skip to main content

IMPLEMENTASI FUNGSI POKOK PELAYANAN PRIMER PUSKESMAS SEBAGAI GATEKEEPER DALAM PROGRAM JKN (STUDI DI PUSKESMAS JUWANA KABUPATEN PATI)

*Ainur Rahma  -  , Indonesia
Septo Pawelas Arso  -  , Indonesia
Anneke Suparwati  -  , Indonesia
Received: 15 Jun 2016; Published: 13 Dec 2017.

Citation Format:
Abstract
The National Health Insurance (NHI) program which embracing the principles of Managed Care, focuses on the health care needs of first level Health Care Provider, where the first level Health Care Provider have an important role because as the main gate of patients who need health care utilization (Gatekeeper), so hoppefully most of health services finished at primary level. Primary Health Center (PHC) as first level health facilitation have strategic role and advantages for supporting the implementation of NHI compared to family doctors and private clinics because it has two functions, that are the function of organizing Primary Health Efforts and Individual Health Efforts. Where the principal function of Individual Health Efforts in NHI as gatekeeper are strengthening the function of first contact care, continuity care, comprehensive care, and coordination care. The purpose of this study was to analyze implementation of 4 primary care principal function of PHC as gatekeeper in NHI program in Juwana PHC, Pati, guidelines with “Manual Pelaksanaan JKN-BPJS Kesehatan” and performance indicators "Quality Indicators 9". This research was carried out to the stakeholders that related with the implementation of primary care principal functions in Juwana PHC, there are five main informants. Triangulation informant is the Head of Primary Health Care Management Unit from BPJS and Head of Basic Health Efforts and Referral Unit from Dinas Kesehatan Kabupaten Pati. The research used qualitative methods of collecting data through in-depth interviews. The results showed that the implementation of the primary care principal functions of Juwana PHC is 70% in accordance with the Guidelines for the ‘Manual Pelaksanaan JKN-BPJS Kesehatan’. While based on 3 indicators fromQI9assessmentin terms ofcommitmentof servicefor the determination ofperformance-basedcapitationnorm, PHCJuwanaonlyget acapitationRp. 4500.00on January-March 2015.
Fulltext View|Download
Keywords: National Health Insurance,Gatekeeper, Juwana Primary Health Center, Primary Care Functions

Article Metrics:

Article Info
Section: Administrasi dan Kebijakan Kesehatan
Recent articles
GAMBARAN POTENSI MASYARAKAT PENGGUNA PELAYANAN KESEHATAN TRADISIONAL DI WILAYAH KELURAHAN ROWOSARI KECAMATAN TEMBALANG KOTA SEMARANG PENGARUH KOMUNIKASI, KEPERCAYAAN DAN KOMITMEN BIDAN PRAKTIK MANDIRI TERHADAP KEPUTUSAN KERJASAMA DENGAN BPJS KESEHATAN HUBUNGAN PENGETAHUAN DAN SIKAP WANITA PUS DENGAN KEJADIAN PERNIKAHAN DINI DI DESA LANJAN KECAMATAN SUMOWONO KABUPATEN SEMARANG TAHUN 2013 PENGARUH MOTIVASI DAN PERSEPSI PELAYANAN TERHADAP KETERATURAN ANTENATAL CARE PADA IBU HAMIL DI PUSKESMAS NGEMPLAK SIMONGAN KOTA SEMARANG PADA TRI WULAN I TAHUN 2015 Hubungan Faktor Host (Umur 6 Bulan-14 Tahun) Dan Keberadaan Vektor Dengan Kejadian Demam Berdarah Dengue di Wilayah Kerja Puskesmas Kedungmundu Semarang Relationship Of Host Factors (Ages 6 Months - 14 Years) And Existence Vector With Dengue Hemorrhagic FAKTOR LINGKUNGAN SOSIAL YANG BERHUBUNGAN DENGAN TINGKAT KEPATUHAN TERAPI PENDERITA HIPERTENSI PRIMER DI PUSKESMAS KEDUNGMUNDU KOTA SEMARANG (Social Environment Factors Associated with The Level of Compliance Therapy in Patients with Primary Hypertension FAKTOR RISIKO DARI ASPEK MATERNAL PADA KEJADIAN BERAT BADAN LAHIR RENDAH (BBLR) DI WILAYAH KERJA DINAS KESEHATAN KOTA CIREBON TAHUN 2014 HUBUNGAN PENGETAHUAN DAN SIKAP IBU NIFAS DENGAN PRAKTIK PERAWATAN MASA NIFAS DI KECAMATAN GUNUNGPATI KOTA SEMARANG BULAN JANUARI-MARET 2015 ANALISIS SISTEM TANGGAP DARURAT KEBAKARAN DI AREA PRODUKSI INDUSTRI KIMIA PT. X TAHUN 2015 HUBUNGAN INTAKE MAKANAN (KALORI) DENGAN KELELAHAN KERJA PADA PERAWAT SHIFT PAGI UGD PAVILIUN RS. X JAKARTA Pengaruh Variasi Lama Waktu Kontak Dan Diameter Media Karang Jahe (Acropora Sp.) Terhadap Penurunan Kadar Logam Chromium (Cr) Limbah Cair Batik Home IndustryKota Pekalongan HUBUNGAN PARTISIPASI MASYARAKAT DENGAN KEBERFUNGSIAN TEMPAT PENGELOLAAN SAMPAH TERPADU (TPST) SAEMAN PADANGSARI, KOTA SEMARANG Analisis Pelaksanaan Promosi Kesehatan Bagi Karyawan Berisiko Tinggi Penyakit Degeneratif Oleh Health Care Center PT Holcim Indonesia Tbk Cilacap Plant Faktor-Faktor Yang Berhubungan Dengan Perilaku Kerja Karyawan Penderita Aging Disease Di PT Holcim Indonesia Tbk Cilacap Plant More recent articles

Last update:

No citation recorded.

Last update:

No citation recorded.