Non PBI (Mandiri). The utilization pattern consists of: Utilization of health services appropriate tiered referral system, utilization of health insurance by their own preference of referral system, utilization of health insurance only for health care outpatient and inpatient hospital and utilization of health insurance only for inpatient health services in hospital Conclusion : There is a tendency for adverse selection and moral hazard on utilization of health financing by Non PBI members. Some referral practices are not in accordance with the procedure of tiered referral system due to several identified reasons either from the demand side and the supply side.
Keyword : social health insurance, Adverse Selection
ABSTRAK
Latar Belakang: Adanya kecenderungan terhadap fenomena adverse selection pada skema Non PBI Mandiri berdampak kepada tingginya rasio klaim pelayanan terutama pada klaim rawat jalan tingkat lanjutan di FKTL. Perlu dilakukan kajian terhadap pola pemanfaatan jaminan pembiayaan kesehatan era JKN pada peserta Non PBI Mandiri untuk mengetahui gambaran determinan yang mempengaruhinya. Rekomendasi terhadap perbaikan kebijakan pembiayaan kesehatan masyarakat sektor informal non miskin diharapkan dapat mendukung upaya perluasan kepesertaan menuju kesehatan masyarakat semesta
Metode: Penelitian ini menggunakan rancangan potong lintang pada periode Bulan Juni-Desember 2015. Pengambilan data menggunakan pendekatan kualitatif dengan panduan wawancara mendalam. Informan yang terlibat sejumlah 24 orang yang terdiri dari 12 informan peserta Non PBI Mandiri, 3 orang petugas pendaftaran di Puskesmas, 2 orang perawat di Puskesmas, 3 orang petugas pendaftaran di RS Swasta dan 4 orang petugas pendaftaran di RS Umum
Hasil : Identifikasi pada informan menemukan adanya 4 pola penggunaan jaminan pembiayaan kesehatan oleh peserta Non PBI Mandiri. Pola pemanfaatan tersebut terdiri dari : Pemanfaatan pelayanan kesehatan sesuai sistem rujukan berjenjang, Pemanfaatan jaminan kesehatan dengan sistem rujukan APS, Pemanfaatan jaminan kesehatan hanya untuk pelayanan kesehatan rawat jalan dan rawat inap di FKTL dan pemanfaatan jaminan kesehatan hanya untuk pelayanan kesehatan rawat inap di FKTL
Kesimpulan: Adanya kecenderungan adverse selection dan moral hazard teridentifikasi pada peserta skema Non PBI Mandiri. Pola pemanfaatan jaminan pembiayaan kesehatan yang tidak sesuai dengan prosedur sistem rujukan berjenjang disebabkan adanya beberapa hal yang dapat teridentifikasi baik dari sisi demand maupun sisi supply.
Keyword : BPJS Non PBI Mandiri, Adverse Selection
Center for Health Policy and Management
2017-10-09 22:38:12
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/30649
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 5, No 3 (2016)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/30650
2017-10-09T15:38:12Z
jkki:ART
"160901 2016 eng "
2620 4703
2089 2624
dc
Kajian Literature: Evaluasi Pelaksanaan Program Jaminan Kesehatan Nasional di Indonesia
Irwandy, Irwandy
Fakultas Kesehatan Masyarakat, Universitas Hasanuddin
Jaminan Kesehatan Nasional, Evaluasi, Kajian Literature
ABSTRACT
Background: The National Health Insurance (JKN) in Indonesia, which started on January 1, 2014 has contributed greatly to reform health care systems and financing in Indonesia. As mandated by law, is expected to gradually JKN can become the backbone for achieving Universal Health Coverage in 2019. Until now, there are various studies aimed to evaluate the JKN program that has been expected to provide recommendations for this program.
Purposes: The purpose of this research was to conduct the literature review about the implementation of the National Health Insurance program in Indonesia and formulate the recommendations to improve it.
Methods: The research was conducted in March 2015 by reviewing the literature on various journals research those have been published during the period January 2014 to March 2015 on the UNHAS website repository. There were 8 Journals found and reviewed in this research.
Results: The results showed that at the beginning of JKN program, there are several problems found in the implementation such as the lack of regulations and guidelines related to the implementation of JKN, low coverage of socialization programs to health centers and hospitals, hospital was unprepared to meet the specific requirements for BPJS credentials, the hospital was unsatisfied with the tariffs of INA CBG, and hospital claims is often too late. However, another journal showed that as for the level of patient satisfaction at hospital, 87.7% of respondents are satisfied.
Conclusions: During the implementation of JKN Program in Indonesia, there are several problems and challenges. Therefore we need to learn and improve the program based on this experience and research findings. To achieve Universal Health Coverage in 2019 we need to improve the quantity and quality of research in evaluating the implementation of JKN in Indonesia.
Keywords: National Health Insurance, Evaluation, Literature Review
ABSTRAK
Latar belakang: Jaminan Kesehatan Nasional (JKN) di Indonesia yang dimulai sejak 1 Januari Tahun 2014 telah memberikan andil yang besar terhadap reformasi sistem pelayanan dan pembiayaan kesehatan di Indonesia. Sebagaimana diamanatkan Undang-Undang, JKN diharapkan secara bertahap dapat menjadi tulang punggung untuk mencapai Universal Health Coverage di Tahun 2019. Hingga saat ini telah banyak dilakukan berbagai penelitian yang bertujuan mengevaluasi program JKN yang diharapkan dapat memberi masukan dalam upaya perbaikan kedepan.
Tujuan: Penelitian ini bertujuan untuk melakukan melakukan kajian literature untuk memperoleh masukan dalam perbaikan implementasi program Jaminan Kesehatan Nasional di Indonesia. \
Metode: Penelitian ini dilaksanakan pada Maret 2015 dengan melakukan kajian literature terhadap berbagai hasil penelitan yang telah dipublish selama periode Januari 2014 hingga Maret 2015 pada website repository Universitas Hasanuddin, Makassar yakni sebanyak 8 jurnal penelitian.
Hasil: Hasil kajian terhadap beberapa penelitian yang dilakukan menunjukkan bahwa selama penerapan JKN ditemui beberapa kendala yang dihadapi yakni pada awal pelaksanaan masih terkendala dengan belum tersedinya beberapa regulasi dan juknis terkait implementasi JKN, sosialisasi teknis program ke fasilitas pelayanan kesehatan baik Puskesmas dan RS masih rendah, disamping itu masih kurang siapnya beberapa RS dalam memenuhi persyaratan kredensial yang ditetapkan BPJS, besaran tarif INA CBG yang dirasa kurang tepat bagi RS serta klaim RS yang terlambat. Hasil penelitian lain juga memperlihatkan untuk tingkat kepuasan pasien BPJS di salah satu RS telah berada pada kategori baik yakni 87,7%.
Kesimpulan: Selama penerapan Program JKN di Indonesia telah ditemukan beberapa faktor pendukung dan penghambat pelaksanaan program JKN. Oleh karena itu diperlukan perbaikan secara terus menerus terhadap pelaksanaan program JKN demi pencapaian Univeral Health Coverage pada Tahun 2019 dengan meningkatkan kuantitas dan kualitas pelaksanaan penelitian dalam mengevaluasi pelaksanaan JKN di Indonesia.
Kata Kunci: Jaminan Kesehatan Nasional, Evaluasi, Kajian Literature
Center for Health Policy and Management
2017-10-09 22:38:12
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/30650
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 5, No 3 (2016)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/30651
2017-10-09T15:38:12Z
jkki:ART
"160901 2016 eng "
2620 4703
2089 2624
dc
Implementasi Kebijakan JKN oleh Pemberi Pelayanan Kesehatan di Kabupaten Kepulauan Anambas
Sagala, Irawati
Dinas Kesehatan Kabupaten Kepulauan Anambas
Trisnantoro, Laksono
Program Studi Ilmu Kesehatan Masyarakat, Fakultas Kedokteran, Universitas Gadjah Mada
Padmawati, Retna Siwi
Program Studi Ilmu Kesehatan Masyarakat, Fakultas Kedokteran, Universitas Gadjah Mada
Implementasi kebijakan, Jaminan Kesehatan Nasional, pemberi pelayanan kesehatan
ABSTRACT
Background: On January 1st, 2014, the implementation of NHI started in Indonesia as well as in the district of Anambas Islands accordance with the mandate of Law No. 24 in 2014. NHI policy is a top-down policy that must be implemented. On the process of implementation, the health service providers in the RSL, as the main reference in Anambas Islands, have some problems due to the characteristics’ differences of regional and limitations the District of Anambas Islands as the border areas, islands and separated-areas (DTPK). In the context of health, rural and remote areas is often associated with a state of limited public transport, poor road infrastructure, long distances to health service facilities and difficulties in recruiting and retaining health personnel. As a result there is a significant impact on the provision of adequate health care. The availability of resources is inadequate in every health facility in Anambas Islands is also an obstacle for the implementation of NHI any existing health facilities in the District of Anambas Islands must qualify credensialing set by BPJS Health.
The Objective: To analyze the implementation of NHI policy by the health service providers in the District of Anambas Islands.
Method: This research is using the descriptive research with qualitative methods using a single case study, design to analyze the implementation of the NHI policy established by the health service providers in Anambas Islands, which is focused on resources, bureaucratic structure and disposition.
Result: Implementation of policy NHI by health care providers both in health centers and hospitals are still many have constraints such as limited power specialist, especially in hospitals, general practitioners definitive still lacking in some health facilities, the limited infrastructure in health centers and hospitals that cause will not want the patient should be referred. This adds to the burden of transportation costs to society as ocean freight rates are quite expensive though some things can be addressed as a problem of information and improvement of bureaucratic structures, but it can not prevent the public to be referred.
Conclusion: The implementation of NHI policy does not match held in Anambas Islands as the border areas, islands and separated-areas area because of the benefits received by the community of NHI be limited due to so many constraints faced by health care providers.
Keywords : Implementation of policy, the National Health Insurance, health service providers.
ABSTRAK
Latar belakang : Dengan diberlakukannya UU Nomor 24 Tahun 2014 maka pada tanggal 01 Januari 2014 Jaminan Kesehatan Nasional dimulai di Indonesia, demikian juga halnya di Kabupaten Kepulauan Anambas. Kabupaten Kepulauan Anambas merupakan kabupaten yang dikategorikan sebagai daerah DTPK. Dalam konteks kesehatan, daerah pedesaan dan terpencil sering dikaitkan dengan keadaan transportasi umum yang terbatas, infrastruktur jalan yang buruk, jarak yang jauh ke fasilitas pelayanan kesehatan dan kesulitan dalam merekrut dan mempertahankan tenaga kesehatan. Akibatnya ada dampak yang signifikan untuk penyediaan pelayanan kesehatan yang memadai. Ketersediaan sumber daya yang tidak memadai pada setiap fasilitas kesehatan di Kabupaten Kepulauan Anambas juga menjadi kendala karena dalam pelaksanaan JKN setiap fasilitas kesehatan yang ada di Kabupaten Kepulauan Anambas harus memenuhi syarat kredensialing yang telah ditetapkan oleh BPJS Kesehatan.
Tujuan: Menganalisis implementasi kebijakan JKN oleh pemberi pelayanan kesehatan di Kabupaten Kepulauan Anambas.
Metode: Penelitian ini merupakan jenis penelitian deskriptif dengan metode kualitatif menggunakan rancangan studi kasus tunggal terjalin untuk menganalisis implementasi kebijakan JKN oleh pemberi pelayanan kesehatan di Kabupaten Kepulauan Anambas, yang difokuskan pada sumber daya, struktur birokrasi dan disposisi.
Hasil: Implementasi kebijakan JKN oleh pemberi pelayanan kesehatan baik di puskesmas maupun rumah sakit masih banyak mengalami kendala seperti terbatasnya tenaga spesialistik khususnya yang ada di rumah sakit, dokter umum yang definitif masih kurang di beberapa fasilitas kesehatan, keterbatasan prasarana di puskesmas dan rumah sakit yang menyebabkan mau tidak mau pasien harus dirujuk. Hal ini menambah beban biaya transportasi bagi masyarakat karena tarif angkutan laut yang cukup mahal walaupun beberapa hal dapat dibenahi seperti masalah informasi dan perbaikan struktur birokrasi namun hal tersebut tidak dapat mencegah masyarakat untuk dirujuk.
Kesimpulan: Implementasi kebijakan JKN tidak cocok dilaksanakan di Kabupaten Kepulauan Anambas sebagai daerah DTPK karena manfaat yang diterima masyarakat dari JKN menjadi terbatas disebabkan begitu banyak kendala yang dihadapi oleh pemberi pelayanan kesehatan.
Kata Kunci : Implementasi kebijakan, Jaminan Kesehatan Nasional, pemberi pelayanan kesehatan
Center for Health Policy and Management
2017-10-09 22:38:12
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/30651
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 5, No 3 (2016)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/30663
2017-10-09T15:38:12Z
jkki:ART
"160901 2016 eng "
2620 4703
2089 2624
dc
Pengelolaan dan Pemanfaatan Dana Kapitasi (Monitoring dan Evaluasi Jaminan Kesehatan Nasional di Indonesia)
Kurniawan, M. Faozi
PKMK FK UGM
Siswoyo, Budi Eko
PKMK FK UGM
Mansyur, Faisal
PKMK FK UGM
Aisyah, Wan
BPJS Kesehatan Pusat
Revelino, Dedy
BPJS Kesehatan Pusat
Gadistina, Welly
BPJS Kesehatan Pusat
dana kapitasi, pengelolaan, pemanfaatan
ABSTRACT
Background: The Indonesian National Health Insurance (JKN)was commenced in early 2014. BPJS Kesehatan (parastatal organization appointed as JKN management entity) and the primary health centers (PHCs) are dealing with challenges and bottlenecks in providing quality health service to JKN beneficiaries. One of the challenges is the management and utilization of the capitation fund, which is used as the payment model for PHC. The monitoring and evaluation of the capitation fund are imperative to improve the attainment of universal health coverage through JKN program.
Objective: To analyze the management and utilization of capitation fund in PHC including the bottlenecks and to generate solutions in the implementation of JKN.
Method: This is a descriptive study using quantitative and qualitative approaches. A total of 384 PHCs in 7 regionals and 20 districts were selected using random sampling. Primary data were collected through series of interviews and FGDs using a standardized questionnaire. Secondary data on capitation fund and health care services (2014-mid 2015) were collected from primary health centers and BPJS Kesehatan database. Qualitative data were analyzed using thematic approach and quantitative data were descriptively analyzed to show the capitation fund and health care utilization trend at PHC level.
Result: Although an increase in overall income from capitation fund was observed in the majority of PHCs, there was a higher increase in patient utilization leading to lower actual capitation income generated by PHCs. Such finding is applicable morely to Private GP Practice (Dokter Praktik Perorangan) and Private Primary Clinic (Klinik Pratama). Quantitative findings show that most private PHCs experienced deficit. Most Puskesmas used Head of District decree/district regulation as the main legal basis for capitation fund management and utilization. However, many of the local regulations are not completely in line with central-level mainly because of the rapid changes at the central-level. Such disconnection of policies between levels of government has led to confusion at the PHC level in fund management and use. As the sole purchaser, BPJS Kesehatan is considered to be not yet well involved in district capitation fund planning and budgeting. Such practices were perceived to be even less condusive in the monitoring and evaluation of capitation fund usage.
Conclusion: To ensure the quality of care and the sustainability of PHCs as JKN providers, capitation fund should be increased. Local government needs to support JKN implementation by issuing clear guidelines that follow central policies on how PHCs should plan and manage capitation fund. Continuous monitoring and evaluation of capitation fund is important to ensure that JKN program targets are achieved at the primary care level.
Keywords: capitation, management, utilization
ABSTRAK
Latar Belakang: Jaminan Kesehatan Nasional (JKN) mulai diselenggarakan di Indonesia sejak tahun 2014. BPJS Kesehatan (badan yang ditunjuk sebagai penyelenggara JKN)dan fasilitas kesehatan tingkat pertama (FKTP) menghadapi tantangan dan hambatan dalam penyediaan pelayanan kesehatan yang berkualitas kepada peserta JKN. Salah satu tantangannya adalah dalam pengelolaan dan pemanfaatan dana kapitasi sebagai model pembayaran FKTP. Monitoring dan evaluasi penyelenggaran dana kapitasi menjadi penting untuk meningkatkan capaian jaminan kesehatan semesta melalui program JKN.
Tujuan: Menganalisis pengelolaan dan pemanfaatan dana kapitasi di FKTP, termasuk kendala dan alternatif solusi dalam penyelenggaraan JKN.
Metode: Studi deskriptif ini menggunakan pendekatan kuantitatif dan kualitatif. Sampel 384 FKTP di 7 regional dan 20 kabupaten/ kota dipilih secara acak. Data primer dikumpulkan melalui serangkaian wawancara dan FGD dengan kuesioner terstan- dar. Data sekunder terkait dana kapitasi dan pelayanan kese- hatan (2014 – pertengahan 2015) dikumpulkan dari FKTP dan BPJS Kesehatan. Data kualitatif dianalisis menggunakan pendekatan tematik sementara data kuantitatif dianalisis secara deskriptif untuk menunjukkan tren dana kapitasi dan utilisasi pelayanan kesehatan di FKTP.
Hasil: Meski peningkatan penerimaan dari dana kapitasi ditemukan di sebagian besar FKTP, namun tingginya utilisasi pasien cenderung menurunkan kapitasi aktual di FKTP. Temuan tersebut terutama dialami dokter praktek perorangan dan klinik pratama. Analisis kuantitatif juga menunjukkan sebagian besar FKTP swasta mengalami defisit. Sebagian besar Puskesmas menggunakan SK Bupati/ Peraturan Daerah (Perda) sebagai dasar hukum utama dalam pengelolaan dan pemanfaatan dana kapitasi. Namun, banyak kebijakan dari Perda yang tidak sepenuhnya sejalan dengan kebijakan Pusat, terutama karena perubahan kebijakan yang cepat di tingkat Pusat. Kondisi ini menyebabkan kebingungan bagi FKTP dalam mengelola dan memanfaatkan dana kapitasi. Sebagai satu-satunya pembayar, BPJS Kesehatan dianggap belum terlalu terlibat dalam perencanaan dan penganggaran dana kapitasi di daerah. Hal ini kurang kondusif dalam mendukung monitoring dan evaluasi penggunaan dana kapitasi.
Kesimpulan: Untuk memastikan kualitas pelayanan kesehatan dan keberlanjutan FKTP sebagai penyedia layanan, dana kapitasi sebaiknya ditingkatkan. Perda juga diperlukan untuk mendukung penyelenggaraan JKN dengan menerbitkan pedoman yang jelas dan mengikuti kebijakan Pusat terkait bagaimana FKTP sebaiknya merencanakan dan mengelola dana kapitasi. Monitoring dan evaluasi kapitasi secara berkelanjutan sangat penting untuk memastikan ketercapaian sasaran program JKN di tingkat pelayanan primer.
Kata Kunci: dana kapitasi, pengelolaan, pemanfaatan
Center for Health Policy and Management
2017-10-09 22:38:12
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/30663
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 5, No 3 (2016)
eng
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
oai:jurnal.ugm.ac.id:article/30667
2017-10-09T15:38:12Z
jkki:ART
"160901 2016 eng "
2620 4703
2089 2624
dc
Analisis Efisiensi Teknis Dana Kapitasi Puskesmas di Kabupaten Sleman Menggunakan Data Envelopment Analysis
Mas’ud, Mas’ud
Dinas Kesehatan Kabupaten Sigi, Sulawesi Tengah
Trisnantoro, Laksono
Program Studi Ilmu Kesehatan Masyarakat Fakultas Kedokteran
Universitas Gadjah Mada, Yogyakarta
Hendrartini, Julita
Program Studi Ilmu Kesehatan Masyarakat Fakultas Kedokteran
Universitas Gadjah Mada, Yogyakarta
Dana Kapitasi, Puskesmas, Efisiensi Teknis, Data Envelopment Analysis (DEA).
ABSTRACT
Background. Presidential Decree No. 12/2013 states that BPJS Health in carrying out health insurance, using a capitation financing system in health care first level (primary). According to Minister Regulation No.19 / 2014, that the allocation of capitation funds used for the payment of health care services for health workers and non-health workers who perform services on health care first level. While the operational services allocated for drugs, medical devices, and medical consumable material and other health care operations. Necessary to study the use of the funds in question so that the operational and health services can run effectively, efficiently in order to determine the appropriate policies by local government and center.
Methods. This type of study is a mixed analytic methods. In the quantitative data analysis method Data Envelopment Analysis (DEA) and qualitative data to explain the quantitative data. The study population includes all government-owned health centers in Sleman (25 health centers. This study will look at the efficiency of technical management puskesmas capitation funds for the implementation of individual health efforts in Sleman district PHC in 2014.
Results. Based on the analysis with DEA method, only 3 of the 25 health centers health centers (12%) which has been technically cost efficiency and 13 health centers (52%) were technically efficient system. Tobit regression analysis shows that there are four variables that significantly, variable utilization figure (positive direction), reference number (positive direction), the ratio of non-medical personnel (negative direction), and capitation funds (negative direction).
Conclusion and Suggestions. In general, health centers in Sleman yet technically efficient in the management of capitation funds. Policy-oriented technical efficiency costs will affect the value of the technical efficiency of the system. Expected DHO monitoring, evaluation and improvement of the efficiency of the management of Puskesmas capitation funds intensively and comprehensively on the quality of the performance of health centers as an indicator.
Keywords. Capitation Funding, Primary Health Care, Technical Efficiency, Data Envelopment Analysis (DEA).
ABSTRAK
Latar Belakang. Perpres No. 12/2013 menyebutkan bahwa BPJS Kesehatan dalam menyelenggarakan jaminan kesehatan, menggunakan sistem pembiayaan kapitasi di faskes tingkat pertama (primer). Menurut Permenkes No.19/2014, bahwa alokasi dana kapitasi dipergunakan untuk pembayaran jasa pelayanan kesehatan bagi tenaga kesehatan dan tenaga non kesehatan yang melakukan pelayanan pada FKTP (60%). Sedangkan layanan operasional dialokasikan untuk obat, alat kesehatan, dan bahan medis habis pakai dan kegiatan operasional pelayanan kesehatan lainnya. Diperlukan kajian penggunaan dana yang dimaksud sehingga operasional dan layanan kesehatan dapat berjalan efektif, efisien guna menentukan kebijakan yang tepat oleh pemdah dan pusat.
Metode. Jenis Penelitian ini merupakan analitik dengan pendekatan mixed methods. Pada data kuantitatif menggunakan metode analisis Data Envelopment Analysis (DEA) dan data kualitatif menjelaskan data kuantitatif. Populasi penelitian meliputi seluruh puskesmas milik pemerintah di Kabupaten Sleman (25 puskesmas). Penelitian ini akan melihat efisiensi secara teknis pengelolaan dana kapitasi puskesmas terhadap penyelenggaraan upaya kesehatan perorangan di puskesmas Kabupaten Sleman tahun 2014.
Hasil. Berdasarkan hasil analisis dengan metode DEA, dari 25 puskesmas hanya 3 puskesmas (12%) yang telah efisiensi secara teknis biaya dan 13 puskesmas (52%) yang efisien secara teknis sistem. Hasil analisis regresi tobit menunjukkan terdapat 4 variabel yang berpengaruh secara signifikan, yaitu variabel angka utilisasi (arah positif), angka rujukan (arah positif), rasio tenaga non kesehatan(arah negatif), dan dana kapitasi (arah negatif).
Kesimpulan dan Saran. Secara umum puskesmas di Kabupaten Sleman belum efisien secara teknis dalam pengelolaan dana kapitasi. Kebijakan yang berorientasi kepada efisiensi teknis biaya akan berpengaruh terhadap nilai efisiensi teknis sistem. Diharapkan Dinkes melakukan monitoring, evaluasi serta peningkatan efisiensi pengelolaan dana kapitasi puskesmas secara intensif dan komprehensif terhadap mutu kinerja puskesmas sebagai indikatornya.
Kata Kunci. Dana Kapitasi, Puskesmas, Efisiensi Teknis, Data Envelopment Analysis (DEA).
Center for Health Policy and Management
2017-10-09 22:38:12
application/pdf
https://jurnal.ugm.ac.id/jkki/article/view/30667
Jurnal Kebijakan Kesehatan Indonesia : JKKI; Vol 5, No 3 (2016)
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