UTILIZATION REVIEW KLINIK PRATAMA YAKES TELKOM AREA V JAWA TIMUR SEBELUM DAN SESUDAH JAMINAN KESEHATAN NASIONAL (JKN)SEBAGAI UPAYA PENGENDALIAN PELAYANAN KESEHATAN
This research aims to compose recommendation in attempt to control health services at the Primary Care Clinic Yakes Telkom Area V East Java based on the results of Utilization Review before and after National Health Insurance (JKN) At the time of JKN Yakes Telkom provide services for the participants who K did not using the BPJS standard and the costs are borned by PT. Telkom as well as additional costs in the form of cost sharing of BPJS participant. The research method in this study is a type of observational analytic cross sectional study. Analysis unit in this research were participants in the Primary Care Clinic Yakes Telkom Area V East Java in 2013 and 2015 as well as using some secondary data of health services in the same year. From the Utilization Review research of Primary Care Clinic Yakes Telkom Area V East Java before and after JKN, it was found that the disease with the most participants visit due to chronic diseases are the Essential Hypertension (Primary) and Diabetes Mellitus. Utilization of primary outpatient health services included in the category of high 63.56% higher R per prescription, the rising cost of health services per participant, health services costs increased in 2015 after JKN compared to 2013 before JKN. Recommendations in controlling health services at the Primary Care Clinic Yakes Telkom Area V East Java as follows: Make health services standards, Reviewing routine health services, Perform cost control (type of drugs prescribed, Number of R/ per prescription, Regular meetings of service providers and Advocacy to PT. Telkom Tbk. regarding health care policy) Home visit, and Optimizing health information.