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Tesis ini bertujuan untuk melakukan analisis implementasi administrasi klaim Jamkesmas di rumah sakit vertikal tahun 2012. Latar belakang permasalahan dalam penelitian ini adalah banyaknya permasalahan di rumah sakit daerah akibat keterlambatan klaim seperti cash flow rumah sakit, pembayaran insentif yang terlambat, dan pembelian obat terhambat. Di rumah sakit vertikal, efek dari keterlambatan pengajuan klaim Jamkesmas belum diketahui, karena belum pernah ada laporan tertulis mengenai implementasi administrasi klaim Jamkesmas sementara data dari Rekapnas menunjukkan adanya keterlambatan klaim di rumah sakit vertikal. Penelitian ini menggunakan pendekatan kualitatif dengan melakukan wawancara mendalam dari informan terpilih.
Hasil penelitian menunjukkan dari berdasarkan kepada teori implementasi kebijakan Edward III faktor komunikasi, sumber daya, disposisi dan birokrasi, serta kendala yang menyebabkan keterlambatan klaim.
Kesimpulannya,implementasi administrasi klaim Jamkesmas di rumah sakit vertikal telah berjalan baik meskipun ada kendala,yaituhambatan faktor komunikasi, sumber daya, dan komitmen. Kedua, belum ada pengawasan langsung terhadap jalannya proses administrasi klaim Jamkesmas di RS vertikal baik oleh Kemenkes ataupun rumah sakit. Saran peneliti bagi Kemenkes adalah membentuk tim casemix di setiap rumah sakit, dan menyusun format pengawasan sistem klaim.
This thesis aims to undertake an analysis of the implementation of the administrative claims Jamkesmas at hospital owned by Ministry of Health (MoH) in 2012. Background problem in this research is the large number of problems in the hospital area due to the delay in the claim such as cash flow, the incentive payment is late, and the purchase of drugs inhibited. At the hospital, the vertical effects of the delay in filing claim Jamkesmas unknown, because there has never been a written report regarding the implementation of the administrative claims data from temporary Jamkesmas national data claims showed a delay in hospital owned by MoH claims. This study used a qualitative approach by doing in-depth interviews of the selected informant.
The results showed of policy implementation based on the theory of Edward III communication factors, resources, disposition and bureaucracy, as well as the obstacles that cause delays in claims.
In conclusion, the implementation of administration claims Jamkesmas vertical hospital was going well despite the constraints, obstacles to communication factors, resources, and commitment. Second, there has been no direct supervision over the course of the administrative proceedings at hospital owned by MoH Jamkesmas claims either by Ministry of Health or the hospital itself. Advice for Ministry of Healthare forming teams of casemix at every hospital, and composing format of supervision claims.
Tesis ini membahas analisis Implementasi Kebijakan Pelaporan Rumah Sakit Lanjutan Program Jamkesmas pada Pusat Pembiayaan dan Jaminan Kesehatan Tahun 2012. Penelitian ini menggunakan pendekatan kualitatif dengan melakukan wawancara mendalam dari informan terpilih. Hasil penelitian menunjukkan dari aspek Input Laporan masih ada Rumah Sakit yang melaporkan belum sesuai dengan manlak aspek proses berdasarkan kepada teori implementasi kebijakan Edward III faktor komunikasi, sumber daya, disposisi dan struktur birokrasi, serta aspek Umpan balik Kesimpulannya, Implementasi Kebijakan Pelaporan PPK Lanjutan Program Jamkesmas pada Pusat Pembiayaan dan Jaminan Kesehatan Tahun 2012 belum dilaksanakan secara maksimal, karena belum adanya batas waktu penyampaian Saran peneliti bagi Pusat Pembiayaan dan Jaminan Kesehatan adanya batas waktu penyampaian pelaporan dan umpan balik secara berkala dan tertulis terhadap Rumah Sakit lanjutan tersebut.
This thesis discusses the analysis of the Policy Implementation Advanced Reporting Hospital JAMKESMAS Program at the Center for Financing and Health Security in 2012. This study used a qualitative approach by conducting indepth interviews from selected informants. Results of the study showed there are still aspects of the Report Input Hospital reported manlak not in accordance with aspects of the process of policy implementation is based on the theory of Edward III factor of communication, resources, disposition and bureaucratic structure, aspect Feedback conclusion, Reporting Implementation Program Advanced Hospital JAMKESNAS the Central Financing and Health Insurance in 2012 has not been fully implemented, because there is no deadline for submission of suggestions researcher for the Center for Health Financing and Guarantee the deadline reporting and feedback on the advanced Hospital.
This study is focusing on the Zero Complaint policy and its implementation in Bhayangkara Tk I R Said Sukanto Hospital. The study reviewed hospital environmental conditions, the relationships between unit in hospital, hospital resources, and characteristics and capabilities of Humsar Dumas Unit. This study is a descriptive qualitative research. The study revealed that there are several factors which are not supporting the implementation of Zero Complaint policy, which include human resources constraints, socio-cultural, the involvement of program beneficiaries from environmental condition factor, commitment of bureaucracy, personnel skills, communication within the unit, unit leadership, and executive commitment from characteristic and capabilities of Humsar Dumas Unit. Nevertheless the results of policy implementation Zero Complaint has reached a predefined goal and managed to create a better change for the hospital, both internally and externally.
