The provision of promotive and preventative healthcare services by private primary care physicians in the era of the national health insurance program
DOI:
https://doi.org/10.53638/phpma.2017.v5.i2.p13Keywords:
Social Security Administering Agency (BPJS), private primary care physician (PCP), national health insurance (JKN), promotive and preventative servicesAbstract
Background and purpose: In addition to their duties in addressing the curative and rehabilitative needs of the community, private primary care physicians (PCP) play an important role in providing promotive and preventative healthcare services. This study aims to determine the behaviours, enabling and inhibiting factors involved with the provision of promotive and preventative services by PCP in the era of national health insurance (JKN) implementation.
Methods: This research is a mix method study using a combination of quantitative and qualitative approaches. Quantitative surveys were conducted with all PCPs already in working collaboration with the Social Security Administering Agency (BPJS) in the Denpasar City area (61 people). Data analysis techniques used descriptive techniques in order to explore the kinds of promotion and preventative services provided by PCPs. Qualitative research was conducted through in-depth interviews of 8 informants selected by purposive sampling and analyzed thematically to discover the enabling and inhibiting factors of the provision of promotive and preventative services by PCPs.
Results: The results showed that 91.8% of PCPs did perform promotive and preventative services in their practice site. PCPs who did not carry out promotive and preventative services demonstrate perceptions, beliefs and motivations categorized as low and weak as well as attitudes that do not support the implementation of such services. Enabling factors of promotion and preventative services by PCPs, include among others, quality of facilities and infrastructure, the receipt of awards from BPJS and capitation systems that benefit physicians financially. Inhibiting factors include a low willingness of the patient to carry out doctor's advice, limitations in the PCPs work time and limited funds to perform preventative/promotive services.
Conclusions: Promotive and preventative services are not being optimally carried out by PCPs in Denpasar. This is due to the low willingness of the patients, the limited time of the doctor, and the limited allocated funds for promotive and preventative services and low capitation.
References
Ministry of Health of Indonesia. Peraturan Menteri Kesehatan RI No. 28 Tahun 2014 tentang pedoman program jaminan kesehatan nasional [Ministry of Health Regulation no. 28 of 2014 on the guidelines of the national health insurance program]. Jakarta: Ministry of Health of Indonesia; 2014.
RCGP. Healthy People: Promoting health and preventing disease. Curriculum Statement. 2013: 1–17.
Soetono G, Kurtanty D. Metode membayar dokter layanan primer dalam era JKN [The method of paying primary care physicians in the era of JKN]. 2013: 65.
Social Security Administering Agency Denpasar Branch. Laporan kunjungan dan rujukan FKTP se BPJS Kesehatan Cabang Denpasar Tahun 2015 [Report of visit and referral of primary health care facilities on Social Security Administering Agency Branch Denpasar in 2015]. Denpasar: Social Security Administering Agency Denpasar Branch: 2016.
Dewi RK. Identifikasi pelayanan promotif pada fasilitas kesehatan tingkat pertama Program Jaminan Kesehatan Nasional [Identification of promotive services in primary health facilities national of health insurance program] [thesis]. Jember: University of Jember; 2015.
Cresswell J. Research design: pendekatan kualitatif, kuantitatif, dan mixed, edisi ketiga [Research design: qualitative, quantitative, and mixed approach, third edition]. Yogyakarta: Pustaka Pelajar; 2008.
Ribera AP, Mckenna J, Riddoch C. Attitudes and practices of physicians and nurses regarding physical activity promotion in the catalan primary health-care system. European Journal of Public Health. 2005; 15: 569–575.
Bock C, Diehm C, Schneider S. Physical activity promotion in primary health care: results from a German physician survey. European Journal of General Practice. 2012; 18: 86–91.
Mckenna J, Naylor P-J, Mcdowell N. Barriers to physical activity promotion by general practitioners and practice nurses. British Journal of Sports Medicine. 1998; 32: 242–247.
Walter U, Flick U, Neuber A, et al. Putting prevention into practice: qualitative study of factors that inhibit and promote preventative care by general practitioners, with a focus on elderly patients. BMC Family Practice. 2010; 11: 68.
Geense WW, van de Glind IM, Visscher TLS, et al. Barriers, facilitators and attitudes influencing health promotion activities in general practice: an explorative pilot study. BMC Family Practice. 2013; 14: 20.
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