Sistem Pembayaran Mixed Method INA-CBGs dan Global Budget di Rumah Sakit: Tahap 1 Uji Coba Mixed Method INA-CBGs-Global Budget di Indonesia

AbstrakTidak ada sistem pembayaran pelayanan kesehatan yang sempurna dalam penerapannya termasuk sistem pembayaran DRG (Diagnosis-Related Groups) yang lebih dikenal dengan nama INA-CBGs (Indonesia Case-Based Groups) di Indonesia. Beberapa negara yang mengadopsi DRG telah menerapkan kebijakan pembayaran mixed method DRG-Global Budget dengan variasi implementasinya demi menjaga kesinambungan sistem jaminan kesehatan nasional di negaranya. BPJS Kesehatan menginisiasi studi operasional penerapan sistem pembayaran rumah sakit mixed-method INA-CBGs dan Global Budget mulai tahun 2018. Terdapat tiga tahapan dalam uji coba sistem pembayaran rumah sakit mixed-method INA-CBGs dan Global Budget ini. Tahap pertama adalah Global Budget Tanpa Resiko yang bertujuan untuk menguji metode penghitungan global budget dan mengidentifikasi tantangan yang dihadapi bila kebijakan mixed method INA-CBGs dan Global Budget ini diberlakukan. Studi dilakukan di 5 (lima) kabupaten/kota di 30 rumah sakit (RS). Hasil studi menunjukkan bahwa metodologi penghitungan global budget yang diterapkan cukup akurat untuk memprediksi realisasi klaim di RS. Penghitungan global budget di tingkat kabupaten/kota lebih akurat hasilnya dibandingkan dengan menghitung global budget di tingkat RS karena mengakomodir shifting pasien dari RS yang satu ke RS yang lainnya akibat perubahan kapasitas RS. Perubahan kapasitas RS di tahun berjalan dan adanya pandemi COVID-19 menyebabkan adanya selisih antara penghitungan global budget dan realisasi klaim.AbstractWhen it comes to provider payment system, no one shoe fits all including DRG payment system which in Indonesia are known as INA-CBGs. In some countries that used DRG have mixed it with Global Budget in various mechanisms to maintain the sustainability of the national health insurance system in their countries. BPJS Kesehatan initiated a three-stage pilot study on the implementation of the mixed-method hospital payment system INA-CBGs and Global Budget starting in 2018. The first stage is the Non-Risk stage which aims to test the accuracy of the global budget calculation and prediction and to identify the challenges faced when the mixed-method payment is implemented. The pilot was conducted in 5 districts in 30 hospitals. Initial results show that the calculation and prediction method is accurate to predict the actual hospital claims in the following year. The calculation of the global budget at the district level is more accurate than the hospital level because it accommodates patient transfer from one hospital to another due to changes in hospital capacity. Changes in hospital capacity in the current year and the COVID-19 pandemic requires some adjustments to the budget calculation

Knowledge, attitudes, and practices related to COVID-19 in Indonesia: A post delta variant wave cross-sectional study

IntroductionPublic information and regulations related to the coronavirus disease 2019 (COVID-19) have been widely published and continuously changed. The Indonesian government has responded to the emerging evidence by regularly updating its unprecedented and preventive measures against the transmission of COVID-19 to the public. It is important to understand how the public responded to these updates. This study aimed to investigate the knowledge, attitudes, and practices of Indonesians toward COVID-19 after the emergence of the delta variant wave.MethodsA cross-sectional study was conducted among the adult population of non-healthcare workers in Indonesia through an online questionnaire using the SurveyMonkey platform. A total of 1,859 respondents completed this survey from September to October 2021. The knowledge, attitudes, and practices data were analyzed descriptively to find their frequency and percentage. A multivariate analysis was conducted to confirm the factors affecting the respondents' knowledge, attitudes, and practices with a p-value of <0.05 set as significant.ResultsBeing female, having a higher education level, and having a higher frequency of access to COVID-19 news showed significant impacts on knowledge, attitudes, and practices (p<0.001). Older age stratification influenced the knowledge level (p<0.05) but had no significant effect on people's attitudes and practices toward COVID-19. Respondents' perceived probability of being exposed to COVID-19 (p < 0.05) and their COVID-19 infection frequency (p < 0.001) significantly influenced their knowledge. Household income and respondents' knowledge significantly affected their attitudes toward COVID-19. Furthermore, only their attitudes had a significant impact on the respondents' practices. Perceived severity, perceived susceptibility, and vaccination status did not significantly influence their knowledge, attitudes, and practices (p > 0.05).ConclusionAfter more than a year of the COVID-19 pandemic, Indonesians maintain their high level of knowledge, attitudes, and practices. COVID-19 disinformation must be combatted by strengthening authorized media, empowering communities, and improving governance among institutions during and post-pandemic

Gambaran Tingkat Stres Selama Pembelajaran Daring Siswa SMA di Kota Payakumbuh dan Kabupaten 50 Kota

ABSTRACT The sudden change in the learning system went online due to the Covid-19 outbreak causing many students to become stressed. Stress is a condition of emotional instability that comes from environmental factors. Has symptoms such as difficulty relaxing, irritability, and anxiety. This study was conducted to determine the level of stress during online learning for high school students in the city of Payakumbuh and the district of Lima Puluh Kota. This study uses descriptive quantitative methods using the DASS-21 data collection instrument developed by Lovibond and Lovibond. Respondents in this study were 100 students consisting of 75 girls and 30 boys who came from five different schools. The results of the study show that respondents have a different picture of stress, where most of the respondents (56%) are categorized as normal, while a few others experience mild stress (11%), moderate stress (15%), severe stress (8%) and stress. very heavy (10%). The differences that students show in facing online learning can be influenced by many factors such as personality type, environment, school majors, and many more. Keywords: Covid-19, Online learning, Stress ABSTRAKPerubahan sistem pembelajaran menjadi daring secara mendadak akibat wabah covid-19 yang melanda menyebabkan banyak siswa menjadi stres. Stres merupakan kondisi ketidakstabilan emosi yang berasal dari faktor lingkungan memiliki gejala seperti susah relaks, mudah marah dan gelisah. Penelitian ini dilakukan untuk mengetahui gambaran tingkat stres selama pembelajaran daring pada siswa SMA di kota Payakumbuh dan kabupaten Lima Puluh Kota.  Penelitian ini menggunakan  metode kuantitatif deskriptif menggunakan instrumen pengumpulan data DASS-21 yang ditemukan oleh Lovibond dan Lovibond. Responden dalam penelitian ini berjumlah 100 siswa yang terdiri atas 75 perempuan dan 30 laki-laki yang berasal dari lima sekolah yang berbeda.  Hasil dari penelitian menunjukkan bahwa responden memiliki gambaran stres yang berbeda, dimana sebagian besar responden (56%) dikategorikan normal, sedangkan sebagain kecil lainnya mengalami stres ringan (11%), stres sedang (15%), stres berat (8%) dan stres yang sangat berat (10%). Perbedaan yang ditunjukkan siswa dalam menghadapi pembelajaran daring dapat dipengaruhi banyak faktor seperti tipe kepribadian, lingkungan, jurusan sekolah dan masih banyak lagi. Kata Kunci : Covid-19, Pembelajaran Daring, Stre