scholarly journals Policy of Primary Health Center as First Level Health Facility for Participants of Social Health Insurance Provider Sidoarjo – Indonesia

2018 ◽  
Vol 7 (1) ◽  
pp. 227
Author(s):  
Hadi Hadi Shubhan ◽  
Rr Herini Siti Aisyah ◽  
L. Budi Kagramanto
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Human Resources ◽  
Health Center ◽  
Public Service ◽  
Social Health Insurance ◽  
Social Health ◽  
Primary Health Center ◽  
Primary Health ◽  
Health Insurance Provider

In 2012 there were 200 cases of public service disputes to be criminalized in East Java. They occured as a logical consequence of Act Number 14 Year 2008 leading to some consequences that public service is required to give satisfaction to the society The problem of health services in Indonesia cannot be separated from the low competence of the medical personnel, infrastructure and medical equipment, human resources, and complex regulations which are not easy to implement. Due to the problem above, a research focused on such policies to improve the capacity building by optimizing the role of Primary Health Center (PHC) as First Level Health Facility (FLHF) especially for Participants Social Health Insurance Provider (SHIP) is highly considered to carry out. The Social Health Insurance Provider is a legal entity established to administer the Health Insurance program, and the Primary Health Center is a health service facility that organizes some efforts on public and individual health at the first level. In ensuring the satisfaction of adequate services, FLHF has been working with PHC as the implementer of health services for SHIP participants. Because of it, PHC becomes the forefront to provide the health services to the community, especially, to SHIP participants. To increase the satisfaction of SHIP participants, it is necessary to note and find some ways out to the problems related to the improvement of Human Resources, Health Facilities, Service system, Information and supervision.

scholarly journals Inequality in Health Services for Internal Migrants in China: A National Cross-Sectional Study on the Role of Fund Location of Social Health Insurance

2020 ◽  
Vol 17 (17) ◽  
pp. 6327
Author(s):  
Qiang Yao ◽  
Chaojie Liu ◽  
Ju Sun
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Insurance Coverage ◽  
Social Health Insurance ◽  
Health Insurance Coverage ◽  
Social Health ◽  
Local Health ◽  
Public Health Services ◽  
Internal Migrants ◽  
Use Of Health Services

On-the-spot settlements of medical bills for internal migrants enrolled with a social health insurance program outside of their residential location have been encouraged by the Chinese government, with the intention to improve equality in healthcare services. This study compared the use of health services between the internal migrants who had local health insurance coverage and those who did not. Data (n = 144,956) were obtained from the 2017 China Migrants Dynamic Survey. Use of health services was assessed by two indicators: visits to physicians when needed and registration (shown as health records) for essential public health services. Multi-level logistic regression models were established to estimate the effect size of fund location on the use of health services after controlling for variations in other variables. The respondents who enrolled with a social health insurance scheme locally were more likely to visit physicians when needed (adjusted odds ratio (AOR) = 1.18, 95% CI = 1.06–1.30) and to have a health record (AOR = 1.47, 95% CI = 1.30–1.65) compared with those who enrolled outside of their residential location: a gap of 3.5 percentage points (95% CI: 1.3%–5.8%) and 6.1 percentage point (95% CI: 4.3%–7.8%), respectively. The gaps were larger in the rural-to-urban migrants than those in the urban-to-urban migrants (AOR = 1.17, 95% CI = 0.93–1.48 for visiting physicians when needed; AOR = 0.71, 95% CI = 0.54–0.93 for having a health record). The on-the-spot medical bill settlement system has yet to fully achieve its proposed potential as inequalities in both medical and public health services remain between the internal migrants with and without local health insurance coverage. Further studies are needed to investigate how on-the-spot settlements of medical bills are implemented through coordination across multiple insurance funds.

Universal health coverage and user charges

2013 ◽  
Vol 8 (4) ◽  
pp. 529-535 ◽  
Author(s):  
Peter C. Smith
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Universal Health Coverage ◽  
Social Health Insurance ◽  
Social Health ◽  
World Health ◽  
World Health Report ◽  
Health Coverage ◽  
User Charges ◽  
Universal Health

AbstractThere has been an explosion of interest in the concept of ‘universal health coverage’, fuelled by publication of the World Health Report 2010. This paper argues that the system of user charges for health services is a fundamental determinant of levels of coverage. A charge can lead to a loss of utility in two ways. Citizens who are deterred from using services by the charge will suffer an adverse health impact. And citizens who use the service will suffer a loss of wealth. The role of social health insurance is threefold: to reduce households’ financial risk associated with sickness; to promote enhanced access to needed health services; and to contribute to societal equity objectives, through an implicit financial transfer from rich to poor and healthy to sick. In principle, an optimal user charge policy can ensure that the social health insurance funds are used to best effect in pursuit of these objectives. This paper calls for a fundamental rethink of attitudes and policy towards user charges.

scholarly journals PROGRAM JAMINAN KESEHATAN NASIONAL DARI ASPEK SUMBER DAYA MANUSIA PELAKSANA PELAYANAN KESEHATAN

2015 ◽  
Vol 11 (1) ◽  
pp. 32
Author(s):  
Maman Saputra ◽  
Lenie Marlinae ◽  
Fauzie Rahman ◽  
Dian Rosadi
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Human Resources ◽  
Health Center ◽  
Health Workforce ◽  
Evaluation Process ◽  
Organizational Governance ◽  
Work List ◽  
Sequential Explanatory

<p>Jaminan kesehatan nasional (JKN) mulai beroperasi sejak 1 Januari 2014. Pelaksanaan jaminan kesehatan di Kabupaten Tabalong, masih mengalami beberapa permasalahan seperti SDM pelaksana pelayanan kesehatan yang masih belum mencukupi baik dari segi kuantitas, distribusi dan kualitas. Penelitian ini bertujuan untuk melakukan evaluasi program JKN dari aspek SDM pelaksana pelayanan kesehatan di Kabupaten Tabalong periode Januari-Juni 2014. Penelitian ini menggunakan <em>mix method </em>dengan desain urutan pembuktian <em>sequential explanatory</em>. Subjek penelitian berasal dari Dinas Kesehatan Kabupaten Tabalong, RSUD H. Badaruddin, Puskesmas Kelua dan BPJS Kesehatan. Hasil evaluasi konteks, informan memahami mengenai batasan JKN, <em>roadmap</em> dan hambatan program. Hasil evaluasi input SDM pelaksana pelayanan kesehatan, kuantitas masih mengalami kekurangan 136 orang. Distribusi di Puskesmas Kelua sudah sesuai dengan standar ketenagaan di puskesmas tetapi kuantitasnya masih belum sesuai standar rasio per 100.000 jumlah penduduk. Distribusi di RSUD H. Badaruddin berdasarkan standar ketenagaan kesehatan di rumah sakit sudah sesuai, kecuali untuk dokter spesialis. Penilaian kualitas SDM di Puskesmas Kelua belum menggunakan standar Kepmenkes Nomor 857 Tahun 2009. Sedangkan di RSUD H. Badaruddin masih menggunakan penilaian Daftar Penilaian Pelaksanaan Pekerjaan (DP3). Hasil evaluasi proses, kuantitas sudah meningkat tetapi masih mengalami kekurangan 82 orang. Distribusi di Puskesmas Kelua tidak ada perubahan. Distribusi di RSUD H. Badaruddin mengalami penambahan tenaga keperawatan. Penilaian kualitas SDM di Puskesmas Kelua tidak ada perubahan. Penilaian SDM di RSUD H. Badaruddin menggunakan Penilaian Prestasi Kerja Pegawai (PKP). Evaluasi output menunjukkan belum ada perubahan kuantitas, distribusi dan kualitas dari hasil evaluasi proses. Pelaksanaan JKN di Kabupaten Tabalong sudah berjalan, baik dari aspek peraturan perundangan, kepesertaan, pelayanan kesehatan, keuangan dan tata kelola organisasi. Ada beberapa hambatan seperti peraturan daerah masih kurang dan kurangnya jumlah SDM pelaksana pelayanan kesehatan. Oleh karena itu, perlu adanya upaya penambahan kuantitas dan pemerataan distribusi SDM pelaksana pelayanan kesehatan oleh Pemerintah Daerah dan upaya memaksimalkan jumlah dan kualitas SDM pelaksana pelayanan kesehatan yang tersedia.<strong><em></em></strong><strong></strong></p><p align="center"> </p><p><em>National health insurance (JKN) started operating on January 1, 2014. The implementation of health insurance in Tabalong, still have some problems such as health services workforce are still not enough in terms of quantity, distribution and quality. This study aims to evaluate the JKN program of </em><em>health services </em><em>workforce aspects in Tabalong period January to June 2014. This study used a mixed method design </em><em>with</em><em> sequential explanatory. Study subjects were from the Department of Health Tabalong, H. Badaruddin Hospital, </em><em>Kelua </em><em>Health Center and BPJS Health. The results of the evaluation context, informants understand the JKN restrictions, roadmap and program obstacle</em><em>s</em><em>. The results of the evaluation of</em><em> health services</em><em> workforce inputs, the quantity is still deficient 136 people. Distribution in Kelua Health Center is appropriate with the standard for personnel in health centers but the quantity is still not appropriate </em><em>with the </em><em>ratio per 100,000 of population standard. Distribution in H. Badaruddin hospital</em><em> </em><em>based health workforce standards in hospitals is appropriate, except to specialists. Assessment of the quality of human resources in </em><em>Kelua </em><em>Health Center </em><em>not </em><em>using Kepmenkes No. 857 of 2009</em><em> </em><em>standard. While in H. Badaruddin</em><em> </em><em>hospital still use assessment Implementation Assessment Work List (DP3). The results of the evaluation process, the quantity has increased but is still deficient 82 people. Distribution in Kelua Health Center no change. Distribution in H. Badaruddin hospital</em><em> </em><em>have additional </em><em>for </em><em>nursing staff. Assessment of the quality of human resources in the </em><em>Kelua </em><em>Health Center no change. Assessment of human resources in H. Badaruddin hospital</em><em> </em><em>using Employee Job Performance Assessment (PKP). Evaluation of the output shows no change in the quantity, distribution and quality of the results of the evaluation process. Implementation JKN in Tabalong already running, both from the aspect of legislation, participation, health care, financial and organizational governance. There are several obstacles such as local regulation are still lacking and the lack of </em><em>workforce</em><em> for the services of health.</em><em> </em><em>Therefore, efforts are needed to increase the quantity and distribution of health workforce by local government and maximizing the amount and quality of available health workforce.</em></p>

scholarly journals The impact of social health insurance on rural populations

2021 ◽  
Author(s):  
Colin Green ◽  
Bruce Hollingsworth ◽  
Miaoqing Yang
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Social Health Insurance ◽  
Social Health ◽  
Rural Populations ◽  
Access To Health Services ◽  
Access To Health ◽  
The Impact

AbstractImproving health outcomes of rural populations in low- and middle-income countries represents a significant challenge. A key part of this is ensuring access to health services and protecting households from financial risk caused by unaffordable medical care. In 2003, China introduced a heavily subsidised voluntary social health insurance programme that aimed to provide 800 million rural residents with access to health services and curb medical impoverishment. This paper provides new evidence on the impact of the scheme on health care utilisation and medical expenditure. Given the voluntary nature of the insurance enrolment, we exploit the uneven roll-out of the programme across rural counties as a natural experiment to explore causal inference. We find little effect of the insurance on the use of formal medical care and out-of-pocket health payments. However, there is evidence that it directed people away from informal health care towards village clinics, especially among patients with lower income. The insurance has also led to a reduction in the use of city hospitals among the rich. The shift to village clinics from informal care and higher-level hospitals suggests that the NRCMS has the potential to improve efficiency within the health care system and help patients to obtain less costly primary care. However, the poor quality of primary care and insufficient insurance coverage for outpatient services remains a concern.

Decentralization of Indonesia social health insurance

2019 ◽  
Vol 61 (2) ◽  
pp. 310-327
Author(s):  
Sanusi Bintang ◽  
Mujibussalim Mujibussalim ◽  
Fikri Fikri
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Social Security ◽  
Service Quality ◽  
Public Service ◽  
Social Health Insurance ◽  
Social Health ◽  
Content Type ◽  
Regional Autonomy ◽  
Aceh Province

Purpose The purpose of this study is to explain the need for the implementation of decentralization of Indonesia social health insurance (INA-Medicare), with particular emphasis for Aceh Province. First, it discusses the inconsistency of Act on National Social Security System (ANSSS) to the 1945 Constitution, because certain rules in ANSSS are contrary to the 1945 Constitution. This weakens the practice of broader regional autonomy, lessens the importance of public service quality in health care and ignores specific cultural and religious values of the regional people. Then, it explains provisions on central and regional government authority in the 1945 Constitution, Act on Regional Autonomy and Act on Governing of Aceh. Later, it explores current law and practice of INA-Medicare under the national social security system and the centralized administering body. Finally, it provides reasons for decentralization of INA-Medicare, as the solution. Design/methodology/approach This study uses doctrinal legal research. It relies on both primary and secondary legal authorities. In additions, it also uses sociolegal research by relying on non-legal materials, including empirical data from books, journals and newspapers. Analysis of legal authorities is by legal reasoning process, whereas analysis of non-legal materials is by qualitative approach. Findings This study argues that the decentralization of INA-Medicare is more suitable for Aceh Province because of several reasons, including implementing broader regional autonomy, improving public service quality in health care and implementing the principle of sharia social health insurance. Originality/value The study is original because it focuses on a specific regional area of Aceh Province, Indonesia. It concentrates on specific legal issues and provides unique reasons for argumentation. Therefore, it provides important specific information for journal readers.

scholarly journals An Audit of Knowledge and Attitude Regarding Implementation of the National Health Insurance (JKN) in BPK RI

2019 ◽  
Vol 6 (5) ◽  
pp. 50
Author(s):  
Hari Suhud
Keyword(s):  
Health Insurance ◽  
Human Resources ◽  
National Health Insurance ◽  
National Health ◽  
Social Health Insurance ◽  
Social Health ◽  
Health Card ◽  
Knowledge And Attitude ◽  
The Republic ◽  
Unfavorable Attitude

This study aims to evaluate the knowledge and attitude of Human Resource Bureau employees regarding implementation of National Health Insurance (JKN) in The Audit Board of the Republic of Indonesia (known as BPK RI). The study is carried out by quantitative method through the distribution of questionnaires. Based on the data obtained from the results of research on 155 respondents in terms of knowledge and attitude, it can be concluded as follows: 1. the level of knowledge of employees at Human Resources Bureau in BPK RI mostly have low knowledge about the National Health Insurance (JKN) (58.1%). The results are exposed to employees who have never used Social Health Insurance/BPJS Health card with a large enough score (36.1%), and the rest are employees who have used the card; 2. the attitude of employees at Human Resources Bureau in BPK RI has a favorable attitude towards the positive statement (84.5%), as for the attitude of employees to negative statements obtained the opposite result, that most respondents have unfavorable attitude (76.1%). The results were distributed to respondents who had never used Social Health/ BPJS Health card with similar percentages.

scholarly journals Program Pelayanan Voluntary Counseling And Testing (VCT) di Puskesmas

2018 ◽  
Vol 2 (4) ◽  
pp. 564-576
Author(s):  
Nisrina Dwi Risqi ◽  
Bambang Wahyono
Keyword(s):  
Human Resources ◽  
Health Center ◽  
Sampling Technique ◽  
Primary Health Center ◽  
Voluntary Counseling ◽  
Sex Worker ◽  
Purposive Sampling ◽  
Voluntary Counseling And Testing ◽  
Primary Health ◽  
Counseling And Testing

Abstrak Data Puskesmas Duren menunjukkan jumlah kunjungan Voluntary Counseling and Testing  (VCT) mengalami penurunan dalam tiga tahun dari 2015 hingga 2017. Pada tahun 2017 adanya kesenjangan antara jumlah kelompok wanita pekerja seksual dan lelaki suka lelaki yang ada di Kecamatan Bandungan dengan jumlah kunjungan VCT pada populasi kunci tersebut serta belum mencapai target yang ditetapkan oleh Dinas Kesehatan Kabupaten Semarang. Tujuan penelitian ini untuk mengetahui gambaran program pelayanan VCT di Puskesmas Duren. Penelitian ini dilakukan pada bulan Mei 2018. Jenis penelitian ini adalah deskriptif kualitatif. Informan penelitian terdiri dari 11 dipilih dengan teknik purposive sampling. Teknik pengumpulan data menggunakan wawancara dan observasi. Hasil penelitian menunjukkan kurangnya ketersediaan sarana dan prasarana serta sumber daya manusia di Puskesmas Duren. Sudah tersedianya dana dan standar operasional prosedur pelayanan VCT. Kegiatan sosialisasi layanan VCT sudah dilakukan. Pelaksanaan VCT belum sesuai dengan pedoman serta jumlah kunjungan VCT mengalami penurunan dalam tiga tahun terakhir dan belum mencapai target yang telah ditetapkan. Simpulan penelitian ini adalah gambaran program pelayanan VCT di Puskesmas Duren belum berjalan baik.   Abstract Data from Duren Primary Health Center showed for the number of VCT visited decreased in three years from 2015 to year 2017. In 2017 there was gap between the number of women sex worker groups and men who were in Bandungan with their number of VCT visited. The purpose of this research was to know the description of VCT program in Duren Public Health Center. This research was conducted in May 2018. This type of research was descriptive qualitative. Research informants consisted of 11 selected by purposive sampling technique. Data collection techniques using interviews and observation. The results showed the lack of availability of facilities and infrastructure and human resources. Availability of funds and standard operational procedures were sufficiented. Socialization of VCT have been carried out. VCT implementation has not been in accordance with guidelines, the number of VCT visited has decreased in the last three years, and has not reached the targets. The conclusions of this study was the description of the VCT program have not gone well.  

scholarly journals Analysis of Factors Causing High Referral Rates at Primary Health Center in the JKN Era: A Literature Review

2020 ◽  
Vol 9 (2) ◽  
pp. 57
Author(s):  
Syamira Nurjannah Ramadhani
Keyword(s):  
Literature Review ◽  
Human Resources ◽  
Health Center ◽  
Health Centers ◽  
Google Scholar ◽  
Referral System ◽  
Primary Health Center ◽  
Primary Health ◽  
Medical Materials ◽  
Medical Indications

Background: The implementation of the referral system in the JKN era is not yet running optimally due to an increase in the number of referrals from FKTP to FKRTL. The applicable standard for referral ratio is 15%, from the total BPJS patient visits every month, but the above standard reference ratio is still found in various health centers in Indonesia.Objectives: This study aims to determine the factors that cause the high number of referrals in health centers in the JKN era Methods: This research is a type of literature review where the articles obtained are sourced from Google Scholar as a database. There were 13 articles published from 2010 to 2020 that were considered relevant to the research topicResults: Research shows that Primary Health Center with increased referral are caused by low quality and quantity of human resources, lack of SOP, lack of complete and adequate facilities and infrastructure, medical indications suffered by patients beyond the ability of Primary Health Center, incompleteness of medicines and medical materials and lack of understanding patients with the referral systemConclusions: Factors causing the high number of referrals in health centers in the JKN era included the availability of human resources, the existence of SOPs, the completeness of facilities and infrastructure, types of medical indications, availability of medicines and patient behavior

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