Abstract

Since 2014, there has been an increase in funds for primary health care (PHC) coming from the National Health Insurance program capitation funds and the Health Operational Assistance Fund. This study aimed to explore the effect of this budget increase on the health care services at PHC. The case study used a qualitative approach and interviews from 19 PHC health workers with the highest and lowest budget. Data were analyzed using thematic analysis and supported by quantitative data. The positive impact of the increasing PHC budget was felt by PHC staff due to the addition of operational equipment and incentives provided. Nevertheless, there was also a negative impact such as feeling overwhelmed due to an increase in the quantity of PHC activities and additional administrative affairs. It also triggered a negative interaction between staff due to the number of incentives received. The regulation on the use of budget empowers PHC to better arrange the schedule of activities and manage human resources. However, these regulations are considered restrictive and the administrative flow of funds is too long that hinder the optimal use of the budget.

References

1. Rokx C, Schieber G, Harimurti P, Tandon A, Somanathan A. Health financing in Indonesia, a reform road map. Washington DC: The Wordl Bank. 2009.

2. Kementerian Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Republik Indonesia nomor: 494/Menkes/SK/IV/2010 tentang petunjuk teknis bantuan operasional kesehatan. Jakarta: Kementerian Kesehatan Republik Indonesia; 2010.

3. Roberts M, Hsiao W, Berman P, Reich M. Getting health reform right. Oxford: Oxford University Press; 2002.

4. Franco LM, Bennett S, Kanfer R. Health sector reform and public sector health worker motivation: A conceptual framework. Social Science & Medicine. 2002; 54(8): 1255-66.

5. McDonald R, Harrison S, Checkland K, Campbell S. M. Roland M. Impact of financial incentives on clinical autonomy and internal motivation in primary care: Ethnographic study. BMJ. 2007; 334 (7608): 1357-62.

6. Gosden T, Forland F, Kristiansen I, Sutton M, Leese B, Giuffrida A, et al. Capitation, salary, fee-for-service and mixed systems of payment: Effects on the behaviour of primary care physicians (Review). Cochrane Database of Systematic Reviews. 2000; (3): 1–25.

7. Musgrove P, Creese A, Preker A, Baeza C, Anell A, Prentice T. The world health report 2000: Health systems: Improving performance. Switzerland: World Health Organization; 2000.

8. Australia Indonesia Partnership For Health Systems Strengthening. Pembiayaan kesehatan dan cakupan kesehatan semesta. Jakarta: Kementerian Kesehatan Republik Indonesia. 2015. Available from: http://aiphss.org/wp-content/uploads/2015/09/Policy-notes-BahasaWEB-PEMBIAYAAN-KESEHATAN-DAN-CAKUPAN-KESEHATANSEMESTA-K.-NOTA-KEBIJAKAN-1.pdf (2015).

9. Fleetcroft R, Cookson R. Do the incentive payments in the new NHS contract for primary care reflect likely population health gains? Journal of Health Services Research & Policy. 2006; 11(1): 27–31.

10. Smith PC, Mossialos E, Papanicolas I. Performance measurement for health system improvement experiences, challenges and prospects. Denmark: World Health Organization; 2008.

11. Tomasi E, Facchini LA, Maia M de FS, Fatima MD, Maia S. Health information technology in primary health care in developing countries : A literature review. Bulletin of the World Health Organization. 2004; 82(11): 867–74.

12. Nurmansyah MI, Kilic B. Impact of national health insurance policy towards the implementation of health promotion program at public health centers in Indonesia. Kesmas: National Public Health Journal. 2017; 11(3): 103-10.

13. Pay DMN, Sinaga M, Pelokilla MR. Utilization of health operational assistance (BOK) in nutrition services in public health center. Jurnal Kesehatan Masyarakat. 2017; 12(2): 313–22.

14. Hendrayani NWA, Indrayathi PA, Wijaya IPG. Persepsi Pegawai Puskesmas tentang sistem pembagian jasa pelayanan Jaminan Kesehatan Nasional (JKN) di Kabupaten Karangasem. Public Health and Preventive Medicine Archive. 2015; 3(2): 158–66.

15. Scott A, Sivey P, Ouakrim DA, Lisa W, Naccarella L, Furler J, et al. The effect of financial incentives on the quality of health care provided by primary care physicians. Cochrane database of systematic reviews (Online). 2011; 9: CD008451.

16. Oxman AD, Fretheim A. Can paying for results help to achieve The mi - llennium development goals? Overview of the effectiveness of resultsbased financing. Journal of Evidence-Based Medicine. 2009; 2(2): 70– 83.

17. Chaix-Couturier C, Durand-Zaleski I, Jolly D, Durieux P. Effects of financial incentives on medical practice: Results from a systematic review of the literature and methodological issues. International Journal for Quality In Health Care: Journal of the International Society for Quality in Health Care. 2000; 12(2): 133–42.

18. Scott T, Mannion R, Davies HTO, Marshall MN. Implementing culture change in health care: theory and practice. International Journal for Quality in Health Care. 2003; 15(2): 111–18.

19. Hogg W, Rowan M, Russell G, Geneau R, Muldoon L. Framework for primary care organizations: The importance of a structural domain. International Journal for Quality in Health Care. 2008; 20(5): 308–13.

Download

Share

COinS