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Abstrak :
Badan Penyelenggara Jaminan Sosial Kesehatan menerbitkan Peraturan Direktur Jaminan Pelayanan Kesehatan (Perdirjampelkes) Nomor 2, 3 dan 5 Tahun 2018, sebagai upaya pengendalian defisit yang saat ini melanda BPJS Kesehatan. Penerbitan ketiga Perdirjampelkes tersebut menuai kontroversi karena banyak pihak menilai sebagai penurunan kualitas layanan kesehatan peserta jaminan kesehatan dan BPJS Kesehatan dalam hal ini, Direktur Jaminan Pelayanan Kesehatan adalah bukan pihak yang berwenang untuk mengeluarkan kebijakan tersebut. Studi ini bertujuan untuk meneliti dan menganalisis penerbitan Perdirjampelkes sebagai sebuah kebijakan publik, apakah sudah dilakukan dengan tepat. Pengumpulan data diperoleh dengan cara wawancara mendalam dengan manajemen level atas, tinjauan literatur dan pengamatan. BPJS Kesehatan sebagai sebuah badan publik yang bertugas menyelenggarakan jaminan kesehatan, termasuk diantaranya membuat kebijakan, perlu melakukan pemetaan pemangku kepentingan agar mengetahui di mana posisi BPJS Kesehatan berada. Dengan mengetahui posisi BPJS Kesehatan dalam pemetaan tersebut, akan mempermudah BPJS Kesehatan dalam menjalankan fungsi dan perannya untuk mensukseskan program jaminan kesehatan di Indonesia. ......Badan Penyelengara Jaminan Sosial Kesehatan or BPJS Kesehatan (Indonesia Health Social Security Agency) issued Regulation of the Health Services Director (Perdirjampelkes) Number 2, 3 and 5 Year of 2018, as an effort to control deficits which currently hit BPJS Kesehatan. The issuance of the Perdirjampelkes reaped controversy over its contents governing the limitation of benefits, which are considered as a quality decrease over health care services for participants and BPJS Healthcare or the Director of Health Care Insurance is not the authorized party to issue the policy. This study aims to analyze the issuance of the Perdirjampelkes as a public policy, whether it has been done properly. Data collection is obtained by in-depth interviews with top-level management, literature review and observation. BPJS Kesehatan as a public agency tasked with organizing health insurance (including making policies), needs to do stakeholder analysis to find out where the position of BPJS Kesehatan is. By knowing the position of BPJS Health in the stakeholder mapping, it will helps carrying out its functions and roles to succeed the health insurance program in Indonesia.

Abstrak :
Indonesia mereformasi sistem pembiayaan kesehatan dengan menjamin seluruh penduduk dengan Jaminan Kesehatan Nasional efektif mulai tanggal 1 Januari 2014. JKN diselenggarakan secara nasional berdasarkan prinsip asuransi sosial dan prinsip ekuitas. Skripsi ini meneliti persepsi nasabah Asuransi Kesehatan Kumpulan PT. XYZ tentang JKN, sehubungan salah satu prinsip asuransi sosial adalah kepesertaan wajib maka kedepannya nasabah asuransi PT. XYZ juga wajib menjadi peserta JKN. Sebanyak 29 responden (49%) mempunyai sikap negatif terhadap JKN dan sebyak 30 responden (51%) mempunyai sikap positif terhadap JKN. Dari seluruh variabel independen berupa karakteristik nasabah dan karakteristik perusahaan tidak memiliki hubungan yang signifikan dengan sikap nasabah terhadap JKN, diduga karena kurangnya informasi yang adekuat mengenai hak dan kewajiban penduduk dalam JKN ......Indonesia conducts a reformation in health care funding system by covering all citizen’s helath care with National Health Security (NHS) which takes effect on January, 1 2014. NHS is held nationally based on social insurance principals and equity principals. This studies researches the perception of PT. XYZ’s clients which represented by company’s decision maker, about the implementation of NHS. One of the social insurance’s principals is membership mandatory, thereby PT. XYZ’s clients have to obey the law to join the NHS in the future. From all the independent variables which comprise of decision maker’s characteristics and company’s characteristics, both don’t have the correlation significantly with the attitude of the clients on NHS. The respondents whom have negative attitude on NHS count of 29 (49%) and 30 respondents (51%) have positive attitude about NHS. This happens probably because of lack of proper information about the right and the duty of the citizen’s in NHS.

Abstrak :
ABSTRAK
Peranan tenaga kerja sebagai penghasil barang atau jasa merupakan salah satu modal penting dalam pembangunan khususnya pertumbuhan ekonomi. Oleh karena itu, sudah selayaknya jika kesejahteraan tenaga kerja perlu menjadi perhatian demi terjaganya atau meningkatnya produktivitas tenaga kerja.Saat ini, pemerintah telah mengeluarkan berbagai regulasi yang mendorong peningkatan kesejahteraan tenaga kerja melalui penyelenggaraan jaminan sosial, salah satunya yaitu jaminan kesehatan nasional. Sebagaimana diatur dalam Undang-undang Nomor 24 Tahun 2011 tentang Badan Penyelenggara Jaminan Sosial bahwa penyelenggaraan jaminan kesehatan khususnya bagi tenaga kerja merupakan kewajiban yang harus diselenggarakan oleh Pemberi Kerja terhadap tenaga kerja paling lambat pada 1 Januari 2016 dengan besaran persentase iuran sebagaimana diatur dalam Peraturan Presiden Nomor 12 Tahun 2013 sebagaimana beberapa kali diubah dan terakhir yaitu Peraturan Presiden Nomor 28 Tahun 2016 tentang Jaminan Kesehatan. Namun sampai saat ini masih banyak pemberi kerja yang tidak patuh terhadap aturan penyelenggaraan program jaminan kesehatan nasional. Berdasarkan hal tersebut, peneliti melakukan penelitian untuk mengkaji efektivitas penyelenggaraan program jaminan kesehatan nasional bagi tenaga kerja di Kota Depok melalui tingkat kepatuhan pemberi kerja dalam program jaminan kesehatan nasional bagi tenaga kerja di Kota Depok. Metode penelitian yang digunakan adalah yuridis empiris dengan tipologi preskriptif. Hasil penelitian menunjukkan bahwa hanya terdapat 29% badan usaha Kota Depok yang patuh dalam program jaminan kesehatan nasional (patuh dalam pendaftaran, pemberian data secara lengkap dan benar, dan pembayaran iuran). Berdasarkan hal tersebut, penegakan kepatuhan melalui pemangku kepentingan dalam program jaminan kesehatan nasional perlu ditingkatkan untuk memastikan efektivitas penyelenggaraan jaminan kesehatan nasional.

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ABSTRACT
The role of employee as producer of goods and services is one of the most important thing in development especially in economy field. Therefore, the prosperity of employee should be the main concern in order to improve their productivity. As of now, the government have issued number of regulations which aim to improve the prosperity of employee through social security such as National Health Security. As of stated in Act 24 Year 2011 about Social Security Institution, Employer is required to provide Health Security for the employee before 1st January 2016 with percentage of dues as stated in President Regulation Number 28 Year 2016 about Social Security. However, there are still many Employers whom do not obey the regulations of providing Health Security. Based on the fact above, the researcher conducted the research reviewing the implementation of National Health Security for Employee in Depok through degree of Employer's obedience in providing Health Security for the employee.Research method that was used in this research is empiric judicial with prescriptive tipology. The result shows only 29% of total Company in Depok that obey The National Health Security regulation (obey in registering, reporting factual data and dues payment). Based on the result above, obedience enforcement by stakeholders in National Health Security program need to be improved to ensure the effectiveness of National Health Security Implementation.

Abstrak :
Sistem pembayaran INA-CBG dalam JKN diduga meningkatkan kejadian readmisi, didefenisikan sebagai kasus rawat-inap kembali pasien dalam waktu kurang 30 hari dengan kondisi Sama (diteliti dalam 4 model readmisi yaitu CMG/Adjacent-DRG/Severity-Level/Diagnosis-Primer Sama), cara pulang rawatan sebelumnya sembuh, pada rumah sakit yang Sama. Hanya satu kasus readmisi dihitung dalam 30 hari dari tanggal pemulangan pasien pada rawatan pertama per-periode-kasus-readmisi. Desain penelitian potong-lintang dengan data sekunder klaim rawat-inap Rumah Sakit wilayah BPJS-Kesehatan Cabang Sukabumi terverifikasi, data tahun 2015. Kejadian readmisi didapatkan pada 11 dari 13 Rumah Sakit untuk keempat model readmisi diteliti, terbanyak pada Readmisi-CMG-Sama, dan paling sedikit pada Readmisi-Severity-Sevel-Sama. Variabel independen adalah kepemilikan RS, Kelas/Tipe RS, diagnosis klinis (CMG, jenis-rawat-inap, Severity-Level, Diagnosis-Primer), selisih biaya, dan LOS (Length of Stay). Analisis multivariat menunjukkan variabel diagnosis-primer (kategori-kronis) dan severit-level (kategori-akut) paling berpengaruh. Selisih biaya negatif dan LOS yang lebih rendah tidak terbukti memiliki risiko readmisi lebih tinggi. Diagnosis Congestive Heart Failure dan Typhoid Fever memiliki kekerapan readmisi tinggi sekaligus diagnosis dengan selisih biaya positif tertinggi. Diagnosis Chemoterapy Session for Neoplasm, Aplastic Anaemia (unspecified), dan End-stage Renal Disease perlu mendapat perhatian karena kekerapan readmisi tinggi dan selisih biaya minus tertinggi. Risiko biaya total lebih 2 kali dari biaya kasus original (initial-admission). ...... The INA-CBG payment system in JKN is suspected to increase the incidence of readmission, defined as a case of patient re-hospitalization in less-than-30-days under the same conditions (studied in 4 readmission models of same- CMG/Adjacent-DRG/Severity-Level/Diagnosis-Primer), previous case recovered, at the same hospital. Only one case of readmission was calculated within-30-days from the date of discharge in the initial-admission per- readmission-case-periode. This is a cross-sectional study design with secondary data of verified-inpatient-claims of the Hospital of BPJS-Kesehatan-Sukabumi- Branch in 2015. The incidence of readmission was found in 11 of the 13 Hospitals of all four models, mostly in the same-CMG-readmission, and at least at the same-severity- level-readmission. The independent variables are hospital-ownership, hospital- types, clinical-diagnosis (CMG, inpatient-type, Severity-Level, Primary- Diagnosis), cost-difference, and LOS (Length of Stay). Multivariate analysis shows the primary diagnosis-type (chronic-category) and severity-level (acute- category) most influential. A lower-negative-cost and lower-LOS are not shown to have a higher risk of readmission. Diagnosis Congestive-Heart-Failure and Typhoid-Fever have high readmission frequency as well as diagnosis with the highest positive-cost-difference. Diagnosis of Chemotherapy Session for Neoplasm, Aplastic Anaemia (unspecified), and End-stage Renal Disease need attention because of high read-list-frequency and highest-minus-cost-difference. The total cost risk is more than 2 times the original-admissions cost.

Abstrak :
ABSTRAK
The small business actors are part of independents participants program of National Health Security or JKN that administered by the Social Security Board or BPJS. Using four variables as stated in the Theory of Planned Behavior and two variable as additional Value and Image will be examined that the Attitudes, Subjective Norms, and Perceived Behavior Controls Small business actors influence both direct and indirect through the variable values and image as an additional of the intentions to become a participant of JKN program? A total of 400 questionnaires were distributed to 6 areas of Jakarta region. The population of small business actors is 683.741, which is one elements group of independent participants in JKN. A total of 339 respondent data can be processed with AMOS ver.20. The complex relationships between numbers of variables run using procedure multivariate statistical analysis techniques with Structural Equation Modeling or SEM.The result of Attitude, Subjective Norm, Value, and Image has a direct influence on the intention to become a participant of the BPJS Health Insurance. However, the perceived behavioral controls do not have a direct influence on the interests of being a participant of BPJS health program. Perceived Behavior Control affects the interest to join BPJS National Health Insurance program if through the Value and Image of the National Health Insurance program. In the case Value and Image National Health Security Program is increased the number of participants will be increase. The Improving Value and Image of the National Health Insurance BPJS Health program can be done by improving the quality and quantity of socialization about the benefits and as well as ways to become a member of JKN.