THE ANALYSIS OF MANAGEMENT AND UTILIZATION OF CAPITATION FUND FOR DENTISTS IN PALEMBANG AND LUBUKLINGGAU

Abstract

Primary dentists in the era of the National Health Insurance were only paid IDR 2,000 for each patient. The capitation funds could not cover the service cost, and thus the payment system must be improved for the quality of service. This study analyzed the management and utilization of dental capitation funds including the bottlenecks and alternative solutions in the implementation of National Health Insurance. This study was descriptive with a qualitative approach. There were sixteen independent dentists who owned primary clinics in Palembang and Lubuklinggau with highest and lowest capitation coverage, respectively. Data were analyzed in some stages, including data reduction, presentation, conclusion and verification. Results showed that there was a disparity in capitation fund income received by dentists both as an independent practitioner and primary clinic. Not all dentists received the ideal number of patients with the ration of 1:10,000. Dentists with low capitation funds had difficulty to set their operational funds. The budget for operational cost was bigger than the service cost. Revenues compared to capitation funds were still lacking. Most capitation funds for primary dentists were insufficient and still relied on patients’ fee for service. The government should set dental capitation norms and regulations in the era of National Health Insurance.