The Role of Public Health Centers (Puskesmas) as the Gatekeeper of National Health Insurance

Abstract

The percentages of referrals for the first level health facilities visits are coming from the health center (Puskesmas) with 16.85% at the highest and from the practicing doctors with 12.45% at the lowest. The aim of the research is to examine the efficiency the promotion, preventive and curative care quality improvement. This study used qualitative exploratory design by case study approach. The collection of data was conducted through field observations, document observation and in-depth interviews. TThe informants consisted of 4 Head of Health Center/Puskesmas, 9 cadres of integrated guiding posts (Pos Pembinaan terpadu /Posbindu) for Non-Communicable Diseases (NCDs), 9 cadres of Integrated Service Post (Pos Pelayanan Terpadu/Posyandu), 33 participants of the National Health Insurance and 23 people from community who have not joined the national health insurance scheme. The results show that mini workshops are held every month in preparing activities with a focus on the causes of most diseases in the previous month. Posyandu may reduce morbidity rate on infants and pregnant women, Posbindu for Non-communicable Diseases can prevent and control non-communicable diseases. Quality of service can improve the perception of the quality of the service and can reduce referrals to hospital.

The Community Satisfaction and Participation of the Health Planning Process in Primary Health Care

“…People who are often involved especially Cadre, Village officers, FKD, public figures/religious leader (Toma/Toga) and public. So far, health cadres are already helping the implementation of UKBM, but have not been able to evaluate its implementation, including its reporting to PHC (Anita et al, 2013).…”

The Trend of Children Mortality Rates in Indonesia

“…17,18 Particularly in community health services (puskesmas), the MoH urged the strengthening of primary care as a gate keeper in community, beside the innovation program in puskesmas that was comprehensively integrated into some programs such as increasing target of minimum services standard (SPM) and implementation of Indonesia health program and family education (PIS-PK). 19 Neonatal mortality in Indonesia was contributed by several factors such as premature birth, asphyxia, sepsis, congenital and ARI. Almost the cause of preterm birth and birth asphyxia in Indonesia are singleton pregnancy and head presentation, ante partum bleeding, premature birth, preeclampsia, post mature and cesarean delivery.…”

Kunjungan Posyandu Terhadap Kunjungan Berobat Di Puskesmas Kota Bengkulu

“…Sistem kesehatan nasional antara lain disebutkan bahwa, sebagai tujuan pembangunan kesehatan adalah tercapainya kemampuan hidup sehat bagi setiap penduduk atau individu agar dapat mewujudkan derajat kesehatan masyarakat yang optimal, sebagai salah satu unsur kesejahteraan umum dari tujuan pembangunan nasional. Pembangunan kesehatan merupakan suatu cara untuk meningkatkan kesadaran, kemauan dan kemampuan hidup sehat bagi setiap orang agar tercapai derajat kesehatan masyarakat yang optimal (Suprapto et al, 2021) (Anita et al, 2016).…”