PERUBAHAN PELAYANAN KLINIK NON-BPJS SEBELUM DAN SETELAH IMPLEMENTASI BADAN PENYELENGGARA JAMINAN SOSIAL (BPJS) KESEHATAN (Studi Kasus di Klinik Utama Rawat Inap Sumber Bahagia, Depok, Jawa Barat)

THE MODIFICATION OF HEALTH SERVICES IN NON-BPJS CLINICS BEFORE AND AFTER THE IMPLEMENTATION OF BPJS-KESEHATAN (A Case Study in KURI Sumber Bahagia Clinic in Depok, West Java)

Abstract

Background: The implementation of the BPJS Kesehatan as a
single payer healthcare cover back in 2014 in Indonesia starts a
new era of a nationwide coverage of health insurance. Every
citizen should be a member of that program, according to the
law. The state owned health services are the main providers of
the services, along with the private owned hospitals and clinics,
as long as they can fulfill the requirements given by the
government. But some small clinics are not eligible to met the
criteria of the BPJS Kesehatan, resulting in the inability to be the
provider. This can lead to the decrease of revenues of those
clinics, and can cause bankruptcy. Objective: The main objective of this research is to find few
alternative strategies that can be applied by the non-BPJS
clinics so they can still gain a significant portion of the health
service industry business and even increase their revenues by
applying those strategies. Methods: This research is a case study conducted in a clinic
called KURI Sumber Bahagia in the city of Depok, West Java,
with using both quantitative data of patient visitation, that was
analysed using a linear regression technique to determine the
signification effect of BPJS Kesehatan, as well as qualitative
information gathering by means of interviewing the stakeholders
in that clinic. The interview data would help the
researcher to explain the phenomena found by the statistics
measurements. Results: The statistic results of this research showed a
significant decrease (p<0,05) in patient visitation after the
implementation of BPJS Kesehatan back in 2014, especially in
types of services such as manual labour, sectio caeserea labor,
infant immunisation in general, and birth control shots. In
contrast, there are several services that showed an increase
usage (p<0,05) even after BPJS Kesehatan, such as IUDs
services, Hepatitis A shots, and Cervical Cancer shots. Based
on the interview conducted afterwards, researcher found on
most health services, patients tend choose BPJS than private
clinics of the same services because it is cost efficient, but on
some services they were willing to pay out of pocket in private
clinics because the quality of services or the products that were
not available in BPJS Kesehatan (eg. NOVA T brand of IUD).
Furthermore, the research also found the increase on services
which are not available in BPJS Kesehatan (eg. Hepatitis A
shots, Cervical cancer shots). Conclusion: There are significant decreases of patient
visitation numbers in KURI Sumber Bahagia clinic since the
implementation of BPJS Kesehatan. This phenomenon is
responded by the clinic by giving a better quality services and
products and also by providing other services in which not
covered by BPJS Kesehatan. Differentiation of services and quality services is proven effective to maintain and even
increase patient visitation, which in the end can give a good
revenues for the clinic.