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Jurnal Manajemen Pelayanan Kesehatan
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POTENSI PARTISIPASI MASYARAKAT MENUJU PELAKSANAAN JAMINAN KESEHATAN DALAM RANGKA UNIVERSAL COVERAGE DI KOTA BANDUNG Djuhaeni, Henni
Jurnal Manajemen Pelayanan Kesehatan Vol 13, No 03 (2010)
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Background: Community is one of the components that mustbe prepared to participate on funding the health insuranceaccording to their ability. The main problem in Indonesia is thatthere are many informal workers who have unsteady incomeand are not the target of Jamkesmas, but they have the abilityfunding for their health insuranceMethod: The study aim was to asses the ability and willingnessof informal workers funding for health insurance in BandungCity. A survey with multy stage random sampling wasconducted using questionnaire for 700 respondents.Descriptive analysis technique was performed.Result: The results were average nonfood expenditure was1.62 times greater than average food expenditure, average“nonprimary” expenditure such as personal expenditure,“arisan”, recreation and saving, was 2.13 times greater thanaverage health expenditure. 94.4% of respondents did nothave any health saving, 87.1% of respondents would like toparticipate funding their health insurance.Conclusions: In Bandung City, the informal workers have theability and willingness to participate on funding their healthinsurance, so that the policy of “free health care” should bereconsidered. On the other hand, there are some actions stillneed to be developed, those are socialization; the collectingmethod; motivating this group to save money for health as theyhave an unsteady income.Keywords: community participation, health insurance, “free”health care
QUO VADIS UNDANG-UNDANG SISTEM JAMINAN SOSIAL NASIONAL? Rivany, Ronnie
Jurnal Manajemen Pelayanan Kesehatan Vol 13, No 03 (2010)
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The National Social Security System Law (SJSN / Law No. 40 of 2004) was set on 2004 and consists of 9 chapters, 53 articles, and 112 clauses. The law regulates the formation for The National Social Security Council and the conduct of Tri Partit between 1)The Social Insurance Management Agency, 2) the participants and 3) Healthcare Facilities owned by the Government or Private Companies who collaborated with The Social Insurance Management Agency. For article 24 clause (1) and (3) about quality of health services and cost affectivityefficiency, few of the working procedures is still unclear, such as how the management of the patients is ranging from admission until discharge process (clinical pathway), and the exact amount of the cost or tariff and capitation to be agreed on as the cost of treatment between The Social Insurance Management Agency and the existing healthcare facilities/ hospitals, in order to achieve mutual agreement based on the principles of fairness and win-win solution. Keywords: INA DRG, clinical pathway, cost of treatment, The National Social Security Law
PENGEMBANGAN PROTOTIPE SISTEM INFORMASI MANAJEMEN REGULASI PRAKTIK KEDOKTERAN BERBASIS WEB DENGAN PENDEKATAN SISTEM INFORMASI GEOGRAFIS Mulyawan, Ketut Hari
Jurnal Manajemen Pelayanan Kesehatan Vol 13, No 03 (2010)
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Background: Every medical practitioner in Indonesia isrequired to have a medical practice lisence (Surat Izin Praktikor SIP). The medical practice lisence not only functions as alegal permision legal paper, but the information can be used tomonitor distribution of existing practitioners.Objective: The study aims at developing a web-based medicalpractice regulation with geographical information systemapproachMethod: The study employed an action research study designwith 13 respondents from Denpasar City Health Departmentand doctors in the area of Denpasar City. The study beganwith in-depth interviews to explore information needs, processflow and expected results. The programming process wascarried out by applying the results obtained from interviews.Trials and demonstrations were then carried out to allrespondents to evaluate the usability aspect of the prototypedeveloped.Result: A prototype has been developed with different featuresand information for two groups of users with different needsfor information. They are the visitors of the website of theHealth Agency of Denpasar City. The medical practices andpopulation distribution are the information necessary for thephysicians in addition to the online registration, while themanagement of the issuance of the of the medical practicelisence and the related report are necessary for the HealthAgency of Denpasar City. The detailed information may beaccessed in table presentation and the distribution may beclearly observed in map presentation.Conclusion: Ease in operating the information system andavailability of the necessary information are important for theusers. The use of map presentation facilitates the users inmaking decisions based on the information given.Keywords: medical practice lisence, medical practicedistribution, information system prototype
BUKTI EMPIRIS KEBIJAKAN ASURANSI KESEHATAN SOSIAL: ANALISIS DATA SURVEI ASPEK KEHIDUPAN RUMAH TANGGA INDONESIA (SAKERTI) Hidayat, Budi
Jurnal Manajemen Pelayanan Kesehatan Vol 13, No 03 (2010)
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Objective: Research that produced empirical evidences forhealth policy formulation presumably limited. This articleelaborates this perception by synthesizing four studies on thedemand for outpatient care (OP), e.g., (i) health insurance andthe number of OP visits, social health insurance and (ii) theuse of OP, (iii) providers choices, and (iv) equity in access.Methods: This study uses data from the second round of theIndonesian Family Life Survey (IFLS). Two considerations havebeen taken into account in selecting estimation methods: thedesign of observational study and type of the data used tomeasure the demand. To predict the number of OP visits, theauthor explored six count data estimators, whilst to investigatethe impact of social insurance on the use of OP, providerchoices, and equity, the author applied a multinomial logisticregression.Results: Whilst the distribution of health insurance isconcentrated on the rich, the highest effect of insurance onaccess found among the lowest income group. Given provideralternatives, the insured tend to choose public rather thanprivate providers. Those who are sicker, not married, wealthierand highly educated also prefer to use private than publicproviders. The impact of social insurance on equity in accessto health care was not observed.Conclusions: Efforts to increase access to health careservices through a national health insurance (NHI) will be moreeffective if the program accommodates consumer preferences.Changes in the demand from public to private providers mustbe taken into account, especially when setting premium subsidyand benefits baskets of the NHI. In general, the NHI policy hasalready empirical evidences. However, NHI implementationrequires a set of technical regulations as a translation of theNational Social Security Act, which also must be supportedfrom the results of empirical studies.Keywords: social health insurance, demand for health care,endogeneity, applied econometrics in health
ROLES OF THE STAKE HOLDER AND PROVIDER OF BATAM CITY IN AN ATTEMPT TO ENHANCE CLINICAL GOVERNANCE OF HEALTH SERVICES IN CONNECTION WITH DOCTOR PRACTICE LAWS Kasim, Felix
Jurnal Manajemen Pelayanan Kesehatan Vol 13, No 03 (2010)
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Background: Deming (1984), Crosby (1979, 1985), and Juran(1988), all found that more than 85% of errors are related to asystem; whereas, only 15% of them constitute human error,or an employee’s. According to NGO coordinator, IskandarSitorus, 2000 victims of malpractice have been recordedthroughout Kepulauan Riau. This malpractice occurs when asystem does not have a proper policy, standard procedure,and equipment needed.Objective: The purpose of this research is to find out themanagement, obstacles, and expectations with regards toclinical governance management from the point of view of thestakeholder and provider of Batam City.Method: The method used in this research was a qualitativemethod with a grounded theory. The primary data are derivedfrom in-depth interview. The respondents involved are thecommission IV chairperson of Batam City local Parliament,Kepulauan Riau, chairperson of Medical Committee of Batu AjiLocal Public Hospital Kepulauan Riau using a purposivesampling with an extreme case sampling approach.Result and conclusion: The research shows that clinicalgovernance by the stakeholder and provider still needs furtherimprovement. There are still obstacles in terms of regulationsand implementation of clinical governance. Based on theMinimum Service Standard, some indicators of Batam City in2008 did not meet the performance target and national standard.Therefore, the clinical governance system has not beenimplemented throughout health services in Batam City.Suggestions: For IV Legislative Commission for People’sWelfare and Human Resources Batam Riau Islands areexpected to lack of regulation and appropriate systems inimproving health services. And then for Hospital MedicalCommittee Batu Aji, Batam Riau Islands is expected to implementClinical Governance.It is expected that the recording and reporting systems as wellas obtaining accurate data in making the next Batam healthprofile based on the quality of evidence-based.Keywords: Clinical Governance, stakeholder, provider
POSISI STAKEHOLDER DAN STRATEGI ADVOKASI KIBBLA KABUPATEN/KOTA DI JAWA TENGAH Budiyono, Budiyono
Jurnal Manajemen Pelayanan Kesehatan Vol 13, No 03 (2010)
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Background: Health status in Central Java on 2009 showsthat the number of maternal mortality is 17.02 (per 100.000 lifebirth), and the number of infant mortality is 10.37 (per 1000 lifebirth). It has gap of the MDG’s target. It’s important for integratingrole of stakeholders to decrease the number of maternal andinfant mortality (AKI-AKB). This research aims to identifystakeholder categories trough matrix of power and interest inregrad to advocacy on KIBBLA program in districts in CentralJava Province based on respondents perception.Method: There are 46 samples from 23 districts/cities(represent of DKK and Bappeda) using observational researchthrough workshops method. Descriptive analysis on powerinterestmatrix of stakeholders is given to make a category ofstakeholder position as player, subject, context setter andcrowd.Result: Player stakeholders are DPRD; Bupati/Walikota;BAPPEDA; DKK; Hospital; PKK; Family Planning Institution;Professional Organization; Camat/Kades/Lurah, and theSubject Stakeholders are Hospital; BAPERMAS; PKK; FamilyPlanning Institution; Professional Organization; NGO;Community/Family Leader; Education Service. The contextsetter stakeholders are DPRD; Bupati/Walikota; BAPPEDA;Hospital; BAPERMAS; PKK; Family Planning Institution; NGO;Community/Family Leader; Camat/Kades/Lurah; Educationservice and crowd stakeholders are DPRD; Bupati/Walikota;BAPERMAS; PKK; Family Planning Institution; ProfessionalOrganization; NGO; Community/Family Leader; Camat/Kades/Lurah; Education Service. The most choice of ad-vocationstrategies are lobbying, discussion, hearing and socialization.Conclusion: It’s concluded that the stakeholder could set inmulti position/category on the advocacy of KIBBLA program indistricts of the Central Java Province.Keywords: stakeholder, KIBBLA program, power-interestmatrix, advocation strategy
PERBANDINGAN BIAYA PELAYANAN TINDAKAN MEDIK OPERATIF TERHADAP TARIF INA-DRG PADA PROGRAM JAMKESMAS DI RSUP DR. MOHAMMAD HOESIN PALEMBANG Septianis, Dwi
Jurnal Manajemen Pelayanan Kesehatan Vol 13, No 03 (2010)
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Background and Goal: The concept of Indonesian DiagnosisRelated Group (INA-DRG) formerly purposed to gain both qualityand efficiency of the health services. By using this packet ratehopefully it could minimize the medical cost rate, where theresurgical operation is one of the most expensive medicalservices. The present study is aimed to investigate thecomparison between surgical operations to the INA-DRG’stariff of JAMKESMAS in RSUP Dr. Mohammad Hoesin Palembangin quartal I 2009.Method: This study was observational with the cross sectionalapproach. The population study used Jamkesmas patients asthe samples who got the surgical operation treatment sinceJanuary up to April 2009, the approximately 232 people.Samples consists of 70 patients have been taken by usingproportional stratified sampling method. Type of the data thathave been analyzed were primary data included stay carerate of the patients that collected by using observation methodhelped with the check list instrument. The analysis of thisstudy aimed to highlight the distribution of rupiahs rate circulationtoward services cost rate and descriptively to produce apicture of rupiah value distribution of the cost of medicalservices operative actions which are categorized into threegroups: a special operation, Operation large and mediumoperations. Then done with cross tabulated both two variablesand the results were shown in form of narration and table ofdistribution.Results: The results of this study show that 98.6% of thesurgical operations rates were not relevant to INA-DRG’s tariff.If viewed from the component costs, the costs of operatingthe actions of special operations have a tendency to losemoney because most of the cost (55.6%) in excess of averagecost. In the cost component of nursing care was found thatthe cost is greater than the average cost at most at the specialoperations (41.2%). In supporting service cost component isknown that the cost is higher than average costs at mostoperations moderate (50%). At the component cost ofmedicines is known that the cost of drugs is greater than theaverage cost of most numerous in a major operation around40%. Therefore, when viewed from the total cost is calculatedbased on the sum of four components above cost is foundthat the total cost of surgery which is smaller than the averagecost at most at the special operations (72.2%), while the costof surgery is greater than the cost average at most at theoperating medium (45.5%). This shows that the total cost ofsurgery is being issued to patients in RSMH Jamkesmas greaterthan the cost which is generally on the operation.Conclusion: In conclusion, this present study indicates thatthere is a tendency to lose the service of the operativeprocedure in patients Jamkesmas in RSMH surgical operationscost rate were not relevant and more than INA-DRG’s tariff.Proposed that a clinical pathway must be constructed basedon INA-DRG’s regulation soonly in order to be guidance forhospitals in giving their medical services mainly to theJamkesmas’s patients.Keywords: health services rate, INA-DRG’s tariff, Jamkesmas

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