M. Hadi Shubhan, - and Rr. Herini Siti Aisyah, - and Lucianus Budi Kagramanto, - (2020) Optimization Of Primary Health Care To Improve Health Services For Participants Of Social Insurance Administering Agency Of Health In Indonesia. Journal of Critical Reviews, 7 (13). pp. 4498-4405. ISSN 2394-5125

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Abstract

The Healthy Indonesia Program is one of the fifth agenda of Nawa Cita. It is Improving the Quality of Life of Indonesian People with the aim of increasing the degree of health and nutritional status of the community through some health efforts and community empowerment supported by the financial protection and equitable distribution of health services. This Program is implemented by upholding three main pillars, namely: the adoption of a healthy paradigm, strengthening health services, and implementing national health insurance (NHI). The implementation of NHI has shifted the paradigm of health care towards the quality of care. The communities can access the primary and secondary health services and begin to take into account the quality of the services they receive. The legal entity formed to organize National Health Insurance (NHI) program is the Social Insurance Administering Agency of Health (BPJS Kesehatan/SIAAH). For the first time, each participant is registered by SIAAH at a First Level of Health Facility (FLHF) determined by SIAAH after getting a recommendation from the local district/city health office. Primary Health Care (PHC) is one of the FLHF which prioritizes the fulfillment of community satisfaction through such qualified health services. Based on the standards of health service, one PHC serves thirty thousand (30,000) residents. Meanwhile, there are still some health facilities that are supported by only limited number of doctors and nurses, and even some do not have any pharmacists. There are many things to do to meet the standards. In fact, the existence of health services of non-local government hospitals is very vital, especially, since the launch of SIAAH program and considering the status of the PHC as FLHF of SIAAH services. Therefore, a study was conducted on the efforts to optimize the role of PHC as the health center to improve the health services, especially for SIAAH participants. The Socio Legal Research method was implemented in this study, the supporting legal materials were collected and the field research was conducted. The results of the research indicated that the renewal and improvement of PHC management through the formation of a Regional Public Service Agency (RPSA) made the PHC more developed since the fund or the financial support spent was according to the needs, and it was not dependent on the health department. All of these led to the operation of RPSA Primary Health Care was more flexible in managing the finance. Some of the benefits are as follows: safety and security at work, readiness of of givimg service at any time, anticipation of such conditions, and of unexpected costs, subsidies, income, accreditation, commercial, ease of reporting and flexibility.

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