| 4. In which ways is the initiative creative and innovative?
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RSUD Wates has been coordinating with guaranteeing institutions to fully implement the innovation without having to violate the medical ethics maintained by the Medical Committee. The hospital management also ensures that the whole process of the implementation is in accordance with the existing local as well as national regulations.
Technically, RSUD Wates also established special unit called TPPRI (Inpatients Registration Unit) to monitor the availability of the ward for the patients from underprivileged families. The officers at TPPRI are all experience medical-support staff, ensuring that all patients are served professionally. To support the medical operational activities, the hospital provides the skilled and experienced doctors and specialist to handle all treatments needed. To accelerate all registration process at TPPRI, the hospital management also equipped the unit with the latest telecommunication tools and IT infrastructure.
Administration officers to handle the linking of the whole process to the BPJS reimbursement scheme are also well prepared, making it easy for high rank officials to monitor and evaluate the development of the innovation implementation and also allowing the whole process to be effortless should it come to any claims handling management.
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| 5. Who implemented the initiative and what is the size of the population affected by this initiative?
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a. The government; both central and local government with the provision of funds and regional budgets channeled through existing collateral that JAMKESNAS (National Health Coverage), JAMKESOS (Social Welfare Coverage) and JAMKESDA (Local Health Coverage);
b. Regent; for giving easy access to hospital services for underprivileged families to take advantage of a variety of collateral, especially for residents of Kulon Progo by utilizing card-based and non-card-based JAMKESDA;
c. The Hospital Management: the party who determined the policy to accept all inpatient users regardless the full ward occupancies;
d. Professional organization (Medical Committee); medical committee will determine the type of drug policy and other services related to inpatients.
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| 6. How was the strategy implemented and what resources were mobilized?
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Sources of financing for the innovation came from guarantee institution and regional budgets. The system used is a cross-subsidy between the guarantees. The hospital management conducted the thorough calculating and financing the system of cross-subsidies in choosing between the underwriting of this innovation, so that the balance between expenditure by financing can always be maintained.
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| 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
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a. Patients from underprivileged families are not going to be ignored. Should the designated ward is fully-occupied, the underprivileged patients will be treated in higher class ward without any extra fees or charges;
b. The innovation supports the bureaucracy reform in Indonesia, in the form of improving services excellence in public hospital regardless the economic status of the patients;
c. The increase number of patients basically will also improve the income of the hospital. Financing aspects of assurance can largely replace the entire expenditure incurred for inpatient services for underprivileged patients. Replacement of guarantee is executed by the INA CBG's system, in accordance with Local Regulation No. 3 Year 2012 on Class III Health Service Tariff at RSUD Wates.
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| 8. What were the most successful outputs and why was the initiative effective?
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The monitoring and evaluation process are done by comparing the fund used in the process to the factual documents prepared by the officials at the hospital. The comparing process is utilizing the standardized forms provided by the management. Besides, weekly evaluation is also done in order to monitor the improvement of the innovation’s implementation.
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| 9. What were the main obstacles encountered and how were they overcome?
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The main constraints mainly set on the wards occupation management and financing matter. Wards occupation management needs precision and accuracy of observation from the field officers. Ward arrangements also need to be supported by telecommunications networks and information technology to accelerate the process. Means of telecommunication and information technology have all been set and prepared as well as been available widely in in the present moments.
The financing matters have not been problems anymore due to the enactment of the guarantee by BPJS. Replacement funding calculation from BPJS are based on the diagnosis so that almost all the costs related to the treatments will always be able to claim.
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