SERVICE QUALITY OF NURSE IN THE SCOPE OF NATIONAL HEALTH INSURANCE IN BATU CITY

2018 ◽  
Vol 2 (1) ◽  
pp. 133
Author(s):  
Sih Ageng Lumadi ◽  
Pipin Shintya Wulandari
Keyword(s):  
Health Insurance ◽  
Service Quality ◽  
National Health Insurance ◽  
National Health ◽  
Second Grade ◽  
Health Provider ◽  
Concept Of Health ◽  
Depth Interview ◽  
Nursing Quality

Introduction. The Program of Indonesian Government in 2014 is to apply health insurance based program which known as National Health Insurance (NHI). The concept of this program is all of Indonesian will have health insurance based on Gotong Royong principal. The concept of health provider will be totally changes in health provider, referral system and financing. This study aimed to known the phenomena of nursing quality assurance under NHI which held in the first and the second grade of health provider in Batu, East Java. Method. Qualitative study with in depth interview was used to explore the phenomena. 18 participants were participating in this study taken based on the inclusion criteria were taken by purposive sampling. There were five theme which were nurse responsiveness, assurance of health provider, tangible, empathy and reliability. Result. The satisfaction of patients receive care in Batu BPJS still not achieved optimally. Discussion. It is suggests for the next researcher to explore the factors which barrier the nurse to give the optimal serveto national health insurance patient.Keywords: Service Quality, Nursing, NHI

scholarly journals ANALYSIS OF SATISFACTION OF NATIONAL HEALTH INSURANCE JKN PARTICIPANTS THROUGH QUALITY OF MOBILE SERVICES AND CONFIDENCE MEDIATED BY DECISION TO CHOOSE MOBILE JKN SERVICE ON BPJS KESEHATAN OF PEKANBARU

2020 ◽  
Vol 1 (3) ◽  
pp. 262-269
Author(s):  
Fitria Ichsani ◽  
Sri Hartono
Keyword(s):  
Health Insurance ◽  
Service Quality ◽  
National Health Insurance ◽  
National Health ◽  
Survey Methods ◽  
Mobile Services ◽  
Equation Modeling ◽  
Mobile Service ◽  
Participant Satisfaction

The purpose of this study is to find out how Analysis of Satisfaction of National Health Insurance JKN Participants through Quality of Mobile Services and Confidence Mediated by Decision to Choose Mobile JKN Service on BPJS Kesehatan of Pekanbaru, by measuring indicators that influence variables service quality, trust, decision and satisfaction. This research applies a descriptive research design using survey methods. Sampling uses certain criteria where the respondent is a health insurance participant as a sampling technique. This study was tested using the structural equation modeling (Lisrel) approach to test the significance of the significance of the overall model and predetermined pathway. The findings show that mobile service quality variables have a positive and significant effect on decisions, trust variables have a positive and significant effect on decisions, decision variables have a positive and significant effect on participant satisfaction, mobile service quality variables have a positive and significant effect on satisfaction and trust variables have a positive and significant effect on participant satisfaction.

scholarly journals Factors affecting independent participants of Indonesia’s National Health Insurance in paying premium compliance: a qualitative study

2020 ◽  
Author(s):  
Deni Kurniadi Sunjaya ◽  
Dewi Marhaeni Diah Herawati ◽  
Adiatma YM Siregar
Keyword(s):  
Health Insurance ◽  
Qualitative Study ◽  
National Health Insurance ◽  
National Health ◽  
Institutional Environment ◽  
Insurance Premium ◽  
Financing System ◽  
Factors Affecting ◽  
Depth Interview

Abstract Background: There are currently 14% independent participants in Indonesia's National Health Insurance (INHI) from the overall (199 millions) participants. However, around 43.8% of them do not comply in paying the insurance premium. The purpose of the study is to explore factors that influence delinquent payment of contributions. Methods : The research design was qualitative study with phenomenology approach and constructivism paradigm. Data collected by in-depth interview and using theoretical sampling approach. We recruited 16 respondents of unpaid worker participants who arrear and who obey to pay the premiums from 4 difference cities/ districts. Triangulation was done trough 15 respondents from various stakeholders. We constructed substantive theory from data trough coding, cathegorizing and pattern matching. Results: Compliance of paying insurance premium is affected by the intention to pay for contribution. Meanwhile, the intention to pay is influenced by the understanding of INHI program, financial ability, self attitude, operational system and service quality. These constructs consist of 5 to 8 indicators. To improve payment contribution of independent participants, INHI program has to pay attention for factors originating internally from the participants themselves and also externally: social and institutional environment support and the quality of health care and financing system. Conclusions: INHI program need to improve a proper socialization, mechanisms for collecting beneficiary contributions, and strengthening the healthcare system, both for services and the implementation of the financing system.

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.

scholarly journals STRATEGY IMPLEMENTATION OF NATIONAL HEALTH INSURANCE USING BALANCED SCORECARD METHOD: A CASE STUDY IN AN – NISA HOSPITAL IN TANGERANG

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Luh Putu Sinthya Ulandari
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Balanced Scorecard ◽  
Business Models ◽  
Clinical Pathways ◽  
Low Cost ◽  
Successful Implementation ◽  
Target Market ◽  
Depth Interview

One of the private hospital successful implementation the National Health Insurance with cost efficiency without neglecting the quality of service is An-Nisa Hospital. This study aimed to finding out the strategy of An-Nisa Hospital in the implementation of the National Health Insurance with Balanced Scorecard. The research was conducted in May 2018 using qualitative approach. Data was collected through in-depth interview to 7 informants from hospital and 2 informants from BPJS Kesehatan. The subjects were selected purposively and the data was analyzed using thematic analysis. The results show that there are several strategies that have been developed and implemented, including: adding types of services, increasing the capacity of inpatients and polyclinics, increasing doctor practice slots, completing medical equipment, applying the principle of low cost and increasing working capital, choosing JKN patients as target market, develop 5 values propotition, complaint management, develop standard operating procedures, develop drug formulary and clinical pathways, carry out operational and audit controls, build business models, form casemix teams and claim management, develop training, giving reward and good salaries, build a competitive work environments, and pay attention to employee career paths. Through this strategy, An-Nisa Hospital is able to implement the JKN Program well and still record a surplus without sacrificing service quality

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.

scholarly journals Analysis of Partnership of Private Practice Midwife in The National Health Insurance Program in District Bungo Jambi Province

2018 ◽  
Vol 3 (1) ◽  
pp. 23
Author(s):  
Nurlie Azwar ◽  
Prastuti Soewondo
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Private Practice ◽  
Rapid Assessment ◽  
Neonatal Care ◽  
Research Approach ◽  
Family Doctors ◽  
Depth Interview ◽  
The Government

On January 1, 2014, the government began to implement the National Health Insurance (NHI) program to realize social welfare for the whole community. Midwifery and neonatal care in the NHI program involves Puskesmas/family doctors and Private Practice Midwife (PPM) as its network. PPM participation in the NHI program in Bungo District was still lacking, only 12 (54.5%) PPM have cooperated with family doctors from 22 existing PPM. This study aimed to get an overview of PPM participation in the NHI program in Bungo District, Jambi Province. The study used qualitative research approach with Rapid Assessment Prosedur design, purposive sampling, and conducted in-depth interview to 10 PPM, Head of Health Office, MPKP BPJS Health Manager, and Chairman of Bungo Regency Section of Indonesian Midwife Organization (IMO). The study was conducted from January to July 2017. The study found that the knowledge, perceptions and attitude towards NHI program were good, but the perceived toward the claim and predetermined tariff procedures were not so good. PPM motivated to join the NHI program as many patients had become NHI participants. Support from the Government, NHI, and IMO were low, either in the form of socialization, or policies. Therefore, the study suggest an improvement in claims procedures, tariffs, and an increase of socialization from government, NHI and IMO on NHI program related to obstetric and neonatal care.

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