scholarly journals An Audit of Knowledge and Attitude Regarding Implementation of the National Health Insurance (JKN) in BPK RI

2019 ◽  
Vol 6 (5) ◽  
pp. 50
Author(s):  
Hari Suhud
Keyword(s):  
Health Insurance ◽  
Human Resources ◽  
National Health Insurance ◽  
National Health ◽  
Social Health Insurance ◽  
Social Health ◽  
Health Card ◽  
Knowledge And Attitude ◽  
The Republic ◽  
Unfavorable Attitude

This study aims to evaluate the knowledge and attitude of Human Resource Bureau employees regarding implementation of National Health Insurance (JKN) in The Audit Board of the Republic of Indonesia (known as BPK RI). The study is carried out by quantitative method through the distribution of questionnaires. Based on the data obtained from the results of research on 155 respondents in terms of knowledge and attitude, it can be concluded as follows: 1. the level of knowledge of employees at Human Resources Bureau in BPK RI mostly have low knowledge about the National Health Insurance (JKN) (58.1%). The results are exposed to employees who have never used Social Health Insurance/BPJS Health card with a large enough score (36.1%), and the rest are employees who have used the card; 2. the attitude of employees at Human Resources Bureau in BPK RI has a favorable attitude towards the positive statement (84.5%), as for the attitude of employees to negative statements obtained the opposite result, that most respondents have unfavorable attitude (76.1%). The results were distributed to respondents who had never used Social Health/ BPJS Health card with similar percentages.

scholarly journals SOCIAL HEALTH INSURANCE LITERACY: LESSON LEARNED FROM SOCIAL INSURANCE FOR MATERNITY CARE BY NATIONAL HEALTH INSURANCE PROGRAMME

2019 ◽  
Vol 7 (1) ◽  
pp. 25
Author(s):  
Choirun Nisa' ◽  
Intan Nina Sari
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Maternity Care ◽  
Social Insurance ◽  
Post Partum ◽  
Social Health Insurance ◽  
Social Health ◽  
Health Insurance Literacy ◽  
The Government

Background: Health insurance is a right for all Indonesian citizens. To provide this, the Indonesian government must provide health services that are equitable, fair, and affordable for all levels of society. Before National Health Insurance (JKN) was established, the government launched Social Insurance for Maternity Care or Jaminan Persalinan (Jampersal) as a special health facility for pre-pregnant to post-partum mothers. The JKN program will run well if it is accompanied with good health service literacy of the community.Aims: This study aims to analyze the relationship of social health insurance literacy with the utilization of Jampersal and predict the response towards JKN utilization based on Jampersal mothers. These responses can be used as an input for JKN improvement.Methods: This research is a descriptive study that focuses on the experience of the subjects. The study does so by analyzing Jampersal users’ response and utilizing it for the improvement of JKN. The respondents of this study are Jampersal and non-Jampersal mothers consisting of 75 pregnant and post-partum mothers.Results: The results show that the number of Jampersal users (47%) were less than non Jampersal (53%) with a ratio of 2:3. In addition, literacy about Jampersal of Jampersal mothers' was higher (28 out of 30 people - 93.33%) compared to non Jampersal mothers (29 out of 45 people - 64.44%).Conclusions: This study concludes that there is a lack of promotion of government programs, especially social health insurance. What needs to be done to improve participation and use of social health insurance is to encourage primary healthcare centers to promote the programs. Intervention policy, especially by educating the communities, is necessary for the improvement of JKN literacy.                                                                                                                                                          Keywords: Literacy, Participation, Social health insurance.

scholarly journals DOES MORAL HAZARD OCCOUR IN THE IMPLEMENTATION OF SOCIAL HEALTH INSURANCE? EVIDENCE FROM PUBLIC HOSPITALS IN A RURAL PROVINCE OF INDONESIA

2020 ◽  
Vol 5 (1) ◽  
pp. 24
Author(s):  
Rizanda Machmud ◽  
Syafrawati Syafrawati ◽  
Prof. Syed Mohamed Aljunid ◽  
Rima Semiarty
Keyword(s):  
Health Insurance ◽  
Moral Hazard ◽  
National Health Insurance ◽  
National Health ◽  
Medical Records ◽  
Social Health Insurance ◽  
Public Hospitals ◽  
Social Health ◽  
Severity Level ◽  
Discharge Status

Indonesia is now encountering moral hazard problems in the implementation of social health insurance. BPJS, as the administrator of Indonesia’s National Health Insurance, reported that there was an increase in deficit in the 4 years of the implementation of National Health Insurance from US$ 228 million in 2014 to US$ 470 million in 2016. Despite efforts conducted to overcome the problem, no evidence-based predictor that might be significantly associated with moral hazard in a rural province hospital in Indonesia. The purpose of this research is to identify the incidence of moral hazard in the implementation of National Health Insurance in Indonesia. Data consisting of 180 medical records obtained from three public hospitals in rural province of Indonesia were selected as samples in this study. These medical records were reviewed by Independent Senior Coder (ISC) who had more than 5 years experiences as a coder. The indicators of moral hazard in this study were upcoding, readmission, and possible unnecessary admission. Logistic regression was used to explore determinant of moral hazard from patient, coder, and physician side. The results show that rate of moral hazard cases for upcoding is 10%, readmission is 2.8%, and possible unnecessary admission is 18.9%. It can be seen from multivariate analysis that discharge status, severity level and LOS have a significant relationship with moral hazard. Illness severity level, Discharge against Medical Advice, and higher Length of Stay are risk factors for moral hazard incidence.

scholarly journals Analysis of characteristics and trends of the In-Hospital Cardiac Arrest incidence in the Republic of Korea: clinical usefulness of national health insurance claim data

2021 ◽  
Keyword(s):  
Cardiac Arrest ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Circulatory System ◽  
Claim Data ◽  
Republic Of Korea ◽  
Classification Of Diseases ◽  
The Republic ◽  
Hospital Cardiac Arrest

Backgrounds: In-Hospital Cardiac Arrest (IHCA) requires the preparation of considerable medical resources in hospitals. Furthermore, compared to Out-of-Hospital Cardiac Arrest, until recently, there have not been many studies on the incidence, characteristics, and prognosis of IHCA. This study is to examine IHCA event rates among hospitalized patients in the Republic of Korea from 2011 to 2015. Methods: The incidence of IHCA in adults was extracted from claim data of the National Health Insurance Service from 2011 to 2015, and analyzed according to age, sex, the classification under the 7th revision of the Korean Standard Classification of Diseases (KCD-7), hospital types, and provinces. Results: From 2011 to 2015, the overall incidence of IHCA in Korea was founded to be 3.00 per 1,000 hospitalizations. The overall 5-year IHCA incidence was higher in male at 3.92 cases per 1,000 hospitalizations and at female 2.19 cases per 1,000 hospitalizations. Incidence due to cardiovascular disease increased year by year, whereas incidences due to respiratory, neurological and infectious disease were decreasing, and in the case of oncologic disease, there was no change. In particular, patients with diseases of the circulatory system had at least a two times higher incidence compared to those with other diseases. The IHCA incidence in general hospitals and tertiary hospitals was at least two-fold higher than the national overall and showed an increasing trend. The provinces that showed a higher IHCA incidence than the five-year national overall were Jeju Special Self-Governing Province, Gangwon Province, and Seoul. Conclusions: The results of this study can be used as important basic data to secure patient safety by reducing the occurrence of IHCA.

scholarly journals Studi Kasus : Kesiapan Rumah Sakit An – Nisa Tangerang Dalam Implementasi Program Jaminan Kesehatan Nasional

2019 ◽  
Vol 47 (4) ◽  
Author(s):  
Luh Putu Sinthya Ulandari
Keyword(s):  
Health Insurance ◽  
Human Resources ◽  
National Health Insurance ◽  
National Health ◽  
Thematic Analysis ◽  
Clinical Pathways ◽  
Qualitative Approach ◽  
Hospital Data ◽  
Private Hospitals ◽  
Depth Interviews

Abstract Health facilities play an important role in achieving the goals of National Health Insurance (JKN), to providing health services to all Indonesian people. The study aimed to determine the readiness of An - Nisa Hospital as one of the private hospitals in Tangerang in the implementation of the JKN. This research was conducted in March 2018 using a qualitative approach through in-depth interviews and documentation study. The sample was determined purposively, consisting of 7 internal informants from An - Nisa Hospital. Data were analyzed using thematic analysis. Various preparations have been made by An - Nisa Hospital before the hospital joined the BPJS Kesehatan provider, starting from casemix training, coding, costing, preparing clinical pathways, and learning about an information technology systems used in the JKN era. The addition of human resources, facilities and infrastructure was also carried out to support the implementation of JKN. An - Nisa Hospital formed a casemix team whose task was to compile claim documents and collect claims to BPJS Kesehatan. This study concludes that An - Nisa Hospital had prepared themselves before joining the BPJS Kesehatan provider, and the hospital is fully committed to successful the JKN Program. Keywords: preparation, implementation, national health insurance Abstrak Fasilitas kesehatan memegang peranan penting dalam tercapainya tujuan Jaminan Kesehatan Nasional (JKN) yaitu dalam memberikan pelayanan kesehatan kepada seluruh masyarakat Indonesia. Tujuan dari penelitian ini adalah untuk mengetahui kesiapan dari RS An – Nisa sebagai salah satu rumah sakit swasta di Tangerang dalam implementasi Program JKN. Penelitian dilakukan pada Maret 2018 dengan pendekatan kualitatif. Data dikumpulkan dengan wawancara mendalam dan studi dokumen. Sampel ditentukan secara purposive, yang terdiri dari 7 informan pihak internal RS An – Nisa. Data dianalisis secara deskriptif kualitatif. Berbagai persiapan telah dilakukan oleh RS An – Nisa sebelum mereka bergabung menjadi provider BPJS Kesehatan, mulai dari mengikuti pelatihan casemix, coding, costing, penyusunan clinical pathway, serta menikuti pembelajaran tentang sistem informasi teknologi yang digunakan di era JKN. Penambahan SDM, fasilitas sarana dan prasarana pun dilakukan guna mendukung penyelenggaraan JKN. RS An – Nisa membentuk sebuah tim casemix yang bertugas untuk menyusun dokumen klaim dan melakukan penagihan klaim kepada BPJS Kesehatan. Penelitian ini menyimpulkan bahwa RS An – Nisa telah mempersiapkan diri secara totalitas sebelum bergabung menjadi provider BPJS Kesehatan, serta berkomitmen penuh dalam menyukseskan program JKN. Kata kunci: Persiapan, implementasi, jaminan kesehatan nasional

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