PEMBIAYAAN PUSKESMAS SEBELUM DAN SESUDAH PELAKSANAAN JAMINAN KESEHATAN NASIONAL DI KABUPATEN BANYUWANGI

PUBLIC HEALTH CENTER FINANCING BEFORE DAN AFTER THE IMPLEMENTATION OF NATIONAL HEALTH INSURANCE IN BANYUWANGI DISTRICT

Abstract

Background: Public health center financing has increased
since the implementation of JKN. The operational budget which
is managed by public health center is so different after the
implementation of National Health Insurance, the increasing is
very drastic. On the other hand, the local government budget
funds is decreasing and the portion is smaller than before.

Objective: To describe the financial management of public
health center before and after the implementation of national
health insurance in Banyuwangi district.

Methods: The study was a descriptive case study with use
qualitative data and quantitative data. Informants in this study
were 36 persons consist of 6 persons from the district health
department, 3 persons from other cross sectors, and 27 persons
from the public health centers. Those samples were taken by
purposive sampling technique.

Results: There were several things that distinguish the
financing management of public health center after the
implementation of JKN. They were the commitment from local
government to focus on routine operations budgeting, the more
complicated for public health centers process of planning and
budgeting due to limited human resources and time, the lack of
internal coordination in the public health center, the less
understanding from human resources on planning process, and
the lower utilization of funds from capitation due to obstruction in
drug procurement process, disposable materials and
regulation. Monitoring was focused on financial administration.
The ANOVA test showed : 1) There was a significant difference
of realization BOK funds in public health center before and after
JKN with p = 0.0025 (p < 0.05), 2) There was a significant
difference capitation funds realization before and after
implementation of JKN with p = 0.0016 (p < 0.05), 3) There was
no significant difference (p = 0.4257) of APBD funds realization
before and after the implementation of JKN.

Conclusions: Implementation of JKN had impacted to
financing management system of public health center and there
were statistically differences of realization of BOK funds and
capitation funds in public health center before and after JKN and
there was no difference of realization of APBD funds before and
after the implementation of JKN