Abstract

Evaluation for the capitation payment system to the primary care dentist contracted by the Indonesian National Health Security Agency (BPJS Kesehatan) needs to be done as a basis for future improvements. This study aimed in describing the utilization of dental services; the average services fee received for each type of service; the level of patient satisfaction on dental service; the dentist level of satisfaction on the capitation payment system; and analyzing the suitability of capitation rates with generally accepted rates in the area of Central Java and Yogyakarta. Quantitative primary data was collected through questionnaires by dentists and their patients. While qualitative primary data was collected by Focus Group Discussion (FGD). Dentists involved in the FGD was selected by purposive sampling by local Indonesian Dental Association (PDGI) chairman. Secondary data of independent primary care dental practice was taken from BPJS Kesehatan. As a result, 26.76 % of primary care dentists have small number of insured patients (2001-5000). Real unit cost average was around IDR350,000 per visit. Most of the subjects (73.77 %) stated that they quite satisfied with the capitation payment system, but not with the nominal value. Most of the patients (98.5 %) were satisfied with the dental services. In conclusion, capitation nominal value needs to be adjusted with a detailed benefit packages. Enrollment-based membership mechanism needs to be evaluated. Routine monitoring and evaluation meetings between BPJS Kesehatan and primary care dentist needs to be done every 3 months, accompanied by PDGI.

Keywords

Capitation, National health insurance, Universal coverage, Pre-payment system, Primary care dentist

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