Implikasi Kebijakan Program Jaminan Kesehatan Bagi Masyarakat Miskin di 4 Kabupaten di Jawa Timur (Studi Tentang Kondisi, Aksesibilitas dan Manajemen Pelayanan Kesehatan Bagi Masyarakat Miskin)

Abstract

Background: Health insurance program for poor began since 1998 namely Social Safety Net and 2005 changed be Health Maintenance Assurance Program for Poor (PJK MM) and since 2007 become Healthy Insurance for Poor (Askeskin).The objectives this research to study for policy implication and program management of Health Maintenance Assurance for Poor (PJKMM) in East Java. Methods: This location selected four regencies with people cultural criteria, namely Malang (Arek Culture), Tulungagung (Mataraman Culture), Sampang (Madura Culture), and Banyuwangi (PendalunganCulture). For each regency chosen 100 poor respondents who visiting health centers at the research be done, by using"quota sampling" method. Results: the research indicating that number of members who utilize out-patient services in the hospital mean 32.25%, out-patient in the health center 77.75% and out-patient utilization in the hospital mean 27.25% and in health center approximately 3.25%. Accessibility of poor to health service facility reviewed from distance aspect, time travel, and cost is good. Eventhough cost of treatment in health centre is free, but still expend money that is transport to health centre and hospital, and adding drug cost. Members management aspect still occur insufficiency, and those condition complicated with SKTM validation, so the cost control more difficult. In services management aspect. health center hope implemented of Society Safety Net model, while Hospital keep intended PT Askes as the Execution Board of this program. From financial management, giving down payment policy to the hospital as well as down payment claim while waiting verification is finish, helpful the hospital as well as to performing their operation. Recommended in order to Central Government and Healthy Department to secure PJKMM/Askeskin program sustainability, implemented Diagnostic Related Group (DRGs) and increasing budget through APBD to maintaining health for society.