The Effect of Capitation Value of Healthcare and Social Security Agency on Service Quality at Primary Clinics

Authors

  • Neny Nurlaily
  • Titik Ernawati
  • FaraValeyria Irma Zain
  • Chomariyah

DOI:

https://doi.org/10.37506/ijfmt.v15i4.16993

Keywords:

Healthcare and Social Security Agency, Fraud, Capitation, Primary Clinic, Quality, Services.

Abstract

Indonesia started to apply the National Health Insurance System on January 1, 2014, and the legal entity
formed to administer this program is the Healthcare and Social Security Agency. Funding for the Healthcare
and Social Security Agency at primary clinic uses the capitation system where the funds are mostly used for
services and operations. The use of capitation funds at the primary clinic is fully managed by itself based on
the agreement. This actually creates the potential for fraud because of the lack of regulations on using the
capitation funds. Fraud at the primary clinic does not really appear on the surface like a fraud in hospitals. It
can be in the form of insufficient resources, facilities and service discrimination. Many studies have shown
a link between capitation funds and health services. A primary clinic needs to have an audit team to evaluate
whether the use of capitation funds is following the expected targets and needs.

Author Biographies

Neny Nurlaily

Student of Master of Law Program, Hang Tuah University, Surabaya, Indonesia

Titik Ernawati

Student of Master of Law Program, Hang Tuah University, Surabaya, Indonesia

FaraValeyria Irma Zain

Student of Master of Law Program, Hang Tuah University, Surabaya, Indonesia

Chomariyah

Associate Professor, Faculty of Law, Hang Tuah University, Surabaya, Indonesia

Published

2021-08-16

How to Cite

Neny Nurlaily, Titik Ernawati, FaraValeyria Irma Zain, & Chomariyah. (2021). The Effect of Capitation Value of Healthcare and Social Security Agency on Service Quality at Primary Clinics. Indian Journal of Forensic Medicine & Toxicology, 15(4), 1985-1992. https://doi.org/10.37506/ijfmt.v15i4.16993