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there is some overlaps responsibility between MOL
and MOH in fostering the BOHS. Implementation of
SJSN will worsen this ambiguity.
Occupation Health Implementation Report 2013
from 26 provinces in Indonesia showed that about 3
million general disease cases and more than 4
hundred thousand health-related diseases cases at
workers. This information looks like Iceberg
Phenomenon, while many of non reported cases of
diseases. Jamsostek working injuries claim data
showed an increasing trend from 2010 to 2012. It is
elevated respectively from Rp 358.45 bio, Rp 401.2
bio, to Rp 504 bio. This condition led to the high
necessity of integrated BOHS with all disciplines,
not merely health and labour field, but also financing
and regulating.
In-company clinic PT X is a comprehensive
BOHS in cement big industries in Indonesia. These
OH services include prevention, curative, and
promotion & development services with the
multidisciplinary specialist team. From initial
discussion with the clinic manager, implementation
of SJSN influenced the financing of wellness cost
that company had double burden costing i.e. costing
for compulsory JKN insurance premium and costing
for OH clinic operation.
National health security (JKN) and Working
injuries security (JKK) as an inseparable part of
SJSN influenced the provision BOHS in Indonesia.
This research studied how the implementation of
SJSN led to In-company clinic adjusted their OH
service to their workers.
2 METHOD
This study arranged at In-company PT X, a leading
foreign capital company in the cement industry. This
company had operated health and safety
management according to OHSAS and provide
comprehensive basic occupational health services
include promotion, preventive, curative, and
rehabilitative program.
This research designed by a qualitative method
with data primary collected by in-depth interview
with selected informants from several institutions or
stakeholders who linked with OHS for workers, such
as an In-company clinic, BPJS Kesehatan, BPJS
Ketenagakerjaan, Ministry of Labour, Occupational
health physician association, and Workers
association. Informants selected based on criterion
and suitability, with purposive and snow-balling
sampling method. Data was managed by Miles and
Huberman method includes reducing, displaying,
and arranging a conclusion, supported by resources
and theoretical triangulation.
The variables were managed by the theoretical
framework of National Health System or SKN
including subsystem of Financing, Human resources,
Infrastructure, Supporting (People empowerment,
Information management, and Regulation), and
Health service program.
3 RESULTS
3.1 Health Service Program
PT X registered all of the workers in JKN program
under BPJS Kesehatan, but in “zero utility”
condition because the unexpected operating time of
service from health provider of BPJS Kesehatan,
meanwhile company kept using their existing
medical facility and program. The informant said
that this condition experienced by another company.
Fundamentally, the management of In-company
clinic welcomed to the implementation of SJSN, but
the service quality especially operating time service
has to improve. The loss of time due to waiting of
health service at health provider is a disadvantage
for the company (Informant-1).
Several companies in Indonesia suggested that
incompanion with BPJS Kesehatan will decrease
health service for the worker, i.e. the long queue of
service and time lose of work (Informant-2). Not of
all company objectionable to collaboration in health
service with BPJS Kesehatan (Informant-5).
There is miss-coordination between BPJS
Kesehatan and BPJS Ketenagakerjaan to provide
the promotive and preventive program. BPJS
Kesehatan provides this with the program for
general members of JKN such as Prolanis (chronic
disease program), early detection of cervical cancer,
etc. BPJS Ketenagakerjaan provides for workers
members of JKN such as safety riding training, SHE
training, the intervention of folic acid to reduce iron
deficiency anaemia. The follow up of this program
may provide by the ministry of health. (Informant 1,
4, and 5).
BPJS Kesehatan provided health promoting carry
forward PT Askes program that not yet based on
occupational risk. BPJS Ketenagakerjaan carries
forward PT Jamsostek program to provide health-
promoting based on occupational health thereby
medical check-up program confined to risk group
over 40 years and selected to the company who
obediently pay an insurance premium of working
injuries security. This program did not continue
Basic Occupational Health Service Management in SJSN Era: Case Study at In-company Clinic PT X Indonesia
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