Kebijakan Pendayagunaan Dokter Spesialis (PGDS) berdasarkan Peraturan Presiden Nomor 31 Tahun 2019 Tentang Pendayagunaan Dokter Spesialis yang bertujuan untuk memenuhi kebutuhan dan pemerataan dokter spesialis di Indonesia perlu dievaluasi. Implementasi Pelaksanaan program PGDS mencakup beberapa tahapan yang meliputi perencanaan, pengadaaan, penempatan, monitoring, evaluasi, pembinaan dan pengawasan dan pendanaan. Namun, masih terdapat beberapa permasalahan dalam pelaksanaannya, salah satunya terkait dengan penempatan tenaga dokter spesialis di daerah tertentu, minimnya motivasi dan minat dokter spesialis untuk menetap di daerah, dokter spesialis lebih memilih untuk menetap di kota-kota besar atau daerah yang lebih berkembang. Penelitian ini menggunakan metode penelitian kualitatif dengan Pendekatan teori Donabedian, Six Building Blocks of a Health System, Edward III, Van Meter Van Horn, Teori Minat Poerwadar dan Perpres 31 tahun 2019. Lokasi penelitian di Sumatera Selatan, Jawa Barat, Nusa Tenggara Timur, Sulawesi Tenggara, Maluku Utara, dan Papua Barat. Penelitian didahului dengan survei kepada 249 Dokter Spesialis Peserta PGDS, kemudian dilakukan wawancara medalam kepada 6 peserta PGDS, Ditjen Tenaga Kesehatan, Sekretaris POGI, Wakil Fakultas Kedokteran Undana, 6 orang Kasie SDK Dinkes Provinsi dan 6 orang Kasie SDK Dinkes Kabupaten, dan telaah dokumen. Temuan penelitian ini mengungkapkan adanya kesenjangan dalam tahap perencanaan, pengadaan, dan penempatan dokter spesialis di Indonesia. Distribusi Dokter spesialis belum merata, peserta PGDS tidak dapat langsung ditempatkan kembali di tempat penugasan awal, dari kebijakan PGDS yang bersifat sukarela dinilai lebih humanis, sarana prasarana dan alat penunjang medis di rumah sakit masih kurang. Kebijakan PGDS dianggap efektif terhadap peningkatan signifikan dalam jumlah kunjungan pasien. Kebijakan PGDS tidak efektif karena terdapat daerah yang masih kekurangan dokter spesialis dan waktu penempatan 1 tahun tidak efektif dan belum ada indikator keberhasilan Program Pendayagunaan Dokter Spesialis. Diharapkan adanya revisi kebijakan Peraturan Presiden nomor 31 Tahun 2019 terkait waktu penempatan dokter spesialis, dengan waktu penugasan minimal diatas 2 tahun dan membuat indikator efektivitas kebijakan PGDS untuk mengidentifikasi keberhasilan dan tantangan. Kata kunci: Efektivitas Kebijakan, pendayagunaan, dokter spesialis

The Policy of Specialist Doctor Utilization (PGDS) based on Presidential Regulation Number 31 of 2019 on Specialist Doctor Utilization, aimed at meeting the needs and equal distribution of specialist doctors in Indonesia, needs to be evaluated. The implementation of the PGDS program involves several stages, including planning, procurement, placement, monitoring, evaluation, development and supervision, and funding. However, there are still several issues in its implementation, such as the placement of specialist doctors in certain regions, lack of motivation and interest among specialist doctors to work in remote areas, as they prefer to settle in big cities or more developed regions. This research adopts a qualitative research method with the Donabedian Theory, Six Building Blocks of a Health System, Edward III, Van Meter Van Horn Theory, Poerwadarminto's Theory of Interest, and Presidential Regulation Number 31 of 2019 as the theoretical framework. The study was conducted in South Sumatra, West Java, East Nusa Tenggara, Southeast Sulawesi, North Maluku, and West Papua. It began with a survey of 249 Specialist Doctor participants in the PGDS program, followed by in-depth interviews with 6 PGDS participants, the Directorate General of Health Human Resources, the Secretary of the Indonesian Society of Obstetrics and Gynecology, the Deputy Dean of the Faculty of Medicine Undana, 6 Head of Subdivision of Human Resources Development from Provincial Health Office, and 6 Head of Subdivision of Human Resources Development from District Health Office, and document review. The findings of this research reveal gaps in the planning, procurement, and placement stages of specialist doctors in Indonesia. The distribution of specialist doctors is still uneven, and PGDS participants are not directly placed back in their initial deployment locations. The voluntary nature of the PGDS policy is considered more humane. However, there are still insufficient infrastructure and medical support facilities in hospitals. The PGDS policy is considered effective in significantly increasing the number of patient visits. However, it is deemed ineffective in areas that still lack specialist doctors, and the one-year placement period is not effective without indicators of the PGDS program's success. It is recommended to revise Presidential Regulation Number 31 of 2019 regarding the placement period of specialist doctors, with a minimum deployment period of over 2 years and to establish indicators for the effectiveness of the PGDS policy to identify its success and challenges. Keywords: Policy effectiveness, utilization, specialist doctors.

Rasio kebutuhan dokter di Indonesia masih dibawah standar WHO. Sesuai dengan amanat Undang-undang, Kementerian Kesehatan berkomitmen memenuhi kebutuhan dokter spesialis di seluruh wilayah Indonesia melalui Kebijakan bantuan biaya Pendidikan dokter spesialis-dokter gigi spesialis. Penelitian ini bertujuan menganalisis implementasi kebijakan yang sudah dilaksanakan yaitu kebijakan bantuan biaya Pendidikan dokter spesialis-dokter gigi spesialis. Penelitian ini merupakan penelitian kualitatif dengan desain penelitian Rapid Assesment Procedure. Penelitian ini menggabungkan model implementasi kebijakan Edward III dan Van Meter Van Horn dengan menggunakan 6 variabel yaitu ukuran dan tujuan kebijakan, komunikasi, sumber daya, disposisi, karakteristik organisasi pelaksana, serta lingkungan politik, sosial dan ekonomi. Pengambilan data dilakukan melalui wawancara mendalam, telaah dokumen dan observasi. Informan Penelitian terdiri dari ketua dan anggota tim kerja penyelenggaraan beasiswa PPDS-PPDGS, dinas Kesehatan provinsi Riau, Nusa Tenggara Timur, Maluku dan Sulawesi Selatan. Penelitian dilakukan mulai bulan Mei- Juni 2023. Hasil Penelitian menunjukkan bahwa implementasi kebijakan sudah berjalan dengan baik. Pada variable ukuran dan tujuan Kebijakan bantuan biaya PDS-DGS telah jelas dan dapat diukur dan tertuang kedalam indikator kinerja kegiatan Direktorat Penyediaan Tenaga Kesehatan yang terdapat dalam Rencana Strategis Kementerian Kesehatan. Komunikasi kebijakan antar organisasi berjalan baik antara Direktorat penyediaan Tenaga Kesehatan, Dinas Kesehatan Provinsi dan stakeholder lainnya melalui sosialisasi dan koordinasi secara rutin. Sumber daya dalam implementasi kebijakan bantuan biaya PDS-DGS baik sumber daya manusia, anggaran, dan kewenangan telah dioptimalkan dengan baik oleh Direktorat Penyediaan Tenaga Kesehatan, namun untuk sumber daya fasilitas yaitu system informasi masih diperlukan pengembangan agar dapat digunakan secara optimal. Karakteristik organisasi pelaksana didukung dengan ketersediaan SOP penyelenggaraan beasiswa PPDS-PPDS yang sudah lengkap dan pembagian wewenang antar organisasi yang sudah jelas. Pada variable disposisi, komitmen pimpinan dan tim kerja dalam implementasi kebijakan bantuan biaya PDS-DGS dengan melaksanakan tugas sesuai peran dan tanggung jawab masing-masing. Variabel lingkungan ekonomi, sosial dan politik menunjukkan besarnya dukungan stakeholder terkait dalam implementasi kebijakan bantuan biaya PDS-DGS 

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The ratio of the need for doctors in Indonesia is still below the WHO standard. In accordance with the mandate of the Law, the Ministry of Health is committed to meeting the needs of specialist doctors in all regions of Indonesia through a policy of assistance with the cost of education for specialist dentists. This study aims to analyze the implementation of policies that have been implemented, namely the policy of educational assistance for specialist dentists. This research is a qualitative research with a Rapid Assessment Procedure research design. This study combines the policy implementation model of Edward III and Van Meter Van Horn by using 6 variables, namely policy size and objectives, communication, resources, dispositions, characteristics of implementing organizations, as well as the political, social and economic environment. Data collection was carried out through in-depth interviews, document review and observation. The research informants consisted of the heads and members of the PPDS-PPDGS working team members, the Riau, East Nusa Tenggara, Maluku and South Sulawesi provincial health offices. The research was conducted from May to June 2023. The research results show that policy implementation has been going well. The size and objective of the PDS-DGS cost assistance policy are clear and measurable and are contained in the performance indicators for the Directorate of Provision of Health Personnel activities contained in the Strategic Plan of the Ministry of Health. Inter-organizational policy communication runs well between the Directorate for the provision of health workers, the Provincial Health Office and other stakeholders through regular outreach and coordination. Resources in the implementation of the PDS-DGS financial assistance policy, both human resources, budget, and authority, have been well optimized by the Directorate for Provision of Health Personnel, but for facility resources, namely the information system, development is still needed so that it can be used optimally. The characteristics of implementing organizations are supported by the availability of complete PPDS-PPDS scholarship implementation SOPs and a clear division of authority between organizations. In the disposition variable, the commitment of the leadership and work team in implementing the PDS-DGS financial assistance policy by carrying out tasks according to their respective roles and responsibilities. The economic, social and political environment variables show the magnitude of the support of relevant stakeholders in the implementation of the PDS-DGS financial aid policy

Penerbitan Surat Izin Praktik (SIP) bagi dokter spesialis merupakan aspek krusial dalam menjamin legalitas dan mutu pelayanan kesehatan. Terbitnya Undang-Undang Nomor 17 Tahun 2023 tentang Kesehatan membawa perubahan signifikan terhadap kebijakan perizinan, salah satunya adalah penghapusan kewajiban memperoleh rekomendasi dari organisasi profesi. Penelitian ini bertujuan untuk menganalisis kesesuaian penerapan kebijakan pembuatan SIP dokter spesialis di DKI Jakarta dengan peraturan terbaru tersebut. Penelitian menggunakan pendekatan kualitatif dengan desain studi deskriptif komparatif melalui wawancara mendalam terhadap informan dari DPR RI, Dinas Kesehatan, DPMPTSP, rumah sakit, dan dokter spesialis di DKI Jakarta. Hasil penelitian menunjukkan bahwa masih terdapat ketidaksesuaian antara norma, standar, prosedur, dan kriteria (NSPK) dengan pelaksanaan di lapangan, terutama dalam aspek komunikasi kebijakan, keterbatasan pemahaman dari sumber daya manusia dan teknologi informasi. Selain itu, masih terjadi kebingungan terkait perubahan regulasi dan lemahnya sosialisasi kepada tenaga medis. Dari sisi output, implementasi kebijakan belum sepenuhnya efektif dalam memastikan percepatan dan efisiensi layanan perizinan, meskipun proses digitalisasi telah mulai diterapkan. Kesimpulannya, penerapan kebijakan pembuatan SIP dokter spesialis di DKI Jakarta pasca terbitnya UU No. 17 Tahun 2023 masih belum sepenuhnya sesuai dengan harapan regulasi dan membutuhkan perbaikan dari aspek struktur birokrasi, dukungan teknologi, dan peningkatan koordinasi lintas sektor.

The issuance of a Practice License (SIP) for medical specialists is a crucial aspect in ensuring the legality and quality of healthcare services. The enactment of Law Number 17 of 2023 on Health has brought significant changes to licensing policies, one of which is the elimination of the requirement to obtain recommendations from professional organizations. This study aims to analyze the conformity of the implementation of SIP issuance policy for medical specialists in DKI Jakarta with the new regulation. The study uses a qualitative approach with a comparative descriptive study design through in-depth interviews with informants from the House of Representatives (DPR RI), the Health Office, One-Stop Integrated Service (DPMPTSP), hospitals, and medical specialists in Jakarta. The results show that discrepancies still exist between the norms, standards, procedures, and criteria (NSPK) and their implementation in the field, particularly in aspects of policy communication, limited understanding among human resources, and inadequate information technology systems. Furthermore, confusion persists regarding regulatory changes and weak socialization efforts toward medical personnel. From the output perspective, policy implementation has not yet been fully effective in ensuring the acceleration and efficiency of licensing services, even though digitalization processes have begun to be adopted. In conclusion, the implementation of the SIP issuance policy for medical specialists in DKI Jakarta following the enactment of Law No. 17 of 2023 has not yet fully aligned with regulatory expectations and requires improvements in bureaucratic structure, technological support, and enhanced inter-sectoral coordination.

Kecurangan (fraud) dalam pelaksanaan Program Jaminan Kesehatan Nasional (JKN) merupakan ancaman serius terhadap efektivitas dan keberlanjutan pembiayaan kesehatan. Untuk menanggulanginya, Kementerian Kesehatan mengeluarkan Permenkes Nomor 16 Tahun 2019 tentang Pencegahan Kecurangan. Penelitian ini bertujuan untuk menganalisis implementasi kebijakan tersebut di Kota Tangerang Selatan. Pendekatan yang digunakan adalah kualitatif dengan kerangka analisis implementasi kebijakan mencakup aspek konten (SDM, pendanaan, wewenang, fasilitas), konteks (sikap dan komitmen), serta proses (komunikasi dan struktur birokrasi). Data diperoleh melalui wawancara mendalam dengan informan dari BPJS Kesehatan, Dinas Kesehatan, Inspektorat, dan Puskesmas. Hasil penelitian menunjukkan bahwa SDM di Dinas Kesehatan dan Puskesmas belum memiliki pelatihan khusus dan struktur yang jelas, berbeda dengan BPJS yang telah membentuk tim dan melaksanakan pelatihan. Pendanaan mulai dialokasikan, namun masih terbatas. Pembagian wewenang belum terstruktur dengan baik. Sarana pendukung cukup di BPJS, tetapi belum tersedia secara khusus di tingkat daerah. Sikap dan komitmen terhadap pencegahan kecurangan (fraud) cukup tinggi, namun belum ditopang dokumen formal seperti pakta integritas dan manajemen risiko. Komunikasi dan edukasi belum terstandardisasi, dan koordinasi lintas sektor masih menghadapi kendala. Implementasi kebijakan pencegahan kecurangan (fraud) JKN di Kota Tangerang Selatan belum berjalan secara optimal dan masih memerlukan penguatan aspek sumber daya, kelembagaan, serta koordinasi lintas sektor. Penelitian ini diharapkan menjadi perbaikan implementasi kebijakan pencegahan kecurangan (fraud) dalam Program Jaminan Kesehatan di Kota Tangerang Selatan maupun daerah lain, guna mendukung tata kelola layanan kesehatan yang transparan, akuntabel, dan bebas dari praktik kecurangan.

Fraud in the implementation of the National Health Insurance (JKN) program poses a serious threat to the effectiveness and sustainability of health financing in Indonesia. To address this issue, the Ministry of Health issued Regulation Number 16 of 2019 concerning Fraud Prevention in the JKN Program. This study aims to analyze the implementation of this policy in South Tangerang City. The findings indicate that human resources at the Health Office and Puskesmas have not received specialized training and lack a clear supporting structure, in contrast to BPJS Kesehatan, which has established a dedicated team and conducted internal training. Funding has begun to be allocated but remains limited. The delegation of authority is not yet well-structured. Supportive facilities are sufficient at BPJS, but not yet adequately available at the local level. Although attitudes and commitment to fraud prevention are relatively strong, they are not supported by formal documents such as integrity pacts or risk management policies. Communication and education efforts are not yet standardized, and intersectoral coordination still faces challenges due to unclear roles and technical SOPs. the implementation of the fraud prevention policy in the JKN program in South Tangerang City has not been fully optimal and requires strengthening in resources, institutional structures, and cross-sector coordination. This study is expected to contribute to improving policy implementation both in South Tangerang and in other regions to support transparent, accountable, and fraud-free health services.