Analisis ketersediaan fasilitas kesehatan dan pemerataan pelayanan pada pelaksanaan jaminan kesehatan nasional di kota Bengkulu, kebupaten Seluma dan kabupaten Kaur
Date
2014
Journal Title
Journal ISSN
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Publisher
Pusat Kebijakan dan Manajemen Kesehatan, Universitas Gadjah Mada, Yogyakarta, ID
Abstract
Background: National health insurance is starting in 2014 to
gradually move towards Universal Health Coverage. The
program should make access health services easier for the
community. However limited number of health care givers, a
vast population and difficult geographical access mean that
there is limited provision of services by the Government and
other parties. It appears that the difficulty of access to health
facilities remains. The provision of health services is dependent
on infrastructure in the community. Without any infrastructure
improvements, equitable health service becomes difficult and
health coverage for the community is not real. The problem is
that whether the national health insurance policy administered
by the health-BPJS can improve access to medical services
and quality health services to all citizens of Indonesia based
on fundamental justice.
Objective: To assess the availability and equitable health
services as well as the policies for equitable distribution of
health facilities within the national health insurance program in
the city of Bengkulu, District Seluma and District Kaur.
Method: This research is using a formative evaluation method,
designed to assess how program policy was implemented
and how to modify and to develop new policies so as to bring
improvement.The kind of data collected are qualitative and
quantitative data. Quantitative data is used to see availability
and coverage health, while qualitative data is used to get
perception of service provider and program manager of the
national health insurance, as well as the challenge and barrier
found in implementation process. Data qualitative is obtained
using open questionnaire. Quantitative data is derived from a
contract between District/municipality health office by health-
BPJS and health facility data. Data analysis is compared
between District/municipal data, standards according to the
regulation and health system according to the WHO and
scenario planning.
Results: The ratio of the available primary care facilityin Kaur
is 17,13 per 100.00o or one per 5.837 inhabitants; while in
Bengkulu city it is 13,16 per 100.000 or one for 7.598 inhabitants;
and in District Seluma it is one for 7.770 inhabitants. Percentage
of contracts for primary services in Bengkulu city is 87,62 %,
in District Seluma is 80.41 %, and in District Kaur is 80.73 %.
The distance to access primary care facility in District Seluma
and District Kaur is 2 hours away if using ‘ojek’ (motorcycle
taxi), and the is fare IDR200.000,- (one-way). In Bengkulu, the
most distant is 20 minutes and the fare is IDR10.000,-. The
ratio of available referral care services in Bengkulu City is 1,88
per 100.000 inhabitants, while in District Seluma is 0,56 per 100.000 inhabitants, and in District Kaur is 0,90 per 100.000
inhabitants. Therefore we need additional primary health
facilities supported by the agency of the social security (BPJS),
District/City government/Provincial government and the Ministry
of Health. While the ratio of beds in the Bengkulu City is 629, in
District Seluma is 3.574, and in district Kaur is 2.778. District
Seluma needs as many as 129 more beds while District Kaur
needs another 60 beds to meet the requirement. The Regional
Public hospital in District Kaur and District Seluma are still class
D. To increase the capacity at these two hospitals to become
class C within 5 (five) years is possible. However, these efforts
require special policy from city/district government, Provinces
and the Ministry of Health as well as the social security agency
(BPJS) considering the limited capacity of the local governments.
Conclusion: The availability of primary health facilities in
Bengkulu city, Seluma districy and Kaur district are not enough
according to Road Map to JKN 2019. Referral health facilities in
Seluma district and Kaur district are much lower than the target,
whereas in Bengkulu city the number is on target. Utilization of
primary health facilities in Bengkulu city, Seluma district and
Kaur district are still lower than national average. Utilization of
referral helth facilities in the province of Bengkulu is still lower
than national average.
Description
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Journal Article (peer-reviewed)
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Text
Keywords
ACCESS TO HEALTH CARE, HEALTH INSURANCE, GEOGRAPHICAL CONDITIONS, PHYSICAL INFRASTRUCTURE, FORMATIVE EVALUATION
Citation
Yandrizal, Suryani, D., Anita, B., & Febriawati, H. (2014). Analisis ketersediaan fasilitas kesehatan dan pemerataan pelayanan pada pelaksanaan jaminan kesehatan nasional di kota Bengkulu, kebupaten Seluma dan kabupaten Kaur. Jurnal Kebijakan Kesehatan Indonesia, 3(2): 103-112.