Simulation Analysis Differences in Capitation Based Service Commitment Fulfillment and Strategies

DATE PUBLISHED
May 8, 2018
SECTION
Articles

Abstract

Most Primary Health Centers (PHCs) has a tendency to increase the number of capitation, but with the indicator of service commitment that must be fulfilled will decrease the actual capitation received. Has not change the norm of capitation since January 2014 and increase drug price have an impact on capitation, gross profit, percentage of drug cost on capitation. The study aims to know difference of capitation, gross profit, percentage of drug cost to capitation before and after simulation of capitation income based on fulfillment service commitment Private Primary Health Centers  in Cirebon and knowing its strategy in achieving and indicator of service commitment. Quantitative data collection uses document review and qualitative data using interviews. Differences before and after simulation is conducted with Wilcoxon Test. The qualitative data were analyzed using qualitative SWOT analysis. Wilcoxon Test showed significant differences between capitation, gross profit, percentage drug cost to capitation before and after simulation. Appropriate strategy  to fulfill the indicator of service commitment is to increase the competences of medical personnel, calculate unit cost, implement health promotion preventive program, and implementation of standard procedure operational. There is a significant difference between capitation, gross profit, percentage of drug cost to capitation before and after simulation. Private Primary Health Centers  should implement preventive health promotion strategy, and improve quality control and cost control.

Keywords

Simulation, Capitation based service commitment fulfillment, and strategies

References

Kulesher, R. R., & Elizabeth Forrestal, E. 2014. International models of health systems financing. Journal of Hospital Administration, 3(4), 127–139.

Andayani, T. M., Sp FRS, A., & Satibi, M. S. 2016. Identification of drug related problems and prescription cost value analysis and percentage of drug component in capitation rate of Community Primary Care Center in Pangkalpinang City (Doctoral dissertation, Universitas Gadjah Mada).

Kurniawan, M.F., Siswoyo,B.E., Mansyur , F., Aisyah,W., Revelino,D., & Gadistina,W. 2015. Management and Utilization of Capitation Fund (Monitoring and Evaluation of National Health Insurance in Indonesia). Journal Indonesian Health Policy, 5(3), 122-131.

Ahmed, S. M., & Islam, Q. S, 2012. Availability and rational use of drugs in primary healthcare facilities following the national drug policy of 1982: is Bangladesh on right track?. Journal of Health, Population, and Nutrition, 30(1), 99.

BPJS Kesehatan. 2017.Peraturan bersama Sekretaris Jenderal Kementerian Kesehatan RI dan Direktur BPJS Kesehatan about The Technical Guidelines for the Implementation of the Capacity-Based Payment of Compliance of Service Commitments.

Dickstein, M. 2011. Physician vs. patient incentives in prescription drug choice.

Buciuniene, I., Blazeviciene, A., & Bliudziute, E. 2005. Health care reform and job satisfaction of primary helath care physician in Lithuania . BMC Family Practice, 6(1), 1.

Agyei-Baffour, P., Oppong, R., & Boateng, D,2013, ‘Knowledge, perceptions and expectations of capitation payment system in a health insurance setting: a repeated survey of clients and health providers in Kumasi, Ghana’, BMC Public Health, 13, 1220.

http://doi.org/10.1186/1471-2458-13-1220

Eijkenaar, F., Emmert, M., Scheppach, M., & Schöffski, O. ,2013, ‘Effects of pay for performance in health care: a systematic review of systematic reviews’, Health Policy (Amsterdam, Netherlands), 110(2–3), 115–30. http://doi.org/10.1016/j.healthpol.2013.01.008

Yip, W. et al., 2014, 'Capitation combined with pay-for-performance improves antibiotic prescribing practices in Rural China', Health Affairs, 33(3), pp.502–510

Dewi, D. A. P. S., Satibi, S., & Puspandari, D. A. 2015.

Analysis of Drug Costs on JKN Era and Factors Affecting Health Support Facility In Yogyakarta, Journal of Management and Pharmacy Practice, 5(4), 283-291.

Nsiah-Boateng, E., Aikins, M., Asenso-Boadi, F., & Andoh-Adjei, F. X. 2016. Value and service quality assessment of the National Health Insurance Scheme in Ghana: evidence from Ashiedu Keteke District. Value in health regional issues, 10, 7-13.

Siswi Utami, D. I. M. A. R, 2016. Implementation study of Capitation based on service commitment of National Health Insurance proram in Surakarta. (Doctoral dissertation, Universitas Sebelas Maret).

Tejolusumo, A. 2017. Hospital Strategy of PKU Muhammadiyah Gamping in Facing NHI.

Author Details

Ari Nurfikri

Firman Pribadi