Analisis Kesiapan Klinik Pratama Akbid Muhammadiyah Cirebon dalam Menghadapi Pembayaran Kapitasi Berbasis Kinerja

https://doi.org/10.22146/jkki.65318

Ari Nurfikri(1*)

(1) Program Pendidikan Vokasi Universitas Indonesia
(*) Corresponding Author

Abstract


Performance-based capitation payments complement capitation payments based on the fulfillment of service commitments, which in principle will make adjustments to the capitation received if it does not meet the predetermined indicators. The Primary Clinic Akbid Muhammadiyah Cirebon requires a performance-based analysis of the readiness to face capitation payments. The purpose of this study was to simulate income before and after performance-based capitation adjustments and to see the readiness of the Primary Clinic Akbid Muhammadiyah Cirebon in facing performance-based capitation payments in terms of information, authority, staff, and infrastructure. This research uses an explanatory sequential mixed-method approach. In the first phase, data from primary care in 2020 is simulated so that income is known after adjustment by looking at three indicators. The qualitative phase is carried out by in-depth interviews with clinic leaders, medical support and service coordinators, management coordinators, and medical record staff to analyze the clinic's readiness to face performance-based capitation payments. The results showed that the clinic had not been able to meet all performance-based capitation payment indicators so that the income decreased by Rp. 23,178,200. Preparation from the information side by optimizing the JKN Mobile application as a telemedicine service, in terms of authority with regulations governing non-specialized referrals, from infrastructure side with the repair of computers and internet networks, from the staff side with training in both educational materials and innovative delivery media. The study concluded that the clinic requires system improvements in terms of information, authority, infrastructure, and staff to meet indicators of contact rates, non-specialist outpatient referral ratios, and prolanis participant ratio.

 

Keywords: Contac number, Referral, Prolanis

 

Keywords


Contac number; Referral; Prolanis

Full Text:

PDF


References

Hasri ET, Wulan S, Djasri H. Evaluasi Kebijakan Kendali Mutu dan Kendali Biaya , Pencegahan Kecurangan dan Kapitasi Berbasis Komitmen dalam Era JKN di Provinsi Bengkulu Menggunakan Pendekatan Realis Evaluasi. PKMK FK-KMK UGM. 2019;1–12. 2. BPJS. Peraturan Badan Penyelenggara Jaminan Sosial Kesehatan Nomor 7 Tahun 2019 tentang Petunjuk Pelaksanaan Pembayaran Kapitasi Berbasis Kinerja. 2019;1–26. 3. Tan SY. Bureaucratic autonomy and policy capacity in the implementation of capitation payment systems in primary healthcare: comparative case studies of three districts in Central Java, Indonesia. J Asian Public Policy [Internet]. 2019;12(3):330–50. Available from: https://doi.org/10.1080/17516234.2018.1459150 4. Pay ME, Meliala A, Handono D. Performance Based Payment (PBP) dan Kepuasan Kompensasi dalam Pemberian Jasa Pelayanan Kapitasi Jaminan Kesehatan Nasional Bagi Tenaga Kesehatan Puskesmas di Kabupaten Ende. BKM J Community Med Public Heal [Internet]. 2018;34(12):461–6. Available from: https://journal.ugm.ac.id/bkm/article/view/38850 5. Tan SY, Qian J. An unintended consequence of provider payment reform: The case of capitation grants in the National Health Insurance reform of Indonesia. Int J Health Plann Manage. 2019;34(4):e1688–710. 6. Munawarah SH, Misnaniarti M, Isnurhadi I. Sumber Daya Terhadap Pencapaian Indikator Kapitasi Berbasis Pemenuhan Komitmen Pelayanan (KBPKP) di Puskesmas Kota Palembang. Gaster. 2020;18(1):37. 7. Creswell JW. Research Design Pendekatan Metode Kualitatif, Kuantitatif, dan Campuran Edisi 4. 2017. 8. Pasaribu KF, Hendrartini J, Hafidz F. Analisis Pemanfaatan Dana Kapitasi Khusus di Kabupaten Nias Utara. J Kebijak Kesehat Indones JKKI [Internet]. 2019;8(3):121–6. Available from: https://jurnal.ugm.ac.id/jkki/article/view/47885 9. Febriawati H, Yandrizal Y, Afriza Y, Pratiwi BA, Yanuarti R, Suryani D. Analisis Besaran dan Pembayaran Kapitasi Berbasis Komitmen Pelayanan terhadap Pengendalian Rujukan di Puskesmas Kota Bengkulu [Internet]. Vol. 6, Jurnal Kebijakan Kesehatan Indonesia : JKKI. 2017. p. 204–9. Available from: https://journal.ugm.ac.id/jkki/article/view/30890 10. Setiawati ME, Nurrizka RH. Evaluasi Pelaksanaan Sistem Rujukan Berjenjang dalam Program Jaminan Kesehatan Nasional. J Kebijak Kesehat Indones JKKI [Internet]. 2019;8(1):35–40. Available from: https://jurnal.ugm.ac.id/jkki/article/view/43843 11. Meiriana A, Trisnanto L, Padmawati RS. Implementasi Program Pengelolaan Penyakit Kronis (Prolanis) Pada Penyakit Hipertensi Di Puskesmas Jetis Kota Yogyakarta. J Kebijak Kesehat Indones JKKI [Internet]. 2018;08(02):51–8. Available from: http://etd.repository.ugm.ac.id/index.php?mod=book_detail&sub=BookDetail&act=view&typ=htmlext&buku_id=163144&obyek_id=4&unitid=&jenis_id= 12. Widodextrosa, Muryanto I, Rany N, Hanafi A, Puspasari A. Achievement Efforts Based On The Fulfillment of Service Commitments (KBPKP) Analysis in Puskesmas Rumbai, Pekanbaru City. 2020;6(3):310–27. Available from: https://jurnal.htp.ac.id/index.php/keskom/article/view/597 13. Sucipto H, Suryawati C, Jati SP. Faktor - Faktor yang Mempengaruhi Komitmen Dokter di Puskesmas untuk Tidak Merujuk Kasus Non-Spesialistik Pasien BPJS di Kota Semarang. J Manaj Kesehat Indones. 2019; 14. Kurniawan A, Mustika DA, Muhammad RC, Putri SC. Evaluasi Implementasi Aplikasi Primary Care (Pcare) di Klinik Laras Hati. J Kesehat Vokasional. 2019;4(1):21. 15. Kurniawan A, Tamtomo D, Murti B. Evaluation of Community Health Center Management Information System (SIMPUS), Primary Care (P Care), and Bridging Data System in Sukoharjo District. J Heal Policy Manag. 2017;02(02):157–64.



DOI: https://doi.org/10.22146/jkki.65318

Article Metrics

Abstract views : 855 | views : 684

Refbacks

  • There are currently no refbacks.


Copyright (c) 2021 Jurnal Kebijakan Kesehatan Indonesia : JKKI

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

The Jurnal Kebijakan Kesehatan Indonesia : JKKI [ISSN 2089 2624 (print); ISSN 2620 4703 (online)] is published by Center for Health Policy and Management (CHPM). This website is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. Built on the Public Knowledge Project's OJS 2.4.8.1.
 Web
Analytics View My Stats