Nurse’s Viewpoint of Gatekeeper Function on Managing Indonesian National Health Insurance: A Qualitatif Study
Abstract
WHO initiated a policy related to the health for all principles and realized it in the application of gatekeeper theory for increasing the quality of public health center services which include the aspects of First Contact, Continuity, Comprehensiveness, and Coordination services. The purpose of this research was to explore nurses’ perceptions of gatekeepers’ role in NhI services at Public Health Center. This research is using descriptive qualitative design and purposive sampling with thematic analysis is used as sampling technique. Characteristics of the participants include 80% female with qualification 80% are vocational nurses and 60% nurses on duty at community public health center. Results of this research found three major themes including the involvement of administrative services, service providers, and service strategy implementers. The three themes are a manifestation of the integration of implementation of the four main gatekeeper functions by nursing staff of Public Health Center. Services run by nurses are considered less than optimal in first contact and continuous aspect, in term of nursing care documentation and the absence of HIV/AIDS treatment services. This research is expected to be a guide for updating information related to the role of nurses in public health center as gatekeeper.
Keywords: NhI, gatekeeper, nurses, public health center, qualitative
References
Achmad, H. K., Wahidin, Halim. (2019). Hubungan Komunikasi Terapeutik Perawat dengan Kepuasan Pasien Rawat Inap di Puskesmas Wotu Kabupaten Luwu Timur. Jurnal Administrasi Negara, 25(2), 123–140. https://garuda.ristekbrin.go.id/documents/detail/1203201
Amir. (2018). Hubungan Mutu Pelayanan Kesehatan Dengan Tingkat Kepuasan Pasien Rawat Inap Di Puskesmas Ampibabo Kabupaten Patigi Moutong. E Jurnal Katalogis, 6(4), 171–181. http://jurnal.untad.ac.id/jurnal/index.php/Katalogis/article/view/13363
Anggriani, S. W. (2016). Kualitas Pelayanan Bagi Peserta BPJS Kesehatan Dan Non BPJS Kesehatan. JISIP: Jurnal Ilmu Sosial dan Ilmu Politik, 5(2), 79–84. doi: https://doi.org/10.33366/jisip.v5i2.249
Ayu, M. Y., A. H. Brata., dan Marji. (2020). Pengembangan Sistem Informasi E-report dan Monitoring Laporan Bulanan (LB1) Penyakit Berbasis Web (Studi Kasus: Puskesmas Dinoyo). Jurnal Pengembangan Teknologi Informasi dan Ilmu Komputer, 4(8), 2697–2704. https://j-ptiik.ub.ac.id/index.php/j-ptiik/article/view/7749
Baroon, A. (2020). Gatekeeper. https://www.investopedia.com/ask/answers/08/gatekeeper.asp [Accessed 8 March 2021]
Bappenas. (2017). Penguatan Pelayanan Kesehatan Dasar di Puskesmas. Jakarta. Kementerian PPN/Bappenas. https://www.bappenas.go.id/id/profil-bappenas/unit-kerja/deputi-sdm/dit-kgm/contents-direktorat-kesehatan-dan-gizi-masyarakat/penguatan-pelayanan-kesehatan-dasar-di-puskesmas/
Crystal, I. D., S. Farlinda., N. Nuraini., dan A. P. Wicaksono. (2020). Evaluasi Implementasi Aplikasi Primary Care (P-Care) Dengan Menggunakan Metode Task Technology Fit Di Puskesmas Patrang Kabupaten Jember Tahun 2019. J-REMI : Jurnal Rekam Medik Dan Informasi Kesehatan, 1(4), 502–510. doi: https://doi.org/10.25047/jremi.v1i4.2127
Gosanty, A. Z., dan Ernawaty. (2017). Analisis Kelengkapan Penulisan Soap, Kie, dan Icd X pada Rekam Medis di Poli Umum dan Kia-Kb Puskesmas X Surabaya. Jurnal Akuntansi dan Keuangan Indonesia, 5(2), 139–144. doi: http://dx.doi.org/10.20473/jaki.v5i2.2017.139-144
Junaed, I. (2016). Analisis Data Kualitatif Dalam Penelitian Pariwisata. Jurnal Kepariwisataan, 10(1), 59–74. https://doi.org/10.31219/osf.io/npvqu
Mulyadi, M. (2012). Riset Desain Dalam Metodologi Penelitian. Jurnal Studi Komunikasi dan Media, 16(1), 71–80. doi http://dx.doi.org/10.31445/jskm.2012.160106
Nababan, T., dan H. U. Sihite. (2018). Efektivitas Peran Perawat Terhadap Pelaksanaan Promkes Pada Penderita Hipertensi Di Wilayah Kerja Puskesmas Tandang Buhit Kecamatan Balige Kabupaten Toba Samosir Tahun 2017. Jurnal Keperawatan Priority, 1(1), 1 – 10. http://jurnal.unprimdn.ac.id/index.php/jukep/article/view/40
Perdana, E. N. K., A. Karyus., S. H. Nasution. (2019). Penatalaksanaan Holistik Pasien Diabetes Melitus Tipe 2 dan Retinopati Diabetik serta Hipertensi dengan Pendekatan Dokter Keluarga. Majority, 8(2), 283–291. https://juke.kedokteran.unila.ac.id/index.php/majority/article/view/2484
Pramono, A. E., dan Nuryati. (2013). Keakuratan Kode Diagnosis Penyakit Berdasarkan Icd- 10 Di Puskesmas Gondokusuman Ii Kota Yogyakarta. Jurnal Manajemen Informasi Kesehatan Indonesia, 1(1): 42–61. doi: http://dx.doi.org/10.33560/.v1i1.58
Putri, P., Afandi, A. T., & Fajaryanti, D. W. (2021). Relationship of Leadership Style to Completeness of Filling in The Early Nursing Assessment in Hospital. Nursing and Health Sciences Journal (NHSJ), 1(1), 64-66.
Rahma, A., S. P. Arso., dan A. Suparwati. (2015). Implementasi Fungsi Pokok Pelayanan Primer Puskesmas Sebagai Gatekeeper Dalam Program JKN (Studi Di Puskesmas Juwana Kabupaten Pati). Jurnal Kesehatan Masyarakat, 3(3), 1–11. https://ejournal3.undip.ac.id/index.php/jkm/article/view/12036
Ratnasari, D. (2017). Analisi Pelaksanaan Sistem Rujukan Berjenjang Bagi Peserta JKN di Puskesmas X Kota Surabaya. Jurnal Akuntansi Dan Keuangan Indonesia, 5(2), 145–154. doi: http://dx.doi.org/10.20473/jaki.v5i2.2017.145-154
Rukmini., B. Rosihermiatie., dan Z. Nantabah. (2012). Ketersediaan Dan Kelayakan Ruangan Pelayanan Puskesmas Berdasarkan Topografi, Demografi Dan Geografi Di Indonesia. Buletin Penelitian Sistem Kesehatan, 15(4), 408–417. doi: https://dx.doi.org/10.22435/bpsk.v15i4%20Okt.3051
Saunders, B., J. Sim., T. Kingston., B. Shula., W. Jackie., B. Bernadette., B. Heather., J. Clare. (2018). Saturation in qualitative research: exploring its conceptualization and operationalization. Springer, 52, 1893–1907. doi: https://doi.org/10.1007/s11135-017-0574-8
Shofiana, N. B., S. P. Arso., E. Y. Fatmasari. (2019). Analisis Proses Pelayanan Pendaftaran Pasien Di Puskesmas Jatisrono I Kabupaten Wonogiri. Jurnal Kesehatan Masyarakat, 7(1), 105–112. https://ejournal3.undip.ac.id/index.php/jkm/article/view/22851
Soleh, M., B. Harianto., N. Lathifah., Suprajitno., J. Jainurakhma. (2020). Caring Of Ponkesdes Nurses For Out Of Hospital Cardiac Arrest (Ohca) (Case Study On East Java Province). Novateur Publications, 6(6), 578–588. https://repo.journalnx.com/index.php/nx/article/view/1308
Supardi, R. (2018). Sistem Administrasi Pelayanan Pasien Bpjs Badan Penyelenggara Jaminan Sosial Pada Puskesmas Sawah Lebar Baru Kota Bengkulu. Jurnal Informatika Kaputama, 2(1), 1–9. doi: https://doi.org/10.1234/jik.v2i1.53
Tafwidhah, Y., E. Nurachmah. T. S. Hariyati. (2012). Kompetensi Perawat Puskesmas Dan Tingkat Keterlaksanaan Kegiatan Perawatan Kesehatan Masyarakat (Perkesmas). Jurnal Keperawatan Indonesia, 15(1): 21–28. doi: https://dx.doi.org/10.7454/jki.v15i1.43
Wahyudi, I. (2020). Pengalaman Perawat Menjalani Peran dan Fungsi Perawat di Puskesmas Kabupaten Garut. Jurnal Sahabat Keperawatan, 2(1), 36–43. doi: https://doi.org/10.32938/jsk.v2i01.459
Wahyuni, N. (2014). In-depth Interview (Wawancara Mendalam). https://qmc.binus.ac.id/2014/10/28/in-depth-interview-wawancara-mendalam/ [Accessed 1 February 2021]
Wang, W., J. Haggerty., E. K. Loban., X. Liu. (2019). Evaluating Primary Health Care Performance from User Perspective in China: Review of Survey Instrumens and Implementation Issues. International Journal of Environmental Research and Public Health, 16(926), 1–14. doi: http://dx.doi.org/10.3390/ijerph16060926
Wibisana, W. (2019). Penguatan Sistem Pelayanan Kesehatan. Jakarta; Kementerian PPN/Bappenas. https://www.bappenas.go.id/id/profil-bappenas/unit-kerja/deputi-sdm/dit-kgm/contents-direktorat-kesehatan-dan-gizi-masyarakat/penguatan-pelayanan-kesehatan-dasar-di-puskesmas/
Yulian, R. (2017). Optimalisasi Pelayanan (Service) Puskesmas Dalam Peningkatan Kualitas Pelayanan Kesehatan Masyarakat Di Kabupaten Kubu Raya Provinsi Kalimantan Barat. Jurnal Manajemen Motivasi, 13(2), 850–867. doi: http://dx.doi.org/10.29406/jmm.v13i2.760
