Pande Putu Januraga
1School of Public Health, Udayana University, Bali, Indonesia

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ANALISIS BIAYA PER KAPITA SEBAGAI UPAYA ADVOKASI PENGENDALIAN BIAYA PROGRAM JAMINAN KESEHATAN JEMBRANA Januraga, Pande Putu
Jurnal Manajemen Pelayanan Kesehatan Vol 13, No 01 (2010)
Publisher : Jurnal Manajemen Pelayanan Kesehatan

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Abstract

Introductions: Jembrana Health Insurance (JHI) program isintended to provide health insurance at first level (PPK I) forinhabitants of Jembrana District. Up till now, financing of JHIdepends on subsidy in which it is growing up and has a trendto be out of target. Therefore, it needs to manage cost byimplementing capitation payment system. Aim of this researchwas to analyze cost per capita and to identify perceptions ofJHI stakeholders towards capitation system.Methods: This research was case study through analyzingsecondary data and performing in-depth interview. Data onmember’s utilization and claim cost were collected using forms.Results: Result of cost per capita calculation based on realutilization of PPK I namely Rp5.262,- per month per member is63 % higher than cost per capita based on normal utilization ofPPK I namely Rp1.949,- per month per member. Furthermore,result of in-depth interview shows that both policy makersand providers have a bad perception towards capitationsystem and results of cost per capita calculation.Conclusions: Local government could apply principles ofmanaged care by controlling cost and quality by developingcapitation payment system for PPK I based on normal utilization.Keywords: health insurance, cost per capita, capitation
PENGARUH PENGEMBANGAN JAMINAN KESEHATAN BALI MANDARA TERHADAP KEBERADAAN JAMINAN KESEHATAN TINGKAT KABUPATEN DI BALI DAN UPAYA PENCAPAIAN UNIVERSAL COVERAGE Januraga, Pande Putu
Jurnal Manajemen Pelayanan Kesehatan Vol 13, No 02 (2010)
Publisher : Jurnal Manajemen Pelayanan Kesehatan

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Background: To conduct an analysis of the influence of theBali Mandara Health Insurance (JKBM) policy concerning theexistence of district level health insurance and its impact onachieving universal coverage.Method: Literature review to produce an analysis of JKBMpolicy and to produce appropriate policy alternatives forfinancing and health care issues which emerged from theimplementation of JKBM.Results: The aim of Bali Mandara Health Insurance is to providehealth services which are fully subsidized by the Provincialand Districts Government in Bali. JKBM is intended for peopleswho do not protected by health insurance programs. Theimplementation of JKBM has forced Tabanan to stop the AskesMandiri program while Jembrana District decided not to takepart in JKBM. Unlike JKJ and Askes Mandiri, JKBM is still managedby a coordination team under Bali Health Office Supervision.Furthermore another fundamental difference is regarding onhow they finance the program. JKBM is fully financed fromsharing subsidies while JKJ and Askes Mandiri are financedfrom member premium. Nevertheless JKBM policy is potentialto expand the efforts of achieving universal coverage, improveequity in health financing and fulfil a non-profit principle ofsocial health insurance. Along with the positives impact, thisprogram also has several weaknesses. One of theweaknesses is lack of consideration to the principles of socialsolidarity and mutual cooperation. Communities’ participation inhealth financing program which has been developed by JKJand Askes Mandiri is abandoned. In addition to theseweaknesses JKBM also less able to adopt the district healthinsurance who have first evolved. JKJ case shows of JKBMfailure to apply the principle of portability and benef itscoordination of the services thereby potentially harming thepeople of Bali.Conclusion: Bali provincial government should immediatelydevelop Implementing Agency (Badan Pelaksana) of JKBM toorganize and develop the program. In addition to this, memberparticipation throughout premium payment could be establishedgradually to ensure the sustainability of the program. JKJ andJKBM should operate in harmony by considering role distributionbetween member, Provincial Government of Bali, andGovernment of Jembrana.Keywords: health insurance and universal coverage
PERSEPSI STAKEHOLDERS TERHADAP LATAR BELAKANG SUBSIDI PREMI, SISTEM KAPITASI DAN PEMBAYARAN PREMI PROGRAM JAMINAN KESEHATAN JEMBRANA Januraga, Pande Putu
Jurnal Manajemen Pelayanan Kesehatan Vol 12, No 01 (2009)
Publisher : Jurnal Manajemen Pelayanan Kesehatan

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Background: Premium subsidy of Jaminan KesehatanJembrana or Jembrana Health Insurance (JKJ) in JembranaDistrict has a rising trend since it began and needs toredistribute, it’s critical to apply the cost containment programsby introducing capitation system to primary health careproviders and premium payment to the member of JKJ.Purpose: To examine perceptions of policy makers towardbackground of premium subsidy, capitation system and premiumpayment of JKJ and perceptions of providers toward capitationsystem.Method: Research was using cross sectional design anddata was taken by qualitative method. The subject was policymakers and primary health care providers of JKJ. Instrumentbeing use was deep interview guidance.Result and Conclusion: Generally policy makers of JKJ hadmisinterpretation about the concept of basic needs and equityegaliter in health, that causing resistance on premium payment.Generally policy makers and providers of JKJ had badperception about capitation system.Keywords: health insurance, capitation, premium payment
SIMULASI PENGHITUNGAN TARIF PREMI SEBAGAI UPAYA ADVOKASI REALOKASI SUBSIDI PREMI PPK I JAMINAN KESEHATAN JEMBRANA Januraga, Pande Putu
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 01 (2008)
Publisher : Jurnal Manajemen Pelayanan Kesehatan

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Background: Program of Jembrana Health Insurance (JHI) isintended to provide health insurance at first level (PPK I) forinhabitants of Jembrana District. Up till now, financing of JHIdepends on subsidy in which it is growing up and has a trendto be out of the target. Therefore, it needs to increase themember participants by implementing the premium payment.Aim of this research was to analyze premium of JHIcomprehensively to advocate the reallocation of premiumsubsidy of JHI.Methods: Type of this research was case study throughanalyzing secondary data. Data on members, utilization,operational cost and claim cost data was collected using format Bapel JKJ, Jembrana District Health Office and NegaraHospital.Results: The first Premium tariff scheme of JHI is free for 40 %inhabitants who earn low income, Rp48.171,00 for 40%inhabitants who earn medium income, and Rp96.341,00 for20% inhabitants who earn high income. The second Premiumtariff scheme of JHI is free for 40% inhabitants who earn lowincome, Rp89.595 for 40 % inhabitants who earn mediumincome, and Rp96.341,00 for 20% inhabitants who earn highincome.Conclusions: Local government could develop JHIcomprehensively by relocating premium subsidy of PPK I for40% inhabitants who earn low income, besides that localgovernment should apply principles of managed care bycontrolling cost and quality in terms of comprehensive healthinsurance.Keywords: health insurance, premium
INCREASING HIV PREVALENCE AMONG FEMALE SEX WORKERS IN INDONESIA: HOW IS IT PRESENTED IN THE MEDIA AND SCHOLARLY JOURNALS? Januraga, Pande Putu
ARCHIVE OF COMMUNITY HEALTH Vol 2, No 2 (2013)
Publisher : ARCHIVE OF COMMUNITY HEALTH

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Within different target audiences, the media and scholarly journals have significant roles in enhancing the awareness and influencing the development of HIV prevention-related policies. However, particularly in developing and poor countries, the media seem to affect policy development in contradictory ways. Thus, it is interesting to investigate how the increase in prevalence of HIV among female sex workers (FSWs) in Indonesia is represented in the media and to make a comparison of this representation with those in scholarly articles. Using three types of newspaper and peer-reviewed scholarly articles, this paper found that the media tend to frame the problem and its risk factors as merely a health problem produced by unsafe behaviours that are inappropriate to the local culture and belief. Efforts to challenge dominant values through the involvement of local media should encourage local journalists aware of the consequences of their chosen media template. Furthermore, given the fact that the majority of scholarly articles included in the analysis focused more on biological and behavioural factors of HIV infection, more social research is needed.
Akses Jaminan Kesehatan Nasional pada Pekerja Seks Perempuan Nopiyani, Ni Made Sri; Indrayathi, Putu Ayu; Listyowati, Rina; Suarjana, I Ketut; Januraga, Pande Putu
Jurnal Kesehatan Masyarakat Nasional Vol. 9 No. 4 Mei 2015
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (138.866 KB) | DOI: 10.21109/kesmas.v9i4.734

Abstract

AbstrakPekerja seks perempuan (PSP) merupakan kelompok yang termarginalkan secara sosial dan memiliki kerentanan yang tinggi terhadap masalah kesehatan. Upaya perluasan Jaminan Kesehatan Nasional (JKN) pada PSP masih terbatas sehingga penting dilakukan untuk mendukung pencapaian universal health coverage. Penelitian ini bertujuan untuk memperoleh gambaran mengenai akses JKN pada PSP di Denpasar. Penelitian ini merupakan studi kualitatif. Data dikumpulkan melalui wawancara mendalam terhadap 15 orang PSP dan empat orang mucikari di Denpasar pada Agustus hingga Oktober 2014. Hasil wawancara diolah dengan analisis tematik. Kerangka analisis yang digunakan adalah The Health Access Livelihood Framework. Kepemilikan JKN pada PSP di Denpasar masih rendah, meskipun sebagian PSP memiliki kemauan untuk menjadi peserta JKN dan memiliki kemampuan membayar iuran JKN. Faktor penghambat akses JKN pada PSP adalah rendahnya pengetahuan mengenai prosedur pendaftaran dan portabilitas JKN, kekhawatiran keberlanjutan pembayaran iuran, persepsi buruk mengenai kualitas layanan yang akan diterima jika menggunakan JKN, ketidaklengkapan administrasi kependudukan serta kebijakan yang mengharuskan peserta bukan penerima bantuan iuran (Non-PBI) Mandiri untuk mendaftarkan seluruh anggota keluarga. Akses JKN pada PSP terhambat oleh faktor-faktor individual, layanan dan kebijakan yang perlu diatasi untuk meningkatkan cakupan JKN pada PSP. AbstractFemale sex workers (FSW) is marginalized social group having a high vulnerability of health problems. Effort to expand national health insurance on FSW is still limited, so it is necessarily performed in order to support the achievement of universal health coverage. This study aimed to obtain the depiction of the insurance access among FSW in Denpasar. This study was qualitative. Data was collected through in-depth interview of 15 FSW and four pimps in Denpasar from August to October 2014. The interview result was analyzed using thematic analysis. The analysis framework used was The Health Access Livelihood Framework. The insurance ownership among FSW in Denpasar was low, even though some FSW were willing to be participants and afford to pay the premium. Factors inhibiting the insurance access were the lack of knowledge regarding registration procedures and portability, fear of premium payment sustainability, negative perceptions of quality of services that would be received if using the insurance, incomplete population administration and policy requiring independent non-premium support receiver participants to register all of their family members. The insurance access among FSW was hindered by individual, service and policy factors that need to be conquered to increase the insurance coverage among FSW.
KAMPANYE KONDOM, KEMENTERIAN KESEHATAN, DAN DETERMINAN SOSIAL KESEHATAN Januraga, Pande Putu
ARCHIVE OF COMMUNITY HEALTH Vol 1, No 1 (2012)
Publisher : ARCHIVE OF COMMUNITY HEALTH

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Abstract

KEPUASAN STAF RSUP SANGLAH DENPASAR TERHADAP PELAYANAN PESERTA DIDIK KEDOKTERAN Widyanthini, Desak Nyoman; Edi Putra, I Gusti Ngurah; Januraga, Pande Putu
Media Kesehatan Masyarakat Indonesia Vol 13, No 3: SEPTEMBER 2017
Publisher : Faculty Of Public Health, Hasanuddin University, Makassar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30597/mkmi.v13i3.2678

Abstract

Status RSUP Sanglah sebagai rumah sakit pendidikan akan menimbulkan dinamika persepsi terhadap kualitas pelayanan baik dari sisi pasien maupun staf RSUP Sanglah karena proses pendidikan peserta didik kedokteran (dokter koas dan dokter residen) yang akan berhubungan langsung dengan pasien. Tujuan dari penelitian ini, yaitu untuk mengukur dan mengidentifikasi faktor yang terkait dengan tingkat kepuasan staf RSUP Sanglah terhadap pelayanan kesehatan yang diberikan peserta didik kedokteran. Metode penelitian ini, yaitu observasional deskriptif dengan rancangan cross-sectional study. Sampel dalam penelitian ini, yaitu staf RSUP Sanglah di 19 ruangan yang menjadi lokasi dokter residen dan koas memberikan pelayanan dengan jumlah sampel sebanyak 382 orang dan di- pilih secara total sampling. Hasil penelitian menunjukkan tingkat kepuasan staf terhadap layanan yang diberikan oleh peserta didik kedokteran, yaitu sebesar 3,790 (SD=0,403) dari minimal 1 (sangat tidak puas) dan maksimal 5 (sangat puas). Seluruh item pernyataan dimensi kepuasan staf menunjukkan proporsi respon positif yang lebih besar, terutama pada dimensi benefit atau manfaat yang dirasakan, tetapi terdapat cukup besarnya respon negatif pada item pernyataan confidence, dengan item terendah yaitu pengisian rekam medik. Secara umum staf RSUP Sanglah menyatakan puas terhadap layanan yang diberikan oleh peserta didik kedokteran, walaupun masih ditemukan respon negatif, yaitu pada kelengkapan pengisian rekam medis.
Akses Jaminan Kesehatan Nasional pada Pekerja Seks Perempuan Nopiyani, Ni Made Sri; Indrayathi, Putu Ayu; Listyowati, Rina; Suarjana, I Ketut; Januraga, Pande Putu
Jurnal Kesehatan Masyarakat Nasional Vol. 9 No. 4 Mei 2015
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (138.866 KB) | DOI: 10.21109/kesmas.v9i4.734

Abstract

AbstrakPekerja seks perempuan (PSP) merupakan kelompok yang termarginalkan secara sosial dan memiliki kerentanan yang tinggi terhadap masalah kesehatan. Upaya perluasan Jaminan Kesehatan Nasional (JKN) pada PSP masih terbatas sehingga penting dilakukan untuk mendukung pencapaian universal health coverage. Penelitian ini bertujuan untuk memperoleh gambaran mengenai akses JKN pada PSP di Denpasar. Penelitian ini merupakan studi kualitatif. Data dikumpulkan melalui wawancara mendalam terhadap 15 orang PSP dan empat orang mucikari di Denpasar pada Agustus hingga Oktober 2014. Hasil wawancara diolah dengan analisis tematik. Kerangka analisis yang digunakan adalah The Health Access Livelihood Framework. Kepemilikan JKN pada PSP di Denpasar masih rendah, meskipun sebagian PSP memiliki kemauan untuk menjadi peserta JKN dan memiliki kemampuan membayar iuran JKN. Faktor penghambat akses JKN pada PSP adalah rendahnya pengetahuan mengenai prosedur pendaftaran dan portabilitas JKN, kekhawatiran keberlanjutan pembayaran iuran, persepsi buruk mengenai kualitas layanan yang akan diterima jika menggunakan JKN, ketidaklengkapan administrasi kependudukan serta kebijakan yang mengharuskan peserta bukan penerima bantuan iuran (Non-PBI) Mandiri untuk mendaftarkan seluruh anggota keluarga. Akses JKN pada PSP terhambat oleh faktor-faktor individual, layanan dan kebijakan yang perlu diatasi untuk meningkatkan cakupan JKN pada PSP. AbstractFemale sex workers (FSW) is marginalized social group having a high vulnerability of health problems. Effort to expand national health insurance on FSW is still limited, so it is necessarily performed in order to support the achievement of universal health coverage. This study aimed to obtain the depiction of the insurance access among FSW in Denpasar. This study was qualitative. Data was collected through in-depth interview of 15 FSW and four pimps in Denpasar from August to October 2014. The interview result was analyzed using thematic analysis. The analysis framework used was The Health Access Livelihood Framework. The insurance ownership among FSW in Denpasar was low, even though some FSW were willing to be participants and afford to pay the premium. Factors inhibiting the insurance access were the lack of knowledge regarding registration procedures and portability, fear of premium payment sustainability, negative perceptions of quality of services that would be received if using the insurance, incomplete population administration and policy requiring independent non-premium support receiver participants to register all of their family members. The insurance access among FSW was hindered by individual, service and policy factors that need to be conquered to increase the insurance coverage among FSW.
SOCIODEMOGRAPHIC CHARACTERISTICS, WORK VENUE, KNOWLEDGE, AND CONDOM USE WITH CLIENTS AMONG INDIRECT FEMALE SEX WORKERS IN DENPASAR, BALI, INDONESIA Putra, I Gusti Ngurah Edi; Phuengsamran, Dusita; Jampaklay, Aree; Thammawijaya, Panithee; Januraga, Pande Putu
Proceedings of the International Conference on Applied Science and Health No 3 (2018)
Publisher : Proceedings of the International Conference on Applied Science and Health

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Abstract

Introduction: Female sex workers (FSWs) remain an important key population affected by HIV&AIDS in Indonesia. Indirect FSWs, in particular, are exposing to higher risk comparing to direct FSWs due to their characteristics and working conditions that could be barriers to safe sex or consistent condom use. This study aimed to identify association between sociodemographic characteristics, work venue, and knowledge on HIV&AIDS toward condom use among indirect FSWs. Methods: This was a cross-sectional study using secondary data from a survey on indirect FSWs conducted by Center for Public Health Innovation (CPHI), Udayana University, Indonesia during August to October 2017. About 171 indirect FSWs were eligible for this analysis. The dependent variable in this study was consistent condom use during the last month. Independent variables consisted of socio-demographic characteristics, work venue, and knowledge on HIV&AIDS. Data were analysed using univariate and multivariate analysis. Results: About half of indirect FSWs (50.17%) reported using condom consistently with their clients during the last month. Indirect FSWs were more likely to use condom consistently if they completed senior high school or higher (OR=3.49; 95%CI=1.42-8.57), but less likely to use condom if they were currently or ever married compared to single ones (OR=0.23; 95%CI=0.06-0.82). Those who worked in karaoke, cafe, and bar were less likely to use condom consistently compared to those in massage parlor, spa, and beauty salon (OR=0.09; 95%CI=0.03-0.26). Conclusions: Level of consistent condom use was low, indicating the need to intensify HIV prevention to indirect FSWs. Significant determinants of consistent condom use included marital status, educational level, and work venue. This study informed that providing HIV&AIDS information and improving negotiation skill that fit with characteristics of indirect FSWs and giving institutional support at workplace is crucial to ensure consistent condom use among indirect FSWs.