Tantangan Eksternal dan Internal Implementasi Kapitasi Berbasis Kinerja di Fasilitas Kesehatan Tingkat Pertama: Studi Literatur
DOI:
https://doi.org/10.32583/pskm.v15i2.3722Keywords:
CFIR, faktor eksternal, faktor internal, FKTP, kapitasi berbasis kinerja (KBK)Abstract
Kapitasi berbasis kinerja (KBK) diterapkan oleh BPJS Kesehatan untuk meningkatkan efisiensi dan kualitas pelayanan di FKTP. Meskipun diharapkan mengurangi biaya dan meningkatkan integrasi pelayanan, namun penerapannya menghadapi tantangan yang berbeda termasuk faktor internal dan eksternal yang mempengaruhinya. Penelitian ini bertujuan mengeksplorasi faktor internal dan eksternal yang mempengaruhi implementasi KBK menggunakan kerangka CFIR. Penelitian ini menggunakan literature review untuk mengidentifikasi faktor internal dan eksternal yang mempengaruhi implementasi KBK di FKTP. Artikel dipilih berdasarkan kriteria inklusi dari database seperti Google Scholar dan PubMed, dengan fokus pada implementasi KBK, indikator kinerja, dan tantangan yang dihadapi di FKTP dalam mencapai indikator. Sebanyak 299 artikel ditemukan, 256 artikel tidak relevan dan 10 artikel dianalisis sesuai kerangka PICO artikel yang dipublikasikan dalam lima tahun terakhir (2019–2024). Faktor eksternal seperti perubahan kebijakan, pandemi COVID-19, dan kurangnya pedoman teknis mempengaruhi implementasi KBK, sementara faktor internal termasuk komunikasi yang buruk, SDM terbatas, masalah TI, dan insentif yang kurang. Implementasi Kapitasi Berbasis Kinerja (KBK) di FKTP Indonesia terhambat oleh faktor eksternal seperti perubahan kebijakan, pandemi, dan dukungan keuangan terbatas, serta faktor internal seperti komunikasi buruk, SDM terbatas, infrastruktur TI lemah, dan insentif tidak memadai. Untuk meningkatkan efektivitas, stabilitas kebijakan, perbaikan komunikasi, dan dukungan insentif perlu diperhatikan.
References
Aarons, G. A., Hurlburt, M., & Horwitz, S. M. (2011). Advancing a Conceptual Model of Evidence-Based Practice Implementation in Public Service Sectors. Administration and Policy in Mental Health and Mental Health Services Research, 38(1), 4–23. https://doi.org/10.1007/s10488-010-0327-7
Ardhiasti, A., & Setiawan, E. R. (2021). Pembayaran Kapitasi Berbasis Kinerja pada Fasilitas Kesehatan Tingkat Pertama (FKTP) Kota Malang. Jurnal Pendidikan Kesehatan Rekreasi, 10(2), 208–225. https://scholar.archive.org/work/wdvqtbzez5cm5faxp746yemt3q/access/wayback/https://ojs.poltekkes-malang.ac.id/index.php/jpk/article/download/2268/391
Ardhiasti, A., Setiawan, E. R., & others. (2021). Pembayaran Kapitasi Berbasis Kinerja Pada Fasilitas Kesehatan Tingkat Pertama (FKTP) Kota Malang. Jurnal Pendidikan Kesehatan, 10(2), 209–225.
Aryani, A. D. (2022). Factors Affecting the Achievements of Performance-Based Capitation: A Scoping Review. Jurnal Jaminan Kesehatan Nasional, 2(1), 53–65. https://doi.org/10.53756/jjkn.v2i1.52
Ashok, M., Hung, D., Rojas-Smith, L., Halpern, M. T., & Harrison, M. (2018). Framework for Research on Implementation of Process Redesigns. Quality Management in Healthcare, 27(1). https://journals.lww.com/qmhcjournal/fulltext/2018/01000/framework_for_research_on_implementation_of.3.aspx
Astuti, J., Solida, A., Augina Mekarisce, A., Noerjoedianto, D., & Wardiah, R. (2023). Analysis of Efforts to Achieve Performance-Based Capitation Indicators Talang Banjar Public Health Center. KESANS : International Journal of Health and Science, 3(3), 267–287. https://doi.org/10.54543/kesans.v3i3.269
Augustian, R., & Ayuningtyas, D. (2023). Analisis Capaian Kapitasi Berbasis Kinerja Fasilitas Kesehatan Tingkat Pertama Di Wilayah Jakarta Timur Pada Masa Pandemi Covid-19. Journal of Syntax Literate, 8(7). https://doi.org/10.36418/syntax-literate.v8i7.13116
Barwick, M., Dubrowski, R., & Damschroder, L. (2020). Factors Associated with Effective Implementation: Research and Practical Implications. In B. Albers, A. Shlonsky, & R. Mildon (Eds.), Implementation Science 3.0 (pp. 81–100). Springer International Publishing. https://doi.org/10.1007/978-3-030-03874-8_4
BPJS Kesehatan. (2019). Peraturan Badan Penyelenggara Jaminan Sosial Kesehatan Nomor 7 Tahun 2019 Tentang Petunjuk Pelaksanaan Pembayaran Kapitasi Berbasis Kinerja Pada Fasilitas Kesehatan Tingkat Pertama. BPJS Kesehatan. https://peraturan.go.id/id/peraturan-bpjs-kesehatan-no-7-tahun-2019
BPJS Kesehatan. (2020). Monitoring Evaluasi KBK Tahun 2020.
Damschroder, L. J., Reardon, C. M., & Lowery, J. C. (2020). Chapter 4: The Consolidated Framework for Implementation Research (CFIR). In Handbook on Implementation Science. Edward Elgar Publishing. https://doi.org/10.4337/9781788975995.00011
Dewi, N. M. R., Hardy, I. P. D. K., & Sugianto, M. A. (2019). Gambaran Pencapaian Indikator Kapitasi Berbasis Komitmen Pelayanan (KBKP) di Klinik Kimia Farma Diponegoro Kota Denpasar. Seminar Ilmiah Nasional Teknologi, Sains, Dan Sosial Humaniora (SINTESA), 161–172.
Dy, S. M., Ashok, M., Wines, R. C., & Rojas Smith, L. (2015). A Framework to Guide Implementation Research for Care Transitions Interventions. The Journal for Healthcare Quality (JHQ), 37(1). https://journals.lww.com/jhqonline/fulltext/2015/01000/a_framework_to_guide_implementation_research_for.6.aspx
Erika Pay, M., Meliala, A., Handono, D., Kebijakan dan Manajemen Pelayanan Kesehatan, D., Kedokteran, F., Masyarakat, K., Keperawatan Universitas Gadjah Mada, dan, Kebijakan dan Manajemen Kesehatan, P., Keperawatan, dan, & Kedokteran Masyarakat, B. (2018). Performance Based Payment (PBP) dan kepuasan kompensasi dalam pemberian jasa pelayanan kapitasi jaminan kesehatan nasional bagi tenaga kesehatan Puskesmas di Kabupaten Ende Performance based payment and compensation satisfaction in the distribution of cap. Berita Kedokteran Masyarakat, 34(12), 461–466.
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., Via, M. P., Dewiyani, A. A. I. C., & Ardhia, A. (2023). Analisis Pencapaian Indikator Kapitasi Berbasis Kinerja Pada Masa Pandemi Covid 19. Jurnal Kesehatan Qamarul Huda, 11(1), 241–249.
Fahmi, S. F., Zulfendri, Z., Dachi, R. A., Ginting, D., & Tarigan, F. L. (2022). Analisis Implementasi Kapitasi Berbasis Pemenuhan Komitmen Pelayanan di Puskesmas Kabupaten Langkat. Prepotif: Jurnal Kesehatan Masyarakat, 6(1), 24–41.
Flottorp, S. A., Oxman, A. D., Krause, J., Musila, N. R., Wensing, M., Godycki-Cwirko, M., Baker, R., & Eccles, M. P. (2013). A checklist for identifying determinants of practice: A systematic review and synthesis of frameworks and taxonomies of factors that prevent or enable improvements in healthcare professional practice. Implementation Science, 8(1), 35. https://doi.org/10.1186/1748-5908-8-35
Gershon, R. R. M., Stone, P. W., Bakken, S., & Larson, E. (2004). Measurement of Organizational Culture and Climate in Healthcare. JONA: The Journal of Nursing Administration, 34(1). https://journals.lww.com/jonajournal/fulltext/2004/01000/measurement_of_organizational_culture_and_climate.8.aspx
Greenhalgh, T., Wherton, J., Papoutsi, C., Lynch, J., Hughes, G., A’Court, C., Hinder, S., Fahy, N., Procter, R., & Shaw, S. (2017). Beyond Adoption: A New Framework for Theorizing and Evaluating Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability of Health and Care Technologies. J Med Internet Res, 19(11), e367. https://doi.org/10.2196/jmir.8775
Grootjans, S. J. M., Stijnen, M. M. N., Hesdahl-De Jong, I., Kroese, M. E. A. L., Ruwaard, D., & Jansen, M. W. J. (2023). Implementation of an integrated community approach in deprived neighbourhoods: a theory-based process evaluation using the Consolidated Framework for Implementation Research (CFIR). Scandinavian Journal of Public Health, November 2022, 838–848. https://doi.org/10.1177/14034948231199804
Gustafson, D. H., Sainfort, F., Eichler, M., Adams, L., Bisognano, M., & Steudel, H. (2003). Developing and Testing a Model to Predict Outcomes of Organizational Change. Health Services Research, 38(2), 751–776. https://doi.org/https://doi.org/10.1111/1475-6773.00143
Haj-Ali, W., & Hutchison, B. (2017). Establishing a Primary Care Performance Measurement Framework for Ontario. Healthcare Policy = Politiques de Sante, 12(3), 66–79.
Helfrich, C. D., Weiner, B. J., McKinney, M. M., & Minasian, L. (2007). Determinants of implementation effectiveness: adapting a framework for complex innovations. Medical Care Research and Review : MCRR, 64(3), 279–303. https://doi.org/10.1177/1077558707299887
Juniarti, Misnaniarti, & Windusari, Y. (2024). Analisis Hubungan Kepemimpinan, Kompensasi Dan Lingkungan Kerja Terhadap Capaian Kapitasi Berbasis Kinerja Puskesmas Di Kota Palembang [Universitas Sriwijaya]. https://repository.unsri.ac.id/158103/
Klein, K. J., Conn, A. B., & Sorra, J. S. (2001). Implementing computerized technology: An organizational analysis. In Journal of Applied Psychology (Vol. 86, Issue 5, pp. 811–824). American Psychological Association. https://doi.org/10.1037/0021-9010.86.5.811
Klein, K. J., & Sorra, J. S. (1996). The Challenge of Innovation Implementation. Academy of Management Review, 21(4), 1055–1080. https://doi.org/10.5465/amr.1996.9704071863
Leeman, J., Baernholdt, M., & Sandelowski, M. (2007). Developing a theory-based taxonomy of methods for implementing change in practice. Journal of Advanced Nursing, 58(2), 191–200. https://doi.org/https://doi.org/10.1111/j.1365-2648.2006.04207.x
Lestari, M. (2017). Analisis Faktor--Faktor Yang Mempengaruhi Pencapaian Indikator Kapitasi Berbasis Pemenuhan Komitmen Pelayanan Pada Puskesmas Di Kota Padang Tahun 2016 [Universitas Andalas]. http://scholar.unand.ac.id/29784/
Lubis, Y. M., & Syahriza, R. (2021). Pelayanan Peserta Jkn-Kis Selama Pandemi Pada Bpjs Kesehatan: Indonesia. PRAJA Observer:Jurnal Penelitian Administrasi Publik, 1(04), 35–39. https://aksiologi.org/index.php/praja/article/view/331
Marco Tagliabue, S. S. S., & Sandaker, I. (2020). The effects of performance feedback on organizational citizenship behaviour: a systematic review and meta-analysis. European Journal of Work and Organizational Psychology, 29(6), 841–861. https://doi.org/10.1080/1359432X.2020.1796647
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.
Mendagudali, R. R., Kundapur, R., & Modi, B. (2020). Primary Health Care and COVID-19 Pandemic. International Journal of Health Systems and Implementation Research, 4(1), 20–29.
Mujiburrahman, M., & Sofyandi, A. (2021a). Analisis Komunikasi dan Sumberdaya dalam Implementasi Kebijakan Kapitasi Berbasis Komitmen Pelayanan Badan Penyelenggara Jaminan Sosial (KBK-BPJS). Bima Nursing Journal, 2(2), 90. https://doi.org/10.32807/bnj.v2i2.711
Mujiburrahman, & Sofyandi, A. (2021b). Analisis Komunikasi dan Sumberdaya dalam Implementasi Kebijakan Kapitasi. Bima Nursing Journal, 2(2), 90–103. http://jkp.poltekkes-mataram.ac.id/index.php/bnj/index
Munawarah, S. H., Misnaniarti, M., & Isnurhadi, I. (2020). Sumber Daya Terhadap Pencapaian Indikator Kapitasi Berbasis Pemenuhan Komitmen Pelayanan (KBPKP) di Puskesmas Kota Palembang. Gaster, 18(1), 37. https://doi.org/10.30787/gaster.v18i1.415
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
Muryanto, I., Rany, N., Hanafi, A., Puspasari, A., & others. (2020). Analisis Upaya Pencapaian Indikator Kapitasi Berbasis Pemenuhan Komitmen Pelayanan (KBPKP) di Puskesmas Rumbai Kota Pekanbaru. Jurnal Kesehatan Komunitas (Journal of Community Health), 6(3), 310–327.
Nilsen, P., & Bernhardsson, S. (2019). Context matters in implementation science: a scoping review of determinant frameworks that describe contextual determinants for implementation outcomes. BMC Health Services Research, 19(1), 189. https://doi.org/10.1186/s12913-019-4015-3
Pronovost, P. J., Berenholtz, S. M., Goeschel, C. A., Needham, D. M., Sexton, J. B., Thompson, D. A., Lubomski, L. H., Marsteller, J. A., Makary, M. A., & Hunt, E. (2006). Creating High Reliability in Health Care Organizations. Health Services Research, 41(4p2), 1599–1617. https://doi.org/https://doi.org/10.1111/j.1475-6773.2006.00567.x
Rambe, N. Y., Suryani, E., & Nasution, L. K. (2024). Implementasi Program Pengelolaan Penyakit Kronis (Prolanis) Di Wilayah Kerja Puskesmas Sangkunur Kabupaten Tapanuli Selatan. Jurnal Kesehatan Masyarakat Darmais (JKMD), 3(1), 72–79.
Rhatomy, S., & Prasetyo, T. E. (2020). Impact of COVID-19 on primary care visits: lesson learnt from the early pandemic period. Journal of Community Empowerment for Health, 3(2), 102. https://doi.org/10.22146/jcoemph.57918
Rosenthal, A., Stover, E., & Haar, R. J. (2021). Health and social impacts of California wildfires and the deficiencies in current recovery resources: An exploratory qualitative study of systems-level issues. PLOS ONE, 16(3), 1–21. https://doi.org/10.1371/journal.pone.0248617
Rosita, S., Rahmayani, R., ZA, R. N., & Asnimar, A. (2024). Implementasi Kapitasi Berbasis Kinerja (KBK) di Puskesmas Meuraxa Kota Banda Aceh. Journal Of Healthcare Technology And Medicine, 10(1), 15–21.
Sembodo, T. H., Azzahra, S. N., & Ramadhania, S. A. (2021). Dampak Pandemi COVID-19 terhadap Implementasi Jaminan Kesehatan Nasional di Indonesia. Researchgate, December, 1–11.
Shortell, S. M., Zazzali, J. L., Burns, L. R., Alexander, J. A., Gillies, R. R., Budetti, P. P., Waters, T. M., & Zuckerman, H. S. (2001). Implementing Evidence-Based Medicine: The Role of Market Pressures, Compensation Incentives, and Culture in Physician Organizations. Medical Care, 39(7). https://journals.lww.com/lww-medicalcare/fulltext/2001/07001/implementing_evidence_based_medicine__the_role_of.5.aspx
Simpson, D. D., & Dansereau, D. F. (2007). Assessing organizational functioning as a step toward innovation. Science & Practice Perspectives, 3(2), 20–28. https://doi.org/10.1151/spp073220
Squires, J. E., Aloisio, L. D., Grimshaw, J. M., Bashir, K., Dorrance, K., Coughlin, M., Hutchinson, A. M., Francis, J., Michie, S., Sales, A., Brehaut, J., Curran, J., Ivers, N., Lavis, J., Noseworthy, T., Vine, J., Hillmer, M., & Graham, I. D. (2019). Attributes of context relevant to healthcare professionals’ use of research evidence in clinical practice: a multi-study analysis. Implementation Science, 14(1), 52. https://doi.org/10.1186/s13012-019-0900-8
Strehlenert, H., Hansson, J., Nyström, M. E., & Hasson, H. (2019). Implementation of a national policy for improving health and social care: A comparative case study using the Consolidated Framework for Implementation Research. BMC Health Services Research, 19(1), 1–10. https://doi.org/10.1186/s12913-019-4591-2
Syam, A., Nurlila, R. U., & Risky, S. (2023). Faktor Faktor yang Berhubungan dengan Pencapaian Indikataor Kapitasi Berbasis Komitmen Pelayanan di Puskesmas Kabupaten Kolaka. Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 6(6), 1213–1226.
Trisatria, D., & Akyuwen, R. (2024). Pengaruh Kepemimpinan, Komunikasi, dan Motivasi Kerja Terhadap Kinerja Pegawai Melalui Kepuasan Kerja. Permana: Jurnal Perpajakan, Manajemen, Dan Akuntansi, 16(2), 44–61. https://permana.upstegal.ac.id/index.php/permana/article/view/456
Wensing, M., Sales, A., Armstrong, R., & Wilson, P. (2020). Implementation science in times of Covid-19. Implementation Science, 15(1), 42. https://doi.org/10.1186/s13012-020-01006-x
WHO. (2020). Operational Framework for Primary Health Care. In World Health Organization. https://www.who.int/publications/i/item/9789240017832
Widaty, D. (2017). Indikator Pembayaran Kapitasi Berbasis Pemenuhan Komitmen Pelayanan Pada Fasilitas Kesehatan Tingkat Pertama di Surabaya. Jurnal Administrasi Kesehatan Indonesia. Jurnal Administrasi Kesehatan Indonesia, 5(2), 111–116.
Yuan, S., Wang, F., Li, X., Jia, M., & Tian, M. (2019). Facilitators and barriers to implement the family doctor contracting services in China: findings from a qualitative study. BMJ Open, 9(10). https://doi.org/10.1136/bmjopen-2019-032444
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