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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.
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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
☉
Angga Bagus Pratama; Pembimbing: Kurnia Sari; Penguji: Vetty Yulianty Permanasari, Agus Rahmanto
Abstrak:
Penerapan kapitasi berbasis komitmen pelayanan yang kini dikenal dengan kapitasi berbasis kinerja (KBK) merupakan upaya untuk meningkatkan mutu pelayanan dalam skema Jaminan Kesehatan Nasional. Telah banyak publikasi yang menyajikan studi kasus di tingkat FKTP mengenai faktor apa saja yang berkontribusi atau menghambat pencapaian. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor apa saja yang membuat Fasilitas Kesehatan Tingkat Pertama mencapai target KBK, dengan menggunakan desain Literature Review. Basis pencarian literatur yang digunakan adalah Google Scholar dan GARUDA. Dari jumlah pencarian 917 artikel, setelah menghilangkan duplikasi, menyaring dengan menggunakan kriteria inklusi dan eksklusi, didapatkan hasil akhir 11 artikel dengan hampir seluruhnya menggunakan desain kualitatif berupa studi kasus. Hasil penyaringan literatur disajikan dengan diagram PRISMA. Hasil penelitian menunjukan bahwa jumlah SDM yang cukup, tersedianya sarana dan prasarana yang cukup, dana di Puskesmas yang cukup serta tersalurkan dengan baik, dan adanya kodifikasi penyakit untuk meningkatkan pelayanan yang optimal, merupakan kondisi yang membuat tercapainya target KBK. Faktor yang dianggap menyulitkan tercapainya KBK antara lain ketersediaan SDM yang belum tercukupi, sarana dan prasarana yang belum memadai, ketersediaan dana yang belum tercukupi , jumlah peserta yang terlalu banyak atau melebihi standar kapasitas di FKTP dan kebijakan target yang dianggap terlalu tinggi oleh FKTP.
The implementation of service commitment-based capitation which is now known as Capitation Based Commitment (CBC) is an effort to improve the quality of services in the National Health Insurance scheme. There have been many publications that present case studies at the FKTP level regarding what factors contribute to or hinder achievement. This study aims to identify the factors that make First Level Health Facilities achieve the KBK target, using the Literature Review design. The literature search bases used are Google Scholar and GARUDA. From the number of searches for 917 articles, after eliminating duplication, filtering using inclusion and exclusion criteria, the final results obtained are 11 articles with almost all of them using a qualitative design in the form of case studies. The results of the literature screening are presented with a PRISMA diagram. The results of the study indicate that a sufficient number of human resources, the availability of adequate facilities and infrastructure, sufficient funds at the Puskesmas and well channeled, and the codification of diseases to improve optimal services, are conditions that make the KBK target achievable. Factors that are considered difficult to achieve KBK include the number of participants who are too many or exceed the capacity standard in FKTP and target policies that are considered too high by FKTP.
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The implementation of service commitment-based capitation which is now known as Capitation Based Commitment (CBC) is an effort to improve the quality of services in the National Health Insurance scheme. There have been many publications that present case studies at the FKTP level regarding what factors contribute to or hinder achievement. This study aims to identify the factors that make First Level Health Facilities achieve the KBK target, using the Literature Review design. The literature search bases used are Google Scholar and GARUDA. From the number of searches for 917 articles, after eliminating duplication, filtering using inclusion and exclusion criteria, the final results obtained are 11 articles with almost all of them using a qualitative design in the form of case studies. The results of the literature screening are presented with a PRISMA diagram. The results of the study indicate that a sufficient number of human resources, the availability of adequate facilities and infrastructure, sufficient funds at the Puskesmas and well channeled, and the codification of diseases to improve optimal services, are conditions that make the KBK target achievable. Factors that are considered difficult to achieve KBK include the number of participants who are too many or exceed the capacity standard in FKTP and target policies that are considered too high by FKTP.
S-11561
Depok : FKM-UI, 2022
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
☉
Lupi Trijayanti; Pembimbing: Ascobat Gani; Penguji: Adang Bachtiar, Pujiyanto, Maria Hotnida, Christina Yana Bintari
Abstrak:
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Kapitasi berbasis kinerja (KBK) merupakan sistem pembayaran kapitasi setiap bulannya yang didasari penilaian kinerja pelayanan fasilitas kesehatan tingkat pertama (FKTP) yang bersangkutan dalam rangka upaya meningkatkan efektifitas dan efisiensi pembiayaan kesehatan dan peningkatan kualitas pelayanan kesehatan. Namun pada pelaksanaannya banyak faktor eksternal dan internal yang mempengaruhi capaian KBK. Capaian pembayaran KBK di puskesmas wilayah Kota Depok hanya 2 (5,3%) puskesmas dari 38 puskesmas yang menerima pembiayaan kapitasi sebesar 100%. Tujuan penelitian ini adalah untuk menganalisis validitas dari setiap indikator penilaian KBK menurut persepsi petugas puskesmas di wilayah kerja kota Depok. Penelitian ini merupakan penelitian non-eksperimental melalui pendekatan kualitatif. Lokasi penelitian dilakukan di 4 (empat) puskesmas dengan kriteria 2 (dua) puskesmas dengan capaian capaian tertinggi atau meningkat dan 2 (dua) puskesmas dengan capaian terendah atau tidak mencapai target. Informan pada penelitian ini dipilih dengan aspek kecukupan dan kelayakan yang mana dianggap sesuai dengan topik terdiri dari (i) Kepala Bagian Penjaminan Manfaat dan Utilisasi, BPJS Kesehatan Ka. Cab. Kota Depok, (ii) Kepala Seksi Pelayanan Kesehatan Primer Dinas Kesehatan Kota Depok, (iii) Kepala Puskesmas, (iv) PIC UKP Puskesmas, dan (v) PIC prolanis. Sumber data bersumber dari data primer (wawancara mendalam) dan data sekunder (telaah dokumen). Hasil penelitian menunjukan bahwa indikator RRNS benar menggambarkan dari kinerja layanan rujukan yang mana pemberian rujukan dibawah wewenang puskesmas tanpa ada intervensi dari pasien atau keluarga pasien. Indikator angka kontak tidak valid dikarenakan tidak dapat menggambarkan kontak rate, banyak faktor yang mempengaruhinya yaitu karakteristik peserta (mobilitas, kerentanan, kecenderungan berobat dan kepercayaan), lokasi puskesmas yang mempengaruhi biaya transportasi, sarana prasarana serta sistem kerja. Serta indikator rasio peserta prolanis terkendali (RPPT) tidak valid karena belum tepat menilai kinerja pelaksanaan kegiatan prolanis, banyak faktor yang mempengaruhi yaitu perilaku peserta prolanis terhadap gaya hidup (rutin berobat, pola makan minum, aktifitas fisik) yang banyak dipengaruhi budaya dan lingkungan sosial, sistem pencatatan dan perhitungan indikator, sistem pelayanan puskesmas dan kecenderungan berobat (health belief).
Performance-based capitation (KBK) is a monthly capitation payment system based on an assessment of the service performance of the first level health facility (FKTP) concerned in an effort to increase the effectiveness and efficiency of health financing and improve the quality of health services. However, in practice, there are many external and internal factors that affect KBK achievements. Only 2 (5.3%) out of 38 puskesmas received capitation financing at the Depok City Health Centers for KBK payments. The purpose of this study was to analyze the validity of each KBK assessment indicator according to the perceptions of health center staff in the working area of the city of Depok. This research is a non-experimental research using a qualitative approach. The research locations were conducted in 4 (four) puskesmas with the criteria of 2 (two) puskesmas with the highest or increasing achievements and 2 (two) puskesmas with the lowest achievements or not reaching the target. The informants in this study were selected based on the adequacy and feasibility aspects which were considered appropriate to the topic consisting of (i) Head of Benefit Guarantee and Utilization Section, BPJS Kesehatan Ka. Cab. Depok City, (ii) Head of the Primary Health Service Section of the Depok City Health Office, (iii) Head of the Puskesmas, (iv) PIC UKP Puskesmas, and (v) PIC prolanis. Sources of data come from primary data (in-depth interviews) and secondary data (document review). The results showed that the RRNS indicator correctly described the performance of referral services in which referrals were made under the authority of the puskesmas without any intervention from the patient or the patient's family. The contact number indicator is invalid because it cannot describe the contact rate, many factors influence it, namely the characteristics of the participants (mobility, vulnerability, tendency to seek treatment and trust), the location of the puskesmas which affects transportation costs, infrastructure and work systems. As well as the controlled prolanis participant ratio indicator (RPPT) is invalid because it is not yet appropriate to assess the performance of the implementation of prolanis activities, many factors influence, namely the behavior of prolanis participants towards lifestyle (routine treatment, eating and drinking patterns, physical activity) which is heavily influenced by culture and the social environment, system for recording and calculating indicators, health center service systems and tendencies to seek treatment (health beliefs).
T-6705
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Ilma Dewayani; Pembimbing: Atik Nurwahyuni; Penguji: Pujiyanto, Reza Rahman
Abstrak:
Penelitian ini bertujuan untuk mengetahui implementasi Peraturan Kapitasi Berbasis Pemenuhan Komitmen Pelayanan pada Puskesmas di Wilayah Jakarta Timur Tahun 2017. Penelitian ini merupakan penelitian kualitatif dengan pengumpulan data melalui wawancara, observasi, dan telaah dokumen. Penelitian ini menunjukkan bahwa ada masalah dalam sisi komunikasi, sumber daya, serta pelaksanaan untuk mencapai indikator kinerja. Peneliti menyarakan agar dilakukan upaya perbaikan dalam hal sosialisasi, peninjauan ulang mengenai beban kerja dan pembagian tugas, membuat SOP khusus untuk kegiatan Prolanis, pelatihan rutin untuk dokter, membuat anggaran khusus Prolanis, serta pembuatan kebijakan khusus terkait pelayanan bagi peserta yang bukan terdaftar di Puskesmas yang dituju.
Kata kunci : Peraturan KBK, Implementasi, indikator angka kontak, indikator rasio prolanis, indikator rujukan non spesialistik.
This research aims to find out the implementation of Performance-Based Capitation Regulation in Primary Helalth Care in East Jakarta Region, 2017. This research is a qualitative study with data collection through interviews, observation, and document review. This study shows that there are problems in communication, resources, and implementation to achieve performance indicators. The researcher suggested that improvement efforts should be made in the case of socialization, review of workload and task division, make SOPs for Prolanis activities, routine training for doctors, make allocation budget for Prolanis, and policy making related to services for participants who are not registered in Primary Health Care Addressed.
Key words : Performance-Based Capitation, Implementation, contack rate indicators, Prolanis ratio indicators, non-specialistic refferal indicators.
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Kata kunci : Peraturan KBK, Implementasi, indikator angka kontak, indikator rasio prolanis, indikator rujukan non spesialistik.
This research aims to find out the implementation of Performance-Based Capitation Regulation in Primary Helalth Care in East Jakarta Region, 2017. This research is a qualitative study with data collection through interviews, observation, and document review. This study shows that there are problems in communication, resources, and implementation to achieve performance indicators. The researcher suggested that improvement efforts should be made in the case of socialization, review of workload and task division, make SOPs for Prolanis activities, routine training for doctors, make allocation budget for Prolanis, and policy making related to services for participants who are not registered in Primary Health Care Addressed.
Key words : Performance-Based Capitation, Implementation, contack rate indicators, Prolanis ratio indicators, non-specialistic refferal indicators.
S-9454
Depok : FKM UI, 2017
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Iqbal Andri Makarim; Pembimbing: Pujiyanto; Penguji: Helen Andriani, Vetty Yulianty Permanasari, Harimat Hendarwan, Atmiroseva
Abstrak:
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Hingga saat ini dari indikator-indikator yang masuk ke dalam komponen pembayaran kapitasi berbasis kinerja yang diinisiasi oleh BPJS Kesehatan, indikator angka kontak menjadi yang pencapaiannya paling rendah dengan capaian nasional kurang dari 50% Puskesmas di Indonesia belum mencapai target angka kontak berdasar data Riset Fasil-itas Kesehatan (Rifaskes) 2019. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh faktor input dan karakteristik dengan ketercapaian angka kontak Puskesmas di Indonesia. Penelitian ini merupakan penelitian analitik dengan menerapkan penelitian kuantitatif dengan pendekatan potong lintang (cross sectional). Sampel dari penelitian ini adalah seluruh Puskesmas yang ada di Indonesia yang masuk dalam Rifaskes 2019 sebanyak 9.831 Puskesmas. Data dalam studi ini diperoleh dari data sekunder yang didapatkan dari hasil Rifaskes 2019. Dari penelitian ini didapatkan dari 5.384 Puskesmas, faktor kelengkapan alat kesehatan esensial poliklinik (OR=1,16; p=0,029), rasio dokter per 5000 peserta (OR=1,06; p<0,0001), rasio bidan per 5000 peserta (OR=1,01; p=0,033), dan pengelolaan keuangan berbasis BLUD (OR=1,13; p=0,062) secara signifikan memengaruhi ketercapaian angka kontak. Namun, model prediktif hanya menjelaskan 2,6% varians (Nagelkerke R²=0,026). Pada penelitian berikutnya dapat dilakukan perampingan data dan mengambil studi menilai pengaruh dari faktor-faktor lain seperti output Puskesmas atau demand dari sisi pasien. Diharapkan pihak berwenang dapat melengkapi alat kesehatan dan menambah tenaga kesehatan di Puseksmas guna meningkatkan angka kontak.
Of the indicators included in the performance-based capitation payment component in-itiated by BPJS Kesehatan, the contact rate indicator has the lowest achievement. Based on 2019 Riset Fasilitas Kesehatan (Rifaskes) data, less than 50% of Puskesmas in Indonesia did not reach the contact rate target. This study aimed to determine the effect of input and characteristics factors on contact rate achievement among Pusk-esmas in Indonesia. This analytical study applied a quantitative research design and used cross-sectional approach. The study sample included all 9,831 Puskesmas in In-donesia included in the 2019 Rifaskes. Data for this study were using secondary data obtained from the 2019 Rifaskes results. The study found that the completeness of es-sential medical equipment for polyclinics (OR = 1.16; p = 0.029), the ratio of doctors to 5,000 participants (OR = 1.06; p < 0.0001), the ratio of midwives to 5,000 partici-pants (OR = 1.01; p = 0.033), and BLUD-based financial management (OR = 1.13; p = 0.062) significantly influenced contact rate achievement. However, the predictive model only explained 2.6% of the variance (Nagelkerke R² = 0.026). Future research could refine the data and examine the influence of other factors, such as output factors or patient demand. It is expected that authorities should equip Puskesmas with medical equipment and increase the number of health workers to improve contact rates.
T-7416
Depok : FKM-UI, 2025
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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