Papers by Budi Eko Siswoyo
Background: During the two years of implementation of the National Health Insurance (JKN), many n... more Background: During the two years of implementation of the National Health Insurance (JKN), many national and district regulations have been published and revised. However, there is no clear regulation in the management of unutilized capitation fund. The high actual capitation in line with the low utilization ratio, which means it could potentially lead unutilized capitation. Financial management in the district that has not been integrated with unutilized capitation become a challenge for the Puskesmas to accommodate the operational requirements of service.
Objective: To analyze the potential and the management of unutilized capitation of JKN program at the Puskesmas and its determinant factors
Method: This is a case study using cross sectional design and implementation research approach. A total of 492 samples in 13 regionals and 26 districts were selected using multistage random sampling. Primary data were collected through series of interviews and FGDs using a standardized questionnaire. Variables that become secondary data (2014-2015) were collected from Puskesmas and BPJS Kesehatan database. Qualitative data were analyzed using thematic approach and quantitative data were analyzed descriptively and analytically using test for comparison and correlation.
Result: Allocation in the utilization of capitation funds, distribution of membership, geographical aspects, service time, the ratio of doctors to the participants, contact rate, total revenue from the Puskesmas have correlation to the unutilized capitation and performance indicators. Planning, budgeting, and disbursement of unutilized capitation follow the budget mechanism of APBD, either early budget document or the mid-year budget document; so it can not be used directly by Puskesmas without submission, reconciliation, and the budget approval from the district government. Nevertheless, the majority of Puskesmas do not manage unutilized capitation because there are no local regulations and technical guidelines for managing unutilized capitation fund.
Conclusion: Intervention should consider the variables that had a significant correlation value, both on unutilized capitation and performance indicators. It is necessary to evaluate the fund channeling; and also the strengthening of the regulation should also be followed by optimizing the role BPJS Kesehatan, Health Office, and other stakeholders to support the implementation of the concept of strategic purchasing.
Keywords: unutilized fund, capitation, JKN
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Background: The Indonesian National Health Insurance (JKN) was commenced in early 2014. BPJS Kese... more Background: The Indonesian National Health Insurance (JKN) was commenced in early 2014. BPJS Kesehatan (parastatal organization appointed as JKN management entity) and the primary health centers (PHCs) are dealing with challenges and bottlenecks in providing quality health service to JKN beneficiaries. One of the challenges is the management and utilization of the capitation fund, which is used as the payment model for PHC. The monitoring and evaluation of the capitation fund are imperative to improve the attainment of universal health coverage through JKN program.
Objective: To analyze the management and utilization of capitation fund in PHC including the bottlenecks and to generate solutions in the implementation of JKN.
Method: This is a descriptive study using quantitative and qualitative approaches. A total of 384 PHCs in 7 regionals and 20 districts were selected using random sampling. Primary data were collected through series of interviews and FGDs using a standardized questionnaire. Secondary data on capitation fund and health care services (2014-mid 2015) were collected from primary health centers and BPJS Kesehatan database. Qualitative data were analyzed using thematic approach and quantitative data were descriptively analyzed to show the capitation fund and health care utilization trend at PHC level.
Result: Although an increase in overall income from capitation fund was observed in the majority of PHCs, there was a higher increase in patient utilization leading to lower actual capitation income generated by PHCs. Such finding is applicable morely to Private GP Practice (Dokter Praktik Perorangan) and Private Primary Clinic (Klinik Pratama). Quantitative findings show that most private PHCs experienced deficit. Most Puskesmas used Head of District decree/district regulation as the main legal basis for capitation fund management and utilization. However, many of the local regulations are not completely in line with central-level mainly because of the rapid changes at the central-level. Such disconnection of policies between levels of government has led to confusion at the PHC level in fund management and use. As the sole purchaser, BPJS Kesehatan is considered to be not yet well involved in district capitation fund planning and budgeting. Such practices were perceived to be even less condusive in the monitoring and evaluation of capitation fund usage.
Conclusion: To ensure the quality of care and the sustainability of PHCs as JKN providers, capitation fund should be increased. Local government needs to support JKN implementation by issuing clear guidelines that follow central policies on how PHCs should plan and manage capitation fund. Continuous monitoring and evaluation of capitation fund is important to ensure that JKN program targets are achieved at the primary care level.
Keywords: capitation, management, utilization
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Background:
The subsidized members (PBI) dominate the membership of the National Health Insurance... more Background:
The subsidized members (PBI) dominate the membership of the National Health Insurance Scheme (JKN) in Indonesia, including in Yogyakarta. The low number of non wage earners (PBPU) and decreasing in the number of new non-PBI members, doesn’t indicate inoptimal socialization, but also the lack of a awareness of informal sector workers towards JKN. Public awareness determines the ability and community involvement in support JKN.
Objective:
To analyze the informal sector workers’ awareness of the JKN programs in Yogyakarta
Method:
This study was observational analytic with cross sectional design. The subjects are informal workers in Yogyakarta who have not joined JKN, set with quota sampling (200 respondents) and they were selected purposively. The data was collected by questionnaire and analyzed using quantitative and qualitative approaches as univariate, bivariate, and multivariate.
Result:
Linear regression test showed that the affect of independent variables towards consciousness, namely: the main types of jobs [B = 2,5452 dan (p) = 0,00 < ±]; education [B = 1,6609 dan (p) = 0,00 < ±]; knowledge [B = 1,3944 dan (p) = 0,00 < ±]; age [B = 1,0736 dan (p) = 0,00 < ±]; employment status [B = 1,0451 dan (p) = 0,01 < ±]; and income [B = 0,0001 dan (p) = 0,02 < ±].
Conclusion:
Generally, the level of awareness of the informal sector workers towards JKN is considered in high category. However, most informal sector workers tend to delay membership.
Keywords:
awareness, informal sector workers, JKN
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Switching barriers are one of the customer retention strategy in suppressing customers retention ... more Switching barriers are one of the customer retention strategy in suppressing customers retention rate. This study was conducted to analyze the effect of switching barriers and promotion effects on patient loyalty in hospitalized installation of RS Muhammadiyah Surabaya. This was an analytical study using the observational method and cross sectional design. Data obtained by distributing questionnaires into 77 patients in the inpatient ward of Muhammadiyah Surabaya Hospital. The results showed that promotion effects highly created attractiveness, willingness purchase, and purchase behavior. Meanwhile it could not create the perceived acquisition value. Respondents' assessment of switching barriers such as interpersonal relationship was considered very good, perceived switching cost was considered very high, and the attractiveness of alternatives considered was very low. Most of patients had enough loyalty and most of them have the affective loyalty and the advocator loyalty. Conclusions can be drawn from this research that there was no effect between the promotion effects on switching barriers. The research showed that no effect of the promotion effects and switching barriers
on patient loyalty, but aspects of interpersonal relationship was unsignificant. So in developing customer retention strategies in order to improve patient loyalty, hospital needs emphasize the promotion effects and switching barriers.
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Papers by Budi Eko Siswoyo
Objective: To analyze the potential and the management of unutilized capitation of JKN program at the Puskesmas and its determinant factors
Method: This is a case study using cross sectional design and implementation research approach. A total of 492 samples in 13 regionals and 26 districts were selected using multistage random sampling. Primary data were collected through series of interviews and FGDs using a standardized questionnaire. Variables that become secondary data (2014-2015) were collected from Puskesmas and BPJS Kesehatan database. Qualitative data were analyzed using thematic approach and quantitative data were analyzed descriptively and analytically using test for comparison and correlation.
Result: Allocation in the utilization of capitation funds, distribution of membership, geographical aspects, service time, the ratio of doctors to the participants, contact rate, total revenue from the Puskesmas have correlation to the unutilized capitation and performance indicators. Planning, budgeting, and disbursement of unutilized capitation follow the budget mechanism of APBD, either early budget document or the mid-year budget document; so it can not be used directly by Puskesmas without submission, reconciliation, and the budget approval from the district government. Nevertheless, the majority of Puskesmas do not manage unutilized capitation because there are no local regulations and technical guidelines for managing unutilized capitation fund.
Conclusion: Intervention should consider the variables that had a significant correlation value, both on unutilized capitation and performance indicators. It is necessary to evaluate the fund channeling; and also the strengthening of the regulation should also be followed by optimizing the role BPJS Kesehatan, Health Office, and other stakeholders to support the implementation of the concept of strategic purchasing.
Keywords: unutilized fund, capitation, JKN
Objective: To analyze the management and utilization of capitation fund in PHC including the bottlenecks and to generate solutions in the implementation of JKN.
Method: This is a descriptive study using quantitative and qualitative approaches. A total of 384 PHCs in 7 regionals and 20 districts were selected using random sampling. Primary data were collected through series of interviews and FGDs using a standardized questionnaire. Secondary data on capitation fund and health care services (2014-mid 2015) were collected from primary health centers and BPJS Kesehatan database. Qualitative data were analyzed using thematic approach and quantitative data were descriptively analyzed to show the capitation fund and health care utilization trend at PHC level.
Result: Although an increase in overall income from capitation fund was observed in the majority of PHCs, there was a higher increase in patient utilization leading to lower actual capitation income generated by PHCs. Such finding is applicable morely to Private GP Practice (Dokter Praktik Perorangan) and Private Primary Clinic (Klinik Pratama). Quantitative findings show that most private PHCs experienced deficit. Most Puskesmas used Head of District decree/district regulation as the main legal basis for capitation fund management and utilization. However, many of the local regulations are not completely in line with central-level mainly because of the rapid changes at the central-level. Such disconnection of policies between levels of government has led to confusion at the PHC level in fund management and use. As the sole purchaser, BPJS Kesehatan is considered to be not yet well involved in district capitation fund planning and budgeting. Such practices were perceived to be even less condusive in the monitoring and evaluation of capitation fund usage.
Conclusion: To ensure the quality of care and the sustainability of PHCs as JKN providers, capitation fund should be increased. Local government needs to support JKN implementation by issuing clear guidelines that follow central policies on how PHCs should plan and manage capitation fund. Continuous monitoring and evaluation of capitation fund is important to ensure that JKN program targets are achieved at the primary care level.
Keywords: capitation, management, utilization
The subsidized members (PBI) dominate the membership of the National Health Insurance Scheme (JKN) in Indonesia, including in Yogyakarta. The low number of non wage earners (PBPU) and decreasing in the number of new non-PBI members, doesn’t indicate inoptimal socialization, but also the lack of a awareness of informal sector workers towards JKN. Public awareness determines the ability and community involvement in support JKN.
Objective:
To analyze the informal sector workers’ awareness of the JKN programs in Yogyakarta
Method:
This study was observational analytic with cross sectional design. The subjects are informal workers in Yogyakarta who have not joined JKN, set with quota sampling (200 respondents) and they were selected purposively. The data was collected by questionnaire and analyzed using quantitative and qualitative approaches as univariate, bivariate, and multivariate.
Result:
Linear regression test showed that the affect of independent variables towards consciousness, namely: the main types of jobs [B = 2,5452 dan (p) = 0,00 < ±]; education [B = 1,6609 dan (p) = 0,00 < ±]; knowledge [B = 1,3944 dan (p) = 0,00 < ±]; age [B = 1,0736 dan (p) = 0,00 < ±]; employment status [B = 1,0451 dan (p) = 0,01 < ±]; and income [B = 0,0001 dan (p) = 0,02 < ±].
Conclusion:
Generally, the level of awareness of the informal sector workers towards JKN is considered in high category. However, most informal sector workers tend to delay membership.
Keywords:
awareness, informal sector workers, JKN
on patient loyalty, but aspects of interpersonal relationship was unsignificant. So in developing customer retention strategies in order to improve patient loyalty, hospital needs emphasize the promotion effects and switching barriers.
Objective: To analyze the potential and the management of unutilized capitation of JKN program at the Puskesmas and its determinant factors
Method: This is a case study using cross sectional design and implementation research approach. A total of 492 samples in 13 regionals and 26 districts were selected using multistage random sampling. Primary data were collected through series of interviews and FGDs using a standardized questionnaire. Variables that become secondary data (2014-2015) were collected from Puskesmas and BPJS Kesehatan database. Qualitative data were analyzed using thematic approach and quantitative data were analyzed descriptively and analytically using test for comparison and correlation.
Result: Allocation in the utilization of capitation funds, distribution of membership, geographical aspects, service time, the ratio of doctors to the participants, contact rate, total revenue from the Puskesmas have correlation to the unutilized capitation and performance indicators. Planning, budgeting, and disbursement of unutilized capitation follow the budget mechanism of APBD, either early budget document or the mid-year budget document; so it can not be used directly by Puskesmas without submission, reconciliation, and the budget approval from the district government. Nevertheless, the majority of Puskesmas do not manage unutilized capitation because there are no local regulations and technical guidelines for managing unutilized capitation fund.
Conclusion: Intervention should consider the variables that had a significant correlation value, both on unutilized capitation and performance indicators. It is necessary to evaluate the fund channeling; and also the strengthening of the regulation should also be followed by optimizing the role BPJS Kesehatan, Health Office, and other stakeholders to support the implementation of the concept of strategic purchasing.
Keywords: unutilized fund, capitation, JKN
Objective: To analyze the management and utilization of capitation fund in PHC including the bottlenecks and to generate solutions in the implementation of JKN.
Method: This is a descriptive study using quantitative and qualitative approaches. A total of 384 PHCs in 7 regionals and 20 districts were selected using random sampling. Primary data were collected through series of interviews and FGDs using a standardized questionnaire. Secondary data on capitation fund and health care services (2014-mid 2015) were collected from primary health centers and BPJS Kesehatan database. Qualitative data were analyzed using thematic approach and quantitative data were descriptively analyzed to show the capitation fund and health care utilization trend at PHC level.
Result: Although an increase in overall income from capitation fund was observed in the majority of PHCs, there was a higher increase in patient utilization leading to lower actual capitation income generated by PHCs. Such finding is applicable morely to Private GP Practice (Dokter Praktik Perorangan) and Private Primary Clinic (Klinik Pratama). Quantitative findings show that most private PHCs experienced deficit. Most Puskesmas used Head of District decree/district regulation as the main legal basis for capitation fund management and utilization. However, many of the local regulations are not completely in line with central-level mainly because of the rapid changes at the central-level. Such disconnection of policies between levels of government has led to confusion at the PHC level in fund management and use. As the sole purchaser, BPJS Kesehatan is considered to be not yet well involved in district capitation fund planning and budgeting. Such practices were perceived to be even less condusive in the monitoring and evaluation of capitation fund usage.
Conclusion: To ensure the quality of care and the sustainability of PHCs as JKN providers, capitation fund should be increased. Local government needs to support JKN implementation by issuing clear guidelines that follow central policies on how PHCs should plan and manage capitation fund. Continuous monitoring and evaluation of capitation fund is important to ensure that JKN program targets are achieved at the primary care level.
Keywords: capitation, management, utilization
The subsidized members (PBI) dominate the membership of the National Health Insurance Scheme (JKN) in Indonesia, including in Yogyakarta. The low number of non wage earners (PBPU) and decreasing in the number of new non-PBI members, doesn’t indicate inoptimal socialization, but also the lack of a awareness of informal sector workers towards JKN. Public awareness determines the ability and community involvement in support JKN.
Objective:
To analyze the informal sector workers’ awareness of the JKN programs in Yogyakarta
Method:
This study was observational analytic with cross sectional design. The subjects are informal workers in Yogyakarta who have not joined JKN, set with quota sampling (200 respondents) and they were selected purposively. The data was collected by questionnaire and analyzed using quantitative and qualitative approaches as univariate, bivariate, and multivariate.
Result:
Linear regression test showed that the affect of independent variables towards consciousness, namely: the main types of jobs [B = 2,5452 dan (p) = 0,00 < ±]; education [B = 1,6609 dan (p) = 0,00 < ±]; knowledge [B = 1,3944 dan (p) = 0,00 < ±]; age [B = 1,0736 dan (p) = 0,00 < ±]; employment status [B = 1,0451 dan (p) = 0,01 < ±]; and income [B = 0,0001 dan (p) = 0,02 < ±].
Conclusion:
Generally, the level of awareness of the informal sector workers towards JKN is considered in high category. However, most informal sector workers tend to delay membership.
Keywords:
awareness, informal sector workers, JKN
on patient loyalty, but aspects of interpersonal relationship was unsignificant. So in developing customer retention strategies in order to improve patient loyalty, hospital needs emphasize the promotion effects and switching barriers.