Kajian Kebijakan Jaminan Kesehatan Masyarakat

2010 ◽  
Vol 13 (2) ◽  
pp. 98-104
Author(s):  
Imami Nur Rachmawati

AbstrakKesehatan adalah hak asasi manusia. Sesuai dengan Pancasila dan amanat UUD 1945 yaitu pasal 28H ayat (1) yang mengatakan bahwa setiap orang berhak hidup sejahtera lahir dan batin, bertempat tinggal, dan mendapatkan lingkungan hidup yang baik dan sehat serta berhak memperoleh pelayanan kesehatan dan pasal 34 ayat (1) yang mengatakan bahwa Negara mengembangkan sistem jaminan sosial bagi seluruh rakyat dan memberdayakan masyarakat yang lemah dan tidak mampu sesuai dengan martabat kemanusiaan dan ayat (2) yang menetapkan bahwa Negara bertanggung jawab atas penyediaan fasilitas pelayanan kesehatan dan fasilitas pelayanan umum yang layak, maka sudah merupakan kewajiban negara untuk menjamin kesehatan warganya. Berbagai program telah dikembangkan oleh Negara termasuk Jaminan Kesehatan Masyarakat (Jamkesmas). Akan tetapi pada pelaksanaannya, Jamkesmas ini masih banyak menemui kendala. Makalah ini akan menjabarkan informasi terkait dengan pelaksanaan program Jamkesmas dan memberikan berbagai pemecahan masalah tersebut. AbstractHealth is a human right. In accordance with Pancasila and 1945 Constitution, namely Article 28H paragraph (1) which says that every person is entitled to live in prosperity and spiritual, living, and earn a good living environment and healthy and receive medical care and article 34 paragraph (1) the said that the State develop a system of social security for all citizens and to empower the weak and unable to human dignity and in accordance with paragraph (2) which provides that the State is responsible for the provision of health care facilities and public service facilities are decent, then it is the obligation of the state to ensure the health of its citizens. Various programs have been developed by the State including Community Health Insurance (Jamkesmas). However, in practice, this is still a lot of obstacles. This paper will describe the information related to the implementation of the program Jamkesmas and provide a variety of problem solving.

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Abdrakhmanova ◽  
Z Baigozhina ◽  
Z h Bekbergenova ◽  
A Umbetzhanova ◽  
G Kabdullina ◽  
...  

Abstract Background Employment of graduates of medical universities is one of the traditional problems of health care in the Republic of Kazakhstan (RK). The annual graduation of medical universities of RK exceeds 4500 young specialists. Despite this, as well as the positive dynamics of employment, the health care industry continues to experience a shortage of medical personnel. Methods To take effective measures to improve the employment performance of graduates of medical education organizations, to cover the shortage of medical personnel, an analysis was made of the employment of graduates of internship programs at 8 medical universities for the period from 2014-15 to 2016-17 school years Results For three years, medical schools of RK prepared 12019 people, of whom 8921 people studied under the state and 1343 under the rural grant. The total number of employed was slightly more than half of the graduates-6533, which amounted to 54.4%. At the same time, the number of those employed in urban hospitals is 1.5 times higher than the number of those employed in rural medical organizations. High percentages are persons who have continued their studies in residency/magistracy, and this figure tends to increase every year. The trend towards an increase is maintained by the free distribution index for pregnant women and people caring for children under the age of 3 years, for a total of three years it was 1,452 (12.1%) of a person. At the same time, those employed in rural health facilities are only 19.1% of those who studied under the grant and 31.5% of those who studied according to the rural quota. Conclusions Thus, the percentage of employed graduates, as well as graduates who studied under the state and rural grant, barely exceeds 50%. Even the employment of persons trained in rural quotas in rural health care facilities is only 31.5%. Universities do not fully monitor the employment of graduates, especially those who studied under a state or a rural grant. Key messages To create and implement an electronic platform with a complete database of students and graduates. To monitor employment and track the graduate’s work route; to organize employment services at universities.


1998 ◽  
Vol 37 (3) ◽  
pp. 299-300
Author(s):  
Samina Nazli

The provision of health care has been recognised as a fundamental human right. Consequently, developed countries incur heavy expenditures in the provision of health care facilities to their citizens. For example, Canada’s public expenditure on health as a percentage of Gross Domestic Product (GDP) is 6.9 percent, Norway’s is 6.6 percent, the USA’s is 6.5 percent, and Japan’s is 5.6 percent. On the other end of the scale are the developing countries such as Niger, which spends 1.6 percent of its GDP on health, Mozambique 1 percent, Haiti 1.3 percent, and Senegal 1.2 percent. In South Asia, Pakistan spends 0.8 percent and India 0.7 percent of their GDP, respectively, on health provision.


2020 ◽  
Vol 9 (4) ◽  
pp. 468-481
Author(s):  
Galih Putri Yunistria

National Health Insurance System (NHIS) program in Indonesia has been launched since 2014,and government spending to support the program has allocated nearly 40% of MoH budget,especially for the NHIS subsidies. This study examined the distribution of NHIS subsidizedbeneficiaries which associated with the household income distribution, and also studied about theutilization rate of health care facilities among the residents since the NHIS program has introducedto change citizens’ health seeking behaviour from traditional services to health facilities. Using the2016 Susenas data, this study employed the benefit incidence analysis method to measure thedistribution of NHIS-subsidized group, and logistic regression analysis to determine the health careseeking behavior. The result shows that households in higher income (quantile III-V) get benefitfrom government subsidy on NHIS program. It indicated there was a leakage on governmentbudget that not belong to the target (quantile I and II). Then, logistic regression analysis found thatpeople with higher income and having health insurance tend to visit health care facilities morefrequently than lower income group and uninsured people. This can be concluded that healthinsurance ownership is one of the important factors to influence people visiting health carefacilities.


2019 ◽  
Author(s):  
Yu-Sheng Lo ◽  
Cheng-Yi Yang ◽  
Hsiung-Fei Chien ◽  
Shy-Shin Chang ◽  
Chung-Ying Lu ◽  
...  

BACKGROUND Medical referral is the transfer of a patient’s care from one physician to another upon request. This process involves multiple steps that require provider-to-provider and provider-to-patient communication. In Taiwan, the National Health Insurance Administration (NHIA) has implemented a national medical referral (NMR) system, which encourages physicians to refer their patients to different health care facilities to reduce unnecessary hospital visits and the financial stress on the national health insurance. However, the NHIA’s NMR system is a government-based electronic medical referral service, and its referral data access and exchange are limited to authorized clinical professionals using their national health smart cards over the NHIA virtual private network. Therefore, this system lacks scalability and flexibility and cannot establish trusting relationships among patients, family doctors, and specialists. OBJECTIVE To eliminate the existing restrictions of the NHIA’s NMR system, this study developed a scalable, flexible, and blockchain-enabled framework that leverages the NHIA’s NMR referral data to build an alliance-based medical referral service connecting health care facilities. METHODS We developed a blockchain-enabled framework that can integrate patient referral data from the NHIA’s NMR system with electronic medical record (EMR) and electronic health record (EHR) data of hospitals and community-based clinics to establish an alliance-based medical referral service serving patients, clinics, and hospitals and improve the trust in relationships and transaction security. We also developed a blockchain-enabled personal health record decentralized app (DApp) based on our blockchain-enabled framework for patients to acquire their EMR and EHR data; DApp access logs were collected to assess patients’ behavior and investigate the acceptance of our personal authorization-controlled framework. RESULTS The constructed iWellChain Framework was installed in an affiliated teaching hospital and four collaborative clinics. The framework renders all medical referral processes automatic and paperless and facilitates efficient NHIA reimbursements. In addition, the blockchain-enabled iWellChain DApp was distributed for patients to access and control their EMR and EHR data. Analysis of 3 months (September to December 2018) of access logs revealed that patients were highly interested in acquiring health data, especially those of laboratory test reports. CONCLUSIONS This study is a pioneer of blockchain applications for medical referral services, and the constructed framework and DApp have been applied practically in clinical settings. The iWellChain Framework has the scalability to deploy a blockchain environment effectively for health care facilities; the iWellChain DApp has potential for use with more patient-centered applications to collaborate with the industry and facilitate its adoption.


10.2196/13563 ◽  
2019 ◽  
Vol 21 (12) ◽  
pp. e13563 ◽  
Author(s):  
Yu-Sheng Lo ◽  
Cheng-Yi Yang ◽  
Hsiung-Fei Chien ◽  
Shy-Shin Chang ◽  
Chung-Ying Lu ◽  
...  

Background Medical referral is the transfer of a patient’s care from one physician to another upon request. This process involves multiple steps that require provider-to-provider and provider-to-patient communication. In Taiwan, the National Health Insurance Administration (NHIA) has implemented a national medical referral (NMR) system, which encourages physicians to refer their patients to different health care facilities to reduce unnecessary hospital visits and the financial stress on the national health insurance. However, the NHIA’s NMR system is a government-based electronic medical referral service, and its referral data access and exchange are limited to authorized clinical professionals using their national health smart cards over the NHIA virtual private network. Therefore, this system lacks scalability and flexibility and cannot establish trusting relationships among patients, family doctors, and specialists. Objective To eliminate the existing restrictions of the NHIA’s NMR system, this study developed a scalable, flexible, and blockchain-enabled framework that leverages the NHIA’s NMR referral data to build an alliance-based medical referral service connecting health care facilities. Methods We developed a blockchain-enabled framework that can integrate patient referral data from the NHIA’s NMR system with electronic medical record (EMR) and electronic health record (EHR) data of hospitals and community-based clinics to establish an alliance-based medical referral service serving patients, clinics, and hospitals and improve the trust in relationships and transaction security. We also developed a blockchain-enabled personal health record decentralized app (DApp) based on our blockchain-enabled framework for patients to acquire their EMR and EHR data; DApp access logs were collected to assess patients’ behavior and investigate the acceptance of our personal authorization-controlled framework. Results The constructed iWellChain Framework was installed in an affiliated teaching hospital and four collaborative clinics. The framework renders all medical referral processes automatic and paperless and facilitates efficient NHIA reimbursements. In addition, the blockchain-enabled iWellChain DApp was distributed for patients to access and control their EMR and EHR data. Analysis of 3 months (September to December 2018) of access logs revealed that patients were highly interested in acquiring health data, especially those of laboratory test reports. Conclusions This study is a pioneer of blockchain applications for medical referral services, and the constructed framework and DApp have been applied practically in clinical settings. The iWellChain Framework has the scalability to deploy a blockchain environment effectively for health care facilities; the iWellChain DApp has potential for use with more patient-centered applications to collaborate with the industry and facilitate its adoption.


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