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<![CDATA[DOES MORAL HAZARD OCCOUR IN THE IMPLEMENTATION OF SOCIAL HEALTH INSURANCE? EVIDENCE FROM PUBLIC HOSPITALS IN A RURAL PROVINCE OF INDONESIA ]]>
<![CDATA[Rizanda Machmud]]>;
<![CDATA[Syafrawati Syafrawati]]>;
<![CDATA[Prof. Syed Mohamed Aljunid]]>;
<![CDATA[Rima Semiarty]]>
<![CDATA[ Asia Pacific Fraud Journal Vol 5, No 1: Volume 5, No. 1st Edition (January-June 2020) ]]>
Publisher : <![CDATA[Association of Certified Fraud Examiners Indonesia Chapter ]]>
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DOI: 10.21532/apfjournal.v5i1.133
<![CDATA[Indonesia is now encountering moral hazard problems in the implementation of social health insurance. BPJS, as the administrator of Indonesia’s National Health Insurance, reported that there was an increase in deficit in the 4 years of the implementation of National Health Insurance from US$ 228 million in 2014 to US$ 470 million in 2016. Despite efforts conducted to overcome the problem, no evidence-based predictor that might be significantly associated with moral hazard in a rural province hospital in Indonesia. The purpose of this research is to identify the incidence of moral hazard in the implementation of National Health Insurance in Indonesia. Data consisting of 180 medical records obtained from three public hospitals in rural province of Indonesia were selected as samples in this study. These medical records were reviewed by Independent Senior Coder (ISC) who had more than 5 years experiences as a coder. The indicators of moral hazard in this study were upcoding, readmission, and possible unnecessary admission. Logistic regression was used to explore determinant of moral hazard from patient, coder, and physician side. The results show that rate of moral hazard cases for upcoding is 10%, readmission is 2.8%, and possible unnecessary admission is 18.9%. It can be seen from multivariate analysis that discharge status, severity level and LOS have a significant relationship with moral hazard. Illness severity level, Discharge against Medical Advice, and higher Length of Stay are risk factors for moral hazard incidence.]]>
<![CDATA[INCIDENCE AND ROOT CAUSE OF UPCODING IN THE IMPLEMENTATION OF SOCIAL HEALTH INSURANCE IN RURAL PROVINCE HOSPITAL IN INDONESIA ]]>
<![CDATA[Syafrawati Syafrawati]]>;
<![CDATA[Rizanda Machmud]]>;
<![CDATA[Prof. Syed Mohammed Aljunid]]>;
<![CDATA[Rima Semiarty]]>
<![CDATA[ Asia Pacific Fraud Journal Vol 5, No 1: Volume 5, No. 1st Edition (January-June 2020) ]]>
Publisher : <![CDATA[Association of Certified Fraud Examiners Indonesia Chapter ]]>
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DOI: 10.21532/apfjournal.v5i1.135
<![CDATA[Upcoding is one of important indicators of moral hazard and fraud in Social Health Insurance scheme. However, there seems to be little evidence about incidence of upcoding and how upcoding occurs in hospital, especially in rural province hospital. The objective of this study is to determine incidence and root cause of upcoding in the implementation of Social Health Insurance in Rural Province Hospital in Indonesia. The data used in this study were both qualitative and quantitative data (mixed method). Three hundred and sixty (360) inpatient medical records from six rural province hospitals were examined in this study. Diagnosis and procedure codes recorded in these medical records were re-coded by an independent senior coder (ISC). Codes from hospitals’ coders and codes from ISC were then re-grouped using INA-CBG casemix grouper to determine the casemix groups and the hospital tariffs. If the hospital tariff obtained by hospital coder is higher than that obtained by ISC, it is considered as upcoding. This qualitative study was conducted using Focus Group Discussion (FGD) and in-depth interviews in hospitals located in a rural province of Indonesia. In depth interview was held for two hospital directors and two officers from the Social Security Administrator (Indonesia: BadanPenyelenggaraJaminanSosial/BPJS), an agent that manages the Statutory Health Insurance (SHI). Six clinicians and six coders attended the FGD. We asked open-ended questions about their perceptions on upcoding in hospitals. The interviews were recorded and transcribed verbatim. The transcripts were then thematically analyzed. Upcoding cases were found in 11.9% (43/360) medical records. Upcoding cases were dominated by Deliveries Group 2.8% (10/360) and Female reproductive system Groups 1.7% (6/360). The potential loss of income due to upcoding was IDR 154.626.000 or 9% of hospital revenue. Appointment of non-medical doctors as internal verifiers, lack of clear coding guidelines, lack of training for doctors and coders, and poor coordination between hospital and BPJS to resolve coding disagreement were root causes of upcoding in hospital. Policies to prevent and manage upcoding should be urgently developed and implemented in the Statutory Health Insurance (SHI) program in Indonesia especially to prepare upcoding guidelines, enhance medical coding trainingregularly, increase number of coders and verification staff from medical background, and strengthen coordination for coding problem solving in hospital.]]>
<![CDATA[PENCAPAIAN TUJUAN MDGs BIDANG KESEHATAN DI INDONESIA ]]>
<![CDATA[Syafrawati Syafrawati]]>
<![CDATA[ Jurnal Kesehatan Masyarakat Andalas Vol 1, No 1 (2006): Jurnal Kesehatan Masyarakat Andalas ]]>
Publisher : <![CDATA[Faculty of Public Health, Andalas University ]]>
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DOI: 10.24893/jkma.v1i1.1
<![CDATA[Millenium Development Goals (MDGs)yang kalau di Bahasa Indonesiakan menjadi Tujuan Pembangunan Milenium (TPM), adalah suatu rancangan pembangunan millenium yang disepakati oleh Konferensi Tingkat Tinggi (KTT) Milenium Perserikatan Bangsa-bangsa (PBB) bulan September 2000. Konferensi ini dihadiri oleh 189 negara anggota termasuk Indonesia.MDGs mempunyai 8 tujuan yang memiliki satu atau beberapa target yang harus tercapai pada tahun 2015 dengan dasar situasi dunia pada tahun 1990.]]>
<![CDATA[ANALISIS BIAYA JAMINAN PERSALINAN (JAMPERSAL) (STUDI KASUS PADA SALAH SATU BIDAN PRAKTEK SWASTA KOTA PADANG) ]]>
<![CDATA[Syafrawati Syafrawati]]>
<![CDATA[ Jurnal Kesehatan Masyarakat Andalas Vol 10, No 1 (2015): Jurnal Kesehatan Masyarakat Andalas ]]>
Publisher : <![CDATA[Faculty of Public Health, Andalas University ]]>
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DOI: 10.24893/jkma.v10i1.168
<![CDATA[Tahun 2011 Kementerian Kesehatan RI membuat suatu kebijakan dengan meluncurkan Program Jaminan Persalinan (Jampersal) sebagai bentuk intervensi dalam penurunan AKI dan AKB. Pelaksanaan program Jampersal ini masih menemukan kendala di lapangan. Salah satunya adalah masih minimnya Bidan Praktek Swasta yang mau menerima pasien Jampersal. Tujuan penelitian adalah dilakukannya analisa biaya untuk satu kali persalinan normal pada salah satu bidan praktek swasta di Kota Padang. Penelitian ini adalah penelitian deskriptif dengan data kuantitatif. Metode analisis biaya yang digunakan adalah metode activity based costing yaitu metode penghitungan biaya berdasarkan aktifitas-aktifitas yang dilakukan bidan pada persalinan normal, mulai dari pasien datang ke rumah bidan sampai pasien pulang. Berdasarkan analisa biaya yang ditimbulkan pada pelayanan persalinan normal adalah Rp. 574.452,-. Hal ini menunjukkan bahwa pengantian biaya persalinan normal oleh pemerintah kepada bidan praktek swasta masih kurang sekitar Rp. 74.452,- dari anggaran pemerintah sebesar Rp 500.000,-. Disarankan kepada pemerintah untuk menambah alokasi dana persalinan normal agar bidan yang ingin melaksanakan pelayanan jampersal mendapatkan pembayaran sesuai dengan biaya yang mereka keluarkan.Kata Kunci: Jampersal, Bidan, Activity Based Costing]]>
<![CDATA[ANALISIS PERENCANAAN TAHUNAN KESEHATAN SUB DINAS PENCEGAHAN DAN PEMBERANTASAN PENYAKIT DINAS KESEHATAN KOTA DEPOK TAHUN 2002 ]]>
<![CDATA[Syafrawati Syafrawati]]>
<![CDATA[ Jurnal Kesehatan Masyarakat Andalas Vol 1, No 1 (2006): Jurnal Kesehatan Masyarakat Andalas ]]>
Publisher : <![CDATA[Faculty of Public Health, Andalas University ]]>
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DOI: 10.24893/jkma.v1i1.4
<![CDATA[Planning is the important function of management. An ideal health planning is planning that create base on fact and condition of teritory area. The goal of this research is to analyse annuall health planning in Sub Dinas Pencegahan dan Pemberantasan Penyakit Dinas Kesehatan Kota Depok on the year of 2002. The research is descriptive study with qualitative data. Data collected with deep interview and document observation. The result is planning process need to be improve in quality ang quantity of planner, fund for making ideal planning, facilites and writing procedur. Situation analysis does not use health determination, problem priority use mathematic methode and intervention comes from central government. The form of POA (Plan of Action ) are not specific describe the need of teritory area.]]>
<![CDATA[JAMINAN PERSALINAN, SOLUSI MENURUNKAN ANGKA KEMATIAN IBU DAN BAYI DI INDONESIA ]]>
<![CDATA[Syafrawati Syafrawati]]>
<![CDATA[ Jurnal Kesehatan Masyarakat Andalas Vol 6, No 1 (2011): Jurnal Kesehatan Masyarakat Andalas ]]>
Publisher : <![CDATA[Faculty of Public Health, Andalas University ]]>
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DOI: 10.24893/jkma.v6i1.80
<![CDATA[Salah satu cara yang paling efektif untuk menurunkan angka kematian ibu adalah dengan meningkatkan pertolongan persalinan oleh tenaga kesehatan terlatih. Persentase persalinan yang ditolong oleh tenaga kesehatan terlatih meningkat dari 66,7 persen pada tahun 2002 menjadi 77,34 persen pada tahun 2009 (Susenas). Angka tersebut terus meningkat menjadi 82,3 persen pada tahun 2010. Tujuan yang ingin dicapai dari Program Jampersal ini adalah, meningkatnya akses terhadap pelayanan persalinan yang dilakukan oleh dokter atau bidan dalam rangka menurunkanAKI dan AKB melalui jaminan pembiayaan untuk pelayanan persalinan. Masyarakat yang menjadi sasaran Jampersal adalah ibu hamil, ibu bersalin, ibu nifas (sampai 42 hari pasca melahirkan, dan bayi baru lahir (sampai dengan usia 28 hari).]]>
<![CDATA[Hubungan Kualitas Pelayanan Asuhan Persalinan Normal dengan Loyalitas Ibu Bersalin di Puskesmas Rawat Inap Lubuk Buaya Padang Tahun 2017 ]]>
<![CDATA[Dewi Anggraini]]>;
<![CDATA[Joserizal Serudji]]>;
<![CDATA[Syafrawati Syafrawati]]>
<![CDATA[ Jurnal Kesehatan Andalas Vol 8, No 4 (2019): Online December 2019 ]]>
Publisher : <![CDATA[Fakultas Kedokteran, Universitas Andalas ]]>
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DOI: 10.25077/jka.v8i4.1114
<![CDATA[AbstrakAngka Kematian Ibu (AKI) dapat menggambarkan bagaimana kualitas pelayanan persalinan di puskesmas. Puskesmas rawat inap Lubuk Buaya Padang termasuk penyumbang jumlah kematian ibu kematian ibu di kota Padang. Tujuan: Menentukan hubungan kualitas pelayanan Asuhan Persalinan Normal (APN) dengan loyalitas ibu bersalin. Kepuasan pasien sebagai confounding variable dan menganalisis kualitas pelayanan APN di Puskesmas Lubuk Buaya Padang tahun 2017. Metode: Penelitian ini menggunakan desain mixed method (kuantitatif dan kualitatif). Hasil: Pada analisis bivariat diketahui bahwa terdapat hubungan yang bermakna antara kualitas pelayanan asuhan persalinan normal (p = 0,004) dan kepuasan ibu (p = 0,001) terhadap loyalitas ibu bersalin. Pada analisis multivariat diketahui kepuasan ibu yang lebih dominan dibandingkan kualitas pelayanan APN dalam mempengaruhi loyalitas ibu bersalin (P=0,001, OR=8,867). Pada aspek input ditemukan bahwa pemerataan penempatan petugas di klinik bersalin puskesmas masih perlu diperhatikan, kemudian diberikan tambahan tenaga bidan untuk mengoptimalkan pelayanan di klinik puskesmas, dan untuk sopir ambulans, tidak selalu ada pada saat dibutuhkan. Aspek perencanaan belum direalisasikan dalam bentuk dokumen. Pelaksanaan pelayanan, langkah-langkah APN tidak selalu semuanya dikerjakan. Pada pengawasan tidak ditemukan dokumentasi hasil pengawasan yang telah dilakukan oleh pihak puskesmas kepada petugas di klinik bersalin. Simpulan: Capaian ibu yang melakukan persalinan normal di puskesmas lebih rendah dibanding jumlah ibu yang melakukan pemeriksaan kehamilan. ]]>
<![CDATA[UPAYA MENURUNKAN ANGKA DEMAM BERDARAH DENGUE (DBD) MELALUI PENGUATAN PERAN SISWA DI SDN 38 KURANJI KOTA PADANG ]]>
<![CDATA[Syafrawati Syafrawati]]>;
<![CDATA[Silvia Argameli]]>;
<![CDATA[Fitia Oktari]]>;
<![CDATA[Heru Satria Nanda Putra]]>
<![CDATA[ Jurnal Hilirisasi IPTEKS Vol 2 No 1 (2019) ]]>
Publisher : <![CDATA[LPPM Universitas Andalas ]]>
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DOI: 10.25077/jhi.v2i1.224
<![CDATA[The number of Dengue Hemorrhagic Fever sufferers in Indonesia has been fluctuated year by year. Kuranji district is an area that has the highest Dengue Hemorrhagic Fever cases in the city of Padang during 2015 and 2016. There were 168 cases in 2015 and increased to 201 cases in 2016. This community service aimed to reduce the Dengue Hemorrhagic Fever disease by strengthening the role of elementary school students. The target community service was elementary school students No. 38 in Kuranji district of Padang. The information was Introduced by health promotion using a media. Firstly, the executor introduced themselves to the participant of community service. Furthermore, pre test was conducted in order to know the knowledge of participants regarding the impact of Dengue Hemorrhagic Fever disease prior to the delivery of information. Delivery of information to students was done throught health promotion using a media. The material given was abaout the impact of Dengue Hemorrhagic Fever in in children and environment, consisted of understanding causes of Dengue Hemorrhagic Fever and efforfs to prevent the impact of Dengue Hemorrhagic Fever disease. Finally, the post test was conducted to participants in order to know the knowledge about the Dengue Hemorrhagic Fever after the information was given. At the end of this program, the executor asked some question to participants and for those who were able to answer correctly would have a reward.]]>
<![CDATA[UPAYA MENURUNKAN DAMPAK NEGATIF GADGET MELALUI MEDIA PROMOSI KESEHATAN PADA SISWA SDN 01 SAWAHAN KOTA PADANG ]]>
<![CDATA[Syafrawati Syafrawati]]>;
<![CDATA[Dien Gusta Anggraini Nursal]]>;
<![CDATA[Rayunda Chikita]]>;
<![CDATA[Nugroho Tundun]]>
<![CDATA[ Jurnal Hilirisasi IPTEKS Vol 2 No 2 (2019) ]]>
Publisher : <![CDATA[LPPM Universitas Andalas ]]>
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DOI: 10.25077/jhi.v2i2.230
<![CDATA[Perkembangan teknologi dan informasi semakin berkembang pesat sesuai dengan perkembangan zaman. Teknologi muncul dari masa ke masa dengan berbagai macam jenis dan fitur yang selalu baru dari hari ke hari. Salah satu teknologi yang populer adalah gadget. Gagdet tidak selalu memiliki dampak positif saja tetapi juga dampak negatif. Menurut hasil observasi yang dilakukan oleh Dewi (2013) kepada beberapa keluarga di salah satu daerah wilayah Yogyakarta pada tahun 2013, menunjukkan sejak menggunakan gadget, ketika di rumah anak menjadi susah diajak berkomunikasi, tidak peduli dan kurang respon pada saat orang tua mengajak nya berbicara. Selain itu gadget juga dapat merusak kesehatan seperti sakit kepala, penglihatan kabur, susah melihat objek yang jauh, dan sering menyipitkan mata ketika melihat objek yang jauh dan tidak nyaman di mata. Melihat kondisi tersebut dikhawatirkan anak-anak sudah terpapar oleh dampak negatif gadget. Tujuan dari pengabdian masyarakat ini antara lain untuk menghindari dampak negatif gadget melalui media promosi kesehatan yaitu media permainan ular tangga. Sekolah Dasar yang menjadi mitra pengabdian masyarakat ini adalah SDN 01 Sawahan Kota Padang. Pengabdian diawali dengan perkenalan dan dilanjutkan dengan pra-tes. Kegiatan selanjutnya adalah pemberian informasi dengan media permainan ular tangga, pos-tes, dan tanya jawab berhadiah dengan peserta pengabdian masyarakat. Peserta antusias dalam mengikuti kegiatan. Dari hasil pra-tes dan pos-tes disimpulkan adanya peningkatan pengetahuan sebelum dan setelah edukasi kesehatan dengan media permainan ular tangga.]]>
<![CDATA[EDUKASI KESEHATAN SADARI UNTUK MENCEGAH KANKER PAYUDARA PADA SISWI SMAN 4 KOTA PADANG ]]>
<![CDATA[Syafrawati Syafrawati]]>;
<![CDATA[Ayulia Fardila Sari ZA]]>
<![CDATA[ BULETIN ILMIAH NAGARI MEMBANGUN Vol 4 No 2 (2021) ]]>
Publisher : <![CDATA[LPPM (Institute for Research and Community Services) Universitas Andalas Padang ]]>
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DOI: 10.25077/bina.v4i2.287
<![CDATA[Data from the Padang City Health Office in 2017 showed that there were 142 women diagnosed with breast cancer in the city of Padang. There are 25.4% of patients with breast cancer in the working area of the Lubuk Begalung Health Center. Community service activities at FKM Unand are carried out with BSE health promotion efforts to prevent breast cancer in SMAN 4 Padang City students. SMAN 4 Padang is one of the schools that has the most students with the average student being part of the population of Lubuk Begalung District. The target of the service output is to increase students' knowledge about breast cancer and students' skills in BSE as an effort to detect breast cancer early. The implementation method is carried out by counseling about breast cancer prevention through BSE activities. The result of the average pretest score of knowledge level is 5.2 with a standard deviation of 1.70. While the results of the post-test average knowledge level was 7 with a standard deviation of 1.51. The statistical test results obtained a p value of 0.000, so it can be concluded that there is a significant difference between the level of knowledge of pre-test and post-test education about BSE in students of SMAN 4 Padang. It is hoped that similar activities can be carried out at other schools in the city of Padang considering that from the results of questions and answers with students, the socialization carried out is an effort to increase students' knowledge regarding breast cancer prevention.]]>
