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Abstrak :
ABSTRAK
Tesis ini membahas tentang Implementasi Kebijakan Jaminan Kesehatan Nasional di Kota Serang dilihat dari Empat Variabel Implementasi menurut George Edward III, yaitu Komunikasi, Sumber daya, Disposisi dan Struktur Birokrasi. Hasil Evaluasi Dewan Jaminan Dalam pelaksanaan Program Jaminan di Provinsi Banten masih banyak ditemui kendala. Penelitian ini menggunakan metode kualitatif. Hasil dari penelitian ini dapat diambil kesimpulan bahwa implementasi JKN di Kota Serang pada variabel Komunikasi sudah berjalan dengan baik, sementara pada variabel Sumber daya masih ditemui bahwa di puskesmas masih ditemui kekurangan dokter dan dokter gigi, pada variabel Disposisi ada respon negatif dari para pelaksana terhadap pembagian jasa pelayanan berdasarkan variabel ketenagakerjaan dan kehadiran, sementara itu pada variabel Struktur birokrasi ada SOP/mekanisme yang belum sesuai standar.

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ABSTRAK
This thesis discusses the implementation of National Health Insurance Policy in Serang city views of Four Variables Implementation by George Edward III, namely Communication, Resources, Disposition and Bureaucratic Structure. In the Security Council Evaluation Assurance Program implementation in Banten Province still many obstacles encountered. This study used qualitative methods. The results of this study can be concluded that the implementation of JKN in Serang on Communication variables are already well underway, while the variable power source is still found in health centers that are still encountered a shortage of doctors and dentists, to no negative response variable disposition of the executor of the division variable based employment services and attendance, while the existing bureaucratic structure variable SOP / mechanisms are not yet standardized.

Abstrak :
Jaminan Kesehatan Nasional merupakan implementasi dari UU No. 40 tahun 2004 tentang Sistem Jaminan Sosial Nasional di bidang kesehatan dengan konsep Universal Health Coverage yang memaksa pesertanya mengikuti sistem rujukan berjenjang untuk mendapatkan pelayanan kesehatan yang komprehensif, murah dan terjangkau namun berkualitas. Belum effektifnya sistem rujukan yang ada di Indonesia, membawa berbagai permasalahan dalam dunia kesehatan dan berdampak pada penumpukan pasien di fasilitas kesehatan lanjutan yang berakibat pemanfaatan tenaga terampil dan peralatan canggih secara tidak tepat guna dan menurunnya kualitas pelayanan kesehatan. Penelitian ini menggunakan pendekatan kualitatif, dengan arah penelitian pada Sistem Rujukan Jaminan Kesehatan Nasional RSUD dr. Adjidarmo di kabupaten Lebak. Metode analisa yang digunakan adalah Content Analysis berdasarkan triangulasi metode, triangulasi sumber dan triangulasi teori. Dengan menganalisis aspek yang terdapat didalamnya, hasil penelitian dan pembahasan dibagi dalam 2 komponen, yaitu Karakteristik Sistem Rujukan Medis dan Sistem Rujukan Berjenjang. Dari hasil penelitian menunjukan bahwa pada Karakteristik Sistem Rujukan Medis implementasi Jaminan Kesehatan Nasional membawa perbaikan dalam sistem rujukan di RSUD dr. Adjidarmo Kabupaten Lebak walaupun belum signifikan dan dari komponen Sistem Rujukan Berjenjang, perbaikan baru nampak pada aspek kebijakan dan prosedur, sehingga masih diperlukan upaya yang keras untuk meningkatkan aspek lainnya untuk menciptakan sistem rujukan yang lebih baik.

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National Health Insurance is an implementation of the Law No. 40 of 2004 on National Social Security System in the field of healthcare with the concept of Universal Health Coverage that forced participants to follow a tiered referral system for health services are comprehensive, affordable, cheap and quality. The ineffectiveness of the existing referral system in Indonesia, bringing a variety of health problems in the world and have an impact on the accumulation of patients in healthcare facilities resulting in continued utilization of skilled personnel and sophisticated equipment is not appropriate and the declining quality of health care. By analyzing aspects contained therein, the results obtained and the discussion is divided into two components, namely the Medical Referral System Characteristics and Referral System Tiered,. From the results of the study showed that the implementation of the Medical Referral System Characteristics of National Health Insurance to bring improvements in the referral system in Public Hospital of dr. Adjidarmo Lebak although not significant and tiered referral system components improvements just occured in both policy and procedures, so that a strong effort is still needed to improve other aspects of creating a better referral system. It is expected that the results of this study may be one of the input for the management of hospitals and related institutions in improving various aspects related to the successful implementation of a tiered referral system in Lebak district in order to achieve Universal Health Coverage in Indonesia.

Abstrak :
[Pada 1 Januari 2014 Negara Indonesia berupaya untuk mensejahterakan rakyatnya melalui Jaminan Kesehatan Nasional (JKN). Jaminan Kesehatan berupa perlindungan kesehatan agar peserta memperoleh manfaat pemeliharaan kesehatan dan perlindungan dalam memenuhi kebutuhan dasar kesehatan. Dalam pelaksanaan penyelenggraan jaminan kesehatan pada prinsipnya menggunakan konsep managed care, yaitu suatu teknik yang mengintegrasikan pembiayaan dan pelayanan kesehatan melalui penerapan kendali biaya dan kendali mutu dengan tujuan mengurangi biaya pelayanan yang tidak perlu melalui cara meningkatkan kelayakan dan efisiensi pelayanan kesehatan. Penelitian ini bertujuan untuk mengetahui dan menganalisa gambaran pola pemanfaatan pelayanan kesehatan bersumber dana kapitasi dan non kapitasi pada FKTP milik Pemerintah di Kabupaten Pandeglang. Penelitian ini merupakan studi analitik dengan desain cross sectional. Sampel sebanyak 615 pasien, merupakan pasien yang berkunjung ke FKTP milik Pemerintah di tiga wilayah Puskesmas terpilih. Hasil penelitian menunjukkan bahwa Proporsi peserta JKN yang memanfaatkan pelayanan kesehatan di FKTP milik Pemerintah di Kabupaten Pandeglang adalah 47,3%, sebesar 52,7% dari yang memanfaatkan pelayanan kesehatan merupakan bukan peserta JKN (pasien umum). Pemanfaatan pelayanan kesehatan pada peserta JKN sebanyak 66,7% memanfaatkan jenis pelayanan kesehatan yang dapat didanai oleh kapitasi dan 33,3% memanfaatkan jenis pelayanan kesehatan yang dapat didanai oleh non kapitasi. Pada peserta JKN pemanfaatan jenis pelayanan kesehatan yang dapat didanai oleh non kapitasi lebih tinggi dibandingkan dengan bukan peserta JKN. Faktor – faktor yang berhubungan dengan pemanfaatan jenis pelayanan kesehatan yang didanai kapitasi dan non kapitasi di FKTP adalah status kesehatan, kepesertaan JKN, dan kemampuan membayar. Disarankan dalam perumusan pembuatan kebijakan tingkat daerah diharapkan dapat lebih memperhatikan acuan pelaksanaan ditingkat pusat, sehingga manfaat pelayanan kesehatan bagi masyarakat tidak menjadi bias. Dalam menunjang Universal Coverage pada tahun 2019, mekanisme pendaftaran peserta JKN diharapkan dapat menjadi bahan pokok bahasan penting di tingkat Kementerian Kesehatan maupun BPJS sebagai pelaksana;On 1st January 2014, Indonesia tried to welfare its people by National Health Insurance (JKN). National Health Insurance in the form of health protection for participants to obtain health care benefits and protection to meet basic health needs. Principle of health insurance implementation is using managed care principle, technique that integrates the funding and health care trough the implementation of cost control and quality control with the aim of reducing the cost of needless services by improve the viability and efficiency of health care. This research aims for knowing and analysing the models of health care utilization which funded capitation and non-capitation in government primary health facility of Pandeglang Regency. This research is an analytical study with cross sectional design. Amount of samples are 615 patients, those are visited to government primary health facility at the three areas selected health centers. The result of research show that national health insurance proportion of participants who use the health care in government primary health facility of Pandeglang is 47.3%, and 52.7% of using health care is not participant of national health insurance. In health care utilization of national health insurance participant there are 66,7% who use health care model of capitation and 33,3% who use health care model of non-capitation. In national health insurance participant of health care utilization with non-capitation model is higher than non-participant of national health insurance. Factors that related to the utilization of health care with funded capitation and non-capitation in primary health facility are health status, membership of national health insurance, and ability to pay. It is suggested in the formulation of policy-making in regional level is expected to be more concerned with the reference implementation at central level, so the benefits of health care for the people will not be refraction. In supporting the Universal Coverage in 2019, the registration mechanism of national health insurance participant is expected to be an important discussion at the Health Ministry level and BPJS as executor, On 1st January 2014, Indonesia tried to welfare its people by National Health Insurance (JKN). National Health Insurance in the form of health protection for participants to obtain health care benefits and protection to meet basic health needs. Principle of health insurance implementation is using managed care principle, technique that integrates the funding and health care trough the implementation of cost control and quality control with the aim of reducing the cost of needless services by improve the viability and efficiency of health care. This research aims for knowing and analysing the models of health care utilization which funded capitation and non-capitation in government primary health facility of Pandeglang Regency. This research is an analytical study with cross sectional design. Amount of samples are 615 patients, those are visited to government primary health facility at the three areas selected health centers. The result of research show that national health insurance proportion of participants who use the health care in government primary health facility of Pandeglang is 47.3%, and 52.7% of using health care is not participant of national health insurance. In health care utilization of national health insurance participant there are 66,7% who use health care model of capitation and 33,3% who use health care model of non-capitation. In national health insurance participant of health care utilization with non-capitation model is higher than non-participant of national health insurance. Factors that related to the utilization of health care with funded capitation and non-capitation in primary health facility are health status, membership of national health insurance, and ability to pay. It is suggested in the formulation of policy-making in regional level is expected to be more concerned with the reference implementation at central level, so the benefits of health care for the people will not be refraction. In supporting the Universal Coverage in 2019, the registration mechanism of national health insurance participant is expected to be an important discussion at the Health Ministry level and BPJS as executor]