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Hospital Reform in Indonesia. Shita Dewi. Context Background. Globalization . Health system development Hospital management. The international market of health care industry. Missionary. The Players. Private Hospital. Public hospital. Corporation Hospital Mainly for profit
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Hospital Reform in Indonesia ShitaDewi
Context Background Globalization Health system development Hospital management The international market of health care industry Missionary
The Players Private Hospital Public hospital • Corporation Hospital • Mainly for profit • Foundation Hospital • Faith-based & Non faith based • Not-for-profit • Association hospital • NGO’s • Not for profit • National hospital • Teaching state-owned hospital • Province hospital • District hospital
HEALTH CARE SYSTEM MINISTRY OF HOME AFFAIRS MINISTRY OF HEALTH CENTRAL NAT. HOSPT GOVERNOR PROVINCE PROVINCE HEALTH OFFICE PROV. HOSP MAYOR/BUPATI DIST RICT DISCTRICT HEALTH OFFICE DIST. HOSP HEALTH CENTERS SUB-DISTRICT CAMAT VILLAGE MIDWIVES SUB HEALTH CENTERS VILL AGE INTEGRATED POST
Hospital Reform • Bureaucratic • Corporation Not for profit Non-privatization
Reform Modalities and The Environment B A C P Budgetary Unit Autonomized Unit Corporatized Unit Privatized Unit Harding-Prekker, 2000
Reform (needs) within the Organization Environment Supervision Empowerment Enforcement Procurement Partnership Costing Payment mechanism Quality improvement Patient Safety Pricing
Key Messages • Reform is also a political issue: pay attention to political-economy context • Clarify (and agreed on) the meaning and concept of what is the reform about and what it is not • Manage the “human” side of reform because reform is painful • The importance of timing and enabling environment: hospital doesn’t exist in vacuum • Pay attention to different interests of at different level of government (Central and Local)