Perpustakaan Terpadu

Upaya peningkatan mutu layanan kesehatan dapat dilihat berdasarkan angka kepuasan yang dihasilkan dari fasilitas kesehatan dan peserta JKN-KIS. Berdasarkan data BPJS Kesehatan, dilaporkan bahwa indeks kepuasan peserta JKN- KIS tahun 2019 sebesar 85% dan 80%. Dalam rangka meningkatkan efektifitas dan efisiensi pelaksanaan program JKN, telah disahkan beberapa kebijakan yaitu Pembayaran Kapitasi Berbasis Pemenuhan Komitmen Pelayanan. Puskesmas Munjungan merupakan Provider BPJS Kesehatan namun Puskesmas Munjungan belum pernah dilakukan evaluasi tentang KBK. Tujuan studi kasus ini adalah untuk mengetahui evaluasi capaian peraturan Badan Penyelenggara Jaminan Sosial Kesehatan Nomor 7 Tahun 2019 Tentang Petunjuk Pelaksanaan Pembayaran Kapitasi Berbasis Kinerja Pada Fasilitas Kesehatan Tingkat Pertama di Puskesmas Munjungan. Penelitian ini menggunakan metode kuantitatif-kualitatif dengan jenis penelitian studi kasus. Penelitian ini menggunakan pendekatan realist evaluation. Data hasil wawancara atau data kualitatif dianalisis dengan model CMO (Context-Mechanism-Outcome). Hasil Penelitian kualitatif pada 4 narasumber menunjukkan bahwa Kapitasi Berbasis Pemenuhan Komitmen Pelayanan sudah berjalan di Puskesmas Munjungan namun dalam pelaksanaannya masih ada indikator yang belum tercapai yaitu angka kontak dan prolanis terkendali untuk rasio rujukan non spesialistik relatif tercapai hal tersebut disebabkan karena dampak pandemic covid-19 yang menyebabkan turunnya jumlah kunjungan dan ditiadakannya kegiatan prolanis. Kesimpulan dari penelitian studi kasus ini adalah belum semua target KBK di Puskesmas Munjungan tercapai. Masih ada indikator yang belum mencapai target seperti angka kontak dan prolanis. Dari segi SDM Kesehatan, Anggaran, fasilitas kesehatan ditunjang denga peralatan yang memadai karena Puskesmas Munjungan telah BLUD sehingga dapat meningkatkan kualitas dan mutu pelayanan.

The Efforts to improve the quality of health services can be seen based on the satisfaction rates generated by health facilities and JKN-KIS participants. Based on BPJS Health data, it was reported that the JKN-KIS participant satisfaction index in 2019 was 85% and 80%. In order to improve the effectiveness and efficiency of the JKN program implementation, several policies have been implemented, namely Capitation Payments based on Fulfillment of Service Commitments. Munjungan Health Center is a BPJS Health Provider, but Munjungan Health Center has never evaluated the KBK. The purpose of this case study is to evaluate the evaluation of the Health Social Security Administering Body Regulation Number 7 of 2019 concerning Guidelines for Implementation of Performance-Based Capitation Payments at First Level Health Facilities at Munjungan Health Center. This research uses quantitative-qualitative methods with a case study research type. This study uses a realist evaluation approach. Interview data or qualitative data were analyzed using the CMO (Context-Mechanism-Outcome) model. The results of qualitative research on 4 informants showed that Capitation Based on Service Commitment Fulfillment was already running at Munjungan Health Center but in its implementation there were still indicators that had not been achieved, namely the number of contacts and controlled programs for the relative non-specialized referral ratio, this could be done because of the impact of the Covid-19 pandemic. which led to a decrease in the number of visits and the elimination of pro-planning activities. The conclusion from this case study research is that not all of the KBK targets at the Munjungan Health Center have been achieved. There are still indicators that have not reached the target, such as contact rate and prolanis. In terms of human resources for health, budget, health facilities supported by adequate equipment because Munjungan Health Center has BLUD so that it can improve the quality and quality of service.