Implementation of Casemix System as Prospective Provider Payment Method in Social Health Insurance: a Case Study of Acheh Provincial Health Insurance
Implementation of Casemix System as Prospective Provider Payment Method in Social Health Insurance: a Case Study of Acheh Provincial Health Insurance

Author: Prof Dr Syed Mohamed Aljunid

Publisher: Partridge Publishing Singapore

Published: 2022-11-20

Total Pages: 147

ISBN-13: 154377198X

DOWNLOAD EBOOK

The Government of Aceh Province in Indonesia has established the Social Health Insurance (SHI) called Jaminan Kesehatan Aceh (JKA) in 2006 that provide health coverage to all 4.6 million population of the province. Fee-for-service was initially used as the provider payment method in the programme until 2013. In 2014, in line with the National Health Insurance of Indonesia (Jaminan Kesehatan Nasional JKN), INA-CBG (Indonesia Case-Based Group) casemix system was adopted by JKA to replace the Fee-for-Service method. This book presents outcome of the evaluation done using a combination of qualitative and quantitative methods on the implementation of JKA programme. The quantitative study was conducted to assess income of three selected hospitals (Type B, C and D) reimbursed using INA-CBG groups covering more than 17,000 cases. Quantitative data analysis revealed that overall, the hospitals received 32.4% higher income when reimbursed with casemix system (INA-CBG) as compared to fee-for-service. Type D hospital is the biggest gainer with 81.0% increase in income. In conclusion, the use of Casemix (INA-CBG) as a prospective payment method has benefitted the hospitals a lot. It is hope that additional resources gained through this programme will allow the hospitals to provide optimum care to the population.

Implementation of Casemix System as Prospective Provider Payment Method in Social Health Insurance
Implementation of Casemix System as Prospective Provider Payment Method in Social Health Insurance

Author: Dr Aljunid

Publisher: Partridge Publishing Singapore

Published: 2022-11-20

Total Pages: 0

ISBN-13: 9781543771978

DOWNLOAD EBOOK

The Government of Aceh Province in Indonesia has established the Social Health Insurance (SHI) called Jaminan Kesehatan Aceh (JKA) in 2006 that provide health coverage to all 4.6 million population of the province. Fee-for-service was initially used as the provider payment method in the programme until 2013. In 2014, in line with the National Health Insurance of Indonesia (Jaminan Kesehatan Nasional JKN), INA-CBG (Indonesia Case-Based Group) casemix system was adopted by JKA to replace the Fee-for-Service method. This book presents outcome of the evaluation done using a combination of qualitative and quantitative methods on the implementation of JKA programme. The quantitative study was conducted to assess income of three selected hospitals (Type B, C and D) reimbursed using INA-CBG groups covering more than 17,000 cases. Quantitative data analysis revealed that overall, the hospitals received 32.4% higher income when reimbursed with casemix system (INA-CBG) as compared to fee-for-service. Type D hospital is the biggest gainer with 81.0% increase in income. In conclusion, the use of Casemix (INA-CBG) as a prospective payment method has benefitted the hospitals a lot. It is hope that additional resources gained through this programme will allow the hospitals to provide optimum care to the population.

Health Financing in Indonesia
Health Financing in Indonesia

Author:

Publisher: World Bank Publications

Published: 2009-01-01

Total Pages: 202

ISBN-13: 0821380079

DOWNLOAD EBOOK

In 2004 the Indonesian government made a commitment to provide its entire population with health insurance coverage through a mandatory public health insurance scheme. It has moved boldly already provides coverage to an estimated 76.4 million poor and near poor, funded through the public budget. Nevertheless, over half the population still lacks health insurance coverage, and the full fiscal impacts of the government's program for the poor have not been fully assessed or felt. In addition, significant deficiencies in the efficiency and equity of the current health system, unless addressed will exacerbate cost pressures and could preclude the effective implementation of universal coverage (Ue and the desired result of improvements in population health outcomes and financial protection. For Indonesia to achieve UC, systems' performance must be improved and key policy choices with respect to the configuration of the health financing system must be made. Indonesia's health system performs well with respect to some health outcomes and financial protection, but there is potential for significant improvement. High-level political decisions are necessary on key elements of the health financing reform package. The key transitional questions to get there include: [ the benefits that can be afforded and their impacts on health outcomes and financial protection; [ how the more than 50 percent of those currently without coverage will be insured; [ how to pay medical care providers to assure access, efficiency, and quality; [ developing a streamlined and efficient administrative structure; [ how to address the current supply constraints to assure availability of promised services; [ how to raise revenues to finance the system, including the program for the poor as well as currently uninsured groups that may require government subsidization such as the more than 60 million informal sector workers, the 85 percent of workers in firms of less than five employees, and the 70 percent of the population living in rural areas.

Dorland's Dictionary of Medical Acronyms and Abbreviations
Dorland's Dictionary of Medical Acronyms and Abbreviations

Author: Dorland

Publisher: Elsevier Health Sciences

Published: 2015-07-24

Total Pages: 481

ISBN-13: 0323442544

DOWNLOAD EBOOK

Medical acronyms and abbreviations offer convenience, but those countless shortcuts can often be confusing. Now a part of the popular Dorland's suite of products, this reference features thousands of terms from across various medical specialties. Its alphabetical arrangement makes for quick reference, and expanded coverage of symbols ensures they are easier to find. Effective communication plays an important role in all medical settings, so turn to this trusted volume for nearly any medical abbreviation you might encounter. - Symbols section makes it easier to locate unusual or seldom-used symbols. - Convenient alphabetical format allows you to find the entry you need more intuitively. - More than 90,000 entries and definitions. - Many new and updated entries including terminology in expanding specialties, such as Nursing; Physical, Occupational, and Speech Therapies; Transcription and Coding; Computer and Technical Fields. - New section on abbreviations to avoid, including Joint Commission abbreviations that are not to be used. - Incorporates updates suggested by the Institute for Safe Medication Practices (ISMP).

Magician of 1919
Magician of 1919

Author: Jeremy Lim

Publisher:

Published: 2014-01-01

Total Pages:

ISBN-13: 9789881410528

DOWNLOAD EBOOK

Interest in Singapore's healthcare system has soared because of the country's impressive health statistics. However, how Singapore achieves these impressive results is made even more remarkable when we consider that the country spends only 4% of its GDP on healthcare, which is comparably half of what the UK spends. This book explains how Singapore manages to achieve such an impressive degree of efficiency in the delivery of quality healthcare services.

Injury Research
Injury Research

Author: Guohua Li

Publisher: Springer Science & Business Media

Published: 2012-01-06

Total Pages: 672

ISBN-13: 1461415985

DOWNLOAD EBOOK

Injury is recognized as a major public health issue worldwide. In most countries, injury is the leading cause of death and disability for children and young adults age 1 to 39 years. Each year in the United States, injury claims about 170,000 lives and results in over 30 million emergency room visits and 2.5 million hospitalizations. Injury is medically defined as organ/tissue damages inflicted upon oneself or by an external agent either accidentally or deliberately. Injury encompasses the undesirable consequences of a wide array of events, such as motor vehicle crashes, poisoning, burns, falls, and drowning, medical error, adverse effects of drugs, suicide and homicide. The past two decades have witnessed a remarkable growth in injury research, both in scope and in depth. To address the tremendous health burden of injury morbidity and mortality at the global level, the World Health Organization in 2000 created the Department of Injury and Violence Prevention, which has produced several influential reports on violence, traffic injury, and childhood injury. The biennial World Conference on Injury Control and Safety Promotion attracts a large international audience and has been successfully convened nine times in different countries. In the United States, the National Center for Injury Prevention and Control became an independent program of the federal Centers for Disease Prevention and Control in 1997. Since then, each state health department has created an office in charge of injury prevention activities and over a dozen universities have established injury control research centers. This volume will fill an important gap in the scientific literature by providing a comprehensive and up-to-date reference resource to researchers, practitioners, and students working on different aspects of the injury problem and in different practice settings and academic fields.

Are You Being Served?
Are You Being Served?

Author: Samia Amin

Publisher: World Bank Publications

Published: 2007-12-28

Total Pages: 454

ISBN-13: 082137186X

DOWNLOAD EBOOK

This publication presents tools and techniques for measuring service delivery in health and education and people's experiences from the field in deploying these methods. It begins by providing an introduction to the different methodological tools available for evaluating the performance of the health and education sectors. Country specific experiences are then explored to highlight lessons on the challenges, advantages and disadvantages of using different techniques to measure quality in a variety of different contexts and of using the resulting data to affect change. This book is a valuable resource for those who seek to enhance capacity for the effective measurement of service delivery in order to improve accountability and governance and enhance the quality of service delivery in developing countries.

Dictionary of Medical Acronyms and Abbreviations
Dictionary of Medical Acronyms and Abbreviations

Author: Stanley Jablonski

Publisher: Hanley & Belfus

Published: 2004-09

Total Pages:

ISBN-13: 9781560536512

DOWNLOAD EBOOK

This dictionary lists acronyms and abbreviations occurring with a reasonable frequency in the literature of medicine and the health care professions. Abbreviations and acronyms are given in capital letters, with no punctuation, and with concise definitions. The beginning sections also include symbols, genetic symbols, and the Greek alphabet and symbols.

Designing and Implementing Health Care Provider Payment Systems
Designing and Implementing Health Care Provider Payment Systems

Author: Jack Langenbrunner

Publisher: World Bank Publications

Published: 2009-01-01

Total Pages: 348

ISBN-13: 0821378244

DOWNLOAD EBOOK

Strategic purchasing of health services involves a continuous search for the best ways to maximize health system performance by deciding which interventions should be purchased, from whom these should be purchased, and how to pay for them. In such an arrangement, the passive cashier is replaced by an intelligent purchaser that can focus scarce resources on existing and emerging priorities rather than continuing entrenched historical spending patterns.Having experimented with different ways of paying providers of health care services, countries increasingly want to know not only what to do when paying providers, but also how to do it, particularly how to design, manage, and implement the transition from current to reformed systems. 'Designing and Implementing Health Care Provider Payment Systems: How-To Manuals' addresses this need.The book has chapters on three of the most effective provider payment systems: primary care per capita (capitation) payment, case-based hospital payment, and hospital global budgets. It also includes a primer on a second policy lever used by purchasers, namely, contracting. This primer can be especially useful with one provider payment method: hospital global budgets. The volume's final chapter provides an outline for designing, launching, and running a health management information system, as well as the necessary infrastructure for strategic purchasing.