Analisis Biaya Per Kapita sebagai Upaya Advokasi Pengendalian Biaya Program Jaminan Kesehatan Jembrana

dr. Pande Putu Januraga, M.Kes, DrPH, PANDE PUTU JANURAGA (2010) Analisis Biaya Per Kapita sebagai Upaya Advokasi Pengendalian Biaya Program Jaminan Kesehatan Jembrana. Jurnal Manajemen Pelayanan Kesehatan (JMPK), 13. ISSN 1410-6516

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Introductions: Jembrana Health Insurance (JHI) program is intended to provide health insurance at first level (PPK I) for inhabitants of Jembrana District. Up till now, financing of JHI depends on subsidy in which it is growing up and has a trend to be out of target. Therefore, it needs to manage cost by implementing capitation payment system. Aim of this research was to analyze cost per capita and to identify perceptions of JHI stakeholders towards capitation system. Methods: This research was case study through analyzing secondary data and performing in-depth interview. Data on member’s utilization and claim cost were collected using forms. Results: Result of cost per capita calculation based on real utilization of PPK I namely Rp5.262,- per month per member is 63 % higher than cost per capita based on normal utilization of PPK I namely Rp1.949,- per month per member. Furthermore, result of in-depth interview shows that both policy makers and providers have a bad perception towards capitation system and results of cost per capita calculation. Conclusions: Local government could apply principles of managed care by controlling cost and quality by developing capitation payment system for PPK I based on normal utilization.

Item Type: Article
Uncontrolled Keywords: health insurance, cost per capita, capitation
Subjects: L Education > L Education (General)
Divisions: Faculty of Law, Arts and Social Sciences > School of Education
Depositing User: Mr. Repository Admin
Date Deposited: 07 Jun 2016 21:58
Last Modified: 21 Jun 2016 05:58

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