Implementation of the health insurance policy at UPTD Puskesmas Ajangale Bone District
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Muh Dandy Rivaldi(1*)
Program Studi Administrasi Publik, Fakultas Ilmu Sosial dan Ilmu Politik, Universitas Nusa Cendana Kupang
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Nursalam Nursalam(2)
Program Studi Administrasi Publik, Fakultas Ilmu Sosial dan Ilmu Politik, Universitas Nusa Cendana Kupang
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Maria M Lino(3)
Program Studi Administrasi Publik, Fakultas Ilmu Sosial dan Ilmu Politik, Universitas Nusa Cendana Kupang
(*) Corresponding Author
Abstract
This study aims to analyze the implementation of health services for BPJS Kesehatan beneficiaries at UPTD Puskesmas Ajangale and to identify the factors that hinder its implementation. The research uses a descriptive qualitative approach with data collected through in-depth interviews, observation, and documentation. The analysis is based on the implementation theory developed by George C. Edwards III, which emphasizes four main variables: communication, resources, disposition of implementers, and bureaucratic structure. The findings indicate that the implementation of BPJS health services has been carried out administratively but has not yet operated optimally. Basic health services such as outpatient treatment, immunization, and referral services are available, yet several obstacles remain. Communication between health workers and patients is often ineffective, the number of medical personnel and the availability of medicines are limited, and some health workers still lack a humanistic approach in providing services. In addition, bureaucratic procedures, particularly the referral process, tend to be slow and less responsive to urgent situations. The main factors that hinder the effectiveness of BPJS service implementation include the shortage of health workers, limited development of service information systems, insufficient public education about health service procedures, and administrative processes that are still relatively complex. Overall, the study concludes that although BPJS health services have been implemented, improvements in both structural and operational aspects are still necessary to ensure that health services become more effective, efficient, and equitable for the community.
Keywords: Implementation; Health Services; BPJS; Public Health Center; Public Policy
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References
Bone District Health Office. (2024). Health Profile of Bone Regency 2024. Bone: Bone District Health Office.
BPJS Kesehatan. (2024). National Health Insurance (JKN) Membership Data 2024. Jakarta: BPJS Kesehatan.
Constitution of the Republic of Indonesia Year 1945
Edwards III, G. C. (1980). Implementing Public Policy. Washington D.C.: Congressional Quarterly Press
Government Regulation No. 86/2013 on Administrative Sanctions for Employers Who Do Not Administer the Social Security Program (1980). Politics and Policy Implementation in the Third World. Princeton University Press
Grindle, M. S. (1980). Politics and Policy Implementation in the Third World. Princeton, New Jersey: Princeton University Press.
Handayani, F. (2022). Evaluation of Tiered Referral Implementation in BPJS Services in Rural Areas. Journal of Public Health Nusantara, 10(2), 90-104
Hardiyansyah. (2018). Public Service Quality: Concepts, Dimensions, Indicators, and Implementation. Yogyakarta: Gava Media.
Law Number 36 of 2009 concerning Health
Law No. 4/2004 on the National Social Security System
Law Number 24 Year 2011 on Social Security Organizing Agency
Miles, M. B., & Huberman, A. M. (1994). Qualitative Data Analysis: An Expanded Sourcebook (2nd ed.). Thousand Oaks, California: Sage Publications.
Minister of Health Regulation No. 71 Year 2013 on Health Services in the National Health Insurance Program
Moenir, H. A. S. (2010). Public Service Management in Indonesia. Jakarta: Bumi Aksara.
Musdalifa. (2020). Analysis of Obstacles to BPJS Health Services at Pekkae Health Center. Journal of Health Administration and Policy, 6(1), 67-78
Presidential Regulation No. 82/2it is nes018 on Health Insurance
Presidential Regulation No. 64/2020 on the Second Amendment to Presidential Regulation No. 82/2018 on Health Insurance
Regulation of the Minister of Health of the Republic of Indonesia Number 28 of 2014 concerning Guidelines for the Implementation of the National Health Insurance Program.
Republic of Indonesia. (1945). The 1945 Constitution of the Republic of Indonesia.
Republic of Indonesia. (2003). Law Number 13 of 2003 concerning Manpower.
Republic of Indonesia. (2004). Law Number 40 of 2004 concerning the National Social Security System.
Republic of Indonesia. (2009). Law Number 36 of 2009 concerning Health.
Republic of Indonesia. (2011). Law Number 24 of 2011 concerning the Social Security Organizing Agency.
Republic of Indonesia. (2013a). Government Regulation Number 86 of 2013 concerning Procedures for the Imposition of Administrative Sanctions in the Administration of Social Security.
Republic of Indonesia. (2013b). Minister of Health Regulation Number 71 of 2013 concerning Health Services in the National Health Insurance Program.
Republic of Indonesia. (2014). Minister of Health Regulation Number 28 of 2014 concerning Guidelines for the Implementation of the National Health Insurance Program.
Republic of Indonesia. (2015). Minister of Health Regulation Number 99 of 2015 concerning Amendments to Minister of Health Regulation Number 71 of 2013 concerning Health Services in the National Health Insurance Program.
Republic of Indonesia. (2016). Minister of Health Regulation Number 52 of 2016 concerning Standards of Health Service Tariffs in the Implementation of Health Insurance Programs.
Republic of Indonesia. (2018). Presidential Regulation Number 82 of 2018 concerning Health Insurance.
Republic of Indonesia. (2019).Government Regulation Number 82 of 2019 concerning Health Insurance.
Republic of Indonesia. (2020a). Law Number 11 of 2020 concerning Job Creation.
Republic of Indonesia. (2020b). Presidential Regulation Number 64 of 2020 concerning the Second Amendment to Presidential Regulation Number 82 of 2018 concerning Health Insurance.
Republic of Indonesia. (2022a). Government Regulation in Lieu of Law Number 2 of 2022 concerning Job Creation.
Republic of Indonesia. (2022b). Presidential Instruction Number 1 of 2022 concerning Optimization of the National Health Insurance Program.
Sinambela, L. P. (2010). Public Service Reform: Theory, Policy, and Implementation. Jakarta: Bumi Aksara.
Sugiyono. (2018). Qualitative Research Methods. Bandung: Alfabeta.
Sugiyono. (2018). Qualitative, Quantitative and R&D Research Methods. Bandung: Alfabeta
Syaukani, H. R., et al. (2004). Regional Autonomy in a Unitary State. Yogyakarta: Pustaka Pelajar.
United Nations. (1948). Universal Declaration of Human Rights. Retrieved from https://www.un.org/en/about-us/universal-declaration-of-human-rightsâ
UPTD Puskesmas Ajangale. (2024). Annual Report of UPTD Puskesmas Ajangale 2024. Bone: UPTD Puskesmas Ajangale.
UPTD Puskesmas Ajangale. (2024). Patient Visit Report and BPJS Membership Data 2024. Bone: UPTD Puskesmas Ajangale.
Widodo, J. (2011). Public Policy Analysis: Concepts and Applications of Public Policy Process Analysis. Malang: Bayumedia Publishing.
Wijaya, D. (2019). Analysis of the Implementation of the BPJS Health Program at the Puskesmas in Malang City. Journal of Public Policy and Health, 5(2), 113-125
