Law Protection on Patients Toward The Health Services Conducted by Social Security Administrator for Health (Ssah) or BPJS in Accordance With The Limitation on Cataract Surgery

SOEPRA ◽  
2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Chori Diah Astuti ◽  
Suherman Suherman ◽  
Arrisman Arrisman
Keyword(s):  
Health Care ◽  
Health Services ◽  
Social Security ◽  
Cataract Surgery ◽  
Health Care Services ◽  
Legal Protection ◽  
Secondary Data ◽  
The State ◽  
Care Services ◽  
The Government

Health is a primary right of every individual and must be guaranteed by the state; therefore, the state has regulated the health of its citizens as stipulated in the 1945 Constitution Article 28 Section 3 which is further regulated in law No. 40 Year 2004 concerning the national social security system. One of the concerns of the government is that many Indonesians who have reached the age of 50-60 years who experience vision problems due to cloudy eye lense or cataract. The government concern is can be seen from their attention on health problems by passing Minister of Health Regulation No. 29 Year 2016. Concerning with eye Health Care Services at the Health Care Amanities and the Director of Health Service Security on Health (SSAH) passed a regulationNo. 2 Year 2018 concering with cataract service security service.The Method Used in this study is a normative juridical method, using secondary data consisting of primary, secondary and tertiary legal materials. The end purpose of this study is to get clarity about the legal protection of patients against health services by the Health amenities and SSAH or BPJS with the existence of restrictions on cataract surgery and to find out the claim procedures concerning with this restriction.Keywords: Legal Protection, BPJS or SSAH, Cataract Surger.

scholarly journals An epidemiological study regarding availability and utilization of public health care services in slum in Amritsar city

2019 ◽  
Vol 6 (6) ◽  
pp. 2396
Author(s):  
Richa Verma ◽  
Tejbir Singh ◽  
Mohan Lal ◽  
Jasleen Kaur ◽  
Sanjeev Mahajan ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Economic Status ◽  
Health Indicators ◽  
Public Health Care ◽  
Cross Sectional ◽  
Government Health ◽  
Care Services ◽  
The Government

Background: Low level of education of the slum dwellers along-with poor socio- economic status and pathetic environmental conditions lead to their poor health indicators. Since the National Urban Health Mission (NUHM) was launched in 2013, the health services are still in their initial stages. Assessment of the availability as well as the utilization of health care services of the urban slums is the need of the hour.Methods: The cross-sectional study was conducted in randomly selected slum in Amritsar city. All the houses were enumerated and visited by the interviewer herself. The eldest adult member of the family was selected as key respondent and written, informed consent was obtained. Predesigned questionnaire was used to collect the data which was then compiled and analyzed using statistical tests.Results: Out of the total respondents, one third respondents had knowledge about the government health center nearby (statistically significant) while out of these, only one third utilized the services at the center (statistically non-significant). Almost half of the respondents had knowledge about the medical camps and out of these, two-thirds utilized the services at medical camps.Conclusions: Overall utilization of services is poor. More respondents were aware of the medical camps than the static government health facility and utilization of medical camps was also more. So the static health services under NUHM need to be further strengthened.

Needs assessment for gender sensitive reproductive health services for adolescents

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fatemeh Rahmanian ◽  
Soheila Nazarpour ◽  
Masoumeh Simbar ◽  
Ali Ramezankhani ◽  
Farid Zayeri
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Reproductive Health Services ◽  
Care Needs ◽  
Reproductive Health Care ◽  
Care Services

AbstractBackgroundA dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents.ObjectiveThis study aims to assess needs for gender sensitive reproductive health care services for adolescents.MethodsThis was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21.ResultsThree hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services.ConclusionsProviding gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.

BPJS Kesehatan Memberikan Jaminan Kesehatan Terhadap Pasien Atau Masyarakat

2021 ◽  
Vol 7 (2) ◽  
pp. 146-154
Author(s):  
Aidha Puteri Mustikasari
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Social Security ◽  
The State ◽  
Universal Health Care ◽  
Universal Health Insurance ◽  
Universal Health ◽  
Provide Health Insurance

Abstrak. Kepesertaan BPJS Kesehatan pada tahun 2020 tidak akan mencakup 90% penduduk Indonesia, namun rencana Universal Health Care Implementation (UHC) telah direncanakan sejak tahun sebelumnya. Di masa pandemi Covid, sejumlah besar status kepesertaan BPJS Kesehatan  dicabut karena terlambat, padahal masyarakat membutuhkan layanan kesehatan dan asuransi dengan kondisi yang ada. Kajian ini bersifat norma deskriptif , dibahas dalam konteks kepesertaan BPJS kesehatan, dan cukup  menggunakan prinsip asuransi dengan hanya memberikan jaminan kepada peserta, tetapi negara mengikuti kewajiban UUD 1945 yaitu memberikan jaminan kesehatan dan pelayanan kepada warga negara. Untuk mendukung keberadaan jaminan kesehatan universal, Indonesia perlu menerapkan formulir kepesertaan dan  sanksi untuk ketentuan wajib  peserta jaminan sosial yang efektif dan efisien. Abstract. BPJS Health membership in 2020 will not cover 90% of Indonesia's population, but the Universal Health Care Implementation (UHC) plan has been planned since the previous year. During the Covid pandemic, a large number of BPJS Health membership statuses were revoked because they were late, even though people needed health services and insurance with the existing conditions. This study is descriptive in nature, discussed in the context of BPJS health participation, and it is sufficient to use the insurance principle by only providing guarantees to participants, but the state follows the obligations of the 1945 Constitution, namely to provide health insurance and services to citizens. To support the existence of universal health insurance, Indonesia needs to implement an effective and efficient membership form and sanctions for mandatory provisions for social security participants.

scholarly journals Analysis of the Effect of Health Insurance on Health Care Utilization in Rwanda

2021 ◽  
Author(s):  
Roger Muremyi ◽  
Dominique Haughton ◽  
François Niragire ◽  
Ignace Kabano
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Health Care Utilization ◽  
Health Care Services ◽  
Insurance Coverage ◽  
Secondary Data ◽  
Living Condition ◽  
Care Utilization ◽  
Health Coverage

In Rwanda, more than 90% of the population is insured for health care. Despite the comprehensiveness of health insurance coverage in Rwanda, some health services at partner institutions are not available, causing insured patients to pay unintended cost. We aimed to analyze the effect of health insurance on health care utilization and factors associated with the use of health care services in Rwanda. This is an analysis of secondary data from the Rwanda integrated living condition survey 2016-2017. The survey gathered data from 14580 households, and decision tree and multilevel logistic regression models were applied. Among 14580 households only (20%) used health services. Heads of households aged between [56-65] years (AOR=1.28, 95% CI:1.02-1.61), aged between [66-75] years (AOR=1.52, 95% CI: 1.193-1.947), aged over 76 years (AOR=1.48, 95% CI:1.137-1.947), households with health insurance (AOR=4.57, 95% CI: 3.97-5.27) displayed a significant increase in the use of health services. This study shows evidence of the effect of health insurance on health care utilization in Rwanda: a significant increase of 4.57 times greater adjusted odds of using health services compared to those not insured. The findings from our research will guide policymakers and provide useful insights within the Rwanda context as well as for other countries that are considering moving towards universal health coverage through similar models.

scholarly journals Prison Health as Public Health in Ontario Corrections

2020 ◽  
Vol 5 (1) ◽  
pp. 19
Author(s):  
Yoko Murphy ◽  
Howard Sapers
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Services ◽  
Care Needs ◽  
Term Care ◽  
Care Services ◽  
Prison Health ◽  
Independent Review ◽  
Recent Reform ◽  
The Government

The majority of incarcerated individuals in Canada, and especially in Ontario provincial correctional institutions, are released into the community after a short duration in custody. Adult correctional populations have generally poor health, including a heightened prevalence of mental health and substance use disorders. There are legal and ethical obligations to address health care needs of incarcerated individuals, and also public health benefits from ensuring adequate, appropriate, and accessible health services to individuals in custody. The Independent Review of Ontario Corrections recommended the transformation of health care in Ontario provincial corrections in 2017, including transferring health service responsibilities to the Ministry of Health and Long-Term Care. The Correctional Services and Reintegration Act, 2018, would affirm the provincial government’s obligation to provide patient-centred, equitable health care services for individuals in custody. We encourage the Government of Ontario to proclaim the Act and continue the momentum of recent reform efforts in Ontario.

scholarly journals Satisfaction of clients with disabilities with services offered at primary health care centres in Ndola, Zambia

2012 ◽  
Vol 68 (2) ◽  
Author(s):  
N. Mlenzana ◽  
R. Mwansa
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Professionals ◽  
Health Care Services ◽  
Waiting Times ◽  
Care Providers ◽  
Persons With Disabilities ◽  
Care Services ◽  
Primary Health

To establish satisfaction level of persons with disabilitiesregarding health services at primary health care centres in Ndola, Zambia.Key stakeholders views on satisfaction of services is an important componentof service rendering thus obtaining information is important in assistingwith the evaluation of health care service delivery. This will assist in improvingeffectiveness and availability of health care services to persons with physicaldisabilities.All persons with disabilities attending both rehabilitation centres andprimary health care centres in Ndola, Zambia, were targeted for this study. Willing participants were convenientlyselected to take part in the study.A cross sectional, descriptive study design using quantitative methods of data collection was used. The GeneralPractice Assessment Questionnaire was adjusted, piloted for Ndola population and used in this study to establishsatisfaction of participants. The study was ethically cleared at the University of the Western Cape and Zambia.Information and consent forms were signed by participants.Quantitative data was analysed descriptively and was reported in percentages.In the current study there were 191 participants of whom 56% were male and 44% were female with age rangefrom 18-65 years. Fifty-two percent of the participants presented with learning disabilities and 38% of persons withphysical disabilities. Majority of clients (54%) were dissatisfied with availability of services and health care servicesat the health care centres. Areas that clients were dissatisfied with were accessibility, consultation with health professionals,waiting times and opening hours of the health care centres.Clients with disabilities who accessed health care services from selected health centres in Ndola were dissatisfiedwith aspects of health services. Accessibility, consultation with health professionals, waiting times and opening hoursof the health care centres were the origin of client dissatisfaction. Other clients were satisfied with thoroughness ofhealth care providers regarding symptoms, feelings, reception and treatment received at the primary health care centre.Understanding the views of the clients is essential in improving health delivery services and could impact on thecompliance of people attending primary health care services.

The Finnish healthcare services lean management

2018 ◽  
Vol 31 (1) ◽  
pp. 17-32 ◽  
Author(s):  
Susanna Hihnala ◽  
Lilja Kettunen ◽  
Marjo Suhonen ◽  
Hanna Tiirinki
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Point Of View ◽  
Lean Management ◽  
Management Skills ◽  
Content Type ◽  
Care Services ◽  
Development Processes ◽  
Specialized Health Care

Purpose The purpose of this paper is to discuss health services managers’ experiences of management in a special health-care unit and development efforts from the point of view of the Lean method. Additionally, the aim is to deepen the knowledge of the managers’ work and nature of the Lean method development processes in the workplace. The research focuses on those aspects and results of Lean method that are currently being used in health-care environments. Design/methodology/approach These data were collected through a number of thematic interviews. The participants were nurse managers (n = 7) and medical managers (n = 7) who applied Lean management in their work at the University Hospital in the Northern Ostrobothnia Health Care District. The data were analysed with a qualitative content analysis. Findings A common set of values in specialized health-care services, development of activities and challenges for management in the use of the Lean manager development model to improve personal management skills. Practical implications Managers in specialized health-care services can develop and systematically manage with the help of the Lean method. This emphasizes assumptions, from the point of view of management, about systems development when the organization uses the Lean method. The research outcomes originate from specialized health-care settings in Finland in which the Lean method and its associated management principles have been implemented and applied to the delivery of health care. Originality/value The study shows that the research results and in-depth knowledge on Lean method principles can be applied to health-care management and development processes. The research also describes health services managers’ experiences of using the Lean method. In the future, these results can be used to improve Lean management skills, identify personal professional competencies and develop skills required in development processes. Also, the research findings can be used in the training of health services managers in the health-care industry worldwide and to help them survive the pressure to change repeatedly.

PERLINDUNGAN HUKUM BAGI RSUD DR. MOEWARDI SURAKARTA TERHADAP KETERLAMBATAN PEMBAYARAN KLAIM OLEH BPJS KESEHATAN

2020 ◽  
Vol 8 (1) ◽  
pp. 42
Author(s):  
Asna Zamharira ◽  
Arief Suryono
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Research Method ◽  
Legal Protection ◽  
Secondary Data ◽  
Primary Data ◽  
Cooperation Agreement ◽  
Insurance Program ◽  
Health Insurance Program ◽  
The Government

<p>Abstract<br />This articles aims to find out how legal protection for health facilities is towards late payment of claims by BPJS Health. The research method used in writing this law is a normative juridical research method that is research that uses secondary data or literature that is supported by primary data in the field as supporting data. Analysis of data using qualitative analysis. The results of the study revealed that health services in implementing the Health Insurance program between RSUD Dr. Moewardi Surakarta with BPJS Health is based on a collaboration agreement between RSUD Dr. Moewardi Surakarta with BPJS Kesehatan about Advanced Level Referral Health Services for Participants in the Health Insurance Program, one of which is the contents of a cooperation agreement regarding the payment system of claims. The claim system is carried out by referring to the agreement. In the system of claims there were still obstacles that is the delay in the payment of claims by BPJS Kesehatan to the hospital. As a form of legal protection, to resolve the problem of late payment of claims made in accordance with the cooperation agreement and Perpres No. 82 Tahun 2018 concerning Health Insurance. The Government and BPJS Kesehatan are expected to be able to make claims payments in accordance with the terms or agreed cooperation agreements.<br />Keywords: Cooperation agreement; Claim; BPJS Kesehatan; Hospital.</p><p>Abstrak<br />Artikel ini bertujuan untuk mengetahui bagaimana perlindungan hukum bagi fasilitas kesehatan tehadap keterlambatan pembayaran klaim oleh BPJS Kesehatan. Metode penelitian yang digunakan dalam penulisan hukum ini adalah metode penelitian yuridis normatif yaitu penelitian yang menggunakan bahan-bahan hukum sekunder atau kepustakaan yang ditunjang dengan data primer di lapangan sebagai data pendukung. Data diolah dan dianalisis secara kualitatif. Hasil penelitian diketahui bahwa pelayanan kesehatan dalam melaksanakan program Jaminan Kesehatan antara RSUD DR. Moewardi  Surakarta dengan BPJS Kesehatan didasarkan pada perjanjian kejasama antara RSUD Dr. Moewardi Surakarta dengan BPJS Kesehatan tentang Pelayanan Kesehatan Rujukan Tingkat Lanjutan bagi Peserta Program Jaminan Kesehatan yang salah satu isi perjanjiannya mengenai sistem pembayaran klaim. Sistem pembayaran klaim dilakukan dengan berpedoman pada perjanjian kerjasama. Dalam sistem klaim masih ditemui hambatan yaitu terjadinya keterlambatan pembayaran klaim oleh BPJS Kesehatan kepada rumah sakit. Sebagai bentuk perlindungan hukum, untuk penyelesaian permasalahan keterlambatan pembayaran klaim dilakukan sesuai dengan perjanjian kerjasama dan Perpres No. 82 Tahun 2018 tentang Jaminan Kesehatan. Pemerintah dan BPJS Kesehatan diharapkan dapat melaksanan pembayaran klaim sesuai dengan ketentuan atau perjanjian kerjasama yang telah disepakati.<br />Kata Kunci: Perjanjian Kerjasam; Klaim; BPJS Kesehatan; Rumah Sakit.</p>

Case Study E-Tailing Health Services in India

2016 ◽  
pp. 292-308
Author(s):  
Bobby Kurian
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Professionals ◽  
Health Care Services ◽  
Information Dissemination ◽  
Health Providers ◽  
The Public ◽  
Care Services ◽  
The World

This case study has been developed to promote understanding the e-tailing of health services. E-health web portal provides a new medium for information dissemination, interaction and collaboration among institutions, health professionals, health providers and the public. This case study provides a founders perspective in setting up and running a medical website that offers online health care services to customers across the world. The case study discusses the challenges and issues faced by the founders and also the promoter's perspective on the lucrativeness of offering e-tailing services. Using this case study an attempt is made to stress the importance of a flexible e-tailing business model specific to the services offered and need of periodic assessments to ensure that the business runs profitable.

scholarly journals THE HEALTH-CARE NEEDS AMONG OLDER PERSONS IN AN INDONESIAN URBAN SETTING

2017 ◽  
Vol 10 (7) ◽  
pp. 233
Author(s):  
Setiawan E ◽  
Poedjibudojo J K ◽  
Tondok Ms
Keyword(s):  
Health Care ◽  
Older Persons ◽  
Health Care Services ◽  
Capital City ◽  
Urban Setting ◽  
Health Care Needs ◽  
Care Needs ◽  
Care Services ◽  
Unmet Health Care Needs ◽  
The Government

Objective: The unmet health-care needs among older persons population should be identified and anticipated due to hideous potential impacts. Ironically, no published study regarding this phenomenon was found in Indonesia. Derived from the Indonesian population and civil data, this study was conducted to identify the health-care needs of urban older people living on Java Island, the most populated island in Indonesia.Methods: A qualitative study was conducted in 3 subdistricts in Surabaya, the capital city of East Java, namely, Rungkut, Kenjeran, and Tenggilis. There were 9 focus group discussions (FGDs) conducted during March-August 2015. Participants in this study were recruited purposively, i.e., person in charge of “Karang Werda,” and the discussion explored thematically various topics in the area of unmet health needs phenomena related to: (1) Availability, (2) accessibility, and (3) acceptability. A FGD guide was developed to ensure in-depth discussion.Results: There were 90 older persons serving as volunteers who participated in this study. The unmet health-care needs addressed by participants in this study were (1) Integrated and specialized health-care services for older persons and (2) skillful yet age-friendly health-care personnel were needed by participants. Our findings pointed out that the unmet health-care needs in Indonesian urban settings were classified as primarily availability, accessibility, and acceptability issues.Conclusion: The government needs to take actions to solve the challenges related to the fulfillment of health-care needs among older persons in Indonesia. Further study of the health care personnel’s beliefs and attitudes in providing care among older persons needs to be conducted to provide a more holistic picture of the phenomena before making any strategy for the future Indonesia’s health-care system.

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