Ditemukan 5 dokumen yang sesuai dengan query :: Simpan CSV
Adhe Ubaidillah; Pembimbing: Mardiati Nadjib; Penguji: Atik Nurwahyuni, Pujiyanto, Wahyu Pudji Nugraheni, Mazda Novi Mukhlisa
Abstrak:
Tujuh tahun semenjak skema jaminan kesehatan nasional (JKN) diperkenalkan, cakupan di Provinsi DKI Jakarta sudah mencapai 85% dari populasi, akan tetapi secara rata-rata out-of-pocket (OOP) pengeluaran kesehatan penduduk DKI Jakarta dua kali lipat dari pengeluaran Nasional. Tingginya cakupan JKN ternyata tetap diiringi dengan naiknya OOP pada Provinsi DKI Jakarta. Penelitian ini berfokus untuk memahami bagaimana hubungan kepemilikan jaminan kesehatan dengan utilisasi layanan kesehatan dan pengeluaran kesehatan tunai di Provinsi DKI Jakarta. Penelitian ini menggunakan data sekunder Susenas Kor Tahun 2021. Analisis kuantitatif yang dilakukan pada penelitian ini mencakup dua tahap, tahap pertama dengan menggunakan data tingkat individu untuk mengetahui determinan perilaku kesehatan individu terhadap utilisasi layanan kesehatan. Tahap kedua dilakukan dengan menggunakan data tingkat rumah tangga untuk mengetahui kecenderungan pemanfaatan jaminan kesehatan dengan out-of-pocket pengeluaran kesehatan di Provinsi DKI Jakarta. Dari penelitian ini didapatkan fakta bahwa status ekonomi penduduk kuintil satu (Q1) dan kuintil dua (Q2) merupakan kelompok penduduk terbesar yang tidak memiliki jaminan kesehatan. Hasil analisis pada tahap pertama menunjukkan bahwa penduduk DKI Jakarta lebih memilih fasilitas kesehatan layanan yang dikelola oleh swasta untuk utilisasi rawat jalan sedangkan untuk utilisasi rawat inap fasilitas layanan kesehatan yang dioperasikan oleh pemerintah sedikit lebih unggul. Penduduk yang memiliki JKN akan memanfaatkannya untuk utilisasi rawat jalan maupun rawat inap. Sedangkan hasil pada tahap kedua menunjukkan bahwa out-of-pocket pengeluaran kesehatan tunai penduduk yang memiliki jaminan kesehatan nasional (JKN) lebih rendah dibandingkan dengan penduduk yang tidak memiliki jaminan kesehatan. Penduduk yang memiliki jaminan kesehatan ganda / kombinasi (JKN dan swasta) saat utilisasi layanan kesehatan adalah menggunakan asuransi kesehatan swasta. Semakin tinggi status ekonomi penduduk, semakin tinggi juga pengeluaran kesehatannya. Penelitian ini menunjukkan bahwa pemerintah sangat perlu memperhatikan cakupan kepemilikan jaminan kesehatan pada penduduk dengan status ekonomi rendah / miskin. Selain itu juga perlu mendorong penduduk lebih memanfaatkan JKN saat utilisasi rawat jalan dan rawat inap agar lebih dapat menurunkan risiko keuangan, terutama pada penduduk yang memiliki anggota rumah tangga kelompok rentan.
Seven years since the national health insurance scheme (JKN) was introduced, coverage in DKI Jakarta Province has reached 85% of the population, but the average out-of-pocket (OOP) health expenditure of DKI Jakarta residents is twice that of the national expenditure. The high JKN coverage was accompanied by an increase in OOP in DKI Jakarta Province. This study focuses on understanding how health insurance ownership relates to health service utilization and cash health expenditure in DKI Jakarta Province. This study uses secondary data from Susenas Kor in 2021. The quantitative analysis conducted in this study includes two stages, the first stage using individual-level data to determine the determinants of individual health behavior on health service utilization. The second stage was carried out using household-level data to determine the tendency of health insurance utilization with out-of-pocket health expenditure in DKI Jakarta Province. This study found that the economic status of the population in quintile one (Q1) and quintile two (Q2) is the largest group of people who do not have health insurance. The results of the first stage of analysis show that DKI Jakarta residents prefer privately-run health facilities for outpatient utilization, while government-operated health facilities are slightly superior for inpatient utilization. Residents who have JKN will use it for outpatient and inpatient utilization. The results of the second stage showed that the out-of-pocket cash health expenditure of people with national health insurance (JKN) was lower than that of people without health insurance. Residents who have dual/combination health insurance (JKN and private) when utilizing health services are using private health insurance. The higher the economic status of the population, the higher their health expenditure. This study suggests that the government should pay close attention to the coverage of health insurance among people with low economic status. It also needs to encourage people to make more use of JKN when utilizing outpatient and inpatient care in order to further reduce financial risk, especially for people with vulnerable household members.
Read More
Seven years since the national health insurance scheme (JKN) was introduced, coverage in DKI Jakarta Province has reached 85% of the population, but the average out-of-pocket (OOP) health expenditure of DKI Jakarta residents is twice that of the national expenditure. The high JKN coverage was accompanied by an increase in OOP in DKI Jakarta Province. This study focuses on understanding how health insurance ownership relates to health service utilization and cash health expenditure in DKI Jakarta Province. This study uses secondary data from Susenas Kor in 2021. The quantitative analysis conducted in this study includes two stages, the first stage using individual-level data to determine the determinants of individual health behavior on health service utilization. The second stage was carried out using household-level data to determine the tendency of health insurance utilization with out-of-pocket health expenditure in DKI Jakarta Province. This study found that the economic status of the population in quintile one (Q1) and quintile two (Q2) is the largest group of people who do not have health insurance. The results of the first stage of analysis show that DKI Jakarta residents prefer privately-run health facilities for outpatient utilization, while government-operated health facilities are slightly superior for inpatient utilization. Residents who have JKN will use it for outpatient and inpatient utilization. The results of the second stage showed that the out-of-pocket cash health expenditure of people with national health insurance (JKN) was lower than that of people without health insurance. Residents who have dual/combination health insurance (JKN and private) when utilizing health services are using private health insurance. The higher the economic status of the population, the higher their health expenditure. This study suggests that the government should pay close attention to the coverage of health insurance among people with low economic status. It also needs to encourage people to make more use of JKN when utilizing outpatient and inpatient care in order to further reduce financial risk, especially for people with vulnerable household members.
T-7002
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Rahma Anindita; Pembimbing: Mardiati Nadjib; Penguji: Pujiyanto, Wachyu Sulistiadi, Ari Dwi Aryani, Maria Hotnida
Abstrak:
Pada sistem pembayaran Kapitasi Berbasis Kinerja (KBK), akan dilakukan perhitungan pencapaian kinerja Fasilitas Kesehatan Tingkat Pertama (FKTP) berdasarkan indikator Angka Kontak, Rasio Rujukan Non Spesialistik, dan Rasio Peserta Prolanis Terkendali sebagai dasar pembayaran kapitasi. Penelitian ini merupakan penelitian non eksperimental melalui pendekatan kuantitatif, yang bertujuan untuk mengetahui hubungan status pemberlakuan KBK konsekuensi, rasio dokter banding peserta, kelengkapan sarana prasanaran, lingkup pelayanan dan pola pengelolaan keuangan Puskesmas dengan nilai capaian KBK pada Puskesmas di wilayah Provinsi Sumatera Utara Tahun 2023. Dari hasil penelitian ini, nilai capaian KBK Puskesmas di Provinsi Sumatera Utara bulan Desember 2023 sebesar 2,8 atau belum bisa mencapai target nilai capaian KBK maksimal. Rasio dokter banding peserta dan kelengkapan sarana prasarana mempunyai hubungan yang signifikan terhadap nilai capaian KBK. Pemenuhan tenaga medis dokter berdasarkan jumlah peserta terdaftarnya, pemenuhan kebutuhan sarana prasarana sesuai kebutuhan tata laksana jenis penyakit yang dapat dilakukan di FKTP dan pengaturan distribusi peserta terdaftar perlu menjadi perhatian untuk meningkatkan kinerja sesuai ketentuan Kapitasi Berbasis Kinerja.
In the Performance Based Capitation (KBK) payment system, the performance achievement of First Level Health Facilities (FKTP) will be calculated based on the indicators of Contact Rate, Non-Specialist Referral Ratio, and Controlled Prolanis Participant Ratio as the basis for capitation payments. This research is a non-experimental research using a quantitative approach, which aims to determine the relationship between the status of implementation of KBK consequences, the ratio of doctors to participants, fulfillment of infrastructure, scope of services and financial management patterns of Community Health Centers with the value of KBK achievements at Puskesmas in the North Sumatra Province region in 2023. From the results of this research, the KBK achievement value for Puskesmas in North Sumatra Province in December 2023 is 2.8 or has not yet reached the target maximum. The ratio of doctors to participants and fulfillment of infrastructure have a significant relationship to the KBK achievement score. Fulfillment of doctors based on the number of registered participants, fulfillment of infrastructure and arrangements for the distribution of registered participants need to be paid attention to in order to improve performance in accordance with the provisions of Performance Based Capitation.
Read More
In the Performance Based Capitation (KBK) payment system, the performance achievement of First Level Health Facilities (FKTP) will be calculated based on the indicators of Contact Rate, Non-Specialist Referral Ratio, and Controlled Prolanis Participant Ratio as the basis for capitation payments. This research is a non-experimental research using a quantitative approach, which aims to determine the relationship between the status of implementation of KBK consequences, the ratio of doctors to participants, fulfillment of infrastructure, scope of services and financial management patterns of Community Health Centers with the value of KBK achievements at Puskesmas in the North Sumatra Province region in 2023. From the results of this research, the KBK achievement value for Puskesmas in North Sumatra Province in December 2023 is 2.8 or has not yet reached the target maximum. The ratio of doctors to participants and fulfillment of infrastructure have a significant relationship to the KBK achievement score. Fulfillment of doctors based on the number of registered participants, fulfillment of infrastructure and arrangements for the distribution of registered participants need to be paid attention to in order to improve performance in accordance with the provisions of Performance Based Capitation.
T-6980
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Naura Parida; Pembimbing: Jaslis Ilyas; Penguji: Ascobat Gani, Pujiyanto, Fadhilah, Muhammad Aras
Abstrak:
Read More
Pembayaran dengan sistem paket seringkali menimbulkan terjadinya selisih antara tarif paket INA-CBG dengan biaya pelayanan rumah sakit yang dianggap tidak mencukupi. Pembiayaan terbesar BPJS kesehatan terhadap penyakit katastropik adalah penyakit jantung dengan biaya sebesar 8,6T dan merupakan kasus terbanyak dibandingkan dengan kasus katastropik lainnya. RSWS merupakan rumah sakit rujukan tertinggi di Kawasan timur Indonesia dan menaungi sebuah instalasi pusat jantung terpadu. Pada tahun 2019, dr. Khalid Saleh, selaku Dirut di RSUP Wahidin Sudirohusodo, di dalam jumpa persnya menyatakan bahwa terjadi tunggakan oleh pihak BPJS Kesehatan yang mencapai ratusan miliar rupiah. Besarnya tunggakan tentunya akan memengaruhi proses pelayanan dan penangan pada pasien. Penelitian ini bertujuan untuk mengetahui besar selisih yang terjadi antara biaya pelayanan penyakit jantung koroner dengan tarif INA-CBGs di RSWS dan faktor-faktor yang mempengaruhi terjadinya selisih. Penelitian ini adalah penelitian mix method dengan observasional analitik menggunakan pendekatan cross-sectional. Sampel yang digunakan dalam penelitian ini sebanyak 112 data pasien PJK yang menjalani rawat inap di RSWS. Hasil penelitian menunjukkan adanya selisih positif sebesar 171.908.682 jika dihitung secara keseluruhan namun jika dilihat perkasus terhadap selisih negatif pada kasus angina pektoris. Faktor yang mempengaruhi terjadinya selisih biaya pelayanan dan tari INA-CBG pada penyakit jantung koroner adalah Tingkat keparahan (p-value = 0,000), lama hari rawat (p-value = 0,001), dan pelayanan medis (p-value = 0,002). Hasil wawancara menunjukkan bahwa faktor yang paling berpengaruh terhadap terjadinya selisih biaya adalah adanya tindakan operasi. Upaya yang dilakukan untuk mengatasi selisih biaya yang terjadi di rumah sakit dengan melakukan subsidi silang, menginformasikan kepada pihak-pihak tertentu, mengadakan pertemuan dengan DPJP, dan membatasi tindakan-tindakan yang melebihi tarif rumah sakit pada kasus yang sifatnya tidak urgent. Rumah sakit perlu mengendalikan biaya agar tidak terjadi selisih negatif yang lebih besar antara pelayanan rumah sakit dengan tarif yang ditentukan BPJS dengan tetap memperhatikan kualitas pelayanan. Terus melakukan kendali mutu pelayanan yang efektif sebagaimana panduan praktik klinis.
Payment with a package system often result in a difference between the INA-CBG package rates and hospital service cost, which are considered insufficient. The largest BPJS health financing for catastrophic diseases is heart disease, with a cost of 8.6T, and it is the most common case compared to other catastrophic cases. RSWS is the highest referral hospital in Eastern Indonesia and houses an integrated heart center installation. In 2019, Dr. Khalid Saleh, as the President Director of RSUP Wahidin Sudirohusodo, stated in a press conference that there were arrears from BPJS Health reaching hundreds of billions of rupiah. The large amount of arrears will certainly affect the service and handling process for patients. This study aims to determine the magnitude of the difference between the cost of coronary heart disease services and the INA-CBGs rates at RSWS and the factors that influence the occurrence of the difference. This research is a mixed-method study with observational analytics using a cross-sectional approach. The sample used in this study was 112 data of CHD patients who underwent inpatient treatment at RSWS. The results showed a positive difference of 171.908.682 when calculated as a whole, but when viewed per case, there was a negative difference in cases of angina pectoris. Factors that influence the difference in service costs and INA-CBG rates in coronary heart disease are the severity level (p-value = 0.000), length of stay (pvalue = 0.001), and medical services (p-value = 0.002). Interview result indicated that the most influential factor in the cost difference is the presence of surgical procedures. Efforts are made to overcome the cost difference that occurs in hospitals by conducting crosssubsidies, informing certain parties, holding meetings with DPJP, and limiting actions that exceed hospital rates in cases that are not urgent. Hospitals need to control costs so that there is no greater negative difference between hospital services and the rates determined by BPJS while still paying attention to the quality of service. Continue to carry out effective quality control of services as guided by clinical practice guidelines.
T-7060
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Arthur Andreas Alfonso; Pembimbing: Ascobat Gani; Penguji: Pujiyanto, Beno Herman, Wasja
Abstrak:
Read More
Indonesia telah menjadi pelopor dalam pengelolaan program jaminan kesehatan sosial (JKN) terbesar di dunia. Program ini diinisiasi sejak tahun 2011 berdasarkan Undang-Undang No 40 tahun 2004 tentang Sistem Jaminan Sosial Nasional dengan pencapaian kepesertaan JKN sebesar 96% terhadap jumlah penduduk pada Desember 2023. Cakupan kesehatan semesta sebagai salah satu upaya dalam program JKN tidak hanya berkaitan dengan kepesertaan, tetapi juga mencakup manfaat yang diterima serta mekanisme pembiayaannya. Ekuitas sebagai salah satu asas dalam memenuhi persyaratan Universal Health Coverage (UHC) masih menjadi masalah dalam pelaksanaan program JKN ini, hal ini terlihat dari data grafik yang dianalisa oleh Ascobat Gani pada tahun 2019 bahwa masih terjadi disparitas yang sangat signifikan antara wilayah propinsi di Indonesia. Tujuan dari penelitian ini untuk melakukan analisis terhadap faktor dari sisi penyedia atau supply side yang mempengaruhi terjadinya disparitas pemanfaatan layanan kesehatan pada fasilitas kesehatan tingkat pertama program JKN. Penelitian ini menggunakan data sekunder BPJS Kesehatan, dan data publikasi dari Kementrian Keuangan dan Kemntrian Dalam Negeri serta Badan Pusat Statistik. Data dianalisis secara univariat, bivariat, dan multivariat dengan menggunakan metode regresi linier berganda. Secara statistik, pemanfaatan layanan kesehatan ditingkat pertama dipengaruhi sebesar 30% oleh kondisi geografis melalui alat ukur status keterpencilan Desa melalui variabel Skor Indeks Desa Membangun (IDM), dan kondisi sosioekonomi melalui alat ukur kapasitas fiskal dan persentase Pendapatan Asli Daerah (PAD) terhadap APBD kabupaten dan kota. Skor IDM dan Persentase PAD terhadap APBD secara signifikan berpengaruh positif sedangkan rasio kapasitas fiskal daerah secara signifikan berpengaruh negatif dengan nilai signifikansi P < 0,05 terhadap kontak rate kunjungan rawat jalan tingkat pertama
Indonesia has become a pioneer in managing the largest social health insurance (JKN) program in the world. This program was initiated in 2011 based on Law No. 40 of 2004 concerning the National Social Security System with the achievement of JKN membership of 96% of the total population in December 2023. Universal health coverage as one of the efforts in the JKN program is not only related to membership, but also includes the benefits received and the financing mechanism. Equity as one of the principles in fulfilling Universal Health Coverage (UHC) requirements is still a problem in the implementation of the JKN program. This can be seen from graphic data analyzed by Ascobat Gani in 2019 that there are still very significant disparities between provincial regions in Indonesia. The aim of this research is to conduct an analysis of factors from the provider side or supply side that influence disparities in health service utilization in first level health facilities of the JKN program. This research uses secondary data from BPJS Kesehatan, and published data from the Ministry of Finance and Ministry of Home Affairs as well as the Central Statistics Agency. Data were analyzed univariately, bivariately and multivariately using multiple linear regression methods. Statistically, the utilization of health services at the first level is influenced by 30% by geographical conditions through measuring village remoteness status through the Village Development Index Score (IDM) variable, and socio-economic conditions through measuring fiscal capacity and the percentage of Regional Original Income (PAD) to the district APBD and city. The IDM score and the percentage of PAD to APBD have a significant positive effect, while the regional fiscal capacity ratio has a significant negative effect with a significance value of P < 0.05 on the contact rate of first level outpatient visits.
T-7044
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Rezki Wahyu Meidayanti; Pembimbing: Atik Nurwahyuni; Penguji: Mardiati Nadjib, Achmad Fauzi Yahya, Miftahussaadah
Abstrak:
Read More
Di Indonesia, penyakit kardiovaskular masih menjadi penyebab kematian tertinggi dibandingkan penyakit lainnya, yaitu sebesar 12.9% dari total kematian pertahunnya yang penyebabnya didominasi oleh penyakit jantung koroner. Data Riskesda tahun 2018 juga menyebutkan prevalensi penyakit jantung di Indonesia mencapai 1.5%, yang artinya jika merujuk pada jumlah populasi penduduk Indonesia yang mencapai 275 juta jiwa, sekitar 4 juta lebih masyarakat di Indonesia menderita penyakit jantung. Dari sisi pembiayaan juga hal ini berakibat pada besarnya pembiayaan untuk tindakan terapi penyakit jantung, salah satunya adalah tindakan Intervensi Koroner Perkutan (IKP). Penelitian ini menganalisa bagaimana efektivitas dan biaya dari tindakan IKP yang konvensional dengan tindakan IKP yang terpandu pencitraan Intravascular Ultrasound (IVUS) sebagai tambahan. Metode penelitian dilakukan secara kombinasi, yaitu melakukan review sistematis untuk memperoleh nilai efektivitas klinis dan penelitian cohort retrospektif untuk analisis biayanya. Diperoleh hasil bahwa Tindakan IKP Terpandu IVUS terbukti memiliki efektivitas klinis yang lebih baik dibandingkan tindakan IKP Konvensional yang hanya menggunakan pencitraan Angiografi Secara besaran biaya, tindakan IKP Terpandu IVUS masih memiliki biaya yang lebih tinggi dibanding tindakan IKP Konvensional, dengan selisih rerata biayanya pada tahun 2023 sebesar Rp 17.725.559,- untuk setiap tindakan IKP dengan pemasangan 1 stent.
In Indonesia, cardiovascular disease is still the highest cause of death compared to other diseases, namely 12.9% of total annual deaths, the cause of which is dominated by coronary heart disease. Riskesda data for 2018 also states that the prevalence of heart disease in Indonesia reached 1.5%, which means that if we refer to Indonesia's population of 275 million, around 4 million more people in Indonesia suffer from heart disease. In terms of financing, this also results in large amounts of funding for heart disease therapy, one of which is Percutaneous Coronary Intervention (IKP). This study analyzes the cost and outcome of conventional IKP procedures compared to IKP procedures that use Intravascular Ultrasound (IVUS) imaging as an adjunct. The research method was carried out in a combination, namely conducting a systematic review to obtain clinical effectiveness values and a retrospective cohort study for cost analysis. The results showed that IVUS Guided IKP procedures were proven to have better clinical effectiveness than conventional IKP procedures which only use angiography imaging. In terms of costs, IVUS Guided IKP procedures still have higher costs than conventional IKP procedures, with the difference in average costs in 2023 amounting to IDR 17,725,559 for each IKP procedure with the implantation of 1 stent.
T-7032
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉