IMPLEMENTASI KEBIJAKAN JAMINAN SOSIAL KESEHATAN SUMATERA SELATAN SEMESTA DI PUSKESMAS SE-KOTA PALEMBANG TAHUN 2009

Abstract

Background and objective: Universal Social Health Insurance
of South Sumatera (Jamsoskes) is an effort undertaken by the
Government of South Sumatera to improve the accessibility of
health services for the people in South Sumatera, held since
22 January 2009. The aim of this study was to analyze the
implementation of Jamsoskes policy in the community health
centers in Palembang during the year 2009.
Methods: This was a policy analysis research with qualitative
and quantitative approaches. Data were obtained in Health
Office of South Sumatera Province, Health Office of Palembang
City, 38 community health centers in Palembang and users of
Jamsoskes. Qualitative data were collected through: in-depth
interviews and FGDs, then quantitative data were collected
through review of documents related to Jamsoskes. Content
analysis was used to analyze qualitative data and quantitative
data were analyzed by univariate statistics.
Results: Results showed that: 1) Implementation of Jamsoskes
has been according to district regulation of South Sumatera
Province Number 2/2009 and Governor Regulation Number 23/
2009; 2) Source of funds were contribution from budget of
South Sumatera Province and Palembang City; 3) Organizing
consist of the provincial coordination team, the city coordination
team, the service managers team, and verification officers. 4)
The utilization of Jamsoskes in 38 community health centers
was 408.830 people and the total of referral 9.089 people. 5)
Several problems in implementation of Jamsoskes i.e. on aspect
of membership administration, services administration, and
financial administration. There were incomplete identities in
membership administration, in services administration aspect,
medical diagnosis’ or treatments sometimes were not appropriate,
whereas in the financial administration, the claims cost were
not in accordance with district regulation. During the year 2009
the difference between billing and approval of claims in 38
community health centers at total of Rp21.037.000,00
Conclusion: Health financing policy in Palembang City through
Jamsoskes program was not optimal, as seen from several
problems: membership, services, and financial administration.
Recommendation for Health Office of South Sumatera Province
to build membership database and not use Jamkesmas
verificator for Jamsoskes verificator in order to reduce work
overload. Health Office of Palembang City need to disseminate
routinely of data verification to community health centers and
also to verificators. Community health centers need to intensify
provisia of information to society about prerequirements to get
Jamsoskes service.
Keywords: healthcare financing, social health insurance,
community health centers