Studi Kasus : Kesiapan Rumah Sakit An – Nisa Tangerang Dalam Implementasi Program Jaminan Kesehatan Nasional
Abstract
Abstract
Health facilities play an important role in achieving the goals of National Health Insurance (JKN), to providing health services to all Indonesian people. The study aimed to determine the readiness of An - Nisa Hospital as one of the private hospitals in Tangerang in the implementation of the JKN. This research was conducted in March 2018 using a qualitative approach through in-depth interviews and documentation study. The sample was determined purposively, consisting of 7 internal informants from An - Nisa Hospital. Data were analyzed using thematic analysis. Various preparations have been made by An - Nisa Hospital before the hospital joined the BPJS Kesehatan provider, starting from casemix training, coding, costing, preparing clinical pathways, and learning about an information technology systems used in the JKN era. The addition of human resources, facilities and infrastructure was also carried out to support the implementation of JKN. An - Nisa Hospital formed a casemix team whose task was to compile claim documents and collect claims to BPJS Kesehatan. This study concludes that An - Nisa Hospital had prepared themselves before joining the BPJS Kesehatan provider, and the hospital is fully committed to successful the JKN Program.
Keywords: preparation, implementation, national health insurance
Abstrak
Fasilitas kesehatan memegang peranan penting dalam tercapainya tujuan Jaminan Kesehatan Nasional (JKN) yaitu dalam memberikan pelayanan kesehatan kepada seluruh masyarakat Indonesia. Tujuan dari penelitian ini adalah untuk mengetahui kesiapan dari RS An – Nisa sebagai salah satu rumah sakit swasta di Tangerang dalam implementasi Program JKN. Penelitian dilakukan pada Maret 2018 dengan pendekatan kualitatif. Data dikumpulkan dengan wawancara mendalam dan studi dokumen. Sampel ditentukan secara purposive, yang terdiri dari 7 informan pihak internal RS An – Nisa. Data dianalisis secara deskriptif kualitatif. Berbagai persiapan telah dilakukan oleh RS An – Nisa sebelum mereka bergabung menjadi provider BPJS Kesehatan, mulai dari mengikuti pelatihan casemix, coding, costing, penyusunan clinical pathway, serta menikuti pembelajaran tentang sistem informasi teknologi yang digunakan di era JKN. Penambahan SDM, fasilitas sarana dan prasarana pun dilakukan guna mendukung penyelenggaraan JKN. RS An – Nisa membentuk sebuah tim casemix yang bertugas untuk menyusun dokumen klaim dan melakukan penagihan klaim kepada BPJS Kesehatan. Penelitian ini menyimpulkan bahwa RS An – Nisa telah mempersiapkan diri secara totalitas sebelum bergabung menjadi provider BPJS Kesehatan, serta berkomitmen penuh dalam menyukseskan program JKN.
Kata kunci: Persiapan, implementasi, jaminan kesehatan nasional
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