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ABSTRAK Nama : Astuti Purbaningsih Program Studi : Magister Ilmu Kesehatan Masyarakat Judul : Dampak Jaminan Kesehatan Sosial Bagi Masyarakat Miskin Terhadap Utilisasi Layanan Kesehatan (Data Indonesia Family Life Survey 2000, 2007 dan 2014) Dalam upaya memberikan perlindungan sosial terhadap masyarakat miskin dari risiko kesehatan, pemerintah Indonesia mengimplementasikan program jaminan kesehatan sosial bersubsidi bagi masyarakat miskin Askeskin. Program ini kemudian diperluas target dan manfaatnya menjadi Jamkesmas. Penelitian ini meneliti dampak jaminan kesehatan bagi masyarakat miskin terhadap utilisasi layanan kesehatan berupa jumlah kunjungan rawat jalan dan rawat inap, proporsi belanja kesehatan terhadap pengeluaran rumah tangga, serta self-assessed health. Analisis dilakukan pada semua populasi dan subpopulasi termiskin (kuintil pertama dalam populasi). Peneliti menggunakan metode propensity score matching dan difference-in-difference untuk analisis data Indonesia Family Life Survey (IFLS) tahun 2000, 2007 dan 2014. Hasil penelitian menunjukkan program jaminan kesehatan bagi masyarakat miskin memiliki dampak positif signifikan terhadap jumlah kunjungan rawat jalan dan rawat inap; di sisi lain program tidak memiliki dampak signifikan terhadap proporsi belanja kesehatan rumah tangga dan self-assessed health. Program jaminan kesehatan bagi masyarakat miskin secara signifikan telah meningkatkan akses masyarakat miskin terhadap layanan kesehatan, namun tidak signifikan melindungi masyarakat miskin dari risiko belanja kesehatan dan tidak signifikan meningkatkan kualitas kesehatan masyarakat miskin. Kata kunci: askeskin, jamkesmas, jaminan kesehatan, analisis dampak, ekonometri, kemiskinan
ABSTRACT Name : Astuti Purbaningsih Study Program : Magister of Public Health Judul : The Impact of Social Health Insurance for The Poor on Health Services Utilization (Indonesia Family Life Survey Data 2000, 2007 and 2014) To improve the poor’s access to healthcare services, the Indonesian government introduced Askeskin, a subsidized social health insurance for the poor. Later, Askeskin had policy expansion and became Jamkesmas. We examine the effects of this social health insurance for the poor on health services utilization — outpatient visits, inpatient admissions, household budget share of health spending, and self-assessed health. We analyze all samples and the poorest (1 st ) quartile of the sample. Using propensity score matching and difference-in-difference matching strategies on Indonesia Family Life Survey (IFLS) datasets 2000, 2007 and 2014, we find the insurance have positive significant impact on outpatient visits and inpatient admissions; it does not seem to have significant impact on household budget share of health spending and self-assessed health, however. This finding suggests that social health insurance for the poor increases health services utilization (outpatient visits and inpatient admissions), on the other hand it does not significantly protect the poor from health spending and not significantly improve health outcome of the poor. Keywords: askeskin, jamkesmas, health insurance, impact evaluation, econometric, poor
Kata kunci : Efektivitas, Penerima Bantuan Iuran (PBI), pelayanan kesehatan.
The JKN is required for all Indonesians from 1 January 2014. In practice, the selection of first-degree healthcare facilities for PBI has not been maximized. All PBI participants in Kecamatan Cipayung are registered in Puskesmas Kecamatan Cipayung, Depok. This study discusses the effectiveness of the JKN program for the poor in access of health services at the Puskesmas Kecamatan Cipayung Depok in 2017 by measuring input indikator, process indicator and output indicator. Data were searched by using questionnaires on a sample of 100 participants of PBI who visited Puskesmas Kecamatan Cipayung. The results of this study were declared effective for assessing different percentages. Input indicator received 67,42%, process indikator get percentage of 71,86%, and for output indicator received 71,86%. Thus, it can be concluded JKN program for the poor in access of health services in Puskesmas Kecamatan Cipayung Depok has been running quite effectively.
Keywords: Effectiveness, the poor, health services.
Kata kunci : Implementasi sistem administrasi kepesertaan, BPJS Kesehatan.
This paper discusses the implementation of the administrative system of participation in health BPJS Bogor District Office Operational Services. From this study, it was faound that the human resources, budget, infrastructure, information technology and policies to support the administration of membership. The registration process participants, change participant data transfer and membership data transfer is also part of the administrative system of membership. Implementation is also visible on the suitability of the results of the administrative process that starts from registration of participants to the registration booth, improvement and development of membership application and scheduling routine socialiation can be considered in overcoming the existing obstacles.
Keywords : membership administration system implementation, BPJS Kesehatan
This thesis aimed to analyze the impact of criminalization of people who use drugsrelated risk factors in the criminalization are analyzed through the Focus of theDiscussion Group with prisoners and in-depth interviews with prison staff . Thisstudy uses qualitative method case study conducted in Jakarta Narcotics Prison in2014. The policy factors that dualism between criminal and public health approach inthe content and implementation of the policy, environmental factors is overcapacityand lack of health care services, the individual factors that drugs dependence andrisky behavior among prisoners that affect each other and impact on increasedvulnerability to physical, mental and social health problems.Keyword : Criminalization , Impact, People who use drugs, Public Health
Indonesia mempunyai target untuk menurunkan kematian ibu menjadi 125 kematian maternal per 100.000 kelahiran hidup. Padahal Indonesia menghadapi tantangan geografis dan variabel social lainnya yang menyebabkan kelahiran kebanyakan di rumah dan ditolong bukan oleh tenaga kesehatan. Salah satu pilihan pemerintah Indonesia untuk mengurangi kematian maternal adalah dengan meningkatkan angka utilisasi penolong persalinan oleh tenaga kesehatan. Agar kebijakan penanggulangan masalah ini lebih tepat perlu diketahui determinan yang menyebabkan ibu melahirkan dengan pertolongan tenaga kesehatan. Dengan menggunakan beberapa teori atau model dari beberapa studi sebelumnya maka disusunlah kerangka konsep yang dapat memahami determinan utilisasi linakes. Data Susenas 2005 dan PODES 2005 digunakan dalam analisis ini. Hasilnya berdasarkan lebih dari 91.000 sampel anak balita, diperoleh hasil prdiksi proporsi pemanfaat pertolongan tenaga kesehatan pada kelahiran sebesar 75,5 %. Model binomial logistic digunakan untuk analisis inferensial. Hasilnya menunjukkan variabel yang signifikan adalah pendidikan ibu, kunjungan ANC, area, kepemilikan jaminan pembiayaan kesehatan, urutan kelahiran, umur ibu, status bekerja ibu, sektor pekerjaan ibu, pekerjaan KRT, pendidikan KRT, jumlah anggota rumah tangga, fasilitas kesehatan seperti puskesmas, polindes dan bidan di desa serta pengeluaran rumah tangga per kapita.
Indonesia has set a target of reducing its maternal mortality rate to 125 maternal deaths per 100,000 live births by the year 2010. This poses formidable challenges in geographically diverse country where the majority of births occur at home by unskilled birth attendant. One option for the Indonesian government in oder to reduce its maternal mortality would be to increase rates of skilled assistance for home deliveries. In order to design appropriate policies to achieve this, it is imperative to understand the determinant of use of skilled birth attendants by mothers. We use several model as an theoretical framework to understand the determinant of the use of a trained provider in Indonesia. The 2005 National Social Economic Survey was used, and data PODES was abstracted for analysis. Out of a total sampel of 91.000 under 5 years, 75% used services of skilled birth attendants. A binomial logistic model was used to predict determinant of use. Our results that maternal education, household expenditure per capita quintile, occupation, and number of antenatal care visit are significant determinants among all choice set.
