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Journal : Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer)

Quality of Health Services in the First Level Health Facilities and the Role of Quality and Cost Control Team in Lampung Province Asep Sukohar; Arli Suryawinata; Aulian Mediansyah
Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) Vol 3, No 1 (2020): January
Publisher : Faculty of Medicine, Public Health, and Nursing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/rpcpe.54162

Abstract

Background: The National Health Insurance/Jaminan Kesehatan Nasional (JKN) program is a public health protection guarantee held by the Social Securite Management Agency/Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS) to ensure that all Indonesians receive comprehensive, fair, and equitable health care benefits. The health services are provided using a tiered service system with the first stage in the First Level Health Facilities/Fasilitas Kesehatan Tingkat Pertama (FKTP) acting as a gatekeeper. In conducting these duties, they must always be maintained with good cost-efficiency to be able to provide optimal health service quality. The audit function is imposed by the Quality and Cost Control Team/Tim Kendali Mutu Kendali Biaya (TKMKB) which partners with BPJS. Until now, various efforts to improve the quality of services continue to be developed, one of which is the capitation-based service commitment/Kapitasi Berbasis Komitmen Pelayanan (KBK) payment method. Quality of health services in FKTP can be seen through the high number of FKTP that are affected by the capitation-based service commitment (FKTP KBK-K) payment. Additionally, the high number of FKTP KBK-K can also be a measure of the success of the quality and cost control program implemented by the regional TKMKB. Objective: To assess the quality of health services in FKTP and the TKMKB performance of Lampung Province. Methods: This research was a descriptive-analytic study using data from the BPJS report of Lampung Province and TKMKB in the first and second quarters of 2019. Results: There was an increase in the number of FKTP KBK-K in Lampung Province in the second quarter of 2019, not achieving the minimum contact number, with a low ratio of Prolanis Routine Participants Visiting/Rasio Peserta Prolanis Rutin Berkunjung (RPPRB) especially at the FKTP non-Primary Health Care Centers (non-Puskesmas) in Lampung Province. Conclusion: An increase in the number of FKTP KBK-K that is not accompanied by an increase in the clinical ability of primary health care providers (such as family doctors/primary care doctors) can reflect suboptimal health services in FKTP. Also, this can further serve as a benchmark that the performance of the provincial TKMKB is not yet optimal.