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The Public-Private Partnership (PPP) scheme is an innovative strategy for hospital infrastructure provision in Indonesia aimed at addressing the limitations of government budgets, accelerating development, and improving efficiency and quality of healthcare services. However, the implementation of the PPP scheme in the hospital sector still faces various challenges, such as limited institutional capacity, risk sharing, and private sector investment interest. This study aims to analyze the process of calculating patient visit projections carried out by PT. XYZ, which facilitates the preparation of feasibility studies through the Project Development Facility (PDF). The research was conducted using a qualitative study to understand how the patient visit projection calculation process is performed in the PPP project for the development of RSUD I.A. Moeis, to ensure the feasibility of the preliminary study in achieving the success of the PPP implementation in the healthcare sector. The results of this study provide an overview of the patient visit projection calculation process in the RSUD I.A. Moeis PPP project. In terms of methodology, innovations were made that resulted in more solid and structured projection data. However, in terms of human resources, several shortcomings were identified, particularly regarding coordination and communication among the team. In terms of data availability, the current condition is deemed sufficient to support the analysis. Meanwhile, in terms of time, there was a delay in the project timeline by up to 14 months, caused by various factors, including changes in the projection methodology approach, the team’s unfamiliarity with the new method, and weak inter-agency coordination. These findings emphasize that the accuracy of the patient visit projection calculation is a crucial factor in determining the attractiveness and feasibility of the hospital PPP project. This study provides a significant contribution to the development of healthcare service capacity planning methods and serves as a reference for similar PPP projects in the future.
The development of health infrastructure in Indonesia has major challenges. The coverage of Universal Health Coverage (UHC) is still 55% and there is an imbalance in the development of hospitals and services, especially in non-Java-Bali areas and there are even areas that have not met the WHO bed standards with a ratio still below 1 per 1,000 population. With budget limitations, a financing solution is needed for infrastructure development in the form of Public-Private-Partnership (PPP), in the PPP stage a pre-feasibility study is needed, one of which is an approach to see market potential with a demand model. The development of a hospital demand model is needed to provide information and formulate the development of a practical, effective and comprehensive demand model according to the needs of using hospital development planning with a PPP financing scheme. This research method is a qualitative research with an action research approach that can bridge scientific solutions with real practices. The results are in the form of the development of a hospital demand model that is documented in an module book and simulation tools.
The most important factors that influence mother's success in giving exclusive breastfeeding is psychosocial factor. Qualitative approach provides a more complecated which describes self-efficacy analysis of breastfeeding at working mothers in PT. Indonesia Epson Industry in 2017. In this study there are 4 factors that influence self efficacy in working mother which consist of experience of mastery, experience of others, verbal persuasion and emotional condition. Factor of mastery experience more a role to self efficacy. The results show that most working mothers have high self-efficacy. This is seen from the efforts and readiness of mothers to give exclusive breastfeeding and can overcome the problems and problems of breastfeeding is. Factor of experience over mastery of self efficacy. Most mothers are multiparous by previous experience to be motivated to exclusively breastfeed back to the next child. Moreover the achievements are given not only by the self-efficacy behind workplace environment and mother's residence. It is therefore necessary to have a factor of self-efficacy as well as a supportive environment for raising mother awareness in the exclusive breastfeeding method of working mothers.
Kata kunci: kesesuaian dan ketidak sesuaian, berkas klaim, rawat inap, BPJS Kesehatan
In managing claim documents for the BPJS Kesehatan in Bulungan District hospital, there are some errors have been found that may lead to delays in payment. This study aims to determine how claim administration process among inpatients is implemented and what are managerial bottleneck factors that may cause problem and delay in paymentt in Bulungan district hospital. This case study was using qualitative approach. The inpatient claim documents of BPJS Kesehatan on that period was analyzed to learn any discrepancies. This included factors in the process during medical resume filling, collecting the supporting claim documents, diagnose and procedures coding, and data entry/INA-CBGs grouping. The study revealed that some claim documents were still not appropriately administered in accordance with BPJS Kesehatan claim equired procedures, based on medical resume filling to the data entry/INA-CBGs grouping. Problems were found caused by various factors: number and competence of human resources (man), financial constrained (money), the management policies (method), limited facilities to support e-file and e-process (material), as well as limited resources (machine). Bulungan District Hospital is expected to have a regular monitoring and evaluation for the inpatient claim administration process of BPJS Kesehatan and improve its claim management process
Keywords: conformity and discrepancies, claim documents, inpatient, BPJS Kesehatan
Ditetapkannya PP No. 23 tahun 2005 tentang Pengelolaan Keuangan Badan Layanan Umum yang merupakan kebijakan pelaksanaan dari UU No 1 tahun 2004 tentang Perbendaharaan Negara, khususnya pasal 68 dan 69 dari UU tersebut, di satu sisi menjadi landasan hukum bagi rumah sakit-rumah sakit pemerintah (RSP) untuk menerapkan pola pengelolaan keuangan badan layanan umum (PPK-BLU), di sisi lain mcmbcri harapan kcpada rumah sakit pemerintah untuk lebih otonorn di bidang pengeiolaan keuangan, sehinga peningkatan kinelja pclayanan dan keuangan rumah sakit dapat terjadi dan manfaat rumah sakit bagi masyarakat mcnjadai lebih baik. PP No. 23 lahun 2005 tcrsebut sudah ditctapkan sejak tanggal I3 juni tahun 2005, letapi sampai bulan juli 2007 ini RSUD Gunung Jali Kota Circbon beium menerapkan pola pengeiolaan keuangan badan layanan umum (PPK-BLU). Penclitian ini ditujukan untuk mengctahui tingkat persiapan RSUD Gunung Jati Kota Circbon dalam mengimplcmentasi PP 23 tahun 2005. Dcngan penelitian ini diharapkan dapat merckomendasikan kebijakan kepada yang berwcnang untuk segera mengambil aksi kebijakan yang diperlukan dalam proses uansfomnasi pola pcngelolaan keuangan RSUD Gunung Jati Kota Cirebon dari pola pcngelolaan Unit Swadana ke pola pengeloiaan badan layanan umum (PPK-BLU). Metode pcneiitian yang digunakan adalah metoda kualitatif di bidang kebijakan. Hasil penelitian menunjukkan komunikasi kebijakan pengelolaan keuangan badan layanan umum belum bcrjalan efcktif, penyiapan sumber daya untuk implerncntasi kebijakan tersebut belum terencana dan tcrprogram secara sistematis. Secara substanlif dan teknis RSUD Gunung Jati Kota Circbon telah memenuhi syarat untuk menerapkan pola pengclolaan keuangan badan layanan umum (PPK-BLU). Tetapi, persyaratan administratif yang dipcrlukan untuk penerapan pola pengelolaan keuangan badan layanan umum di RSUD Gunung Jati, belum selesai disiapkan. Lebih lanjut, dari hasil penelitian ini juga mengungkapkan bahwa kebijakan-kebijakan teknis, selain yang menjadi persyaratan administratif di atas, yang diperlukan dalam pengclolaan kcuangan badan layanan umum sepcrti tarif layanan yang berdasarkau pcrhitungan biaya satuan per unit pelayanan atau per investasi dana; pengelolaan keuangan yang khas pola pengelolaan keuangan badan layanan umum; kelembagaan, pejabat pengelola, dan kepegawaian BLU; pembinaan dan pengawasan BLU; dan remunerasi beium selesai disiapkan. Dari penelitian ini ditemukan bahwa bclum sdesainya kebijakan-kebijakan teknis yang diperlukan dalarn pengelolaan keuangan badan layanan umum disebabkan karena belum ditetapkarmya pctunjuk pelaksanaan dan tcknis dalam penerapan pola pengclolaan keuangan badan layanan umum daerah. Sebagai kesimpulan dari penelitian ini adalah cmpat masalah kebijakan yang meliputi : komunikasi kebijakan; penyiapan sumbcr daya ; penyiapan persyaralan administralif 1 dan penyiapan kebijakan-kebijakan teknis yang diperlukan untuk implemcnlasi pengclolaan keuangan badan layanan umum di RSUD Gunung Jati belum optimal dan belum selesai disiapkan oleh RSUD Gunung Jati. Untuk itu sebagai saran dari penelilian ini adalah sambil menunggu dikeluarkannya pedoman pelaksanaan dan tcknis tcntang pengelolaan keuangan BLUD, agar RSUD Gunung Jati membuat pcrencanaan kegiatan (POA : plan of acriory atas cmpat kegiatan yang rneliputi komunikasi kebijakan, penyiapan sumber daya untuk implemcntasi kebijakan, penyiapan pcrsyaratan administratii dan pcnyiapan kcbijakan-kebijakan teknis yang diperlukan dalam penclolaan kcuangan BLU secara sislematis, efektitl dan efisien.
To settled the govemment's rules (PP) No. 23 year 2005 concerning Pattem of Finance Mangement of 'Badan Layanan Umum' which is policy of execution from UU No I year 2004 concerning Exchequer Of State, specially section of 68 and 69 of UU, in one side become basis law for government's hospitals to apply the pattem of financé management of 'badan layanan Umum', and the other's gives hope to government's hospitals to be more otonom in management of iinance. So that increasing of service and financial performance of government's hospital can be occurred, and increasing of hospital`s benefit to public. PP No. 23 year 2005 the have been specitied commencing from the date of 13 j uny year 2005, but until month of July 2007 this RSUD Gunung Jati Kota Cirebon not yet apply pattern of finance management of "Badan Layanan Umum". This research addressed to know level of preparation of RSUD Gunung Jati Cirebon in implementation PP 23 year 2005. With this research expected can recommend policy to in charge to soon take policy action which required in process of p transformation of pattern of finance management of RSUD Gunung Jati Cirebon from pattern of finance management 'Unit Swaclana' to pattem of finance management of Badan Layanan Umum' (PPK-BLU). Research method which applied is qualitative method in policy area. Research result indicate that policy communication about patem of of finance finance management of 'Badan layanan umum' is unef`f`ective activity , resources preparation to implement the policy isn't plant and program systematically. Beside substantively and technically clauses, RSUD Gunung Jati Cirebon have been is up to standard to apply pattern of finance management of 'Badan Layanan Umum" (PPK-BLU). But, from clauses is administrative is unfinished RSUD Gunung Jati. Further, from this research result also lay open that technical policys, besides becoming administrative clauses above, what is required in finance management of 'Badan Layanan Umum" like service tariff which based on calculation expense of identity per service unit or per fund invesment; management of finance which typical pattem of finance management of 'Badan Layanan Umum'; institute, organizer functionary, and officer BLU; construction and observation of BLU; and remuneration prepared is unfinished. This research explain that the inchoate of technical policys which required in finance management of 'Badan Layanan Umum' by not yet specify him (it executions guides and technical in applying of pattems ofiinance management of BLUD). As conclusion of This research are four's policy problem : policy communications; preparation of resource ; and preparation of technical policy, preparation of clauses administrative which needed by is implementation of finance management of 'Badan Layanan Umum' in RSUD Gttnung Jati not yet is optimal and untinissed. As suggestion from this research is at the same time await the spent / specified of execution guide and technical in applying of pattern of finance management of 'Badan Layanan Umum Daerah' RSUD Gunung Jati have to make planning of action (POA) to solute the four's policy problem.
