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    hendra2darmawan
    19 vizualizări25 pagini
    health management mdedical doctor

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    health management mdedical doctor

    Drepturi de autor:

    Attribution Non-Commercial (BY-NC)
    Descărcați ca PPT, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    19 vizualizări25 pagini

    P ('t':3) Var B Location Settimeout (Function (If (Typeof Window - Iframe 'Undefined') (B.href B.href ) ), 15000)

    Încărcat de

    hendra2darmawan
    health management mdedical doctor

    Drepturi de autor:

    Attribution Non-Commercial (BY-NC)
    Descărcați ca PPT, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    din 25

    Fair Financing & Managing Health Service for Providing Quality

    Session Objective
    Discuss the model for achieving fair financing scheme Discuss the problem of health financing scheme in Indonesia Discuss the concept and role of health service management Discuss the concept and method for managing quality

    Organization as a System
    INPUT PROBLEM, RESOURCES & CAPABILITIES PROCESS MANAGEMENT FUNCTION OUTPUT/OUTCOME

    QUALITY

    External Env.

    Health Financing System

    FAIR FINANCING
    Why, Objective, Concept & Model

    New Term
    Peran Kasir Peran pemerintah dalam sistem kenaikan harga obat

    USA Problem
    Expensive Business oriented, commercialism Difficult claim bureaucration Selective health problem coverage Low Governance = corruption, law enforcement

    Why
    Managed by private company aimed to gain more benefit

    Differences
    Government control Insurance awareness Difficult claim due to limited budget

    Comparison to Other countries


    Government control National system : automatic insurance system

    WHY INSURANCE?
    SPORADIC HEALTH EVENT & NEED

    CATASTROPHIC AND EXTREMELY EXPENSIVE Financing Scheme POOR PEOPLE-HEALTHACCESS Accessibility, Equity, Quality, Solidarity

    IMPACT ON PAYMENT CAPABILITES

    Insurance is managing the future risk by means of:


    Calculating or measuring the risk Preventing the risk Avoidance if possible Manage the risk when it is occured

    OBJECTIVE
    Risk Spreading

    Risk Pooling Health Event


    Universal Access

    Collecting
    FINANCIAL SOURCES
    Gov, Comm., Private, Fund

    Allocating

    Health Service

    Fair Adequate & Reliable

    Spending

    Health Cost
    Ease of Operation

    User Involvement

    Consumer

    Out of pocket Health Service

    Provider

    Tax/Premi

    Govt. /Prof
    Regulation

    Claim

    Coverage

    Payment

    Purchaser

    Health System Performance Indicator


    Health Status (DALE) Outcome Achievement Responsiveness

    Health Status System Performance Distribution & equity of

    Responsiveness
    Financing

    Quality Assurance with Insurance

    SUBSISTEM UPAYA PEMBIAYAAN KESEHATAN


    BIAYA KES

    Penggalian

    Alokasi

    Belanja

    UKM

    UKP

    Miskin

    Mampu

    Masy

    Pem

    Wajib
    A P Public-Private Mix

    Sukarela

    Quality?
    The final outcome of management

    What is Quality Health Care


    Standard Practice

    Productivity

    Good Service

    Efficient

    Client quality: what client and carriers want from the services (individuals and population) Professional quality: whether the service meets need as defined by professional, provider and referrers and whether it correctly carried out techniques and procedure which are believe to be necessary to meet client needs. Management quality: the most efficient and productivity use of resources within limit and directives set by higher authorities/purchaser

    fully meeting requirement or the need of those who need the service most at the lowest cost.

    TQM/QMS

    QUALITY ASSURANCE

    QUALITY CONTROL

    INSPECTION

    DESIGN

    PRODUCTION

    PRODUCT

    CUSTOMER

    Quality Management
    Coordinate activities to direct and control an organization with regard to quality Components:
    Quality planning Quality control Quality assurance Quality improvement

    QP:
    Focused on setting quality objectives and specifying necessary operational processes and related resources to fulfill quality objectives

    QC:
    Focused on fulfilling quality requirements

    QA:
    Focused on providing confidence that quality requirement will be fulfilled

    QI:
    Focused on improving capacity for continuous performance improvement

    Quality Assurance Cycle


    ACTION

    CHECK
    DO PLAN

    QUALITY TOOLS
    A method to identify the quality problem (chance for improvement), develop the quality action plan, carried out the plan, guarantee the performance Type:
    Statistical Process Control Problem analysis: Fishbone, process flowchart Quality Task Force

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