东爪哇省4个地区的贫困人口健康保障计划政策含义(对条件、可接近性和卫生管理的研究)

Wasis Budiarto, Ristrini Ristrini
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摘要

背景:穷人健康保险方案自1998年即社会安全网开始实施,2005年改为穷人健康维护保障方案(PJK MM), 2007年改为穷人健康保险(Askeskin)。本研究目的为东爪哇贫困人口健康保障(PJKMM)的政策启示及项目管理提供参考。方法:选取具有民族文化标准的4个县,即Malang(阿瑞克文化)、Tulungagung(马塔拉曼文化)、Sampang(马杜拉文化)和Banyuwangi (pendalunung文化)。为每个摄政选择100名在进行研究时访问保健中心的贫困应答者,采用“配额抽样”方法。结果:研究表明,会员在医院使用门诊服务的人数平均为32.25%,在保健中心使用门诊服务的人数平均为77.75%,在医院使用门诊服务的人数平均为27.25%,在保健中心使用门诊服务的人数约为3.25%。从距离、时间旅行和成本等方面考察了穷人获得卫生服务设施的可及性。虽然在保健中心的治疗费用是免费的,但仍然要花钱去保健中心和医院,而且还要增加药费。会员管理方面还存在不足,加之SKTM的验证,使得成本控制更加困难。在服务管理方面。健康中心希望实施社会安全网模式,而医院则希望PT Askes作为该计划的执行委员会。从财务管理,给医院的首付款政策和首付款索赔,等待审核完成,帮助医院和他们的运作。为了确保PJKMM/Askeskin项目的可持续性,建议中央政府和卫生部门实施诊断相关小组(DRGs),并通过APBD增加预算,以维护社会健康。
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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)
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.
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Buletin Penelitian Sistem Kesehatan
Buletin Penelitian Sistem Kesehatan PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
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