Yandrizal Yandrizal(1*), Betri Anita Anita(2), Desri Suryani(3)

(*) Corresponding Author


Background. Mayor of Bengkulu Regulation Number 13 Year
2012 on The Implementation Guidelines for State Health
Insurance Assistance Costs (Jamkeskot) in Bengkulu city is
managed by the Secretariate of the Government of Community
Welfare Section in Bengkulu. The cost of referral health care
in Provincial General Hospital could be made more efficient by
optimizing the role of community health centers as a curative,
preventive and promotive health services. It is hoped to reduce
the number of visits for treatment and referral to hospital. The
purpose of this study is to analyze the City Health Insurance
policies in an effort to improve the efficiency and effectiveness
of primary health care and public health efforts to reduce the
number of visits for treatment and referral to hospital.
Method: The type of research is non-experimental research,
or also called qualitative research. It is an exploratory research
to find a new role of the city government and Administering
Agency to improve the efficiency and effectiveness of health
services at the health center.
Unit of Analysis: 1) Community Health Center Unit 20, 2)
organizing: PT. Askes 2 person and Community Welfare section
2 person, 3) the City: Head of the Community Welfare Section
1 person, Bengkulu City Health Office 2 person. Data is collected
using interview using questionnaire as the instrument, and
documents review.
Results: Bengkulu Jamkeskot policies have not applied the
principle of insurance in which the organizers serves to control
the quality and cost of health care provided in both basic
services/primary and referral services. Most of the health
centers tend to refer patients (67%) that are still within their
authorization to provide care. The reason being: the health
centers have limited equipment and drugs, and some patients
demanded to be referred due to perceived bad quality of service
at the health centers. The Community Welfare section has not
coordinated with the City Health Office to conduct training for
the health center in an effort to increase the effectiveness of
Recommendation: The City Government is to establish a
team to conduct technical guidance supervision to health
centers to ensure that the health centers play the role of
gatekeeper and only refer patients that need complex care,
providing medical equipment and drugs to the health centers
with proposed funding from Bengkulu City budget and provincial
budget. The Health Centers are to provide routine counseling
on healthy behavior and IEC on nutrition and hygiene to every
posyandu. The City Health Office provides technical guidance
in drafting POA for promotive and preventive activities to have
more focus in efforts to control the causes of disease. Improve
policy management of Jamkeskot by submitting the management
to an administering body, so that the Jamkeskot can apply the
insurance principles where the strong help the weak, the
healthy help the sick, the rich help the poor; and also can
control the quality and cost of service.
Keywords: Health Policy, Health Insurance, Gatekeeper

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