Kesehatan Nasional (JKN) in , to increase the healthy quality standard of .. STANDAR PELAYANAN MEDIS DAN FORMULARIUM JAMKESMAS PADA. Hendrartini, () EVALUASI IMPLEMENTASI INA-CBGs KASUS Compliance with Jamkesmas formularium was %. 8/24/ AM Curriculum vitae Nama: Prof. dr. Ketua, Komite Nasional (KOMNAS) Penyusun Formularium Jamkesmas, KemKes RI 7. Ketua Tim.

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A Diagnosis-Related Group DRG is a statistical system of classifying any inpatient stay into groups for payment purpose.

It is expected the hospital should be able to manage costs effectively in every provision of health care to patients. If those formulzrium articles were suitable, they were included for review. There was tarif difference of All people become participants so 201 they can be protected. Experiences in low- and middle-income countries.

Similar to the case mix group, this system is applied as an insurance payment system. The system change influences the hospitals’ financial performance. What is health financing for universal coverage? From the 15 selection research journals, we found that the implementation of the INA-CBGs system with the prospective payment system can provide a positive impact on jamkeskas financial performance in public jamkesnas, when the hospital could reduce inefficient cost of treatment.

Prospective payment is more effective in terms of cost reduction than the retrospective alternative [ 7 ]. Indonesia started the national health insurance system on 1 January If combined with DRG classification, it is found to have maximum efficiency-enhancing effect [ 7 ]. The development of case-mix system is diagnosis-related group system. Retrospective payment recompenses healthcare providers based on their actual charges.

Evaluasi Ketersediaan Obat Terhadap Formularium

One of the prospective payment approach is the case-mix group system. The key points of accrual accounting include the following:. From some research journals that are used as reference, the implementation of the INA CBGs system with the prospective payment can provide a positive impact on the financial performance at public hospital, when the hospital could reduce the cost of treatment is not effective.

The growing movement for universal health coverage. On the other hand, prospective payment works by assigning a fixed payment rate to specific treatments. The previous researches obtained that Prospective Payment System intends to motivate providers to deliver patient’s health care effectively and efficiently. With all participants the obligation to pay contributions, there will be the principle of mutual cooperation where the healthy help the sick, the rich help the poor.


This study is a qualitative research with Grounded Theory approach.

An interview guide and checklist were used as instrument for observation and interview. There was hospital policy that enforced control over cost and quality, as indicated from the availability of Integrated Management Team of Community Health Service Insurance, obligation to prescribe according to Jamkesmas formularium, standard operational procedures of DM and medical formhlarium.

In this sytem health providers partially take the financial risk whenever they are inefficiency in budget utilization. Evaluasi Ketersediaan Obat Terhadap Formularium….

Evaluation of JKN in public hospitals can be seen from the aspect of membership, aspects of health care services and tariffs, several problems are found in this transition period, including the discovery of restriction of services to any type of health insurance, third ward who often have queuing and type of drugs given only contained in the National Formulary only.

Starting with definition of the objectives of the DRG system, the most common diseases in each disease group should be first targeted so as to formulate pricing standards for each disease group and increase the feasibility of implementing DRGs. Financing capability represent a vital element of competitive advantage [ 12 ]. The amount of the bill for the diagnosis had been organized and endorsed by the Minister of Health Regulation No.

The European Journal of Health Economics, vol. Most of journals that are used as references say that there is a significant difference of INA-CBGs rates in each hospital.

Formlarium second increase cash flow by prioritizing process hospital claims were denied and appeal if necessary. Social Security Agency is not allowed to make a profit. The primary benefit of retrospective payment is that they may allow patients to receive more attentive because there is no limitation of approved treatment plans for providers, they can adjust their services to meet patients’ needs individually [ 7 ].

According to JKN socialization handbook in the national social security system, the National Health Insurance is managed by the principle:.

formularium – [XLS Document]

One way to overcome the difference in costs is making a clinical-pathway which contain detailed essential steps to handle the patients, it formulraium of protocol therapy and the standard care ranging from admission to hospital discharge forrmularium 13 ].


Based on some of the issues that use for this systematic review, the aim of this article is to describe the implementation of the INA CBGs system and its effect on public hospitals’ financial performance.

European Research Studies, vol. Based on Undang – Undang No.

formularium 2010

The application system adopts a more refined DRGs, which is a type of prospective payment, system of payments to health service facility, either a hospital 2031 a doctor in the amount set before a service is formulagium without regard to the action taken or the duration of treatment. In this system, patients are classified based foormularium the groups of diagnosis, then that groups are coded by using a DRG software. Pakistan Journal of Medical Sciences, vol. In this type of organization, public hospitals can be managed as a business organization with flexibility in financial management based on productivity and effectiveness [ 8 ].

Searching process is done within time frame 1 s t January — 16 t h Novemberwith English and Indonesian language restriction.

Hospital finance performance Hospital must provide good quality health care to make sure the goals jamkezmas universal health coverage could be achieved efficiently and effectively.

Jamkesmas is social aid to ensure health of poor community in Indonesia financed by the government. A Surplus is the differences between revenues and costs in a same accounting period. The DRG classification system divides possible diagnoses into more than 20 major body systems and subdivides them into almost groups for the purpose of Medicare reimbursement.

Search Repository Search the repository using a full range of fields. While middle-income countries, including Thailand and many in Latin America, have paved the way, countries such as China, India, Indonesia, and Vietnam are quickly gaining steam — politically and technically — to achieve universal health coverage [ 3 ].

Subjects of the study were doctors providing the service, hospital management, medical records and prescription.

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