JKN Program Research Articles

Implementasi Program Jaminan Kesehatan (JKN) Dalam Presfektif Pelayanan Publik Di RSUD Dr Doris Sylvanus Palangka Raya

This study aims to: find out and analyze the implementation of the Health Insurance Program (JKN) in the perspective of public services at the Regional General Hospital, dr. Doris Sylvanus Palangka Raya. The method used in this research is qualitative with qualitative descriptive type. Observation data collection techniques, interviews and documentation, Observation test uses the Standard Operating Procedure of the National Health Insurance Program (JKN) and uses the Principles and Principles of Public Service.
 The results show that 1). There needs to be improved services both in terms of administrative services, direct health services, and the need for additional human resources, accompanied by facilities and infrastructure. 2). Need to establish intensive communication between the Health Social Security Administration Agency, and the Regional General Hospital dr. Doris Sylvanus Palangka Raya, related to service delivery, service delivery and health service flow. As well as information related to the implementation of the JKN program at the Regional General Hospital, dr. Doris Sylvanus Palangka Raya.
 Recommendations 1. There is a need to improve services both in terms of administrative services, health services directly, and the addition of human resources, accompanied by facilities and infrastructure. 2. It is necessary to establish intensive communication between the Health Social Security Administration Agency, and the Regional General Hospital, dr. Doris Sylvanus Palangka Raya, related to service delivery, service delivery and health service flow. 3. There needs to be support from the central and regional governments both legislative and executive in allocating budgets in improving facilities and markets.

Influence Of Capital Funds, Infrastructure Means, And Professionalism Human Resources On Service Quality And Patient Satisfaction Of Puskesmas District Polewali Mandar West Sulawesi

Social security is a Universal Declaration of Human Rights as well as nationally (the 1945 Constitution and various other laws and regulations). The problems that often arise in relation to the BPJS tariff that has been determined in accordance with the Regulation of the Minister of Health of the Republic of Indonesia Number 69 Year 2013 on the Health Service Tariff Standard At First Level Health Facilities And Health Facilities Continued Level In The Implementation Of Health Insurance Program. The fulfillment of access to health services, then the community of JKN users began to pay attention to the quality of service shown by their satisfaction to receive services from BPJS Health faskes. Based on the results of interviews with BPJS Health Branch Office of Polewali Mandar district obtained data regarding the complaints of JKN participants in FKTP in Polewali Mandar District include less friendly service, less informative, long queues, rejection of patients outside the region and unserved patients for medical treatment outside FKTP working hours. This is an indication of problems in patient satisfaction JKN while patient satisfaction is one of the target in the implementation of JKN program. This study aims to analyze the effect of Capitation Fund on service quality, analyze the effect of Kapuas Fund on patient satisfaction, analyze the effect of infrastructure facilities on service quality, analyze the influence of infrastructure facilities on patient satisfaction, analyze the influence of professionalism HR on service quality, analyze the influence of professionalism HR toward satisfaction patients, and analyzed the effect of service quality on patient satisfaction of Puskesmas in Polewali Mandar regency of West Sulawesi.

National Health Insurance, Profitability, and Service Quality: Case Study at the Private Hospital in West Java

National health insurance is one of the government programs to facilitate health services for the people. The purpose of this research to determine whether there are effects of National Health Insurance program (JKN) on profitability and service quality at Juanda Kuningan Hospital, of West Java. The method using the paired-t-test to analyze the difference between before and after the National Health Insurance program. The result showed that there is a difference in profitability and service quality between pre and post the implementation of national health insurance program. Gross profit margin measured the profitability, net profit margin, return on total assets, and return on equity. This result means that the value of the company's profitability is better when the program JKN yet takes place in the Juanda hospital. While on the service quality variable it is found that the mean value is higher when the JKN program has conducted at the hospital.DOI: 10.15408/etk.v17i1.7064

Impact Evaluation of National Health Insurance toward Access Hospital Inpatient Care in Indonesia

Indonesian government launched officially the National Health Insurance (JKN Program) on January 14, 2014. JKN program constructed with participation is mandatory and there is no selection, the spirit of cross subsidy (rich-poor, healthy-ill, young-old), non-profit and fees calculated as a percentage of wages or income. One of the main objectives of JKN is to improve equity in access to health services. This study aims to evaluate the impact of National Health Insurance program that has been running more than one year over the access to inpatient care at the hospital. This study used Indonesian Family Life Survey IFLS-4 (2007) and IFLS-5 (2014/2015). The analysis used a combination of propensity score matching methods and difference in difference. This analysis enables the research resembles the experiment considering the access changes to the inpatient care on the same individuals were evaluated before and one year after the National Health Insurance starts. The results showed that the National Health Insurance program have impact 2.4% on access to health care of inpatient at the government hospital and or private hospital. The resulting effect of National Health Insurance is not final because the data is just collected in 2014 until mid-2015, about half a year of the commencement of National Health Insurance.

The Effect of Health Service Quality of JKN-BPJS Program Upon the Improvement of Patient's Satisfaction in Jember District

Background and Objectives: Since its first inception on 1st of January 2014, the National Health Insurance (JKN) Program managed by National Security Health Agency (BPJS-Kesehatan) has been executed across Indonesia including in Jember district. A survey result suggested that JKN health service implementation in Jember district has not yet been able to provide patients and people with satisfaction upon JKN health service. Good quality of health service will surely influence patients’ satisfaction, and satisfaction will lead to patients’ loyalty towards the institution providing health service as the organizer of JKN program. The research aimed to analyze the quality of health service of JKN program and its influence upon patients’ satisfaction towards the service of hospitals and health centers as JKN program executors. Research Method: The research deployed ex-post facto research design, associative explanation level, in the form of causal variable, and with data collection through cross sectional. The research population was patients of local hospital and health centers across Jember district as JKN members. Samples were collected through Stratified Random Sampling technique. The measurement of samples was identified through Bernoulli formula. The sample collection was then carried out at each institution providing health service through incidental sampling, while analysis technique was conducted through double linear regression. Research Result: statistic test showed that value of Multiple R as 0,988 and value of p as 0,000. Value of Fsum-upas 3564,639 bigger than Ftable as 2,01. This indicated that the correlation among free variables simultaneously influence patients’ satisfaction as 98,8%.The correlation might be very strong due to the correlation co-efficient close to 100% or 1. In other words, significant influence in the aspect of Reliability, Assurance, Tangibles, Empathy and Responsivesness towards patients’ satisfaction of JKN-BPJS Kesehatan members in Jember district has well-grown. Discussion: Thus, efforts to improve the quality of health service of members of JKN program in each health centers across Jember district to improve patients’ satisfaction to ensure patients’ recovery that they are eventually loyal to JKN program managed by National Security Health Agency.

PERAN RSUD PAMBALAH BATUNG AMUNTAI DALAM IMPLEMENTASI PROGRAM BPJS KESEHATAN DI HULU SUNGAI UTARA

The issues discussed in this study were the implementation of BPJS program on health in RSUD of Pambalah Batung, Amuntai. It is inspired by the complaints of patients who were admitted to redeem the drug, the number of beds and rooms which was not adequate as well as there were many facilities and infrastructures which were still in bad condition, and there were many people who were not aware of the availability of BPJS program on health. The samples of data sources used purposive sampling technique. As many as 10 people were considered to have strong relations with the issues examined. The data were collected by observations,interviews,and documentation. The survey results revealed: the constraint from the aspect of the unclear communication which resulted in the delays of service process carried out by the Executive of RSUD, the aspect of resources interms of facilities which was still in sufficient because there were many health facilities which were not functioning properly and in damaged condition.It is suggested to socialize BPJS on health program more often by RSUD of Pambalah Batung through flags, banners, and localtelevision, toad health facilities for BPJS patients especially in patient and sanitary rooms, to repair damaged facilities. The addition of internet (wifi), particularly for Emergency Room (ER) is required when information on JKN program is in need.

Inpatient Readmission Insidence of National Health Insurance Patients at Partner Hospitals of BPJS-Health in Sukabumi 2015

The INA-CBG payment system in the JKN program allegedly increasing the incidence of readmission. This study aims to map the incidence of readmission in JKN participants admitted to thirteen partner hospitals of BPJS-Health in Sukabumi. The research design is a descriptive study with the unit of analysis is patient. The study used secondary data from inpatient claims in thirteen partner hospitals BPJS-Health Sukabumi which has been verified during 2015. The study found that the number of readmission is 8.81% with the most readmission incidence occurs in the equal CMG category and at the least in the equal severity level category. The cost of inpatient readmission services is more expensive 104-113% of the initial care cost. Moreover, about 15-16% cases of severity level readmission is increasing and 12-13% of its severity level is decreased. Less than 3% cases of readmission ended not good because they died, were referred, or had to come home forcibly.

EVALUASI PROGRAM JAMINAN KESEHATAN NASIONAL (STUDI EVALUASI PROGRAM BPJS KESEHATAN PADA TENAGA KERJA DI SURABAYA TAHUN 2014-2016)

Law Number 24 Year 2011 on Social Security Administering Institution functions as guidance in the implementation of social insurance. One of the membership requirement mentioned in the act is the workforce (PPU). To obtain the Health Insurance, the Manpower (PPU) is required to pay a contribution of 5% of the Regional Minimum Wage under the terms of 4% of employers and 1% of Labor. Nevertheless the expected health services have not been achieved yet. The needs for evaluating National Health Insurance program were to assess the extent of program effectiveness, service improvement and membership expansion. This research focused on input, process, and output of JKN Program implementation operated by BPJS Health KCU Surabaya. The research used descriptive qualitative method. The results showed that the assessment of the JKN program implementation both in terms of input, process and output has been implemented quite well.Keywords: Policy Evaluation, National Health Insurance Program, BPJS on Health Surabaya, and Manpower

EVALUASI PELAKSANAAN JAMINAN KESEHATAN NASIONAL

Health care is one of the fundamental rights of the people who held the government as mandated in the 1945 Constitution Article 28H Paragraph (1) Everyone has the right to live physically and mentally prosperous, residence and got a good environment and healthy and receive medical care. Social Security Agency consists of BPJS BPJS Health and Employment which will cover the entire population of Indonesia no later than January 1, 2019. Services BPJS many people questioned. According to Assistant Representative ORI D.I.Y. Reports BPJS services complaints procedure is quite high in 2015. There are also complaints of them in the management of the bureaucracy, registration, until the queues are long and the related payment. Of the existing problems researchers aim to investigate the implementation of the National Health Insurance (JKN) focused on Stakeholder Relations, Financing Model and Outcome JKN in Bantul. This research approach using a combination of methods. The research location in the district of Bantul. Sources of data in this study are primary data and secondary data. Data collection techniques in this study using interview, questioner and documentation. The unit of data analysis in this study is the Social Security Agency. The sampling technique using the formula Slovin. Data analysis techniques in this study using data reduction, data presentation and conclusion. According to the research there is a relationship between BPJS with Health Facilities regulated in PP No.85 Year 2013 on cooperation in improving health services. Hospitals and health centers in collaboration with BPJS had been running quite positive. A total of 90 health facilities in Bantul who cooperate with BPJS. Of health insurance financing model thats enough ideal assessed on the index average of 2.74 included in either category. JKN one principle of mutual assistance means helping each one participant to the other participants. While the outcome JKN assessed on the percentage of the guarantee of health in Indonesia (52.5%) in the province D.I.Y. (64.6%) and in Bantul (73%). Tinkat Bantul merepon public awareness by becoming participants BPJS. Service is guaranteed for the First level services and advanced stipulated in Presidential Decree No. 19 Year 2016. And the cost of minor health for the poor. Of the average index value JKN outcome of 3:06 categorized as either could mean that JKN program has considerable benefits for both participants.

Evaluasi Program Jaminan Kesehatan Nasional Pada Fasilitas Kesehatan Tingkat I Kabupaten Sleman Tahun 2016

National Health Insurance Program is held BPJS Health is an insurance program that helps communities in order to improve community health status. BPJS Health is a legal entity formed to administer the health insurance program. Thus, this research is very important as the evaluation of health care programs implemented JKN BPJS in Sleman. This study used mix-method research methods or a combination of qualitative research and quantitative. Thus, the method of data collection using surveys and interviews, accompanied by direct observation in the field. The research location is in the district of Sleman, precisely at the level of health facilities I. While the process of data analysis in this study begins with this data collection, mengkodefikasi the data, calculate the index, interpret the data, categorize data and linking the findings. Based on the results of the study, the authors found that people's judgment JKN Program is organized by the Health BPJS in Sleman district on a service model gets pretty good value, and the quality of service also get pretty good value. Although there are some problems such as the lack of public knowledge at the service model, and problems in the work force, but queried the whole program is going pretty well

Faktor � Faktor yang Mempengaruhi Keikutsertaan Bidan Praktik Mandiri pada Program Jaminan Kesehatan Nasional di Kota Palangka Raya

Efforts to reduce maternal and infant mortality through various programs including the National Health Insurance program. Midwives play an important role in reducing MMR and IMR, because the midwife is a health worker at the forefront and deal directly with the public, to provide continuous service and complete. This study aims to determine the factors that affect the participation of Independent Midwife Practice On the National Health Insurance Program in the city of Palangkaraya. The approach used in this study was an observational analytic and cross-sectional design. The population in this study are all midwives private practice located in the city of Palangkaraya in 2016. The samples included 105 midwives in private practice. Univariate analysis performed by the frequency distribution for bivariate analysis, age, education, length of practice, knowledge, communication, motivation, cooperation procedure, process claims, the administration process and tariff services using chi-square (x2) and the relationships among several variables were analyzed with multiple logistic regression , The result showed that the factors of education (p = 0.002), duration of practice (p = 0.003), procedure of cooperation (p = 0.000), the process claim (p = 0.042), and administrative processes (p = 0.001) showed a significant effect on the participation of midwives practice of independent Reviewed JKN program. Multiple logistic regression analysis showed that factors of education (OR = 72.23; 95% CI = 2.38 to 218.76), p <0.05, Lama practices (OR = 79.94; 95% CI = 5.22 - 122.45, p <0.05), communications (OR = 97.98; 95% CI = 3.10 to 309.40, p <0.05) and administrative procedures (OR = 56.25; 95% CI = 4.21 to 750.77, p <0.05) simultaneously have a significant influence on the program with the participation of midwives private practices JKN. Conclusion The research results are the effect of education, length of practice, communication, cooperation procedure, process claims, and administrative processes with midwives private practices participation in the program JKN

Factors Influencing the Difference between Indonesian Case-Based Group Reimbursement and Medical Cost for Patients with Chronic Renal Disease Cases in Kasih Ibu Hospital, Surakarta

Backgorund : JKN program has stipulated the INA CBGs reimbursement for the payment of treatment in referral health facilities, including for chronic renal disease which is a disease burden. This study aimed to analyze factors influencing the difference between Indonesian case-based group reimbursement and medical cost for patients with chronic renal disease cases in Kasih Ibu Hospital, Surakarta. Subjects and Method : The study design was an analytic observational with cross sectional design. The study was conducted in Kasih Ibu Hospital Surakarta in August-October, 2017. With a total of 231 subjects sample which was selected by using proportional random sampling. The dependent variable was the difference between Indonesian case-based group reimbursement and medical cost. The independent variables were length of stay, type of class, medical treatment/ surgery, ICU treatment, and medication use. The data were analyzed using multiple linear regression. Result : INA CBGs reimbursement ( mean = Rp 6,120,000; SD= Rp 2,330,000) paid by BPJS Kesehatan was lower than actual hospital’s medical care cost ( mean = Rp 7,070,000; SD= Rp 4,650,000). Factors profitable for hospitals were medical treatments/ surgery (b= 0.032; p= 0.552). Factors that inflicted financial loss were class 1 care (b= -0.104; p= 0.094), class 2 care (b= -0.033; p= 0.590) compared to class 3 care, length of stay (b= -0.541; p<0.001), medication use in accordance with national formulation (b= -0.183; p= 0.008) and the use of ICU (b= -0.045; p= 0.543). Patients who upgraded the class type ( mean = Rp 5,526,074; SD= Rp 1,449,621) was higher than hospital’s medical cost for class 2 ( mean= Rp 3,933,767; SD= Rp 1,887,900). Conclusion : Mean of INA CBGs reimbursement on inpatient care of chronic renal disease is lower than the mean of hospital’s medical care cost. Length of stay and doctors’ compliance in using national medication formulation are important determinants to increase medical care cost. Hospital obtains profit from patients who upgrade type of class. Key words : care cost, INA CBGs reimbursement, chronic renal disease Correspondence : Mardhatillah. Kasih Ibu Hospital, Surakarta, Central Java. Email: mardhatillah.bws@gmail.com. Mobile: 089510610891. Journal of Health Policy and Management (2017), 2(2): 117-127 https://doi.org/10.26911/thejhpm.2017.02.02.03

Evaluasi Program Jaminan Kesehatan Nasional Pada Fasilitas Kesehatan Tingkat I Kabupaten Sleman Tahun 2016

National Health Insurance Program is held BPJS Health is an insurance program that helps communities in order to improve community health status. BPJS Health is a legal entity formed to administer the health insurance program. Thus, this research is very important as the evaluation of health care programs implemented JKN BPJS in Sleman. This study used mix-method research methods or a combination of qualitative research and quantitative. Thus, the method of data collection using surveys and interviews, accompanied by direct observation in the field. The research location is in the district of Sleman, precisely at the level of health facilities I. While the process of data analysis in this study begins with this data collection, mengkodefikasi the data, calculate the index, interpret the data, categorize data and linking the findings. Based on the results of the study, the authors found that people's judgment JKN Program is organized by the Health BPJS in Sleman district on a service model gets pretty good value, and the quality of service also get pretty good value. Although there are some problems such as the lack of public knowledge at the service model, and problems in the work force, but queried the whole program is going pretty well

IMPLEMENTASI KEBIJAKAN SISTEM JAMINAN KESEHATAN IBU HAMILDALAM RANGKA MEMPERCEPAT PENCAPAIANMILLENIUM DEVELOPMENT GOALS- MDG′S DI KOTA BANJARMASIN, KALIMANTAN SELATAN

Maternal and child health is one of the Millennium Development Goals MDG's 2015 global agreement targeting the maternal mortality rate in Indonesia can be reduced to 102 per 100,000 live births in 2015. Efforts to suppress AKI continue to be pursued, including the provision of health services for pregnant women. In 2014, the government began implementing a National Health Insurance (JKN) nationally. Implementation of the JKN program causes Delivery Guarantee (Jampersal) for pregnant women deleted. The deletion encourage local governments to be creative pressing AKI with JKN program and the Regional Health Insurance (Jamkesda). Policy of Implementation Security System Maternal Health in Banjarmasin, which inhibits MCH program because the program JKN knows no territorial, pregnant women can choose the health care she likes, while the MCH program is monitoring the health of pregnant women by the cantonal ie PWS-KIA for evaluation and program planning region. The cause of the mortality rate among pregnant women in the city of Banjarmasin is due late in delivery to the referral occurs as a result of factors helper (service providers at a basic level), delayed detection of high risk so that the condition of pregnant women who were referred is severe enough, and too late to reach health care at the level of referral services. Lack of adequate resources, facilities and infrastructure that do not support and quality of service at referral level is a factor causing delay in rescue efforts maternal health. JKN program bureaucratic system does not support MCH programs, thus largely independent midwives are reluctant to deal with pregnant women / mothers give birth this was due to a convoluted bureaucracy and services / approved rates are too low in accordance with Law of the Ministry of health No 59, 2014.Keywords: implementation of policies, health insurancepregnant women.

Predisposing Factors of the Head of Family with Bali ID Card to Join the National Health Insurance (JKN) Program: A Qualitative Study in Health Centre I North Denpasar

Background and purpose: Since 2010, The Government of Bali has implemented local health financing (JKBM) to provide free health care services for Bali’s citizen, meanwhile, since 2014 the central government has started to implement the National Health Insurance program (JKN) based on participant’s monthly contribution. Although JKBM still available until 2017, there is a phenomenon of people who have Bali ID card turned into JKN. This article explores predisposing factors of the family head with Bali ID cards so that they switched into JKN scheme with relatively the same medical services and facilities.Methods: Interviews were conducted with purposively selected participants through the exit interview by using in-depth interview guide to 13 participants of JKN, three region leaders, three participants of JKBM and one public health central officer. Data were analyzed thematically and presented in a narrative form.Results: The interviews showed that participants who switched to JKN are concerned with sustainability and the quality of services in JKBM program. Participants perceived high vulnerability to disease from previous experience using JKBM program.Conclusion: Based on the consideration of participants to switch the membership becoming independent JKN Class III, it can be recommended improve the cooperation among stakeholders to enhance the socialization of JKN especially through the involvement of listed participants who already used JKN program.

IMPLEMENTASI KEBIJAKAN SISTEM JAMINAN KESEHATAN IBU HAMIL DALAM RANGKA MEMPERCEPAT PENCAPAIAN MILLENIUM DEVELOPMENT GOALS - MDG′S DI KOTA BANJARMASIN, KALIMANTAN SELATAN

Maternal and child health is one of the Millennium Development Goals MDG's 2015global agreement targeting the maternal mortality rate in Indonesia can be reduced to 102per 100,000 live births in 2015. Efforts to suppress AKI continue to be pursued, includingthe provision of health services for pregnant women. In 2014, the government beganimplementing a National Health Insurance (JKN) nationally. Implementation of the JKNprogram causes Delivery Guarantee (Jampersal) for pregnant women deleted. The deletionencourage local governments to be creative pressing AKI with JKN program and theRegional Health Insurance (Jamkesda). Policy of Implementation Security SystemMaternal Health in Banjarmasin, which inhibits MCH program because the program JKNknows no territorial, pregnant women can choose the health care she likes, while the MCHprogram is monitoring the health of pregnant women by the cantonal ie PWS-KIA forevaluation and program planning region. The cause of the mortality rate among pregnantwomen in the city of Banjarmasin is due late in delivery to the referral occurs as a result offactors helper (service providers at a basic level), delayed detection of high risk so that thecondition of pregnant women who were referred is severe enough, and too late to reachhealth care at the level of referral services. Lack of adequate resources, facilities andinfrastructure that do not support and quality of service at referral level is a factor causingdelay in rescue efforts maternal health. JKN program bureaucratic system does not supportMCH programs, thus largely independent midwives are reluctant to deal with pregnantwomen / mothers give birth this was due to a convoluted bureaucracy and services /approved rates are too low in accordance with Law of the Ministry of health No 59, 2014. Key words: implementation of policies, health insurance pregnant women

IMPLEMENTASI KEBIJAKAN TATAKELOLA PESERTA PROGRAM JAMINAN KESEHATAN NASIONAL DI JATIM

Health insurance system is one of the important components in ensuring theneeds of basic human rights, namely health. Government as theimplementing regulations in the fulfillment of basic rights such as healthhave been doing the development, guidance, and acceleration in organizinghealth care. So that the government is very strategic role in theimplementation of the National Health Insurance program (JKN). But thereis one problem JKN program implementation, namely the weakmanagement of the participants. It affects both services and financing JKNprogram. There have been several studies that analyze these problems,among others, the study of health care seeking behavior of participants ofpublic health insurance, the readiness of stakeholders in the implementationof JKN, and the program participant data JKN invalid and not targeted. Sothat in this research conducted a study which aims to analyze themanagement of participants through the method of interpretation, describe,analyze, and the build a model of the implementation of managementpolicies of insured people, and the synchronization of the health insuranceprogram regional level into the health insurance system nationwidemanaged by BPJS Health in the Province of East Java. The results showedthat participants in the program management JKN is not optimal, andcurrently poor people who can not be accommodated in the management ofContribution Recipient (PBI) has been well managed by the regionalgovernment, through the Regional Health Insurance program. Further theparticipant management implementation model is not effective as a modelof policy implementation of Van Metter and Van Horn due to weakoversight of the bureaucratic system and the human resources involved inthe implementation of the management of the participants. Keywords : Implementation of policy, National Health Insurance (JKN), management of participants.