scholarly journals Medicine management in districts and primary health care centres (PHC) in the national health insurance (JKN) programme

2021 ◽  
pp. 251-257
Author(s):  
Raharni ◽  
Rini Sasanti ◽  
Yuyun Yuniar

Objective: This study aimed to identify medicine management in district health offices and primary health care centres (PHCs) after the national health insurance (JKN) programme implementation. Methods: A cross-sectional study was carried out by collecting documents related to medication management and in-depth interviews with the head of the PHC officials and JKN medicine management officers at the PHC in four provinces of Indonesia. Results: The results showed no regional policies related to medicine management; all policies were based on central policies. Medicine management in districts follows the procurement planning suggested by PHCs, which relies on disease patterns. Medicine procurement at PHCs is done by e-purchasing using an e-catalog. Medicines above IDR 200 million are purchased through catalogs provided by the procurement service unit (ULP), and those under IDR 200 million are obtained through a direct appointment. Conclusion: The storage of medicine requires more space and air humidity controlling. The reporting and monitoring of medications e-logistic system are based on 20 indicators and have not been carried out regularly. It is necessary to improve reporting and monitoring systems.

Author(s):  
Satibi Satibi ◽  
Dewa Ayu Putu Satrya Dewi ◽  
Atika Dalili Akhmad ◽  
Novita Kaswindiarti ◽  
Dyah Ayu Puspandari

Objective: In national health insurance (JKN) era, pharmacy can play roles in the form of behind refer pharmacies, or networking pharmacy and clinic pharmacy pratama. Behind refer pharmacies drug cost can be claimed directly to BPJS, meanwhile for the other type of pharmacy have to negotiation first with the primary health care. Drug cost variations in the JKN era affect the profitability of the business pharmacies. This research aims to the drug percentage charges against capitation and variety of drug costs.Methods: This research is analytic observational cross-sectional. This research uses secondary data from a JKN prescription patient. This research was conducted on 6 affiliated pharmacies, 6 networking pharmacies, and 7 clinical pharmacy pratama in DIY. The sampling in this research is by purposive with 8.430 prescriptions. Data drug costs JKN era was analyzed by descriptive statistics and comparative test (Kruskal Wallis test).Results: The result showed that average percentage of drug costs for capitation fee in the networking pharmacy is 13.58% and primary health care is 15.91%. Pharmacy in JKN era has drug cost variations (p=0.000). Drug cost in JKN era depends on the pattern of play roles with the health facilities and BPJS. The average percentage of drug costs against capitation health facilities in networking pharmacy is lower than clinical pharmacy pratama.Conclusions: Drug costs in an era of JKN depending on the pattern of cooperation with health facilities pharmacies and BPJS. The average percentage of the cost of drugs to the pharmacy capitation health facilities in networking lower than clinic pharmacy pratama. Differences in drug costs JKN era influenced by the long days of drug administration, the number of prescription sheets, margin.Keywords: Drug cost analysis, National health insurance (JKN), Pharmacy, Primary health care, Capitation.


Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1718
Author(s):  
Euphemia Mbali Mhlongo ◽  
Elizabeth Lutge

Introduction: Evidence from many countries suggests that provision of home and community-based health services, linked to care at fixed primary health care facilities, is critical to good health outcomes. In South Africa, the Ward-Based Primary Health Care Outreach Teams are well placed to provide these services. The teams report to a primary health care facility through their outreach team leader. The facility manager/operational manager provides guidance and support to the outreach team leader. Aim: The aim of the study was to explore and describe the perceptions of facility managers regarding support and supervision of ward-based outreach teams in the National Health Insurance pilot sites in Kwa Zulu-Natal. Setting: The study was carried out in three National Health Insurance pilot districts in KwaZulu- Natal. Methods: An exploratory qualitative design was used to interview 12 primary health care facility managers at a sub-district (municipal) level. The researchers conducted thematic analysis of data. Findings: Some gaps in the supervisory and managerial relationships between ward based primary health care outreach teams and primary health care facility managers were identified. High workload at clinics may undermine the capacity of PHC facility managers to support and supervise the teams. Field supervision seems to take place only rarely and for those teams living far away from the clinic, communication with the clinic manager may be difficult. The study further highlights issues around the training and preparation of the teams. Conclusions: Ward based primary health care outreach teams have a positive impact in preventive and promotive health in rural communities. Furthermore, these teams have also made impact in improving facility indicators. However, their work does not happen without challenges.


2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Kadek Suranugraha ◽  
Ni Made Sri Nopiyani ◽  
Pande Putu Januraga

Since 2014, there has been an increase in funds for primary health care (PHC) coming from the National Health Insurance (NHI) program capitation funds and the Health Operational Assistance Fund (HOAF). This study aimed to explore the effect of this budget increase on the health care services at PHC. The case study used a qualitative approach and interviews from 19 PHC health workers with the highest and lowest budget. Data were analyzed using thematic analysis and supported by quantitative data. The positive impact of the increasing PHC budget was felt by PHC staff due to the addition of operational equipment and incentives provided. Nevertheless, there was also a negative impact such as feeling overwhelmed due to an increase in the quantity of PHC activities and additional administrative affairs. It also triggered a negative interaction between staff due to the number of incentives received. The regulation on the use of budget empowers PHC to better arrange the schedule of activities and manage human resources. However, these regulations are considered restrictive and the administrative flow of funds is too long that hinder the optimal use of the budget.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Margaret Kweku ◽  
Hubert Amu ◽  
Martin Adjuik ◽  
Fortress Yayra Aku ◽  
Emmanuel Manu ◽  
...  

Abstract Background To strengthen the implementation of the Community-based Health Planning and Services (CHPS) programme which is Ghana’s key primary health care delivery strategy, the CHPS+ Project was initiated in 2017. We examined community utilisation and satisfaction with CHPS services in two System Learning Districts (SLDs) of the project. Methods This community-based descriptive study was conducted in the Nkwanta South Municipality and Central Tongu District of Ghana. Data were collected from 1008 adults and analysed using frequency, percentage, chi-square, and logistic regression models. Results While the level of utilisation of CHPS services was 65.2%, satisfaction was 46.1%. Utilisation was 76.7% in Nkwanta South and 53.8% in Central Tongu. Satisfaction was also 55.2% in Nkwanta South and 37.1% in Central Tongu. Community members in Nkwanta South were more likely to utilise (AOR = 3.17, 95%CI = 3.98–9.76) and be satisfied (AOR = 2.77, 95%CI = 1.56–4.90) with CHPS services than those in Central Tongu. Females were more likely to utilise (AOR = 1.75, 95%CI = 1.27–2.39) but less likely to be satisfied [AOR = 0.47, 95%CI = 0.25–0.90] with CHPS services than males. Even though subscription to the National Health Insurance Scheme (NHIS) was just 46.3%, NHIS subscribers were more likely to utilise (AOR = 1.51, 95%CI = 1.22–2.03) and be satisfied (AOR = 1.45, 95%CI = 0.53–1.68) with CHPS services than non-subscribers. Conclusion Ghana may not be able to achieve the goal of universal health coverage (UHC) by the year 2030 if current levels of utilisation and satisfaction with CHPS services persist. To accelerate progress towards the achievement of UHC with CHPS as the vehicle through which primary health care is delivered, there should be increased public education by the Ghana Health Service (GHS) on the CHPS concept to increase utilisation. Service quality should also be improved by the GHS and other stakeholders in Ghana’s health industry to increase satisfaction with CHPS services. The GHS and the National Health Insurance Authority (NHIA) should also institute innovative strategies to increase subscription to the NHIS since it has implications for CHPS service utilisation and satisfaction.


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