scholarly journals KAJIAN MUTU PELAYANAN KEFARMASIAN DAN KEPUASAN PASIEN RAWAT JALAN PADA ERA JAMINAN KESEHATAN NASIONAL

2018 ◽  
Vol 21 (1) ◽  
pp. 22-31
Author(s):  
Lukman Prayitno ◽  
Suharmiati Suharmiati
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Health Care Facilities ◽  
Google Scholar ◽  
Pharmacy Services ◽  
Relationship Of ◽  
The Relationship ◽  
Outpatient Drug

Pharmacy services is one of health care facilities is essential and support services medical care in the era of national health insurance. This study aims to determine the relationship of the quality of pharmaceutical services and outpatient satisfaction in the era of national health insurance. This study is a review of five studies that were taken from google scholar with topics related to quality pharmacy services and patient satisfaction, especially outpatients with the aim to see the relationship between the two topics. Satisfaction outpatient pharmacy services to be measured from five aspects: the tangible (direct evidence / physical), reliability (reliability), responsiveness (responsiveness), assurance (assurance), empathy (hospitality / caring). Outpatient satisfaction with the services of pharmacy measured from five aspects of service quality. There are three research which states that the satisfaction of outpatients have a low value at the time of drug services (reliability). There are two results of the study which states that satisfaction of outpatients have a low value on the guarantee (assurance). Increasing satisfaction with time outpatient drug services can be reached by making work system more simple, adding pharmacy workers, educating consumers about the services provided. While the increase in outpatient satisfaction about the assurance can be reached by increasing the amount of drug in the recipe included in BPJS dependents and ensure the availability of drugs.   ABSTRAK Pelayanan kefarmasian merupakan salah satu sarana layanan kesehatan yang sangat penting dan menunjang layanan perawatan medik pada era jaminan kesehatan nasional. Penelitian ini bertujuan untuk mengetahui hubungan mutu pelayanan kefarmasian dan kepuasan pasien rawat jalan pada era jaminan kesehatan nasional. Penelitian ini merupakan review dari 5 penelitian yang diambil dari google scholar dengan topik yang terkait dengan mutu pelayanan farmasi dan kepuasan pasien khususnya pasien rawat jalan dengan tujuan untuk melihat hubungan kedua topik tersebut. Hasil penelitian menunjukkan kepuasan pasien rawat jalan terhadap pelayanan kefarmasian dapat diukur dari 5 aspek yaitu tangible (bukti langsung/ fisik), reliability (keandalan), responsiveness (daya tanggap), assurance (jaminan), empathy (keramahan/ kepedulian). Terdapat tiga hasil penelitian yang menyatakan bahwa kepuasan pasien rawat jalan mempunyai nilai rendah pada waktu layanan obat (reliability) serta dua hasil penelitian yang menyatakan bahwa kepuasan pasien rawat jalan mempunyai nilai rendah pada jaminan (assurance). Penelitian ini menyimpulkan bahwa peningkatan kepuasan pasien rawat jalan terhadap waktu layanan obat dapat ditempuh dengan cara membuat sistem kerja yang lebih sederhana, menambah petugas farmasi, edukasi konsumen tentang layanan yang diberikan. Sedangkan peningkatan kepuasan pasien rawat jalan terhadap jaminan (assurance) dapat ditempuh dengan cara meningkatkan jumlah obat dalam resep yang masuk dalam tanggungan BPJS dan menjamin ketersediaan obat.

scholarly journals Patient’s Satisfaction With Quality of Care at a National Health Insurance Clinic at a Tertiary Center, South-South Nigeria

2021 ◽  
Vol 8 ◽  
pp. 237437352098147
Author(s):  
Temitope Esther Olamuyiwa ◽  
Foluke Olukemi Adeniji
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Bivariate Analysis ◽  
P Value ◽  
Tertiary Center

Introduction: Patient satisfaction is a commonly used indicator for measuring the quality of health care. This study assessed patients’ satisfaction with the quality of care at the National Health Insurance Scheme (NHIS) clinic in a tertiary facility. Methods: It was a descriptive cross-sectional study in which 379 systematically selected participants completed an interviewer-administered, semi-structured questionnaire. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 23. Bivariate analysis was performed using Pearson χ2 with a P value set at ≤ .05. Results: The study found out that about half (193, 50.9%) of the respondents were satisfied with the availability of structure. Patients were not satisfied with waiting time in the medical records, account, laboratory, and pharmacy sections. Overall, 286 (75.5%) of the respondents were satisfied with the outcome of health care provided at the NHIS clinic. A statistically significant association ( P = .00) was observed between treatment outcome and patient satisfaction. Conclusion: There is a need to address structural deficiencies and time management at the clinic.

Cases of Dispute and Pending Claims in Hospitals in the Era of National Health Insurance

2022 ◽  
Vol 2 (1) ◽  
pp. 32-38
Author(s):  
Mrs. Yastori
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
National Health Insurance ◽  
National Health ◽  
National Health Insurance System ◽  
Quality Health ◽  
Icd 10 ◽  
Data Collection Technique ◽  
Observation Method

Background: Indonesia began to implement a National Health Insurance System based on the National Social Security System in 2014 with the support of government regulations which states that Indonesia requires every citizen to have access to comprehensive and quality health services so that can continue their life through the National Health Insurance. Pending and dispute claims are problems that often occur in the era of national health insurance that can affect hospital budget allocation and planning policies, increasing the high cost burden for hospitals which will affect the quality of health services provided. The purpose of this study was to determine pending cases and dispute claims in hospitals in the Era of National Health Insurance.Methods: The study used a descriptive method with a qualitative approach. The data collection technique used is the observation method, namely directly to the e-claim file at several hospitals. 15 e-claim files taken in total from April – July 2021.Results: Obtained 13 cases of pending claims and 2 cases of dispute claims. Cases pending claims are caused by not complying with the code with evidence or resources, not in accordance with medical clinical practice guidelines and the rules of the health insurance provider.Conclusions: In coding, it is necessary to match the theory on the ICD-10, update the ICD-10. It is necessary to understand the rules and provisions made by the insurer and the related guidelines and rules. Please be aware of every latest code update.

Quality Healthcare Service Assessment under Ghana’s National Health Insurance Scheme

2019 ◽  
Vol 54 (4) ◽  
pp. 569-587
Author(s):  
Michael Kodom ◽  
Adobea Yaa Owusu ◽  
Perpetual Nancy Baidoo Kodom
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Public Hospital ◽  
National Health Insurance Scheme ◽  
Quality Of Healthcare ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Private And Public

Ghana implemented the National Health Insurance Scheme (NHIS) in 2005 with the intention of providing residents with quality affordable healthcare. Over the past few years, concerns have been raised about the quality of healthcare clients receive. This study assesses the experiences of NHIS subscribers with the quality of care they receive under the scheme by both private and public hospitals. The results from the 56 interviews show that the majority of the subscribers were dissatisfied with the overall quality of healthcare they received in both private and public hospital because of the long waiting hours, the poor attitude of nurses and the demand for payment of additional money. Even though clients who visited the private hospital paid for all services, excluding consultation, their level of satisfaction with the quality of healthcare was relatively higher than those who visited the public hospital. The paper concludes that NHIS clients do not receive the quality of healthcare the scheme promised, and this has implications for premium renewals and health-seeking behaviour.

Utilization of the Ghana National Health Insurance Scheme and its association with patient perceptions on healthcare quality

2018 ◽  
Vol 31 (6) ◽  
pp. 485-491
Author(s):  
Nel Jason L Haw
Keyword(s):  
Quality Of Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
National Health Insurance Scheme ◽  
Patient Perceptions ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
The Difference

Abstract Objective To determine the association between the utilization of the Ghana National Health Insurance Scheme (NHIS) and patient perceptions of quality of care. Methods Ghana Demographic and Health Survey (GDHS) 2014 had 19 questions on perceptions of quality of care received during the last reported health visit (n = 4332). These questions were summarized into an overall 100-point perception score using item response theory (IRT). Patients were divided into three utilization categories: those paying with their NHIS card fully, those paying with their card and out-of-pocket (OOP), and those paying fully OOP. A multiple linear regression model was used to measure the association between NHIS utilization and overall perception. Results In general, NHIS utilization was negatively associated with overall perception, and the difference across utilization categories was higher among private facility users than public facility users. Among private facilities, those who paid fully with NHIS reported five points lower than those who paid fully OOP (P = 0.005). Among public facilities, the difference is only 1.7 (P = 0.4342). Conclusion NHIS utilization was a negative predictor for patient perceptions, but the differences are more nuanced according to type of facility. Future GDHS rounds should continue measuring perceptions in aid of policy to improve service delivery under the NHIS.

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