The Role of Academic Health System in Building & Optimal Health Care

KEMENTERIAN RISET, TEKNOLOGI, DAN PENDIDIKAN TINGGI REPUBLIK INDONESIA

WWW.RISTEKDIKTI.GO.ID

Prof.dr.Ali Ghufron Mukti, M.Sc. Ph.D.Direktur Jenderal Sumber Daya Ilmu Pengetahuan, Teknologi dan Pendidikan Tinggi

Ketua Komite Bersama Kementerian Ristekdikti – Kementerian KesehatanRektor Universitas Trisakti

SOFT LAUNCHINGINDONESIA NETWORK OF CLINICAL RESEARCH

REFORMATION INHEALTH CARE SYSTEM

• - Health Care Financing

• - Health Care Delivery System

BEFORE REFORMATION TO UHC

• Many poor and near poor difficult to have access to health care

• Health is not an important issues for public

• Doctors/specialists/hospitals set their own tariff

• No structured referral system of health care

• Cost-effective health care system

AFTER REFORMATION

• Every citizen has access to health care much easier

• Health is important issues

• Tariff and the way to pay doctors and hospitals are set by BPJS

• Structured referral health care system

• Not cost effective health care system

4

Financing

Membership

Benefit Package

Source: WHO, The World Health Report. Health System Financing; the Path to Universal Coverage, WHO, 2010, p.12,

SITUATION OF UHC IN INDONESIA A DECADE AGO

• Population Coverage 11% : 22 Million by various schemes

• Financial Protection : heavy out of pocket 70%

• Poor and near poor people : Social Safety Net for 36 Million people with high cost sharing and the rest have to pay (the Poor is Forbidden to get sick)

5

5

CURRENT CONDITIONS

• The budget deficit of the National Social Security Organizing Agency (BPJS) is expected to grow this year. BPJS Health deficit in 2019 is estimated to reach Rp. 28 ,5 trillion.

BUILDING AN ACADEMIC HEALTH SYSTEM AS A PROMISING FUTURE SOLUTION

AHS Definition & Mission Statement

of medical and health faculties,

institutes, private sectors, and/or

healthcare.

Reference : Draft of AHS Development Guideline(Joint Commission MoRTHE‐MoH, 2016)

Academic Health System (AHS) isorganizational network that consist

teaching hospitals, research

local government, that become part of health‐education system integration to provide best health outcomes to society through health education and translationalresearch that will impact to the continuous quality improvement for

The mission of AHS development in Indonesia, in pursuing  continous quality improvement for  education‐research‐services integration, are as follows :

Implementing excellent health care through evidence‐based innovationConducting new state of the art medical and health education which uphold moral and ethicsConducting innovative research to improve science mastery and medical technology in healthcare services through translational researchPerforming good governance for every member of Academic Health System and cultivating other healthcare facilitiesSupporting and providing input for the formulation of government policy

Philosophy of Academic Health System from HigherEducation Perspective :Tridharma of Higher Education

EDUCATION

INTEGRATION

RESEARCHHEALTH &

COMMUNITYSERVICES

Joint Committee of Minister ofResearch, Technology, and Education

and Minister of Health :Improving the Quality of Education,

Research, and Health Services

• Providing health services according to theneeds of local and national society

• Implementing  intervention program thatwill solve health problems in the societyaccording to the evidence‐based research

• Implementing traslational research forscience technology developmentalligned with the purpose to improvethe quality of health outcomes

• Developing   integrated    database   ofhealth‐higher education

Providing standardized education facilities thataccommodate development of science,technology and education in order to fulfil theneeds of health services

AHS Development StageExisting Legal Aspect :1.2.

UU No.20/2013, Medical EducationPP No.93/2015, Teaching HospitalRumah Sakit Pendidikan

Synergy and integrationphase of education‐research‐health servicemanagement system(AHS business model) :‐ Operational Guideline‐ Organization structure‐ Integrated Recruitment &Procurement System‐ Integrated FinancialManagement System‐ Integrated database & ICTSystem

Consensus Building &Commitment amongStakeholders :‐ Mission Alignment‐ Strategic plan‐ Regulation

Implementation ofAHS :

‐ Functional Integration‐ Structural Integration

Main Stakeholders :1. Central Government (MoRTHE, MoH, MoF, Min of Internal Affairs,

and related Ministry of Coordinator Affairs)Local Government (Health District, Governor)Educational Institution (University, Faculty, Research Center, etc) Health Service Institution (Teaching Hospital, Center for Health Services, etc)

2.3.4.

Academic Health Center/System Model in IndonesiaBenchmarking : AHS Model In America

••

Faculty of MedicineOther  Faculty in  HigherEducation Institution Research Center Laboratory, etc

UNIVERSITYCOMMUNITY •

•

AHC/SCenter of ExcellenceContinuum of Care

• Health District (localgovernment)IndustryPrivate sector

• University Hospital• Health facilities forhealth education

PRACTICEPLANTEACHING

HOSPITAL••

5 prospective AHS model in Indonesia

1.    UNHAS (South Sulawesi region)2.    UI (Jabodetabek region)3.    UGM (DI Ygyakarta region)4.    UNAIR (East Java region)5.    UNPAD (West Java region)

HarmonizingMulti‐Sectoral Regulation to 

Formulate Robust Legal Aspect for AHS

Challenge in Integration ofOrganization StructureHarmonizing

OrganizationCulture amonginstitutions

Developingand management System

AHS Model forIndonesiaConsensus building and 

commitment from government and 

stakeholders to develop AHS model for Indonesia

(HR, finance,procurement, etc)

Entrepreneurial Universityis a central concept

ACADEMIC(UNIVERSITY)

INNOVATION

Innovation in technologytransfer, collaboration andconflict moderation,collaborative leadership,substitution, and networking

BUSINESS(INDUSTRY) GOVERNMENT

(Ranga and Etzkowitz, 2013)

Increase higher education and training, science and technology readiness,innovation and business sophistication

AHS & RESEARCH

Factual, reseach in Indonesia Research Knowledge

Applied dan Translational Research

bench to bedside research, health education and hospital collaboration

research publication

Sumber : BPK 2019

Sumber : BPK 2019

AHS DAN PENINGKATAN HASIL PENELITIAN

• Penelitian di Indonesia masih menjadi sekedar Research Knowledge

• Applied & Translational Research

• Mendorong bench to bedside research, kerjasama pendidikan kesehatan danrumah sakit

• Meningkatkan jumlah publikasi penelitian

SOLUTION

EVIDENCE BASED

EFFECTIVE &EFFICIENT

Improve & Developed Research Innovations for HEALTH SERVICES          AHS 

Offline: Indonesia—unravelling the mystery of a nation

Richard Horton

Vol 387 | February 27, 2016

• The first published Lancet research paper with Indonesia in its title was in 1957—on homozygous haemoglobin-E disease, by Lie-Injo Luan Eng and Oey Hoey Giok at the University of Indonesia.

• A decade ago, its publication output was small. But in 2015, Eijkman could boast 50 publications in respected international journals

• But the footprint of Indonesia in the journal is, overall, weak. If you search for the word “India” in the title of Lancet publications, you will find 2098 entries. The US: 1287. China: 841. Indonesia? 33

21ScopusOkt 2015

319772%

DOCUMENTS

PT 2009 2010 2011

PTN 1627 2132 2777

PTS 254 288 429Publikasi di jurnal internasional dosen tersertifikasi (DIKTI 2012)

Perlu peningkatan kualitas/kuantitas publikasi

Seminar Professorship

22

Publikasi Terindeks Scopus s/d 2014

Seminar Professorship

PENINGKATAN PUBLIKASI INTERNASIONAL (SCOPUS, 2015-2017)

(Scopus.com, diakses 3 September 2017, 06:32 WIB) 

2,583 2,925 1,798

7,993

11,897 10,793

12,911 14,446

9,350

19,971 20,619

12,637

26,963

29,407

17,800

2015 2016 2017

Philippines Indonesia Thailand Singapore Malaysia

Malaysia 17.800

Singapore12.637

Philippines1.798

Indonesia10.793

Thailand9.350

Data Jan‐Sep 2017

23

PENINGKATAN PUBLIKASI INTERNASIONAL (SCOPUS, 10 OKTOBER 2018)

Sumber Data Scopus 10 Oktober 2018

TERIMA KASIH

Director General of Human Resources for Science, Technology, and Higher Educationwww.sumberdaya.ristekdikti.go.id