scholarly journals IMPLEMENTASI KEBIJAKAN TATAKELOLA PESERTA PROGRAM JAMINAN KESEHATAN NASIONAL DI JATIM

2016 ◽  
Vol 2 (01) ◽  
Author(s):  
M. Ali Imron Rosyadi
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Poor People ◽  
Care Seeking ◽  
Health Insurance System ◽  
Insurance System ◽  
Insurance Program ◽  
Health Insurance Program ◽  
The Government

Health insurance system is one of the important components in ensuring theneeds of basic human rights, namely health. Government as theimplementing regulations in the fulfillment of basic rights such as healthhave been doing the development, guidance, and acceleration in organizinghealth care. So that the government is very strategic role in theimplementation of the National Health Insurance program (JKN). But thereis one problem JKN program implementation, namely the weakmanagement of the participants. It affects both services and financing JKNprogram. There have been several studies that analyze these problems,among others, the study of health care seeking behavior of participants ofpublic health insurance, the readiness of stakeholders in the implementationof JKN, and the program participant data JKN invalid and not targeted. Sothat in this research conducted a study which aims to analyze themanagement of participants through the method of interpretation, describe,analyze, and the build a model of the implementation of managementpolicies of insured people, and the synchronization of the health insuranceprogram regional level into the health insurance system nationwidemanaged by BPJS Health in the Province of East Java. The results showedthat participants in the program management JKN is not optimal, andcurrently poor people who can not be accommodated in the management ofContribution Recipient (PBI) has been well managed by the regionalgovernment, through the Regional Health Insurance program. Further theparticipant management implementation model is not effective as a modelof policy implementation of Van Metter and Van Horn due to weakoversight of the bureaucratic system and the human resources involved inthe implementation of the management of the participants. Keywords : Implementation of policy, National Health Insurance (JKN), management of participants.

scholarly journals National Health Insurance Deficit in Indonesia: Identification of Causes and Solutions for Resolution

2020 ◽  
Vol 12 (13) ◽  
pp. 58
Author(s):  
Wahyu P. Nugraheni ◽  
Asri Hikmatuz Zahroh ◽  
Risky Kusuma Hartono ◽  
Ryan Rachmad Nugraha ◽  
Chang Bae Chun
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Short And Long Term ◽  
The Government ◽  
Catastrophic Disease ◽  
Depth Interviews

INTRODUCTION: Since it was implemented in 2014, National Health Insurance Program (JKN) in Indonesia experienced a financial deficit. JKN recorded a deficit of 9.7 trillion, 9.75 trillion and 10.98 trillion rupiah from 2016-2018, respectively. The deficit is estimated to still continue in the upcoming years. Systemic solutions are needed to bring JKN improvement in the future. METHODS: Data was collected from June to December 2019 by in-depth interviews with selected informants and literature review, which later was analyzed by content and with data triangulation. RESULT: The results of in-depth interviews and a review of some of the literature shows that there are four main factors that causes JKN deficit, which are capitation payment system to provider, the alleged fraud, lag of backed-referral system, and catastrophic disease. CONCLUSION: This study provides a solution to the handling of JKN deficits in the short and long term in accordance with problems in terms of funding and JKN expenditure. The solution can be an alternative policy that can be implemented by the Government of Indonesia to deal with the JKN deficit.

scholarly journals National Health Insurance, Profitability, and Service Quality: Case Study at the Private Hospital in West Java

ETIKONOMI ◽  
2018 ◽  
Vol 17 (1) ◽  
pp. 153-160
Author(s):  
Andriyani Rahmah Fahriati
Keyword(s):  
Health Insurance ◽  
Service Quality ◽  
National Health Insurance ◽  
National Health ◽  
Profit Margin ◽  
National Health Insurance Program ◽  
West Java ◽  
Insurance Program ◽  
Health Insurance Program ◽  
The Government

National health insurance is one of the government programs to facilitate health services for the people. The purpose of this research to determine whether there are effects of National Health Insurance program (JKN) on profitability and service quality at Juanda Kuningan Hospital, of West Java. The method using the paired-t-test to analyze the difference between before and after the National Health Insurance program. The result showed that there is a difference in profitability and service quality between pre and post the implementation of national health insurance program. Gross profit margin measured the profitability, net profit margin, return on total assets, and return on equity. This result means that the value of the company's profitability is better when the program JKN yet takes place in the Juanda hospital. While on the service quality variable it is found that the mean value is higher when the JKN program has conducted at the hospital.DOI: 10.15408/etk.v17i1.7064

scholarly journals Factors Associated with Participation in the National Health Insurance Program: A Path Analysis Evidence From Kudus, Central Java

2020 ◽  
Author(s):  
Anom Dwi Prakoso ◽  
◽  
Endang Sutisna Sulaeman ◽  
Arief Suryono ◽  
◽  
...  
Keyword(s):  
Health Insurance ◽  
Family Support ◽  
Social Environment ◽  
National Health Insurance ◽  
National Health ◽  
National Health Insurance Program ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Perceived Benefit ◽  
Perceived Seriousness

ABSTRACT Background: Government of Republic of Indonesia provides the national health insurance program since January 1st 2014. The payment scheme requires hospitals to provide the service first and then make a claim to BPJS on the service by using the tariff package called Indonesia Case Based Groups (INA CBGs). The purpose of this study was to examine factors associated with participation in the national health insurance program using path analysis model. Subjects and Method: This was a case control study. The study was conducted at 5 sub-districts in Kudus, Central Java, from September to October 2019. A sample of 200 informal workers was selected by purposive sampling. The dependent variable was participation in national health insurance. The independent variables were education, income, knowledge, perceived susceptibility, perceived seriousness, perceived benefit, family support, self-efficacy, and social environment. The data were collected by questionnaire and analyzed by path analysis run on stata 13. Results: Participation in the national health insurance program was directly and positively affected by high perceived susceptibility (b= 2.14; 95% CI= -0.09 to 4.38; p= 0.060), high perceived seriousness (b= 4.71; 95% CI= 2.15 to 7.28; p<0.001), high perceived benefit (b= 2.45; 95% CI= 0.07 to 4.83; p= 0.044), strong family support (b= 6.31; 95% CI= 3.20 to 9.41; p<0.001), strong self-efficacy (b= 3.55; 95% CI= 1.02 to 6.07; p= 0.006), and supportive social environment (b= 3.39; 95% CI= 1.24 to 5.55; p= 0.002). Participation in the national health insurance program was indirectly affected by education, income, and knowledge. Conclusion: Participation in the national health insurance program is directly and positively affected by high perceived susceptibility, high perceived seriousness, high perceived benefit, strong family support, strong self-efficacy, and supportive social environment. Participation in the national health insurance program is indirectly affected by education, income, and knowledge. Keywords: national health insurance, Health Belief Model, Social Cognitive Theory Correspondence: Anom Dwi Prakoso. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Centra Java, Indonesia. Email: [email protected]. Mobile: +62895363054393. DOI: https://doi.org/10.26911/the7thicph.04.37

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