scholarly journals Evaluation on the Implementation of Regional Mapping Referal System in the National Health Insurance Primary Care Services in Boyolali, Central Java

2016 ◽  
Vol 01 (02) ◽  
pp. 95-101
Author(s):  
Linda Widyaningrum ◽  
◽  
Didik Tamtomo ◽  
Arief suryono ◽  
◽  
...  
Keyword(s):  
Primary Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Regional Mapping ◽  
Care Services ◽  
Central Java ◽  
Primary Care Services

scholarly journals Exploring the Determinants of Antenatal Care Services Uptake: A Qualitative Study among Women in a Rural Community in Northern Ghana

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Gilbert Ti-enkawol Nachinab ◽  
Charles Ampong Adjei ◽  
Florence Assibi Ziba ◽  
Richard Asamoah ◽  
Priscilla Adumoah Attafuah
Keyword(s):  
Health Insurance ◽  
Antenatal Care ◽  
National Health Insurance ◽  
National Health ◽  
Sampling Technique ◽  
Northern Ghana ◽  
Face To Face ◽  
Care Services ◽  
System Factor ◽  
The Individual

Background. Global evidence has shown significant contribution of Antenatal care (ANC) in the detection and treatment of pregnancy related complications. Over the years, many areas in Ghana have recorded high uptake of ANC. However, this is not the case for Binduri district in Northern Ghana where only 37.4% of pregnant women utilised the services of ANC during their period of pregnancy compared to a national figure of 87%. We therefore sought to explore the determinants of ANC uptake among women who failed to utilise ANC services during their period of pregnancy in Binduri District in Northern Ghana. Methodology. The study was an exploratory descriptive study using purposive sampling technique. A total of 15 women who met the inclusion criteria for the study were recruited for a face-to-face interview. The data were analysed using the procedure of inductive thematic analysis. Results. The study findings showed that several factors hindered the use of ANC among our participants. The individual factors that were responsible for nonutilisation of ANC included financial constraints hindering registration with the national health insurance scheme, excuses of being busy, perception that pregnancy was not sickness and concentration on work. Perceived poor attitude of nurses was the only health system factor that contributed to non utilisation of ANC services. Conclusion. There is the need for establishment of registration centres of the national health insurance in all communities to make the scheme more accessible. There should also be intensive public education on importance of attending ANC.

scholarly journals Fraud in Healthcare Service

2018 ◽  
Vol 54 ◽  
pp. 03015
Author(s):  
Dara Pustika Sukma ◽  
Adi Sulistiyono ◽  
Widodo Tresno Novianto
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
National Health Insurance ◽  
National Health ◽  
Healthcare Service ◽  
Social Insurance ◽  
Empirical Method ◽  
Professional Organization ◽  
Social Insurance System ◽  
Central Java

In Indonesia, the fraud of healthcare service implementation occurs widely in hospitals, thereby harming the participants of social insurance. The objectives of research were to find out, to analyze, and to give solution to the fraud in the healthcare service. This research was taken place in several hospitals in Central Java Indonesia using non-doctrinal or empirical method on stakeholders related to national health insurance. The result of research showed that the substance of the ratification of Health Minister’s Regulation Number 36 of 2015 about Fraud Prevention in National Health Insurance in National Social Insurance System becomes the government’s attempt in suppressing fraud in healthcare service. In its structure, healthcare service occurs due to the pressure of enacted costing system, limited supervision, and justification in committing fraud and the imbalance between health service system and burden among clinicians, service provider not giving adequate incentive, inadequate medical equipment supply, system inefficiency, less transparency in health facilities, and cultural factor. Those who are responsible for the attempt of eradicating fraud such as Health Ministry, Regency/City Health Service, Hospital’s Board of Directors, Hospital Supervision Agency and Council, Social Insurance Administration Organization, professional organization, and Social Insurance participants should walk in the cycle starting from building awareness, reporting, detecting, investigating, sanction imposing, to building awareness.

scholarly journals Physician Palliative Education Associated With High Use of Hospice Care Service

2021 ◽  
pp. 104990912110141
Author(s):  
Mei-Hsing Chuang ◽  
Fang-Niarn Lee ◽  
Yih-Tsong Shiau ◽  
Hsiu-Yi Shen ◽  
Chih-Ching Lee ◽  
...  
Keyword(s):  
Renal Failure ◽  
Health Insurance ◽  
End Of Life ◽  
National Health Insurance ◽  
National Health ◽  
Hospice Care ◽  
Care Service ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Care Services

Background: Taiwan’s National Health Insurance provides coverage for palliative and hospice care. The following 10 types of diseases have been added to the National Health Insurance reimbursement regulation: end-stage cancer, motor neuron disease, organic psychosis, brain degeneration, heart failure, chronic airway obstruction diseases, other lung diseases, chronic liver disease and cirrhosis, acute renal failure, and chronic renal failure. Objective: This study aimed to determine the association between physicians’ palliative education and use of hospice care in hospitalized patients at the end of life. Design and Setting: A cross-sectional study in a Taipei community hospital. Participants: Patients who died between 2014 and 2019 were identified. The deceased had at least 1 of the 10 diseases covered by health insurance were included. Hospice care services included hospice ward care and hospice shared care. This study included 2,661 individuals. In total, 972 (36.5%) patients used hospice care services. Results: After adjusting for age, gender, and comorbidities, physicians’ palliative education was found to significantly associated with the use of hospice care (OR: 14.38, 95% CI: 10.90-18.98). Conclusions: Physicians’ palliative education was found to be an independent factor associated with higher use of hospice care. The findings suggest increasing palliative and hospice education among physicians so that they can ensure that their patients have high-quality end-of-life medical care in an aging society.

scholarly journals Patterns of Care in Michigan Emergency Departments as Insurance Coverage Expands

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Fatema Mamou ◽  
Matthew Davis ◽  
Jim Collins ◽  
Jay Fiedler ◽  
Tiffany Henderson ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Syndromic Surveillance System ◽  
Care Services ◽  
Primary Care Services ◽  
Ed Visits ◽  
Increasing Trends

Using the Michigan Syndromic Surveillance System changes in emergency department (ED) volume are being monitored as health insurance coverage expands through the Healthy Michigan Plan (HMP), which provides healthcare coverage to low-income adults. Seasonally adjusted monthly ED visits prior to and after the HMP implementation on April 1, 2014 are being compared. Preliminary data show increasing trends in ED utilization among populations with previously low levels of health insurance coverage. Increased health insurance coverage may expand healthcare service options beyond EDs. Alternatively, the demand for primary care services may exceed the level of access leading to increased ED utilization for primary care.

scholarly journals The provision of promotive and preventative healthcare services by private primary care physicians in the era of the national health insurance program

2017 ◽  
Vol 5 (2) ◽  
pp. 140
Author(s):  
Ketut Ary Diana Artha ◽  
Ketut Suarjana ◽  
Pande Putu Januraga
Keyword(s):  
Primary Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Primary Care Physicians ◽  
Healthcare Services ◽  
Qualitative Approaches ◽  
Inhibiting Factors ◽  
Preventative Healthcare ◽  
Preventative Services

Background and purpose: In addition to their duties in addressing the curative and rehabilitative needs of the community, private primary care physicians (PCP) play an important role in providing promotive and preventative healthcare services. This study aims to determine the behaviours, enabling and inhibiting factors involved with the provision of promotive and preventative services by PCP in the era of national health insurance (JKN) implementation.Methods: This research is a mix method study using a combination of quantitative and qualitative approaches. Quantitative surveys were conducted with all PCPs already in working collaboration with the Social Security Administering Agency (BPJS) in the Denpasar City area (61 people). Data analysis techniques used descriptive techniques in order to explore the kinds of promotion and preventative services provided by PCPs. Qualitative research was conducted through in-depth interviews of 8 informants selected by purposive sampling and analyzed thematically to discover the enabling and inhibiting factors of the provision of promotive and preventative services by PCPs.Results: The results showed that 91.8% of PCPs did perform promotive and preventative services in their practice site. PCPs who did not carry out promotive and preventative services demonstrate perceptions, beliefs and motivations categorized as low and weak as well as attitudes that do not support the implementation of such services. Enabling factors of promotion and preventative services by PCPs, include among others, quality of facilities and infrastructure, the receipt of awards from BPJS and capitation systems that benefit physicians financially. Inhibiting factors include a low willingness of the patient to carry out doctor's advice, limitations in the PCPs work time and limited funds to perform preventative/promotive services.Conclusions: Promotive and preventative services are not being optimally carried out by PCPs in Denpasar. This is due to the low willingness of the patients, the limited time of the doctor, and the limited allocated funds for promotive and preventative services and low capitation.

scholarly journals Assessment of satisfaction and utilization of health-care services by National Health Insurance Scheme enrolees at Aminu Kano Teaching Hospital, Kano, Nigeria

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Abubakar Yusuf ◽  
Abubakar M. Jibo ◽  
Sanusi Abubakar ◽  
Bukar A. Grema ◽  
Auwal U. Gajida ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Access To Care ◽  
National Health Insurance ◽  
National Health ◽  
Health Care Services ◽  
National Health Insurance Scheme ◽  
Service Improvement ◽  
Insurance Scheme ◽  
Care Services

The National Health Insurance Scheme (NHIS) aims at universal health coverage through access to high-quality health-care to all enrolees. To achieve this goal, it is necessary to incorporate feedbacks from periodic patient-surveys into service improvement plans. This study therefore, assessed satisfaction and utilization of health-care services by enrolees of a Nigerian tertiary hospital. This was a crosssectional study of 399 respondents randomly selected from enrolees attending the NHIS-clinic of Aminu Kano Teaching Hospital, Kano. Using an intervieweradministered questionnaire, it assessed their sociodemographics, medical history, number of and reason for clinic visits, satisfaction with- access to care, patient-provider relationships and hospital facilities/environment. Respondents’ mean age was 38.3 ± 9.2 years and females accounted for 55.9% of respondents. Most respondents (60.4%, 69.8%, 96.0%) were satisfied with the ease of accessing care, waiting-time and hospital facilities/environment respectively. Most respondents (94.8%, 81.1%, 73.3%, 74.5%, 83.1%, 91.1%) were satisfied with their relationship with physicians, nurses, laboratory staff, pharmacists, record officers and other hospital-staff respectively. Overall, 80.5% of respondents were satisfied with the hospital’s services. All respondents had visited the clinic at least once in the preceding 12-weeks. Although 49.1% visited for non-communicable diseases, more respondents who were for antenatal-care (followed by non-communicable and communicable diseases) had had ≥ 2 clinic visits (c2 =15.5%, df=2, P=0.0001). This study observed a high utilization of and overallsatisfaction with the hospital’s services; however, there is a need for service improvement plans to address the challenges of patient access to care and waitingtime.

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