scholarly journals TINJAUAN YURIDIS PERTANGGUNG JAWABAN RUMAH SAKIT ATAS KE IKUT SERTAAN DALAM PROGRAM BADAN PENYELENGGARA JAMINAN SOSIAL (BPJS) KESEHATAN

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Ariawan Gunadi ◽  
Ida Nursida
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
Health Services ◽  
Social Security ◽  
Service Providers ◽  
Good Health ◽  
Active Role ◽  
Insurance Company ◽  
The Social ◽  
The Government

The Social Security Administering Body (BPJS) is a public legal entity formed to organize a social security program. Social Security Agency can alleviate the burden of society in obtaining health services in hospitals or clinics. This is in accordance with Article 5 Paragraph (1) and Paragraph (2) of Law No.36 Year 2009 on Health. and Article 47 Regulation of Health BPJS No.1 Year 2014 on the implementation of Health Insurance. As an insurance company BPJS health ensures the implementation of health programsHospitals and Clinics as health service providers in demand by the government to play an active role in providing good health services to the community according to its function, in accordance with Law Number 44 Year 2009 on Hospital. But even if the hospital or health service supports the social health insurance program or BPJS is proved by the poster that the Hospital or Clinic receive BPJS patients, does not mean that the service received by the community is in line with expectations.

HARMONISASI POLA PENGELOLAAN KEUANGAN FASKES DI LINGKUNGAN KEMENTERIAN PERTAHANAN DAN TNI DENGAN UU NO. 44 TAHUN 2009 tentang RUMAH SAKIT

2019 ◽  
Vol 19 (2) ◽  
pp. 182
Author(s):  
Sutarno Sutarno
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Social Security ◽  
Health Facility ◽  
Health Facilities ◽  
Fundamental Change ◽  
Legal Research ◽  
Legal Rules ◽  
The Social ◽  
The Government

<em>Since the enactment of Law Number 24 of 2011 concerning the Social Security Organizing Agency, there has been a very fundamental change in terms of Health Services. Health facilities within the Ministry of Defense and TNI which also affect budget governance. This legal research is a normative law with sources of primary and secondary legal materials that aim to review and analyze the legal rules regarding the management of income income received by Health Facilities within the Ministry of Defense and the TNI based on Law Number 44 of 2009; and reviewing and analyzing conflicting norms for the use of the TNI Health Facility as of the enactment of Law Number 24 of 2011 concerning the Health Insurance Administering Body. The results showed that the TNI Hospital which is a health facility owned by the Government should be subject to the rules contained in RI Law No. 44 of 2009 concerning Hospitals.</em>

scholarly journals Membangun Komunikasi dalam Sinergi Pelayanan Kesehatan di Kabupaten Bandung

2020 ◽  
Vol 14 (1) ◽  
pp. 17-28
Author(s):  
Ditha Prasanti ◽  
Ikhsan Fuady ◽  
Sri Seti Indriani
Keyword(s):  
Public Health ◽  
Health Service ◽  
Health Services ◽  
Active Role ◽  
Communication Process ◽  
Public Health Services ◽  
District Health ◽  
The Government ◽  
The One ◽  
The Village

The "one data" policy driven by the government through the Ministry of Health is believed to be able to innovate and give a new face to health services. Of course, the improvement of health services starts from the smallest and lowest layers, namely Polindes. Starting from this policy and the finding of relatively low public health service problems, the authors see a health service in Polindes, which contributes positively to improving the quality of public health services. The health service is the author's view of the communication perspective through the study of Communication in the Synergy of Public Health Services Polindes (Village Maternity Post) in Tarumajaya Village, Kertasari District, Bandung Regency. The method used in this research is a case study. The results of the study revealed that public health services in Polindes are inseparable from the communication process that exists in the village. The verbal communication process includes positive synergy between the communicator and the communicant. In this case, the communicators are village midwives, village officials, namely the village head and his staff, the sub-district health center, and the active role of the village cadres involved. In contrast, the communicant that was targeted was the community in the village of Tarumajaya. This positive synergy results in a marked increase in public services, namely by providing new facilities in the village, RTK (Birth Waiting Home).   Kebijakan “one data” yang dimotori oleh pemerintah melalui Kementerian kesehatan diyakini mampu membuat inovasi dan memberikan wajah baru terhadap layanan kesehatan. Tentunya, perbaikan layanan kesehatan tersebut dimulai dari lapisan terkecil dan terbawah yakni Polindes. Berawal dari kebijakan tersebut dan masih ditemukannya masalah pelayanan kesehatan publik yang relatif rendah, penulis melihat sebuah layanan kesehatan di Polindes, yang memberikan kontribusi positif dalam peningkatan kualitas layanan kesehatan masyarakat. Pelayanan kesahatan tersebut penulis lihat dari perpektif komunikasi melaui penelitian Komunikasi dalam Sinergi Pelayanan Kesehatan Publik Polindes (Pos Bersalin Desa) di Desa Tarumajaya, Kecamatan Kertasari, Kabupaten Bandung ini dilakukan. Metode yang digunakan dalam penelitian ini adalah studi kasus. Hasil penelitian mengungkapkan bahwa pelayanan kesehatan publik di Polindes, tidak terlepas dari adanya proses komunikasi yang terjalin di desa tersebut. Proses komunikasi verbal tersebut meliputi sinergitas positif antara pihak komunikator dan komunikan. Dalam hal ini, komunikator tersebut adalah Bidan Desa, Aparat Desa yakni Kepala Desa beserta staffnya, Puskesmas tingkat kecamatan, serta peran aktif dari para kader desa yang terlibat. Sedangkan komunikan yang menjadi target adalah masyarakat di desa Tarumajaya. Sinergitas positif tersebut menghasilkan peningkatan pelayanan publik yang nyata, yaitu dengan adanya penyediaan fasilitas baru di desa, RTK (Rumah Tunggu Kelahiran).

scholarly journals Social Security Policy in Response to the Pandemic COVID-19: A Case Study from Vietnam

2021 ◽  
pp. 193672442110269
Author(s):  
Le Hoang Viet Lam
Keyword(s):  
Health Service ◽  
Social Security ◽  
Security Policy ◽  
Armed Forces ◽  
Social Consensus ◽  
The Social ◽  
The Government ◽  
Social Security Policy ◽  
Level Resistance

On the international scale of measurement, Vietnam stands out as a country that has successfully accomplished the objectives of minimizing the spread of COVID-19. These objectives have been achieved through several factors, including the Government’s commitment, excellent success of the health service, and the “wholeheartedness” of the armed forces, especially the social consensus, which is clearly reflected in the decisions and policies made. Among those crucial decisions, the stable social security system has been the key priority of the government of Vietnam because it provides a strong foundation for the disadvantaged, who are not expected to overcome the pandemic based on their low-level “resistance.” The article aims at illustrating Vietnam’s social security interventions and strategies when faced the global COVID-19 pandemic and it also draws some experience that need to be referenced in implementing Social Security Society witnessed from Vietnamese reality.

scholarly journals Principal-agent problems in implementation of Ghana’s health insurance scheme

2018 ◽  
Vol 11 (2) ◽  
pp. 59 ◽  
Author(s):  
Daniel Dramani Kipo-Sunyehzi
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
Health Services ◽  
Service Providers ◽  
Diagnosis Related Groups ◽  
Principal Agent ◽  
Fee For Service ◽  
The Public ◽  
Health Service Providers ◽  
Profit Maximisation

<p>Principal-agent relationship exists between health service providers and their authority and clients. It asserts that health service providers as ‘imperfect agents’ of the authority and clients will take actions that aim to maximise profits at the expense of authority and clients (principal). The situation is possible when reimbursement is based on fee-for-service or a diagnosis-related groups. It looks at relationships between health service providers as agents and health insurance authority, and clients as principals in areas of provision of health services, supply of drugs, medicines and reimbursement. Results showed the private health service providers prescribed more drugs and medicines for clients towards profit maximisation (agency) than their public counterparts. Also, it was found that the public health service providers continued to provide health services and drugs despite health insurance authority indebtedness to them exhibiting more stewardship towards health insurance authority. It recommends strict regulations in tariffs/vetting claims and prompt reimbursement.</p>

Revenue and financing of patients with national health insurance by the social security organizing agency to improve health services

2020 ◽  
Vol 30 ◽  
pp. 276-279
Author(s):  
Syarifuddin Yusuf ◽  
Nuzul Achmar ◽  
Haniarti ◽  
Hasdiana ◽  
Mahkrajani Madjid ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Social Security ◽  
National Health Insurance ◽  
National Health ◽  
The Social ◽  
Improve Health

scholarly journals Implications of Social Inequality for Soldiers in Health Services of the Indonesian National Armed Forces Managed by the Social Security Agency

2021 ◽  
Vol 56 (3) ◽  
pp. 307-317
Author(s):  
Ida Bagus Purwalaksana ◽  
Sumartono ◽  
Bambang Santoso Haryono ◽  
Wike ◽  
Bambang Slamet Riyadi
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
Health Services ◽  
Social Security ◽  
Scientific Journal ◽  
Implementation Process ◽  
Armed Forces ◽  
Health Service Delivery ◽  
Scientific Activity ◽  
Social Security Agency

This scientific journal research analyzes Law No. 24 of 2011 on health services for the Indonesian National Armed Forces (TNI) sector along with their families included in the national health insurance managed by the Healthcare and Social Security Agency (BPJS) and its implementation regulated in the Presidential Regulation and Health Minister Regulation. However, the implementation of the BPJS health insurance at the TNI institutions does not show effective results, and it tends to decline. Therefore, it is necessary to interpret various factual factors affecting the success of the implementation process of health service delivery policies, which will be useful for finding synergies in the implementation of health services in the TNI. This research on the implementation of policies in the TNI health services was a scientific activity prepared using certain types and strategies and at the same time viewed from certain aspects which had several types and strategies. Therefore, this research used the descriptive qualitative method. Six factors should be interpreted to know the implementation of the TNI health service policy under Law No. 24 of 2011, namely; 1) policy standards and objectives, 2) resources, 3) characteristics of the implementing organization, 4) attitudes of the implementers, 5) communication among organizations related to implementation activities, 6) social, economic and political environments. All these factors synergize with each other and affect health services to TNI, which are administered by BPJS.

scholarly journals Comparing Public and Provider Preferences for Setting Healthcare Priorities: Evidence from Kuwait

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 552
Author(s):  
Abdullah M. Alsabah ◽  
Hassan Haghparast-Bidgoli ◽  
Jolene Skordis
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
Health Services ◽  
General Public ◽  
Private Health Insurance ◽  
Service Providers ◽  
Health Resources ◽  
The Public ◽  
Health Funding ◽  
Health Service Providers

As attempts are made to allocate health resources more efficiently, understanding the acceptability of these changes is essential. This study aims to compare the priorities of the public with those of health service providers in Kuwait. It also aims to compare the perceptions of both groups regarding key health policies in the country. Members of the general public and a sample of health service providers, including physicians, dentists, nurses, and technicians, were randomly selected to complete a structured, self-administered questionnaire. They were asked to rank health services by their perceived importance, rank preferred sources of additional health funding, and share their perceptions of the current allocation of health resources, including current healthcare spending choices and the adequacy of total resources allocated to healthcare. They were also asked for their perception of the current local policies on sending patients abroad for certain types of treatments and the policy of providing private health insurance for retirees. The response rate was above 75% for both groups. A higher tax on cigarettes was preferred by 73% of service providers as a source of additional funding for healthcare services, while 59% of the general public group chose the same option. When asked about the sufficiency of public sector health funding, 26.5% of the general public thought that resources were sufficient to meet all healthcare needs, compared with 40% of service providers. The belief that the public should be offered more opportunities to influence health resource allocation was held by 56% of the general public and 75% of service providers. More than half of the respondents from both groups believed that the policy on sending patients abroad was expensive, misused, and politically driven. Almost 64% of the general public stated that the provision of private health insurance for retirees was a ‘good’ policy, while only 34% of service providers agreed with this statement. This study showed similarities and differences between the general public and health service providers’ preferences. Both groups showed a preference for treating the young rather than the old. The general public preferred more expensive health services that had immediate effects rather than health promotion activities with delayed benefits and health services for the elderly. These findings suggest that the general public may not accept common allocative efficiency improvements in public health spending unless the challenges in this sector and the gains from reallocation are clearly communicated.

scholarly journals Policy Implementation of Health Coverage for Indonesian Migrant Workers

2016 ◽  
Vol 1 (2) ◽  
Author(s):  
Risky Kusuma Hartono ◽  
Budi Hidayat ◽  
Pujiyanto Puji
Keyword(s):  
Health Insurance ◽  
Social Security ◽  
Policy Implementation ◽  
Migrant Workers ◽  
Social Aspect ◽  
Health Coverage ◽  
Insurance Policy ◽  
The Social ◽  
Bilateral Cooperation ◽  
The Government

Abstract. The purpose of this research is to analyze the policy implementation of health coverage for TKI. This research uses a qualitative method with in-depth interview. The framework of this research consists of the aspect of the advisable policy, the implementation factors, and the schematic representation of the problem by using SWOT. The result of this research is the health insurance owned by TKI comes from TKI insurance, the membership of JKN, and insurance during their employment abroad. TKI insurance policy is the instruction of Law No. 39 of 2004 which regulates the obligation of the ownership of the social security and or insurance policy for TKI. However, TKI insurance has not been involved with the social aspect because the agency commercializes the coverage of TKI and it is not included a social security. The change of consortium may have decreased the ratio of claim’s values to the annual premium which is attributable to the decreasing complaint cases from TKI. In the implementation, TKI insurance has been assisted by a lot of agencies. However, the bilateral cooperation related to the coordination of health coverage among countries has not been maximized. This research concludes that the coverage of health insurance for TKI is still lower (curative) and the government's attempt to integrate the social security for TKI is important. The researcher suggests the government should comprehensively implement the health coverage for TKI by incorporating the principle of promotion and prevention. Keywords: TKI Insurance, Consortium, Law No. 39 of 2004, SWOT, Bilateral Cooperation

scholarly journals The Satisfaction of Patient and Interest to Re-Using Health Services in Kandang Public Health Center Bengkulu

2017 ◽  
Vol 24 (1) ◽  
pp. 28-34
Author(s):  
Susilo Wulan ◽  
Desliana Desliana
Keyword(s):  
Patient Satisfaction ◽  
Health Service ◽  
Health Services ◽  
Health Center ◽  
Health Care Services ◽  
Community Health Center ◽  
Sampling Technique ◽  
Good Health ◽  
Cross Sectional ◽  
The Government

Puskesmas as the first-level provider of health services belonging to the government must prioritize the provision of quality health services, affordable, fair and equitable. The quality of good health services will create patient satisfaction and loyalty. The purpose of this study was to study the Relationship of Patient Satisfaction with Interest in Reusing Health Service in Puskesmas Kandang Kota Bengkulu.Is an analytic survey research using Cross Sectional approach. The population of this study were all the patients who visited and recorded in the register book pukesmas Kandang town Bengkulu August 2016. Sampling technique using Accidental Sampling. Measurement of patient satisfaction and interest in reusing health care services was measured using a questionnaire. Data analysis using univariate test, bivariate test using chi square test (χ2). Results From 54 patients who came to Puskesmas Kandang there were Patients who were satisfied with the health service at Puskesmas Kandang Kota Bengkulu as many as 34 patients (63.0%), Patients interested in reusing health services at Bengkulu City Kandang Community Health Center as many as 38 people patients (70.4%). There is a significant correlation between patient satisfaction and interest in re-utilizing health service in Puskesmas Kandang Kota Bengkulu with medium category. Keywords: health service, interest, patient  satisfaction

scholarly journals Kualitas Pelayanan BPJS Pada Klinik Di Kota Pekanbaru

2015 ◽  
Vol 1 (1) ◽  
pp. 99-109
Author(s):  
Hadiyati Hadiyati
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Social Security ◽  
Low Cost ◽  
Medical Needs ◽  
The Social ◽  
The Government ◽  
The Right ◽  
Social Security Agency

Abstract: Abstract: Ministry of Social Security Agency (BPJS) is the Social Security Agency established by the government to provide for Public Health Insurance, National Health Insurance (JKN) is a public health program to realize the health services in accordance with medical needs. BPJS Health Care not for all Indonesian people. Public complaints against the service based on the results of the study proved to be due for service procedures that are less well applied and also because of the service provided is not using the right people and facilities are also incomplete, although the specified low cost but not efficient in making the community recover of the disease.   Keywords: Quality of Service, BPJS

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