Indonesian Journal of Health Administration
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HEALTH FINANCING ANALYSIS OF MINIMUM SERVICE STANDARDS IN THE HEALTH SECTOR
Full text linkBackground: This research focuses on health financing Minimum Service Standards (MSS) in the health sector in Lumajang Regency, Indonesia, spanning 2019 to 2022. Despite the government's emphasis on Health MSS, disparities in service access and health conditions persist across different regions.
Aims: The research aims to provide insights into the effectiveness of health financing, serving as a foundation for policy recommendations to enhance the efficiency and effectiveness of health fund allocation in Lumajang Regency.
Methods: The research employs a quantitative descriptive approach, utilizing DHA and CBA. The study also investigates the budget allocation for MSS Health services.
Results: The findings of the research reveal that the realization of Local Original Revenue (LOR) in the Health sector tends to fall below targets. Non-Physical DAK dominate the funding sources in Community Health Centers (Puskesmas). Maternal health services receive the highest MSS Health budget allocation, but the spending proportion relative to total health expenditure is decreasing.
Conclusion: The research underscores the importance of addressing disparities in health financing and service access in Lumajang Regency. Recommendations include the diversification of funding sources, optimization of financing at the Puskesmas level, and a reevaluation of the budget allocation for maternal health services.
Keywords: CBA, DHA, health financing analysis, minimum service standard
NAVIGATING BARRIERS: THE NEED FOR INTEGRATED HEALTH INFORMATION SYSTEM FOR TUBERCULOSIS-DIABETES CO-SCREENING
Full text linkBackground: Tuberculosis-diabetes mellitus (TB-DM) is a co-epidemic condition representing a double burden for high TB burden countries like Indonesia. Private primary care (PPC) in Indonesia was newly reintroduced to the TB program.
Aims: This study explores the challenges PPC healthcare workers (HCWs) face in implementing TB-DM bi-directional screening and strategies to improve it.
Methods: An explorative qualitative method was used by conducting two-round focus group discussions (FGDs) with HCWs (n=15) from five private clinics in Yogyakarta Special Region Province Indonesia and triangulated with 10 DM patients and the TB program manager from the provincial health office. The data were audio recorded, transcribed verbatim, and subjected to thematic analysis.
Results: HCWs face complex barriers in TB-DM co-screening implementation from patients, HCWs, and health system aspects. An integrated system to remind, support decision-making, report, reduce documentation duplication, monitor, and evaluate co-screening implementation emerged as a potential strategy, although some challenges to deploy.
Conclusion: Albeit HIS is promising in enhancing integrated TB-DM screening and management, a comprehensive approach and multisector roles are still needed to overcome impediments to TB-DM bidirectional screening in PPCs.
Keywords: diabetes mellitus, health information system, screening, tuberculosi
AN EXAMINATION OF THE IMPLEMENTATION OF INTERNET OF THINGS IN HEALTHCARE UTILIZING SMARTWATCHES
Full text linkBackground: Smartwatches can use sensors to collect and send data to medical teams and family members through the platform of the Internet of things (IoT). The data are first analysed on the platform and the final results are used by the medical team.
Aims: This paper reviews and categorises studies conducted in the field of the Internet of things based on smartwatches.
Methods: The covered papers have been published over 13 years from 2010 to 2022. The search yielded 227 papers out of which 43 papers were reviewed after screening. The search keywords were “wearables, internet of things, smartwatches, smart bracelet, healthcare, and disease”. The search covered databases including PubMed, ScienceDirect, and IEEE.
Results: Smartwatches are used in three fields of healthcare, including palliative care, speech therapy, diagnosis, disease prevention, rehabilitation, and health improvement.
Conclusion: Smartwatches are not free of drawbacks and have not received the attention they deserve in the healthcare field. Given the potential of smartwatches, they can be useful in the health sector.
Keywords: Disease, IOT, Smartwatch, Wearabl
MEMBERSHIP IN NATIONAL HEALTH INSURANCE AMONG WORKERS IN INDONESIA
Full text linkBackground: The government regulates National Health Insurance (NHI), making it mandatory for everyone. However, at this time, only some, including workers, are NHI members. Moreover, the government regulates who pays these workers' premiums.
Aims: The study aimed to analyze the disparities of occupation type in NHI membership among workers in Indonesia.
Methods: We involved 22,275 workers in the analysis. The analyzed variables included NHI's membership, occupation type, residence type, age group, gender, education level, marital status, and wealth status. The study employed binary logistic regression in the final step.
Results: The results showed that government employees were 11.864 times more likely to be a member of NHI than the informal sector (95%CI 11.811-11.917). The private sector was 1.646 times more likely than the informal sector to be an NHI member (95%CI 1.643-1.648). Meanwhile, entrepreneurs were 0.828 times less likely to be NHI members than the informal sector (95%CI 0.827-0.829). The study found six control variables related to NHI membership: residence, age, gender, education, marital, and wealth status.
Conclusion: The study concluded that NHI membership disparities existed based on occupation type. Accordingly, government employees, the private sector, the informal sector, and entrepreneurs are the most likely to become NHI members.
Keywords: health insurance, health policy, national health insurance, occupation type
ENHANCEMENT OF PRIMARY CARE ASSESSMENT TOOL (PCAT): A SCOPING REVIEW
Full text linkBackground: Strengthening the quality of primary health care is one way to improve public health. For this reason, an appropriate primary care assessment tool (PCAT) is necessary to evaluate and improve primary health care.
Objective: This study aims to provide an overview of the development of primary care assessment tools.
Methods: The study was conducted through a scoping review of articles written in English that were published in the PubMed, Scopus, Science Direct, and Semantic Scholar databases from 2010 to 2023.
Results: A total of 10 selected articles describe the development of primary care assessment tools, namely PCAT Malawi, Vietnam PCAT-PE, Vietnam PCAT-AE, CR-PCAT (China), PCAT-TI (Tibet), UG-PCAT (Uganda), PCAT-C (China), PCAT-Facility (Spain), KS-PCAT (Standard Korean), PCAT-10 (Spain), and Colombia PCAT. Each tool has a different development focus according to the context of each country.
Conclusion: This study provides an overview of the development of PCAT. In general, the development of PCAT in each country demonstrates different characteristics. The selection of a health service assessment tool must align with the needs of the element or aspect to develop.
Keywords: primary care assessment tool, PCAT development, primary health care assessment, PCAT modification
THE EFFECTS OF SOCIAL ASSISTANCE PROGRAMS ON STUNTING PREVALENCE RATES IN INDONESIA
Full text linkBackground: Social assistance, such as Non-Cash Food Assistance (BPNT) and the Family Hope Program (PKH), is among the instruments used to eradicate stunting in the short and long term. Therefore, it is important to ensure that individuals effectively use it.
Aims: This study aimed to review the effect of social assistance on stunting prevalence rates in Indonesia.
Methods: This research employs a quantitative approach, utilizing numerical measurements and statistical analysis. The data is secondary and sourced from the Central Bureau of Statistics and the Ministry of Finance. The specific method applied is the generalized method of moments (GMM) dynamic panel regression. The research sample encompasses panel data from 34 provinces from 2015 to 2021. This study utilizes the indicator of very short height for children less than five years of age as a proxy for stunting. Furthermore, low height in children is adopted as a measure of stunting. Furthermore, this study adopted a measure of low height in children to indicate stunting.
Results: The results showed that social assistance negatively affected stunting, supported by various other indicators such as the proportion of proper sanitation, the average length of schooling, protein consumption, and drinking water sources. Meanwhile, excessive calorie consumption increases stunting in a certain period.
Conclusion: In this condition, government social assistance was urgently needed since access to the lowest decile households increased stunting rates. The practical implications for policy derived from these findings involve optimizing the efficiency of social assistance initiatives, emphasizing the significance of addressing environmental factors in programs aimed at preventing stunting, integrating health and nutrition initiatives, and implementing educational campaigns within communities to raise awareness about calorie consumption.
Keywords: child health, social assistance, stunting, toddler
RELATIONSHIP OF SERVICE RECOVERY TOWARDS PATIENT SATISFACTION IN HOSPITAL IN WEST SUMATERA
Full text linkBackground: Patient satisfaction in the M. Djamil Hospital was recorded as 79.61% between January and March 2018. It signifies that patient satisfaction rate has not met the target set of 85%.
Aims: This study aims to determine the frequency distribution of service recovery patients, patient satisfaction, and the relationship between services and service recovery patient satisfaction to improve service recovery.
Methods: The authors used a cross-sectional research design. The sample was inpatients at RSUP M. Djamil in total of 424 people. The sampling technique was consecutive sampling. The data were collected using the Importance Performance Analysis questionnaire. Data were analyzed using unpaired t-tests and multiple linear regression.
Results: The results of the service recovery (distributive justice, procedure justice, interactive justice, reputation justice) has a significant relationship (p-value <0.05) with patient satisfaction. Interactive justice has the strongest relationship with appropriate patient satisfaction and has the greatest Beta value (0,254). Patient satisfaction has a significant relationship (p-value <0.05) with Word of Mouth.
Conclusion: RSUP M. Djamil needs to emphasize interactions and justice, especially in providing clear information about medical actions to the patient's family, serving patients politely and friendly, and providing solutions to patients if there are service complaints.
Keywords: Hospitalization, Satisfaction, Service Recover
USER ACCEPTANCE OF MOBILE-JKN: INSIGHTS FROM THE TECHNOLOGY ACCEPTANCE MODEL
Full text linkBackground: Technological advancements in healthcare have driven BPJS Kesehatan Indonesia to develop the Mobile JKN application to enhance accessibility, efficiency, and quality of services. Despite its potential benefits, the implementation of this application faces various challenges, such as application errors, differing levels of digital literacy, and data security issues, necessitating an evaluation of its adoption and acceptance.
Aims: To analyse the public acceptance of Mobile JKN based on the Technology Acceptance Model (TAM) variable while also exploring user experiences towards the application.
Methods: A descriptive-analytical approach with a cross-sectional design. Data were collected through a questionnaire developed based on the TAM model, involving 406 respondents across Indonesia. Data analysis was performed using a regression linear test with SPSS after all basic assumptions were met.
Results: Perceived Ease of Use, Perceived Usefulness, and Attitude Toward Use individually and simultaneously impact Actual System Use (Sig. 0.000; R-Square 0.827). Respondents generally answered “Agree” to all TAM indicators, with mean scores of 4.20 for Perceived Usefulness, 4.16 for Perceived Ease of Use, 4.25 for Attitude Toward Use, and 4.33 for Actual System Use. Most users accessed the app through self-access (48%), frequently used features were membership information (28%), and encountered issues such as application errors (25%).
Conclusion: The app was deemed relevant, accurate, easy to use, and beneficial. To enhance public acceptance, BPJS Kesehatan should focus on developing a user-friendly Mobile JKN app by incorporating key TAM factors, optimizing popular features, improving technical stability, and regularly addressing user feedback to ensure effective health administration and service delivery.
Keywords: Adoption, Application, BPJS Kesehatan, Mobile JKN, TA
RECOMMENDATIONS TO IMPROVE EMPLOYEE PERSONAL ATTITUDE TOWARD REPORTING PATIENT SAFETY INCIDENTS
Full text linkBackground: Patient Safety Incidents (PSI) in hospitals are adverse events that need to be reported for effective identification and risk management, aiming to prevent reoccurrence of incidents. However, not all incidents are documented, as evidenced by the discrepancy in the number of phlebitis reported by employees as well as Infection IPCLN at three hospitals.
Aims: Provide recommendations to improve employee Personal Attitude towards reporting PSI at three hospitals owned by Company A.
Methods: The method adopted was a cross-sectional research design; data were collected from three hospitals owned by company A and tested using multiple logistic regression statistics tests. Data on Phlebitis reported from January to July 2018 at three hospitals owned by Company A was used. Furthermore,135 respondents were taken from the service installations of the three hospitals. The Lameshow formula and proportional random sampling are applied to determine the sample.
Results: The variables of error orientation (p = 0.001; β = 0.349), behavioral belief (p = 0.008; β = 0.234), and perceived behavioral control (p = 0.003; β = 0.222) had a positive and significant effect on the personal attitude of employees reporting PSI.
Conclusion: Two approaches were recommended to improve the personal attitude of employees in reporting PSI.
Keywords: Hospital, Patient safety incidents, Personal attitude, Underreportin