Yuliyanti, Citra
Proceedings of the International Conference on Applied Science and Health

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DELAYED CLAIM PAYMENT AND THE THREAT TO HOSPITAL CASH FLOW UNDER THE NATIONAL HEALTH INSURANCE SCHEME IN INDONESIA Yuliyanti, Citra; Thabrany, Hasbullah
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

Background: Indonesia commits to ensure health care access for all population through the National Health Insurance (JKN) managed by the BPJS Health. By February 2018, the JKN covered 193 million people (73% of the total population). To ensure health delivery, 2,104 public and private hospitals are contracted by the BPJS and prospective payment using Case-mix Based Group (CBG) that changes hospital managements. Hospitals become more dependent on payments by BPJS. Delay in claim payment will have serious impact on hospital managements. This study aims to identify current practices in timely payment to hospitals and finding factors correlate with delay in payments. Methods: This study used trend analysis of the secondary claim data of BPJS with the total sample of 57,475 bundles of claims. Total claim population was used in this study. In addition, qualitative study via in-depth interview with six informants consisting of members of National Social Security Council, hospital director of three different classes, and BPJS. Results: This study found 60% of claims were paid within one month (N-1) of claim submission, below the target of 100%. There were tendencies of delays in claim settlements since November 2017. Informants believed that late payments were correlated with non-compliance of doctor to complete medical records, incompetence coders, inadequate management information system, and financial condition of BPJS. There were three main problems faced by hospitals as a result of delay in payments: 1) disturbed drug availability, 2) decreased performance of doctors, 3) poorer maintenance of medical equipment. Conclusion: Delayed in claim payments were occurred and led to a threat of decreasing quality of care to patients. The study suggests the government should fix the problems to protect patients from decreasing quality of care. Hospitals should provide reserve funds to protect them from financial hardship when delays occur. 
EFFECTIVENESS OF ‘FAST’ STROKE CAMPAIGN FOR FAST STROKE RECOGNITION AND RESPONSE: A SYSTEMATIC REVIEW Sudirman, Herpani; Yuliyanti, Citra; Sari, Andrea Indra
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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Background: FAST campaigns help people recognize the signs and symptoms of stroke rapidly to bring the patient to the hospital or emergency department immediately. However, the effectiveness is still be questioned. This present study is to evaluate the effectiveness of the campaign of early detection in stroke patients to reduce the risk of disability. Methods: A systematic review of articles published between 2010 and 2017 examining the effectiveness of FAST campaign using interventions was conducted along with narrative synthesis and review of intervention development. Information from all relevant published articles that determine how the intervention was developed and evaluated for measuring the effectiveness of FAST campaign were extracted and analyzed. Results: Eleven studies were included, six studies report the effectiveness of FAST campaign, but the other five studies report that the campaigns still do not hit the target. The professionals claim that FAST campaign has been promoted internationally as a great success, but some studies report that the FAST campaign still do not have any significant impact in promoting swift response for Emergency Medical Services (EMS). Conclusions: Campaigns aimed at the public may raise awareness of signs of stroke, but have limited impact on behavior. Thus, new campaigns of FAST should survey the principles of good design and be intensely evaluated for the effectiveness of the implementation.