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The COVID 19 pandemic poses challenges for hospitals in terms of service and administration. The increase in COVID 19 patients requires relatively high costs which have implications for hospital revenues. Based on the Minister of Health Regulation No. 56/2016, the cost of PIE patients including COVID 19 can be claimed to the Ministry of Health. KMK 5673 of 2021 is a policy in the form of technical guidelines for claiming reimbursement for COVID 19 patient services. This policy is effective from October 1, 2021, where previously there have been 3 changes to the technical guidelines for claims. Changes in technical guidelines resulted in differences in perception between claims officers, causing many cases of pending claims, disputes and claim expiration dates. Based on BPJS Health data, the total claims submitted from hospitals in 2020 were 433,077 patients, namely Rp. 27 T with details of 348,046 (61.71%) appropriate cases, 83,931 (37.80%) disputed cases and 1,097 (0.49%) inappropriate cases where Rp. 35 T for 536,482 cases. In 2021 total claims Rp. 90.20 T with completed verification of Rp. 50.1 T with the realization of new repayments reaching 67.36%, which is Rp. 28, t. There are cases of pending, disputed and expired claims occurred in the area of RSUD Dr. Soehadi Prijonegoro Kab. Sragen where based on Governor's Decree No. 445 became one of the COVID 19 referral hospitals. This study aims to analyze the implementation of the policy for reimbursement of claims for costs of COVID-19 patients at Dr Soehadi Prijonegoro Hospital, Sragen Regency during the 2020 2021 pandemic. This study used a qualitative method, carried out during March 2022 to May 2022 at Dr Soehadi Prijonegoro Hospital, Kab. . SRAGEN, DEPARTMENT OF HEALTH KAB. Sragen, BPJS Kesehatan Surakarta Branch and the Ministry of Health. Data collection techniques through in-depth interviews, observation and document review. This study uses the Van Meter and Van Horn Policy Implementation model approach. The results of the research from April 2022 to May 2022 showed that the implementation of the policy was not optimal, there were still many obstacles such as no SOP, organizational structure, no training, internet stabilization and the lack of the role of the Health Office in resolving cases of dispute and pending claims. The conclusions in this study have theoretical implications that Van Meter and Van Horn theories can be used to explain the success of Policy Implementation through 6 variables, namely size and objectives, resources, organizational characteristics, inter-organizational communication, disposition and the social, economic and political environment that are mutually influence. Suggestions in this study are strengthening inter-organizational and intra-organizational coordination, making SOPs and organizational structures as well as optimizing the role of the health department in resolving claims for COVID 19 patients
This covid-19 pandemic gives impact toward the decreasing of child immunization so that government made a policy to increase the child immunization service. The purpose of this research is to know how is the policy of child immunization implemented during covid-19 pandemic in Puskesmas Kecamatan Kramat Jati Jakarta Timur. This research was conducted in April to May 2021 by using qualitative method based on Van Meter and Van Horn theory. The amount of informant for this research is 20 persons and it is purposively determined. The result of this research shows that there is no significant decreasing of immunization service for all but BIAS (immunization for students). Resources (finance, infrastructure, human resource) have been adequate and available. The communication between all the officials and the implementation of immunization service are good seen from the coordination for socialization toward society held by health workers together with cross sector, even though the socialization still not be done evenly. Generally, the character of implementor is also good seen from the main task and function done by them, even though there should be the distinction between main task and priority, additional and incidental task. The disposition of implementor is good seen from the supportive attitude, the commitment of parents to bring their babies and comply the health protocol and and the commitment of Puskesmas Kramat Jati to provide the infrastructures needed according to Permenkes (The Regulation of Ministry of Health) and the principles of PPI (The prevention and controlling of infection), even though the implementor still lack of consistency in asking about covid-19 history before doing the immunization, etc. From economic environment, there is neither obstacle or support for this policy, while social environment is quite supportive by the involvement of public figure to socialize child immunization and to support the implementation itself. The mothers of children are actively looking for the information for immunization. However, in the other side, social environment can be less supportive because some of society believe that vaccine is forbidden (haram). As the policy is still in formed of circular letter, it is needed to make an official regulation about child immunization during pandemic covid-19. It can be concluded that the policy of child immunization service in Puskesmas Kramat Jati has been well implemented. The biggest obstacle in implementing this policy is the fear of parents bringing their children to puskesmas due to pandemic covid-19. Therefore, socialization must be intensely done in order to gain trust from parents that doing immunization in puskesmas is safe
Pelayanan Obstetri dan Neonatal Emergensi Dasar (PONED) merupakan salah satu pelayanan Puskesmas yang diharapkan dapat memberikan kontribusi untuk penurunan AKI dan AKB. Angka Kematian Ibu (AKI), Angka Kematian Bayi (AKB) dan Angka Kematian Balita (AKABA) di Indonesia tertinggi dibandingkan negara-negara ASEAN lainnya. Kabupaten Administrasi Kepulauan Seribu memiliki 2 Puskesmas Kecamatan yang memiliki rawat inap yang berfungsi PONED dan 4 Puskesmas Kelurahan yang mempunyai perawatan 24 jam. Namun demikian indikator pelayanan Program PONED masih belum mencapai target, salah satunya angka Kematian Bayi dan Rujukan Ibu Melahirkan yang masih sangat tinggi. Penelitian ini merupakan penelitian analitik kualitatif. Informan ditentukan dengan menggunakan purposive sampling. Informan penelitian antara lain masyarakat, Pemerintah Daerah, Tim PONED Puskesmas, Para Kepala Puskesmas PONED, penanggung jawab program PONED Sudinkes Pulau Seribu, dan Penanggung Jawab SDM Kesehatan Sudinkes Kepulauan Seribu. Data yang dikumpulkan berupa data primer dan data sekunder berupa hasil wawancara mendalam dan telaah dokumen. Hasil penelitian diperoleh data bahwa pada standar dan ukuran kebijakan telah dipahami oleh pelaksana kebijakan. Pemahaman ini didukung komunikasi yang jelas dan berkelanjutan antara Dinas Kesehatan, puskesmas dan stakeholder, kejelasan informasi dan konsistensi informasi. Ketersediaan anggaran, sarana dan prasarana sudah mencukupi tetapi terkendala masalah pemeliharaan alat karena faktor air asin yang menyebabkan peralatan mudah berkarat dan rusak. Struktur birokrasi sudah terdapat Keputusan Bupati mengenai tim PONED, namun belum ada struktur khusus PONED di Suku Dinas Kesehatan Kepulauan Seribu Disposisi ditunjukan dengan sikap positif berupa komitmen bersama Pemerintah Daerah dan Puskesmas dalam penanganan ibu hamil, penanganan kasus rujukan ibu melahirkan dengan penyulit. Peran serta masyarakat dalam pelaksanaan PONED sudah ditunjukan dengan pemanfaatan Puskesmas PONED dalam pemeriksaan kehamilan dan proses melahirkan, Output pelaksanaan program PONED sudah dilakukan pencatatan dan pelaporan capaian program kepada penanggung jawab di Sudinkes, belum ada format pelaporan khusus PONED dan belum dilakukan analisa pelaporan PONED serta feedbacak pelaporan belum dilaksanakan. Implementasi pelayanan PONED di Puskesmas Kepulauan Seribu Selatan dan Puskesmas Pulau Seribu Utara sudah berjalan tapi belum optimal dengan adanya hambatan dan kendala di komponen input, proses maupun output yang harus diatasi sehingga pelayana PONED di Kepulauan Seribu bisa berjalan dengan baik.
Basic Emergency Obstetric and Neonatal Care (PONED) is one of the Primary Health Care services that is expected to contribute to the reduction of MMR and IMR. Maternal Mortality Rate (MMR), Infant Mortality Rate (IMR) and Toddler Mortality Rate in Indonesia are the highest compared to other ASEAN countries. The Seribu Islands Administrative Regency has 2 sub-district health centers that have PONED inpatient care and 4 sub-district health centers that have 24-hour care. However, the service indicators of the PONED program have not yet reached the target, one of which is the very high infant mortality rate and maternal referral. This study was a qualitative analytic study. Informants were determined using purposive sampling. The research informants included the community, local government, Primary Health Care PONED team, Heads of Primary Health Care PONED, the person in charge of the Thousand Island sub-district PONED program, and the person in charge of the Thousand Islands sub-district health human resources. The research results show that the policy standards and measures have been understood by implementers. This understanding is supported by clear and continuous communication between the Health Service, community health centers and stakeholders, clarity of information and consistency of information. The availability of budget, facilities and infrastructure is sufficient but is hampered by equipment maintenance problems due to the salt water factor which causes the equipment to rust easily and cause damage. The bureaucratic structure already has a Regent's Decree regarding the poned team, but there is no special PONED structure in the Seribu Islands Health Sub-Department. The disposition is shown by a positive attitude in the form of a joint commitment between the Regional Government and the Community Health Center in handling pregnant women, handling referral cases of mothers giving birth with complications. Community participation in the implementation of PONED has been demonstrated by the use of PONED Community Health Centers in pregnancy checks and the birthing process. The output of the implementation of the PONED program has been recorded and reported on program achievements to the person in charge at the Health Sub-Department. reporting has not been implemented. The implementation of PONED services at the South Seribu Islands Community Health Center and North Thousand Islands Health Center is already underway but is not yet optimal due to the existence of barriers and obstacles in the input, process and output components that must be overcome so that PONED services in the Thousand Islands can run well.
Tuberkulosis masih menjadi masalah kesehatan di dunia, Negara Indonesia menempati peringkat kedua kasus TB terbanyak di dunia. Provinsi Jawa Barat menempati peringkat satu kasus TB terbanyak di Indonesia dan Kota Depok menempati peringkat 10 besar kasus TB di Provinsi Jawa Barat. Pemerintah Kota Depok telah membentuk inovasi Kampung Peduli Tuberkulosis (KAPITU) sebagai wadah komunikasi antara masyarakat, lintas program dan lintas sektor dalam melakukan penanggulangan tuberkulosis melalui kegiatan penemuan, pendampingan pengobatan, dan sosialisasi tuberkulosis. Penelitian ini bertujuan menganalisis bagaimana implementasi kebijakan Kampung Peduli Tuberkulosis yang sudah dijalankan. Penelitian ini menggunakan metode kualitatif dan pengumpulan data dilakukan dengan wawancara mendalam dan telaah dokumen. Hasil penelitian menunjukkan bahwa aspek input (sumber daya manusia, anggaran, fasilitas, kebijakan), aspek proses (komunikasi, disposisi, struktur birokrasi), serta aspek output (hasil implementasi KAPITU) sudah berjalan baik di Kelurahan Mampang dan Suka Maju Baru. Implementasi KAPITU sempat tidak berjalan pada Kelurahan Sawangan Baru dan Sawangan Lama karena adanya pergantian petugas dan petugas yang pindah kerja. Pada Kelurahan Cilodong dan Pasir Putih masih kurangnya sumber daya manusia, tidak tersedianya anggaran, belum optimalnya komunikasi dan disposisi sehingga menyebabkan implementasi KAPITU belum berjalan optimal. Selanjutnya faktor lingkungan sosial, ekonomi, dan politik juga mempengaruhi implementasi KAPITU. Kesimpulan implementasi KAPITU yang berjalan dengan baik berbanding lurus dengan capaian indikator program TB yang juga baik. Kelurahan yang menunjukkan implementasi program KAPITU yang baik, seperti Mampang dan Suka Maju Baru, memiliki capaian yang lebih baik, Selanjutnya Kelurahan Sawangan Baru dan Sawangan Lama juga menunjukkan adanya peningkatan capaian program setelah satgas KAPITU mulai berjalan kembali. Kelurahan yang belum mengimplementasikan KAPITU dengan baik, seperti Cilodong dan Pasir Putih, juga menunjukkan capaian program TB yang belum baik.
Tuberculosis is still a health problem in the world, Indonesia ranks second in the world for the most TB cases. West Java Province ranks first in the number of TB cases in Indonesia and Depok City ranks in the top 10 for TB cases in West Java Province. The Depok City Government has formed the Kampung Peduli Tuberkulosis (KAPITU) innovation as a means of communication between the community, across programs and across sectors in preventing and controlling tuberculosis through discovery activities, treatment assistance, and tuberculosis socialization. This study aims to analyze how the implementation of the Kampung Peduli Tuberkulosis policy has been carried out. This study uses qualitative methods and data collection is carried out through in-depth interviews and document reviews. The results of the study indicate that the input aspects (human resources, budget, facilities, policies), process aspects (communication, disposition, bureaucratic structure), and output aspects (results of KAPITU implementation) have been running well in Mampang and Suka Maju Baru Sub-districts. The implementation of KAPITU was not running in Sawangan Baru and Sawangan Lama Sub-districts due to changes in officers and officers who moved jobs. In Cilodong and Pasir Putih Sub-districts, there was still a lack of human resources, unavailability of budget, suboptimal communication and disposition, which caused the implementation of KAPITU to not run optimally. Furthermore, social, economic, and political environmental factors also influenced the implementation of KAPITU. The conclusion is that the implementation of KAPITU that is running well is directly proportional to the achievement of TB program indicators which are also good. Sub-districts that show good implementation of the KAPITU program, such as Mampang and Suka Maju Baru, have better achievements. Furthermore, Sawangan Baru and Sawangan Lama Sub-districts also show an increase in program achievements after the KAPITU task force started operating again. Sub-districts that have not implemented KAPITU properly, such as Cilodong and Pasir Putih, also show poor achievement of TB program indicators.
