YUSTINA, ENDANG WAHYATI (2022) The Principle of Equity in the Implementation of the National Health Insurance Program at Mission Lebak Hospital Through Quality Control and Cost Control. SOEPRA Jurnal Hukum Kesehatan, 8 (2). pp. 269-295. ISSN 2548-818X (media online)
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Abstract
The National Health Insurance Program is a provision of Law No. 40 of 2004 About the National Social Security System; in its implementation, various principles have been developed as the philosophical foundations that implementing parties must adhere to. In addition to the social insurance principle, the equity principle is used as a guiding principle while providing services to National Health Insurance participants. In practice, however, this equity idea has not been fully and uniformly grasped by all parties. In the meantime, the National Health Insurance members must utilize quality control and cost-control instruments in the delivery of health services. In truth, the Health Social Security Agency of Indonesia and the Misi Lebak Hospital are unable to maintain low costs. This study aims to establish the equity principle in the implementation of the National Health Insurance program, as well as the procedures for quality control and cost-control instruments in the National Health Insurance program, and how hospitals are administered. The Misi Lebak Hospital's objective is to implement equality principles in the National Health Insurance program by controlling quality and costs. This research method employs a sociologically-based legal strategy with descriptive parameters. In this study, the combination approach was used for data analysis. The research was done in Lebak Regency, which is where Misi Lebak Hospital is located. It is a Class C hospital that is also an Advanced Level Referral Health Facility. According to the research conducted, the Misi Lebak Hospital achieved the equity principle in implementing the National Health Insurance program through quality control and cost-control management. Medical services or medical benefits offered to National Health Insurance participants do not vary based on their membership rights, which only change the supply of non-medical advantages. The results demonstrated that the meaning of the equity principle shifted from general to specific. Thus, the systems for quality control and cost-control instruments at the Misi Lebak Hospital utilize the same principle. The contract between the Health Social Security Agency of Indonesia and the Advanced Level Referral Health Facility specifies that hospitals must adhere to the quality and cost indicators outlined in the agreement. Each organizer should apply synergy in carrying out their tasks and responsibilities and provide the appropriate supervision to achieve the National Health Insurance program's objectives.
| Item Type: | Article |
|---|---|
| Subjects: | 300 Social Sciences > 340 Law > 348 Laws, regulations & cases |
| Divisions: | Journal Publication |
| Depositing User: | ms Endang Wahyati |
| Date Deposited: | 15 Feb 2023 03:08 |
| Last Modified: | 25 Apr 2024 06:18 |
| URI: | http://repository.unika.ac.id/id/eprint/30834 |
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