FK-UGM. In Indonesia, for this is still focused on improving the secondary health care (hospitals), who spent much of the country’s health budget and the impact on the number of people seeking treatment at the hospital.
In the international world average number of referrals to secondary services only 5%, whereas in Indonesia amounted to 80% (based on research). In ASEAN, Indonesia under the health status of Vietnam, the equivalent of Laos, Myanmar, Cambodia and Timor Leste.
The National Working Group Primary Physician Services organizes the International Seminar on Primary Care Medicine Indonesia to Strengthen The Universal Coverage (Health Insurance) National-JKN Indonesia at Ballroom 1 Hotel Tentrem (3/4). Chairman of the Committee, dr. Mora Claramita, MHPE., Ph.D explained that the purpose of this activity is to learn about the implementation of JKN in Indonesia, to learn about the role of a professional doctor or Primary Physician Services (DLP) as a health worker, and preparing further education for doctors who will work in primary care.
Task-health personnel especially doctors, are not only treat, but served as an advocate in the field of health for the patient. The doctor becomes a companion for patients, educate, explain in detail what will be done by a doctor to a patient until the patient understands, provide information, give support, empower patients, teach problem solving skills, approach to patients, their families, and their communities. Additionally, able to holistically look at the patient as a whole biopsikososialculturalspiritual. Not only examine, prescribe and administer medications, but also interact with a variety of factors emergence of diseases, the impact of the disease for patients and their families. The doctor was also able to treat patients in a comprehensive manner that is promotive, preventive, curative, rehabilitative and palliative care. Palliative care for patients with terminal (incurable) aims to maintain the quality of life and achieve a good death, to provide grief counseling. These doctors work in the community and on an ongoing basis as well as ongoing follow the journey of the patient’s health. Of course, in collaboration with primary care, secondary care and tertiary care. So that patients do not yet sick can promotive and preventive efforts, when already ill can be referenced appropriately. Patients are becoming more satisfied with primary health care and health care costs can be reduced.
Rector, Prof. Dwikorita Karnawati, M.Sc., Ph.D. also asserts that the Gadjah Mada University as an educational institution will contribute to realizing the Universal Health Coverage (UHC), especially in primary care. “Dean of the Faculty of Medicine has launched a program-based healthcare applications NusaHealth android to give access to the community in terms of education and health,” he said.
Minister of Health, Prof. Nila F. Moeloek, SPM (K) explained that until now has been 60% of the poor who have earned JKN and 9.2 million people in Indonesia premiums are paid by the government. In fact, about 192.600 inhabitants already using JKN to health facilities. Unfortunately, these issues affect the swelling state spending in 2015, the budget for health increased to US $ 4.2 million. With a large budget, the government Indionesia constantly striving to improve health services, especially in terms of Human Resources (HR), facilities and infrastructure resulting in even distribution in a number of regions in Indonesia to quality health services. “The system of health strengthening carried out by the health ministry is to provide easy access in places of health services, support quality health care, primary health layananan give to the community, advocacy and regulation at local and national levels associated with JKN,” he added. This is so that the people of Indonesia can reach 12 indicators of healthy families which include the participation of families in planning, provision of facilities for maternal, giving imuniasasi in infants, exclusive breastfeeding for six months, provide health care standards for Tuberculosis (TB), provide treatment for patients with hypertension, not megabaikan the mentally ill, no one smokes in the family, granting access to clean water, use the toilet, and a member JKN. In this case, the DLP was instrumental in improving the quality of the health center.
“Primary health care that has been done in some countries were able to reduce the mortality rate to 6%. WHO hopes that through this program is being executed, the world can achieve UHC in efforts to achieve the UN SDG’s number three on healthy living and well-being for everyone, “said Jihan Tawilah which is a WHO representative for Indonesia.
Even so, the Head of Healthcare Management Vivre VI dr. Elke Winasari explained that in the implementation of JKN, Social Security Agency (BPJS) experienced various challenges such as the financial burden is high, the availability of doctors and medical staff scattered throughout Indonesia, the commitment of policy holders in the implementation of primary health care, access to health care especially for the disadvantaged areas, and Indonesia still focused effort paada cure rather than prevention.
Another health problem in Indonesia is patient trust. With the enactment of everyone is obliged to have dues BPJS BPJS and Employment, will ensure the community to come to the health service. Konsekuenasinya health services must improve, so that the public trust in the health services in Indonesia will increase.
Commission Member of Medical Science Academy of Sciences of Indonesia, Prof. Dr. dr. Med. Akmal Taher, SpU (K) explained that the medicine currently being developed personalized medicine, the treatment is based on genomic data. This genomic data will then be used as a reference in primary health care for the treatment menentuan what should be done to the patient. So that the patient will get the best treatment.
The existence of DLP increasingly a point of light because on 1 April 2017 in a meeting in London conducted by The World Organization of Family Doctors (WONCA) approved the DLP in Indonesia. This was stated by Prof. Michael Kidd, who is president of WONCA.
In addition, the support of Parliament, especially the Commission X on course DLP though initially controversial. In fact, the Minister of Research and Higher Education Mohamad Nasir also said that the DLP is there to answer today’s health challenges related to the fulfillment of the primary pelayann and it is proposed by the Minister of Health under Law No. 20 of 2013 concerning medical education.
Member of House of Representatives Commission X, Dr. Marlinda Irwanti said S.E. M.Sc., On January 16, 2017 the House of Representatives together with some representatives of the Faculty of Medicine in Indonesia mensepakati that DLP program is not an obligation but a choice. But the actual need for DLP is so large, it is estimated by 2019 the provision of primary health care services will be conducted by the DLP and not by the general practitioner as it is today. Further needs in JKN least 40 DLP DLP for every 100,000 inhabitants of Indonesia based on ratio of doctors today. With a total population of 225 million, it takes at least 100,000 DLP. “Commission X provide full support for the DLP program for the benefit of the welfare of the people of Indonesia,” he concluded. (Mega / Reporter)