The Effort to Reach the Contact Number Target at the Primary Health Care Facilities within the National Health Insurance Program in Depok, Indonesia


Khairun Nisa’il Hulwah1), Pujiyanto2)

 

1)Faculty of Public Health, Universitas Indonesia

2)Department of Administration and Health Policy, Faculty of Public Health, Universitas Indonesia

 

ABSTRACT

Background: Health Social Insurance Administration Organization (Health BPJS) set a target of 150/1000 primary health care (PHC) contact number target per month within the national health insurance (NHI) program. The contact num­­ber target is an indicator in the commitment-based capitation policy. It is set by the Health BPJS that must be achie­v­ed by the PHC. Data from January to February 2017 showed that 98 PHCs in Depok Ci­ty collaborated with Health BPJS, but only 27 PHCs (27.5%) reached the target. This study aimed to examine the effort to reach the con­­tact number target at the PHC facility within the NHI program in De­pok, Indonesia

Subjects and Method: A qualitative study was conducted at PHC facilities including 2 clinics and 2 community health centers (puskesmas). The heads of PHCs and persons in charge of the contact number target were selected for this study. The study theme was the success status of PHC in reaching the contact number target. The data were collected using in-depth interview and document review.

Results: At clinic, the number of human resources (HS) and facilities was sufficient. But at puskesmas, there was a lack of HS and facilities, such as computer and internet access. The policy of the clinic to pursue the contact number target was the commitment to input data on the day’s visit to primary-care on the same day but this policy was not exist in puskesmas. The activities carried out were improving the quality of services, counselling, participating in the integrated health post (posyandu), home visit, and checking the use of BPJS card. The puskesmas faced several obstacles so the contact number target was not reached.

Conclusion: The policy of the clinic to pursue the contact number target is the commitment to input data on the day’s visit to primary-care on the same day but this policy is not exist in puskesmas. The puskesmas face several obstacles so the contact number target is not reached.

Keywords: contact number, capitation, primary health care, clinic, community health center

Correspondence: Khairun Nisa’il Hulwah. Faculty of Public Health, Universitas Indo­ne­sia, Depok, West Java, Indonesia. Email: khairun.nisail81@ui.ac.id Mobile: 081348638460.

DOI: https://doi.org/10.26911/the6thicph-FP.04.23

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