Challenges And Strategies For Implementing Performance-Based Capitation In Indonesian Community Health Center : A Scoping Review

Authors

  • Oki Ino Fatwa Firdhaus Master of Public Health, Faculty of Public Health, Universitas Diponegoro
  • Ayun Sriatmi Department of Health Policy and Administration, Faculty of Public Health, Universitas Diponegoro
  • Antono Suryoputro Department of Health Policy and Administration, Faculty of Public Health, Universitas Diponegoro

DOI:

https://doi.org/10.59188/eduvest.v4i10.43186

Keywords:

performance, capitation, KBK, community, puskesmas, health care, health center

Abstract

This study examines the implementation and challenges of performance-based capitation (KBK) at Community Health Centers (Puskesmas) in Indonesia, as a part of the National Health Insurance Program, aiming to improve the efficiency and quality of primary health services. Despite its potential, the implementation of KBK faces various challenges including inadequate human resources, limited infrastructure, and insufficient monitoring systems. The study uses a scoping review framework based on the Public Health Care Monitoring Conceptual Framework by WHO, analyzing 11 selected studies from 2021 to 2024. Findings indicate that internal factors such as management capacity, health worker competence, and organizational culture significantly impact the effectiveness of KBK. External factors like local government support, funding policies, and infrastructure availability also play crucial roles. Technological barriers, particularly in remote areas, hinder optimal policy implementation. The study emphasizes the need for clear regulations, consistent policy dissemination, and effective monitoring to ensure successful KBK implementation. Recommendations include strengthening leadership, training health workers, improving infrastructure, and enhancing digital health technology utilization. These strategies aim to optimize resource allocation, enhance service access, and improve patient satisfaction in Indonesia’s primary health care system.

References

Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology: Theory and Practice, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616

Aryani, A. D., Bachtiar, A., & Candi, C. (2024). The Structural Equation Modelling of First Level Health Facilities’ Performance-Based Capitation Payment in National Health Service. Kesmas, 19(1), 35–41. https://doi.org/10.21109/kesmas.v19i1.7340

Fadila, R., & Ahmad, A. N. (2021). Determinan Rendahnya Partisipasi dalam Program Pengelolaan Penyakit Kronis di Puskesmas. Jurnal Kesehatan Vokasional, 6(4), 208. https://doi.org/10.22146/jkesvo.66299

Fadila, R., & Katmini. (2022). Determinan Pencapaian Indikator Kapitasi Berbasis Kinerja pada Fasilitas Kesehatan Tingkat Pertama: Tinjauan Sistematik. Jurnal Kesehatan Komunitas, 8(3), 408–417. https://doi.org/10.25311/keskom.vol8.iss3.1272

Fadila, R., Mega Putri Via, AAI Citra Dewiyani, & Anggi Ardhia. (2023). Analisis Pencapaian Indikator Kapitasi Berbasis Kinerja Pada Masa Pandemi Covid 19. Jurnal Kesehatan Qamarul Huda, 11(1), 241–249. https://doi.org/10.37824/jkqh.v11i1.2023.446

Fahmil, S., Alyakin Dachi, R., Ginting, D., & Lina Tarigan, F. (2022). Analisis Implementasi Kapitasi Berbasis Pemenuhan Komitmen Pelayanan Di Puskesmas Kabupaten Langkat. Prepotif Jurnal Kesehatan Masyarakat, 6(1).

Juwita, N. E., & Santoso, D. (2023). Analisis Komunikasi Efektif Terhadap Capaian Kapitasi Berbasis Kinerja di Fasilitas Kesehatan Tingkat Pertama Kabupaten Bengkayang. Jurnal Jaminan Kesehatan Nasional, 3(2), 37–55. https://doi.org/10.53756/jjkn.v3i2.175

Kemenkes RI. (2016). Buku Panduan Jaminan Kesehatan Nasional (JKN) Bagi Populasi Kunci.

Korneta, P., Kludacz-Alessandri, M., & Walczak, R. (2021). The impact of COVID-19 on the performance of primary health care service providers in a capitation payment system: A case study from Poland. International Journal of Environmental Research and Public Health, 18(4), 1–19. https://doi.org/10.3390/ijerph18041407

Lestari, A. D., Witcahyo, E., & Sandra, C. (2022). Sumber Daya Manusia dan Manajemen Puskesmas dalam Mencapai Indikator Rasio Peserta Prolanis Terkendali (RPPT) di Kabupaten Situbondo. Jurnal Penelitian Kesehatan Forikes, 13(4). https://doi.org/10.33846/sf13418

Maulidati, L. F., & Maharani, C. (2022). Evaluasi Program pengelolaan Penyakit Kronis (PROLANIS) Pada Masa Pandemi Covid-19 Di Puskesmas Temanggung. Jurnal Kesehatan Masyarakat, 10(2), 233–243. https://doi.org/10.14710/jkm.v10i2.32800

Mujiburrahman, & Sofyandi, A. (2021). Analisis Komunikasi dan Sumberdaya dalam Implementasi Kebijakan Kapitasi Berbasis Komitmen Pelayanan Badan Penyelenggara Jaminan Sosial (KBK-BPJS) Kesehatan. Bima Nursing Journal, 2(2). http://jkp.poltekkes-mataram.ac.id/index.php/bnj/index

Munawarah, S. H., Misnaniarti, M., & Isnurhadi, I. (2022). Analisis Faktor Pencapaian Indikator Kapitasi Berbasis Pemenuhan Komitmen Pelayanan (KBPKP) di Puskesmas Kota Palembang. JUMANTIK (Jurnal Ilmiah Penelitian Kesehatan), 7(2), 159. https://doi.org/10.30829/jumantik.v7i2.11309

Obadha, M., Chuma, J., Kazungu, J., Abiiro, G. A., Beck, M. J., & Barasa, E. (2020). Preferences of healthcare providers for capitation payment in Kenya: A discrete choice experiment. Health Policy and Planning, 35(7), 842–854. https://doi.org/10.1093/heapol/czaa016

Peraturan BPJS Kesehatan No. 7 Tahun 2019 Tentang Petunjuk Pelaksanaan Pembayaran Kapitasi Berbasis Kinerja Pada Fasilitas Kesehatan Tingkat Pertama (2019).

Peraturan Menteri Kesehatan Republik Indonesia No. 43 Tahun 2019 Tentang Pusat Kesehatan Masyarakat (2019).

Peraturan Presiden No 82 Tahun 2018 Tentang Jaminan Kesehatan Nasional (2018).

Rosita, S., & Nuzul, R. Z. (2024). Implementasi Kapitasi Berbasis Kinerja (KBK) di Puskesmas Meuraxa Kota Banda Aceh Implementation of Performance Based Capitation (KBK) at the Meuraxa Community Health Center, Banda Aceh City. In Journal of Healtcare Technology and Medicine (Vol. 10, Issue 1).

Roykardo, B. A., & Nurani, N. (2024). Pengaruh Remunerasi dan Motivasi Pegawai terhadap Kinerja di Puskesmas Pasundan dan Puskesmas Talaga Bodas Kota Bandung. Jurnal Syntax Admiration, 5(5), p-ISSN.

Semarajana, I., Suwedia, I., Daruki, M., & Damayanti, A. (2022). Faktor Faktor yang Berhubungan dengan Tingginya Rujukan Kasus Non Spesialistik oleh Fasilitas Kesehatan Tingkat Pertama Di Era Jaminan Kesehatan Nasional: Systematic Review. Jurnal Administrasi Rumah Sakit Indonesia, 8.

Setiawati, A., & Hadihtya, R. (2024). Analisis Implementasi Angka Kontak Pasien BPJS di Puskesmas Cibodas Kecamatan Lembang Kabupaten Bandung Barat. Manajemen Informasi Kesehatan, 9(1).

Supartika, E. Y., Kosasih, & Asnar, E. S. M. (2024). Strategi Meningkatkan Capaian Indikator Kapitasi Berbasis Kinerja (KBK) Melalui Fungsi Manajemen Di Puskesmas Wilayah Bandung Barat. Open Journal System, 18(10).

Syam, A., Nurlila, R. U., & Risky, S. (2023). Faktor Faktor yang Berhubungan dengan Pencapaian Indikator Kapitasi Berbasis Komitmen Pelayanan di Puskesmas Kabupaten Kolaka. Media Publikasi Promosi Kesehatan Indonesia, 6(6). https://doi.org/10.31934/mppki.v2i3

Tobey, R., Maxwell, J., Turer, E., Singer, E., Lindenfeld, Z., Nocon, R. S., Coleman, A., Bolton, J., Hoang, H., Sripipatana, A., & Huang, E. S. (2022). Health Centers and Value-Based Payment: A Framework for Health Center Payment Reform and Early Experiences in Medicaid Value-Based Payment in Seven States. Milbank Quarterly, 100(3), 879–917. https://doi.org/10.1111/1468-0009.12580

WHO. (2021). South-East Asia Regional Strategy for Primary Health Care : 2022-2030. World Health Organization. Regional Office for South-East Asia.

Wijayanta, S., Ginanjar, R., & Fadhillah, I. Q. (2023). Prototype Aplikasi Sistem Informasi Manajemen Pelayanan Prolanis Online (SIMPELPRO) untuk Mendukung Pencapaian Indikator Kapitasi Berbasis Komitmen Pelayanan di Fasilitas Kesehatan Tingkat Pertama Klinik Pratama Poltekkes Kemenkes Semarang. Jurnal Rekam Medis Dan Informasi Kesehatan, 6(1), 7–15. https://doi.org/10.31983/jrmik.v6i1.9303

Yanthi, B., Hendratini, J., & Sulistyo, D. H. (2023). Determinan Rujukan Non Spesialistik Dengan Kriteria TACC di FKTP Kabupaten Batang Hari Tahun 2022. Jurnal Jaminan Kesehatan Nasional, 3(1). https://doi.org/10.53756/jjkn.v3i1.63.

Downloads

Published

2024-10-28