Determinants of Achievement Indicators Capitation Based Performance in First Level Healthcare: A Systematic Review
DOI:
https://doi.org/10.25311/keskom.Vol8.Iss3.1272Keywords:
FKTP, National Health Insurance, Capitation Based PerformanceAbstract
The implementation of Capitation Based Performance payments has been carried out since 2016 but until now there are still many First Level Healthcare that have not been able to reach all the performance indicators. This study aims to analyze the determinants of the achievement of the Contact Number indicator, the Non-Specialized Case Referral Ratio, and the Controlled Prolanis Participant Ratio so that it is expected to know the effectiveness of the KBK implementation policy. This study uses a systematic review method using the PRISMA (Preferred Reporting Items for Systematic Review and Meta Analysis) guidelines. Literature searches were carried out using search engines: Research Gate, DOAJ, Google Scholar, and ScienceDirect so as to obtain 15 articles that were eligible for review. Overall, the main factors that influence the achievement of KBK are the availability of human resources, infrastructure, also knowledge of JKN participants. However, other factors such as the availability of funds, the existence of supporting policies and information systems and a commitment to fulfill the KBK indicators also affect the achievement of the KBK. In this case, the FKTP must carry out a workload analysis to count the number of human resources, fulfill infrastructure and routinely provide education to Prolanis participants.
Downloads
References
Kementerian Kesehatan. Peraturan Menteri Kesehatan No.28 Tahun 2014 tentang Pedoman Pelaksanaan Program Jaminan Kesehatan Nasional. 2014;
Maujudah S. Faktor-faktor yang berhubungan dengan indikator kapitasi berbasis komitmen pelayanan puskesmas di Wilayah DKI Jakarta tahun 2018= Factors related to. 2018 [cited 2021 Jan 14]; Available from: https://library.ui.ac.id/detail?id=20476992&lokasi=lokal
Pemerintah RI. UU RI No.40 Tahun 2004 Tentang Sistem Jaminan Sosial Nasional. 2004;1–45.
BPJS Kesehatan. Peraturan Badan Penyelenggara Jaminan Sosial Kesehatan Nomor 7 Tahun 2019 tentang Petunjuk Pelaksanaan Pembayaran Kapitasi Berbasis Kinerja. BPJS Kesehatan. Jakarta; 2019.
Kementerian Kesehatan. Peraturan Menteri Kesehatan No.71 Tahun 2013 tentang Pelayanan Kesehatan Pada Jaminan Kesehatan Nasional. 2013.
Thabrany H, Setiawan E, Puteri GC, Qodarina UK, Pujiastuti AS, Aisyah W, et al. Evaluasi Penyelenggaraan Sistem Rujukan Berjenjang Era JKN-KIS. Ringkasan Riset JKN-KIS [Internet]. 2017;3:1–8. Available from: https://www.bpjs-kesehatan.go.id/bpjs/dmdocuments/dca313943f8f8b6f322071045ed1ceb6.pdf
Darmawan A, Kusdiyah E, Enis RN, W S, Realita E. Kajian Capaian Indikator Kapitasi Berbasis Pemenuhan Komitmen Pelayanan (KBK) BPJS Di FKTP Kota Jambi. Jambi Medical Journal. 2020;8(1):75–84.
Nofriyenti N, Syah NA, Akbar A. Analisis Faktor-Faktor yang Mempengaruhi Pemenuhan Indikator Angka Kontak Komunikasi dan Rasio Peserta Prolanis di Puskesmas Kabupaten Padang Pariaman. Jurnal Kesehatan Andalas. 2019;8(2):315-324.
Faulina AC, Khoiri A, Herawati YT. Kajian Pelaksanaan Sistem Rujukan Berjenjang Dalam Program Jaminan Kesehatan Nasional di UPT. Pelayanan Kesehatan Universitas Jember. Jurnal Ikesma. 2016;12(2):91–102.
Nurlinawati I, Rosita R, Werni S. Gambaran Faktor Penyebab Rujukan Di Puskesmas Kota Depok. Buletin Penelitian Sistem Kesehatan. 2019;22(3):176-183.
Alawi M, Junadi P, Latifah SN. Analisis Faktor-Faktor yang Berhubungan dengan Tingginya Rujukan Kasus Non Spesialistik Pasien Jaminan Kesehatan Nasional pada Puskesmas di Kabupaten Sukabumi Tahun 2015. Jurnal Ekonomi Kesehatan Indonesia. 2017;2(1):17-23.
Munawarah SH, Misnaniarti M, Isnurhadi I. Sumber Daya Terhadap Pencapaian Indikator Kapitasi Berbasis Pemenuhan Komitmen Pelayanan (KBPKP) di Puskesmas Kota Palembang. Gaster. 2020;18(1):37-49.
Widaty D. Analisis Pemenuhan Indikator Pembayaran Kapitasi pada Fasilitas Kesehatan Tingkat Pertama di Surabaya. Jurnal Administrasi Kesehatan Indonesia. 2018;5(2):111-116.
Maramis JVF, Mandagi CKF, Wowor R. Analisis Pencapaian Indikator Kapitasi Berbasis Komitmen (KBK) Terhadap Pembayaran Dana Kapitasi Di Puskesmas Wawonasa Kota Manado. Jurnal Kesmas. 2019;7(4). Available from: http://www.ejournalhealth.com/index.php/kesmas/article/view/892
Asfiani LV, Ilyas Y. Level of Adherence and Its Determinants of Prolanis Attendance in Type 2 Diabetes Mellitus Participants at Five BPJS Primary Health Care in Bekasi 2016. Journal Of Indonesian Health Policy And Administration. 2017;2(2):6-13.
Maharanti S, Oktamianti P. An Analysis Of The Healthcare Center System As A Gatekeeper In 2018. Journal Of Indonesian Health Policy And Administration. 2018;3(2):46-50.
Pamungkas RA, Chamroonsawasdi K, Charupoonphol P, Vatanasomboon P. A health-based coaching program for diabetes self-management (DSM) practice: A sequential exploratory mixed-method approach. Endocrinol Diabetes y Nutricion. 2020; Available from: https://doi.org/10.1016/j.endinu.2020.07.010
Eskawati MY, Murti B, Tamtomo D. Implementation of the Referral System Policy in the National Health Insurance Scheme at Community Health Centers, Ngawi District, East Java. Journal of Health Policy and Management. 2017;2(2):104–113.
Manurung J. Analisa Capaian Indikator Kapitasi Berbasis Komitmen (KBK) Pelayanan Terhadap Pembayaran Dana Kapitasi Di Puskesmas Hutabaginda Kecamatan Tarutung Kabupaten Tapanuli Utara Tahun 2019. Jurnal Akrab Juara. 2021;6(2):189–200.
Arifa AFC. Pengaruh Informasi Pelayanan Prolanis Dan Kesesuaian Waktu Terhadap Pemanfaatan Prolanis Di Pusat Layanan Kesehatan Unair. Jurnal Administrasi Kesehatan Indonesia. 2018;6(2):95-102.
Fadila R, Purnomo AF. Analisis Faktor Penyebab Tingginya Rasio Rujukan Non Spesialistik Puskesmas Rawat Inap. Jurnal Kesehatan Komunitas. 2021;7(2):144–149.
Widodextrosa, Muryanto I, Rany N, Hanafi A, Puspasari A. Achievement Efforts Based On The Fulfillment of Service Commitments (KBPKP) Analysis in Puskesmas Rumbai, Pekanbaru City. 2020;6(3):310–327.
Sabrina Q. Kebijakan dan Manajemen Publik Pelaksanaan Program Jaminan Kesehatan Nasional (JKN) Dalam Peningkatan Kualitas Pelayanan Kesehatan di RSU Haji Surabaya. Kebijakan dan Manajemen Publik. 2015;3(2):54–62.
Additional Files
Submitted
Accepted
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Jurnal Kesehatan Komunitas
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright @2017. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted non-commercial used, distribution and reproduction in any medium
