OPTIMIZING NATIONAL HEALTH INSURANCE MEMBERSHIP REDISTRIBUTION TO REMEDIATE THE DELIVERY OF HEALTHCARE SERVICE IN THE BANGLI REGENCY

Putu Yuyun Saraswati; I Ketut Widnyana; A A Ketut Sudiana; I Gusti Ngurah Nyoman Alit Wiswasta

doi:10.29121/granthaalayah.v11.i7.2023.5250

Authors

Putu Yuyun Saraswati Master Study Program of Regional Development Planning and Environmental Management, Indonesia
I Ketut Widnyana Postgraduate Program of University of Mahasaraswati Denpasar, Indonesia
A A Ketut Sudiana Postgraduate Program of University of Mahasaraswati Denpasar, Indonesia
I Gusti Ngurah Nyoman Alit Wiswasta Postgraduate Program of University of Mahasaraswati Denpasar, Indonesia

DOI:

https://doi.org/10.29121/granthaalayah.v11.i7.2023.5250

Keywords:

Health Insurance, Redistribution, Remediate, Healthcare

Abstract [English]

The recent collaboration between the Indonesia Social Security Administrative Body (SSAB) and the Ministry of Health emanated the notion to optimize the National Health Insurance (NHI) membership redistribution program. This latest scheme aims to enable health access comprehensively and improve the healthcare service quality through equal member distribution in the primary care health facilities (PCHF). This was a descriptive study using an evaluation approach, summative, and observational design. A Context, Input, Process, and Product (CIPP) evaluation model was followed to assess the membership transfer redistribution scheme. Data were collected from February to March 2022 through observation, interview, and documentation techniques. Subsequently, the data were then analyzed using the CIPP Evaluation Model and Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis with Focus Group Discussion (FGD). Based on the CIPP evaluation, five and eight PCHFs were executing outstanding (>14,893 or 80.79%) and good level of transferring and receiving scheme practices (11,123 – 14,892 or 60%-79%), respectively. Thus, it could be argued that the membership transferring redistribution procedure has been delivered adequately. Regardless, we still encourage efforts to foster the monitoring and evaluation process. Further, future studies are suggested to include additional evaluation elements to provide a more thorough finding and allow constant membership redistribution program improvement, acquiring the program end goals to the fullest extent.

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References

Arikunto. (2008). Manajemen Penelitian. Rineka Cipta.

Balitbang. (2016). Riset Implementasi JKN dan Mutu Pelayanan Kesehatan Di Puskesmas Kota Medan (Studi Kasus di 3 Puskesmas). Medical Annual.

Dewi, A. S. (2019). Perbandingan Cara Kelahiran, Luaran Maternal dan Luaran Neonatal Berdasarkan Kepesertaan BPJS. Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 2(3), 219–224. https://doi.org/10.56338/mppki.v2i3.810.

Endartiwi, S. S., & Setianingrum, P. D. (2019). The Kualitas Pelayanan Berhubungan Dengan Kepuasan Peserta Jkn Di Fasilitas Kesehatan Tingkat Pertama Provinsi Daerah Istimewa Yogyakarta. Buletin Penelitian Sistem Kesehatan, 22(3), 158–166. https://doi.org/10.22435/hsr.v22i3.897. DOI: https://doi.org/10.22435/hsr.v22i3.897

Gunadi. (2014). Evaluasi Pembelajaran Aktif Kreatif Efektif Dan Menyenangkan Dengan Model Context Input Process Product. Jurnal Llmiah Widya, 2 Nomor 2 Mei-.

Hendrawan, D., Nurcahyo, C., & Afdal, A. (2021). Pelayanan Primer yang Berkualitas : Sebuah Tinjauan Literatur. [The Qualified Primary Care : A Literature Review]. Jurnal Jaminan Kesehatan Nasional, 1(1), 1–14. https://doi.org/10.53756/jjkn.v1i1.13. DOI: https://doi.org/10.53756/jjkn.v1i1.13

Kuntoro, H. (2011). Dasar Filosofis Metodologi Penelitian. Pustaka Melati.

Local Health Department of Bangli Regency. (2021). Profil Kesehatan Kabupaten Bangli Tahun 2021, Bangli.

Munthe Ashiong, P. (2015). Pentingnya Evaluasi Program Di Institusi Pendidikan.

Notoadmojo, S. (2003). Ilmu Kesehatan Masyarakat. Rineka Cipta.

Nurhaeda, U., & Rusman, A. D. P. (2018). The Relationship Between The Quality of health Sevices and Patien Satisfaction of Users of the Social Security Organizing Body (BPJS) at the Maiwa Health Center in Enrekang regency. Jurnal Ilmiah Manusia dan Kesehatan, 1(3), 201–219. https://doi.org/10.31850/makes.v1i3.106. DOI: https://doi.org/10.31850/makes.v1i3.106

Otang, A. S., & Arfandi, H. (2018). Transformasi Yang Belum Usai : Perlindungan Kesehatan Pekerja Dalam Skema Bpjs Kesehatan. Mewujudkan Jaminan Kesehatan Nasional Yang Non-Diskriminatif.

Putra, I. M. H. A., Yudha, N. L. G. A. N., & Suarjana, N. (2019, October). Analisis peran Pemerintah Daerah Terkait Optimalisasi Pelaksanaan Program Jaminan Kesehatan Nasional Bagi Masyarakat Miskin Di kabupaten Karangasem. In Seminar Ilmiah Nasional Teknologi, Sains & Sosial Humaniora (SINTESA), 2.

Supriyanto, S., & Damayanti, N. A. (2007). Perencanaan dan Evaluasi. Airlangga university Press. Surabaya, Indonésie.

Sugiono. (2010). Metode Penelitian Kualitatif dan Kuantitatif. Cv. Alfabeta.

Sugiono. (2018). Metode Penelitian Pendidikan Kualitatif dan Kuantitatif. Cv. Alfabeta.

Sudiari, M. (2022). Pemilihan Fasilitas Kesehatan Tingkat Pertama Pada Pasien Perserta bpjs kesehatan: [First Level Health Facilities Selection in bpjs Kesehatan Participants]. Bali Medika Jurnal, 9(1), 99–106. https://doi.org/10.36376/bmj.v9i1.237.

Social Security Administrative Body for Health. (2014), Panduan Praktis Gate keeper Concept Faskes BPJS Kesehatan, Jakarta.

Thamrin, D. (2018). Implementasi Jaminan Kesehatan Nasional (JKN) Dalam Konteks Perlindungan Sosial dan Keamanan Nasional: Tinjauan Kritis Dimensi Keamanan Non Tradisional. Jurnal Keamanan Nasional, 4(1), 69–102. https://doi.org/10.31599/jkn.v4i1.337. DOI: https://doi.org/10.31599/jkn.v4i1.337

Tatia, A. I. W. (2019). Perlindungan Hukum Terhadap Pelaksanaan Jaminan Kesehatan Bagi Pekerja Setelah Peralihan Status Kelembagaan Jamsostek Menjadi badan Penyelenggara Jaminan Sosial (BPJS). Lex et Societatis, 6(9). https://doi.org/10.35796/les.v6i9.22773.