| dc.description.abstract | Indonesia is a country with a large population, ranks the 4th largest population in the world. The number of dentists in Indonesia in 2014 has reached 24 thousand, to provide dental and oral health services to 257 Million Indonesian society. This can be illustrated that when divided equally, then 1 dentist in Indonesia will serve approximately 10,700 people. However, due to the uneven spread of population and dentists in Indonesia, and are mostly concentrated in Java and Sumatra islands, the shape and completeness in providing oral health services eventually become unequal.
It is a common that the financing system of oral health services is based on a fee for service or out of pocket, which means that patients pay for dental and oral health services when they are receiving treatment from a dentist. Consequently, the current dental health services has some culture and patterns as follows :
• Dentist’s income is based on compensation in providing services and care ; the more patients the more revenue for dentists"
• The tough competition in the market requiring latest knowledge and technology to minimize the error, which is always costly.
• People are willing to come to dentist when they have dental symptoms. This provokes the need for curative services which tend to require a high cost
• Customers will determine the market competition by valuing the service quality. Since quality attract money, so it will be more and more dentists who attract customers as many as possible
Based on the current situations above, it can be indirectly seen that the price of dental treatment will tend to increase and more expensive. In the big cities, many dentists have successfully exploit the momentum of this condition and satisfied with the earned income from this kind of practice which is quite promising. Unlike the situation in remote areas, the awareness of oral health is still low. Self medication is a common practice in the community, until finally extraction is the only one demand treatment when visiting the dentist. These conditions lead many dentists prefer big cities, of course in addition to other factors into consideration such as education for their children and access to other family needs. This situation is beginning to have an impact on the pattern of uneven spread of dentists in Indonesia
In 2014, the Indonesian government has launched a national health insurance system. It is expected that in 2019, the entire citizens will be covered by the system. The government has appointed BPJS as a manager or implementing agency (BAPEL). Primary care dentist will be bound in a contractual relationship with BPJS to ensure the dental health of a certain community for a specific time period. The financing system is capitation (prospective payment system), with the expectation that primary care dentist will manage efforts to suppress the use of the cost to perform curative procedure (aspects that need largest resources), so that fund resources can be best utilized by prioritizing promotion and prevention aspects. By this system, BPJS can control the work of primary care dentists based on the number of complaint on service quality.
The amount of capitation set by the government for oral health care is IDR 2000 / participant / month. The calculation is not yet fully understood by dentists in Indonesia, and is exacerbated by the absence of the support system which resulting a lot of pros and cons. The capitation system in primary care dentist actually had a core of "health paradigm" : the more participants (community) healthy, the dentist also getting wealthy. Therefore, it is necessary to parse the discussion of the advantages and disadvantages when dentists participate as BPJS’ health care providers. Careful consideration can be taken by a dentist corresponding to the information about the concept of service in BPJS today.
On paper, implementation of primary care dentists scheme promises a variety of positive effects, but on the other hand, the difficulties and challenges that may arise from the territory and population of Indonesia cannot be avoided. However, it is not appropriate to use it as a reason to not to do anything. Lessons can be learned from other nations that already having an established system ; they has gone through a long process that cannot be separated from the failure which actually, become an important part of developing a forward system. | en_US |
