Analisis Pemetaan Integrasi Program Jaminan Kesehatan Daerah ke Program Jaminan Kesehatan Nasional di Kabupaten Purbalingga Tahun 2016-2018

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan 2016 ABSTRAK Devi Setyawati Analisis Pemetaan Integrasi Program Jaminan Kesehatan Daerah ke Program Jaminan Kesehatan Nasional di Kabupaten Purbalingga Tahun 2016-2018 xvii+ 147 halaman + 26 tabel + 7 gambar + 19 lampiran Sistem jaminan kesehatan di Indonesia telah berkembang dengan diberlakukannya program Jaminan Kesehatan Nasional sejak 1 Januari 2014. Pada tahun 2015 Pemerintah Kabupaten Purbalingga melaksanakan integrasi Program Jaminan Kesehatan Daerah ke Jaminan Kesehatan Nasional, namun terdapat beberapa permasalahan antara lain pada aspek kepesertaan, pelayanan kesehatan, pembiayaan dan kelembagaan. Oleh karena itu perlu dilakukan pemetaan Integrasi Program Jaminan Kesehatan Daerah ke Program Jaminan Kesehatan Nasional di Kabupaten Purbalingga. Penelitian ini adalah penelitian kualitatif. Subjek penelitian ditetapkan dengan purposive samplingpada Tim Integrasi dan bidang terkait Jaminan Kesehatan. Data diolah dan dianalisis dengan menggunakan analisis isi.Hasil penelitian menunjukkan bahwa permasalahan yang dijumpai adalah: 1) Aspek kepesertaan: belum dilakukan validasi terhadap peserta program Jamkesda masyarakat miskin, kemungkinan adanya inclussion error atau exclussion error, ketidaklengkapan data, dan penurunan jumlah peserta program Jamkesda masyarakat mampu; 2) Aspek pelayanan kesehatan: Fasilitas kesehatan swasta belum merata, pelayanan di fasilitas kesehatan tingkat lanjut belum memuaskan, belum seluruh masyarakat memahami prosedur pelayanan kesehatan; 3) Aspek pembiayaan: Anggaran Pendapatan dan Belanja Daerah Kabupaten Purbalingga belum mencukupi untuk pelaksanaan integrasi; 4) Aspek kelembagaan: Koordinasi Tim Integrasi belum optimal, keberadaan UPTD Jamkesda tidak sejalan dengan Undang-Undang Nomor 24 Tahun 2011 tentang Badan Penyelenggara Jaminan Sosial. Sebagai upaya mengatasi masalah tersebut maka dilakukan pemetaan dan disusun peta jalan integrasi program Jaminan Kesehatan Daerah ke Jaminan Kesehatan Nasional di Kabupaten Purbalingga dimulai dengan validasi data program Jamkesda, validasi data Penerima Bantuan Iuran dari Anggaran Pendapatan Belanja Negara, penambahan Sumber Daya Manusia Kesehatan, pemetaan wilayah fasilitas kesehatan, penambahan fasilitas kesehatan swasta, Akreditasi Puskesmas, Monitoring dan Evaluasi, Sosialisasi Program Jaminan Kesehatan Nasional, dan Koordinasi Tim Integrasi.Disarankan kepada Pemerintah Kabupaten agardilakukan pembahasan dengan stakeholder yang lebih luas terkait peta jalan integrasi Program Jamkesda ke JKN dapat dilaksanakan lebih baik. Kata kunci : Integrasi, Jamkesda, JKN, Purbalingga Kepustakaan : 85 (1992-2015) Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Administration and Health Policy 2016 ABSTRACT Devi Setyawati Integration Mapping Analysis of Regional Health Insurance Programto National Health Insurance Program in District of Purbalingga in 2016-2018 xvii + 147 pages + 26 tables + 7 figures + 19 appendices A health insurance system in Indonesia has implemented National Health Insurance program since 1 January 2014. In 2015, a local government of Purbalingga District integrated the regional health insurance program to the national health insurance program. Notwithstanding, there had some problems such as aspects of membership, health service, funding, and institutional. Therefore, there needed to map these integration activities in Purbalingga District. This was a qualitative study. Research subjects were selected using a technique of purposive sampling on an integration team and health insurance-related sectors. Data were analysed using a method of content analysis. The results of this research showed that some problems faced were as follows: 1) regarding aspect of membership, there were no validation for members of the regional health insurance program from poor society; any possibility of inclusion or exclusion errors, incomplete data, and the decrease of membership number of the regional health insurance program from rich society; 2) regarding aspect of health service, private health facilities were unequal and not all people understood a procedure of health service; 3) regarding aspect of funding, local budget revenue and expenditure of Purbalingga District were insufficient to conduct integration; 4) regarding aspect of institutional, coordination of integration team was not optimal, the existence of the regional health insurance unit was not in line with the act number 24 year 2011 about Social Insurance Provider. As an effort to overcome these problems, mapping was arranged by the following activities: validating data of the program, validating data of receivers, adding health human resource, mapping area of health facilities, adding private health facilities, doing accreditation for health centre, monitoring and evaluating, socialising the National Health Insurance program, and coordinating the integration team. The local government needs to discuss with other stakeholders about the integration road map of the regional health insurance programto the national health insurance in order to be well implemented. Keywords : Integration, Regional Health Insurance, National Health Insurance, Purbalingga Bibliography: 85 (1992-2015)