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Submitted
17 October 2022
Accepted
24 November 2022
Published
5 December 2022
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Abstract

Since the COVID-19 pandemic occurred at the end of January 2020, the health social security administering body (BPJS Kesehatan) as the payer has an important part in handling COVID-19, namely by carrying out the process of verifying claims for COVID-19 cases while the financing is carried out by Ministry of Health. However, COVID-19 benefits may be transferred to the National Health Insurance benefits during the endemic period. Therefore, this study aims to evaluate services and obtain policy recommendations for the transfer of COVID-19 benefits. Qualitative research through focus group discussions was conducted in September 2021 with policymakers, clinicians, COVID-19 survivors, and BPJS Kesehatan. The results of the qualitative study show that there are still many obstacles in the service process. Therefore, it is necessary to regulate the provisions of service regulations. As for the claim process, health facilities find it difficult to change the dynamic regulations during the pandemic. BPJS Kesehatan requires policy certainty to determine the end of the pandemic period. If the COVID-19 benefits are transferred to JKN after the pandemic, the source of financing may not only be done through the conversion of contributions but there is also an option for assistance funds from the government. In terms of tariffs, it is necessary to calculate costs according to the agreed benefit package through INA-CBG. Gradual and thorough preparations are needed for the implementation of the transfer of COVID-19 benefits in the benefits of JKN.

Keywords

COVID-19 JKN BPJS Kesehatan Dispute Klaim Benefit of JKN Financing Pandemic Universal Health Coverage

Article Details

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This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite
Kusila, G. R., Suparniati, E. ., Ardyanto, T. D. ., Pardede, D., Hafidz, F. ., Baros, W. A., Revelino, D. ., Dhanalvin, E., Saut, B., Jaya, C. ., & Oktavia, A. . (2022). Kebijakan Alih Manfaat Covid-19 Dalam Manfaat Jaminan Kesehatan Nasional. Jurnal Jaminan Kesehatan Nasional, 2(2), 217–238. https://doi.org/10.53756/jjkn.v2i2.111
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References

  1. Ambarwati, W. 2021. Pembiayaan Pasien COVID-19 dan Dampak Keuangan terhadap Rumah Sakit yang Melayani Pasien COVID-19 di Indonesia Analisis Periode Maret 2020 – Desember 2020. Jurnal ekonomi kesehatan Indonesia. 6(1).
  2. Blankenship, S.B., Nakano-Okuno, M. and Zhong, R. 2021. Physicians’ role in the COVID-19 infodemic: A reflection. Southern medical journal. 114(12), pp.812–814.
  3. Chen, C., Haupert, S.R., Zimmermann, L., Shi, X., Fritsche, L.G. and Mukherjee, B. 2022. Global prevalence of post COVID-19 condition or long COVID: A meta-analysis and systematic review. The journal of infectious diseases.
  4. Fisher, K.A., Olson, S.M., Tenforde, M.W., Self, W.H., Wu, M., Lindsell, C.J., Shapiro, N.I., Files, D.C., Gibbs, K.W., Erickson, H.L., Prekker, M.E., Steingrub, J.S., Exline, M.C., Henning, D.J., Wilson, J.G., Brown, S.M., Peltan, I.D., Rice, T.W., Hager, D.N., Ginde, A.A., Talbot, H.K., Casey, J.D., Grijalva, C.G., Flannery, B., Patel, M.M. and Feldstein, L.R. 2021. Symptoms and recovery among adult outpatients with and without COVID-19 at 11 healthcare facilities-July 2020, United States. Influenza and other respiratory viruses. 15(3), pp.345–351.
  5. Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., Xiao, Y., Gao, H., Guo, L., Xie, J., Wang, G., Jiang, R., Gao, Z., Jin, Q., Wang, J. and Cao, B. 2020. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 395(10223), pp.497–506.
  6. Humphreys, H., Kilby, L., Kudiersky, N. and Copeland, R. 2021. Long COVID and the role of physical activity: a qualitative study. BMJ open. 11(3), p.e047632.
  7. Kemenkes 2021a. Keputusan Menteri Kesehatan Republik Indonesia Nomor Hk.01.07/Menkes/4718/2021 Tentang Petunjuk Teknis Klaim Penggantian Biaya Pelayanan Pasien Corona Virus Disease 2019 (COVID-19) Bagi Rumah Sakit Penyelenggara Pelayanan Corona Virus Disease 2019 (COVID-19). Jakarta: Kementerian Kesehatan.
  8. Kemenkes 2021b. KMK RI nomor HK.01.07/menkes/5673/2021 Tentang petunjuk teknis klaim penggantian biaya pelayanan pasien [Online]. Jakarta: Kementerian Kesehatan. Available from: https://COVID19.hukumonline.com/wp-content/uploads/2021/09/keputusan_menteri_kesehatan_nomor_hk_01_07_menkes_5673_2021_tahun_2021.pdf.
  9. Kemenkes 2016. Peraturan Menteri Kesehatan tentang Pembebasan Biaya Pasien Penyakit Infeksi Emerging Tertentu. Jakarta: Kementerian Kesehatan.
  10. Khan, Mujeeb, Adil, S.F., Alkhathlan, H.Z., Tahir, M.N., Saif, S., Khan, Merajuddin and Khan, S.T. 2020. COVID-19: A global challenge with old history, epidemiology and progress so far. Molecules (Basel, Switzerland). 26(1), p.39.
  11. Kusumawati, A.N. and Pujiyanto 2020. Faktor-Faktor Penyebab Pending Klaim Rawat Inap di RSUD Koja tahun 2018. Cermin Dunia Kedokteran. 47(1).
  12. Menges, D., Ballouz, T., Anagnostopoulos, A., Aschmann, H.E., Domenghino, A., Fehr, J.S. and Puhan, M.A. 2021. Burden of post-COVID-19 syndrome and implications for healthcare service planning: A population-based cohort study. PloS one. 16(7), p.e0254523.
  13. Nandasena, H.M.R.K.G., Pathirathna, M.L., Atapattu, A.M.M.P. and Prasanga, P.T.S. 2022. Quality of life of COVID 19 patients after discharge: Systematic review. PloS one. 17(2), p.e0263941.
  14. Normand, C. and Weber, A. 2009. Social Health Insurance. Eschborn: GTZ.
  15. Putri, B.A. 2022. Analisis dispute klaim pasien coronavirus disease 2019 (COVID-19) (studi kasus pada Rumah Sakit X kelas B di Kabupaten Bantul. Master, Yogyakarta: Universitas Gadjah Mada.
  16. Rakhmad, H., Administrative Studies, Faculty of Public Health, Universitas Indonesia, Budi, H. and Faculty of Public Health, Universitas Indonesia 2020. Dispute analysis of claims for COVID-19 patients at hospitals of Indonesia University In: Childhood Stunting, Wasting, and Obesity, as the Critical Global Health Issues: Forging Cross-Sectoral Solutions [Online]. Masters Program in Public Health, Universitas Sebelas Maret. Available from: http://dx.doi.org/10.26911/the7thicph.04.17.
  17. Suti Ismawati, N.D., Supriyanto, S., Haksama, S. and Hadi, C. 2021. The influence of knowledge and perceptions of doctors on the quality of medical records. Journal of public health research. 10(2), jphr.2021.2228.
  18. Tang, K.L., Lucyk, K. and Quan, H. 2017. Coder perspectives on physician-related barriers to producing high-quality administrative data: a qualitative study. CMAJ open. 5(3), pp.E617–E622.
  19. WHO 2020. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. World Health Organization. [Online]. [Accessed 6 June 2021]. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-COVID-19---11-march-2020.

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