Pelayanan

Kesehatan Kerja
dalam SKN & BPJS

KELOMPOK 11
Mata Kuliah Pelayanan Kesehatan Kerja
◦ The WHO Global Strategy for Basic Occupational
Health Services
◦ Peraturan Perundangan

◦ Akses, Rujukan dan Pembiayaan

The WHO Global Strategy
for Basic Occupational
Health Services

Introduction of the concept of Basic

Occupational Health Services (BOHS)
has its roots in the WHO Alma Ata
Declaration from the year 1978

The BOHS are an application of the

Alma Ata principles in occupational
health

(BOHS, 2005)
 Basic Occupational Health Services
Principle

Affordable to
Available to all Addressing to local Adapted to local
providers and
working people needs conditions
clients

Provided by public
Organized by the Supported by
sector for the self-
employer for intermediate level
employed and the
employees services
informal sector

(BOHS, 2005)
 BOHS System
and
Infrastructures

A wide coverage of
services cannot be
achieved without
BOHS infrastructure

(BOHS, 2005)
 Concept, Mission and Objectives
of BOHS

The Basic Occupational Health Services are an essential service for

protection of people's health at work, for promotion of health, well-being
and work ability, as well as for prevention of ill-health and accidents. The
BOHS provide services by using scientifically sound and socially
acceptable occupational health methods through primary health care
approach.

(BOHS, 2005)
 Activities within the framework of BOHS

(BOHS, 2005)
 Orientation and planning Preventive actions for management and
control of health and safety hazards and
◦ Analysis of the type of production will
risks
indicate the risks and problems typical of
the branch or occupation in concern The actions may comprise :
◦ Review of problems that have been • Control of hazards at the source
identified previously in the company
• Ventilation or control technology
◦ Review of the characteristics of the
workforce of the company • Dust control
• Ergonomic measures
◦ Available data on occupational diseases
and accidents • Use of personal protective equipment
◦ Data on working methods, chemical • Regulation of thermal conditions
substances, etc.
◦ The knowledge by employers and
employees of occupational health
problems
◦ Plans for changes in production systems,
e.g. installation of new facilities, machinery
and equipment
(BOHS, 2005)
 Maintaining preparedness to first aid and
participation in emergency pre-paredness
The role of BOHS in first aid and
emergency preparedness:
Providing first aid services at the workplace
when appropriate
Introducing and training first aid practices to
workers and supervisors
Maintaining and periodically inspecting the
first aid readiness and facilities
Participating from the health point of view in
emergency planning and organising the
health elements in emergency response
(BOHS, 2005)
General health care, curative and
rehabilitation services
Where appropriate the BOHS may
include:
• Immunizations and other preventive
measures
• Participation in public health actions
and programmes
• GP level general health services
• Inspection and advice on canteens,
sanitary facilities etc
• Advice and education in general
personal and community hygiene
• General health promotion and
introduction of healthy lifestyles
Evaluation Stage Provision of Basic Human resources for Basic
Occupational Health Services Occupational Health Services
In general, numerous models for the provision • In the optimal case the occupational
of occupational health services are available: health services will be provided by a
◦ Primary health services model multidisciplinary team (comprising a
physician, nurse, occupational
◦ Big company model with in-company
hygienist, ergonomist and
services
psychologist).
◦ Group services organized jointly by several
SMEs
◦ Social security institution as a service provider
◦ Private physician who has special Financing
competence in occupational health
• According to the ILO Convention No.
◦ Private health centre either providing
occupational health 161 on Occupational Health Services, the
financial responsibility for the provision of
◦ Services only or occupational health as a
occupational health services rests on the
part of its services
employer.
◦ Local or regional outpatient clinic of hospitals
(BOHS, 2005)
 Actors in Organization and Development of Basic Occupational
Health Services
Government's special agencies in occupational safety and health and in health sector

Provincial and local municipal authorities

Social partners, employers' organizations and trade unions

Branch organizations and chambers of commerce

Associations of agricultural producer and small enterprises

Associatons of occupational health professionals

Safety representatives of local workplaces and communities

Ministry of Agriculture and Ministry of Industry

(BOHS, 2005)
Peraturan Perundangan
dalam Yankesja
Peta Jalan Menuju Jaminan Kesehatan Nasiona 2012-2019 (2012)
-DJSN
 Dasar
Hukum
JKN

Paham JKN (2014)

seri 4, Asih Eka Putri
 Peraturan
Terkait
JKN

Paham JKN (2014)

seri 4, Asih Eka Putri
Akses, Rujukan, Pembiayaan
dalam Yankesja
Peta Jalan Penyelenggaraan Jaminan Sosial Bidang Ketenagakerjaan,
Menkokesra, kemenaker, DJSN (2014)
 BPJS-TK
(BPJS KETENAGAKERJAAN)

Peta Jalan Penyelenggaraan Jaminan Sosial Bidang Ketenagakerjaan oleh Menkokesra, kemenaker, DJSN (2014)
 AKSES YANKESJA (BPJS-K)
Kepesertaan Hak
PBI Identitas Peserta
(Penerima Bantuan Iuran)

Peserta Manfaat pelayanan kesehatan di

Faskes yang bekerja sama dg BPJS-K
NON-PBI

Pekerja Kewajiban
Membayar iuran
Melaporkan data kepesertaan
Pemberi kepada BPJS Kesehatan dg
Kerja menunjukkan identitas Peserta saat
pindah domisili dan / pindah kerja

Buku Pegangan Sosilaisasi Jaminan Kesehatan Nasional (JKN) dalam Sistem Jaminan Sosial Nasional , Kemenkes (2014)
 AKSES YANKESJA (BPJS-K)
Pelayanan
DIJAMIN TIDAK DIJAMIN
Ada 16, diantaranya:
Pelayanan kesehatan tingkat pertama, pelayanan
non spesialistik: ◦ Yankes yg dilakukan di fasilitas kesehatan yg
- Administrasi tidak bekerjasama dg BPJS Kesehatan
- Promotif preventif ◦ Yankes yg telah dijamin oleh program
- Transfusi darah jaminan kecelakaan kerja terhadap penyakit
- Pemeriksaan, pengobatan dan konsultasi medis atau cedera akibat kecelakaan kerja atau
hubungan kerja
Pelayanan kesehatan rujukan tingkat lanjutan ◦ Gangguan kesehatan/penyakit akibat
-Rawat Jalan ketergantungan obat dan/atau alkohol serta
-Rawat Inap akibat sengaja menyakiti diri sendiri
Buku Pegangan Sosilaisasi Jaminan Kesehatan Nasional (JKN) dalam Sistem Jaminan Sosial Nasional , Kemenkes (2014)
AKSES YANKESJA (BPJS-TK)

Program
JKK(Jaminan Kecelakaan Kerja)

JHT (Jaminan Hari Tua)

JP (Jaminan Pensiun)

JKm (Jaminan Kematian)

Peta Jalan Penyelenggaraan Jaminan Sosial Bidang Ketenagakerjaan oleh Menkokesra, kemenaker, DJSN (2014)
AKSES YANKESJA (BPJS-TK)

Program Pelayanan kesehatan akibat

kecelakaan kerja

JKK(Jaminan Kecelakaan Kerja)

Santunan
JHT (Jaminan Hari Tua)

JP (Jaminan Pensiun)

JKm (Jaminan Kematian)

Peta Jalan Penyelenggaraan Jaminan Sosial Bidang Ketenagakerjaan oleh Menkokesra, kemenaker, DJSN (2014)
RUJUKAN YANKESJA-BPJS

Paham JKN (2014)

seri 4, Asih Eka Putri
PEMBIAYAAN YANKESJA (BPJS-K)
Peserta Pekerja Penerima Upah

Peserta Fakir miskin dan tidak

mampu
 Dibayar oleh pemerintah

Paham JKN (2014)

seri 4, Asih Eka Putri
PEMBIAYAAN YANKESJA (BPJS-K)
Peserta Pekerja Bukan Penerima Upah dan Peserta Bukan Pekerja

Paham JKN (2014)

seri 4, Asih Eka Putri
PEMBIAYAAN YANKESJA (BPJS-TK)
JKK(Jaminan Kecelakaan Kerja)

• Iuran jaminan kecelakaan kerja ditanggung sepenuhnya oleh

pemberi kerja, untuk pekerja penerima upah ditetapkan dalam
bentuk persentase dari upah dan dibayar oleh pemberi kerja,
sedangkan pekerja bukan penerima upah, iuran dibayar dalam
bentuk nominal rupiah oleh pekerja yang bersangkutan.

• Besarnya iuran untuk setiap kelompok kerja sesuai dengan risiko

lingkungan kerja yang diatur lebih lanjut dalam Peraturan Pemerintah.

Peta Jalan Penyelenggaraan Jaminan Sosial Bidang Ketenagakerjaan oleh Menkokesra, kemenaker, DJSN (2014)
Daftar Pustaka
◦ WHO. 2005. Basic Occupational Health Services. Tersedia di : http://hzzzsr.hr/wp-
content/uploads/2016/11/Smjerniceo-primarnim-slu%C5%BEbama-medicine-rada.pdf.
Diakses pada Februari 2018
◦ DJSN. 2012. Peta Jalan Menuju Jaminan Kesehatan Nasional 2012-2019
◦ Menkokesra, Kemenaker, DJSN. 2014. Peta Jalan Penyelenggaraan Jaminan Sosial
Bidang Ketenagakerjaan.
◦ Putri, E. A. 2014. Paham JKN. Seri 4. Jakarta: Kantor Perwakilan Indonesia
◦ Kemenkes. 2014. Buku Pegangan Sosialisasi Jaminan Kesehatan Nasional (JKN) dalam
Sistem Jaminan Sosial Nasional