Implementation of the National Health Insurance Referral System at the Public Health Center in the Pangkajene Kepulauan District in 2019

Nurul Fajriah Istiqamah; Darmawansyah Darmawansyah; Muhammad Syafar; Anwar Mallongi

doi:10.3889/oamjms.2020.5178

Authors

Nurul Fajriah Istiqamah Department of Health Administration and Policy, Public Health of Faculty, Hasanuddin University, Makassar, Indonesia
Darmawansyah Darmawansyah Department of Health Administration and Policy, Public Health of Faculty, Hasanuddin University, Makassar, Indonesia
Muhammad Syafar Department of Health Promotion and Behavioral Sciences, Public Health of Faculty, Hasanuddin University, Makassar, Indonesia
Anwar Mallongi Department of Environmental Health, Public Health of Faculty, Hasanuddin University, Makassar, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2020.5178

Keywords:

Health Services, National Health Insurance, Standard Operasional Procedures, Public Health Center, Referral System, Emergency

Abstract

BACKGROUND: The health service referral system is the organization of health services that regulate the mutual assignment of tasks and responsibilities of health services both vertically and horizontally.

AIM: The purpose of this study was to determine the appropriateness of referral service operational standards at the Kalabbirang Public Health Center in Pangkajene Kepulauan district.

METOHDS: This research method uses a qualitative with a phenomenological. The location of this study is in the Kalabbirang Public Health Center. The informants in this study were the Head of Medical Records Installation, the medical records installation staff of registration, doctors, and nurses. Data collection techniques using in-depth interviews, document review, and observation. The data obtained analyzed using the content analyze.

RESULTS: The results showed that the Kalabbirang Public Health Center, no operational service standards were governing the procedures of the Public Health Center when receiving patients to be referred back. In addition, doctors do not explain in full to patients information about the referral. The conclusion of this research is the implementation of the referral system at the Kalabbirang Public Health Center in terms of the requirements for referring to be in accordance with the national referral system.

CONCLUSION: We need socialization to understand more deeply about the referral system and equate perceptions among health workers about the referral mechanism in the Kalabbirang Public Health Center.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Kemenkes RI. Peraturan Kementerian Kesehatan Republik Indonesia Nomor 28 Tahun 2014 Tentang Pedoman Pelaksanaan Program Jaminan Kesehatan Nasional. Jakarta: Menteri Kesehatan; 2014. https://doi.org/10.20884/1.jih.2018.4.2.115

Ratnasari D. Analisis pelaksanaan sistem rujukan berjenjang bagi peserta national health insurance di puskesmas X Kota Surabaya. J Adm Kesehatan Indones. 2018;5(2):145-54. https:// doi.org/10.20473/jaki.v5i2.2017.145-154

Febriawati H, Yandrizal Y, Afriza Y, Pratiwi BA, Yanuarti R, Suryani D. Analisis besaran dan pembayaran kapitasi berbasis komitmen pelayanan terhadap pengendalian rujukan di public health center Kota Bengkulu. J Kebijakan Kesehatan Indones. 2017;6(2):204-9.

Marina E, Setiawati, Rahmah HN. Evaluasi pelaksanaan sistem rujukan berjenjang dalam program jaminan kesehatan nasional. J Kebijakan Kesehatan Indones. 2019;8(1):35-40. https://doi. org/10.33485/jiik-wk.v5i2.129

Kemenkes RI. Peraturan Kementerian Kesehatan Republik Indonesia Nomor 001 Tahun 2012 Tentang Sistem Rujukan Pelayanan Kesehatan Perorangan. Jakarta: Menteri Kesehatan; 2012. https://doi.org/10.20884/1.jih.2018.4.2.115

BPJS Kesehatan. Peraturan Badan Penyelenggara Jaminan Sosial Kesehatan Nomor 8 Tahun 2016 Tentang Penerapan Kendali Mutu Dan Kendali Biaya Pada Penyelenggaraan Program Jaminan Kesehatan Nasional. Jakarta: BPJS Kesehatan; 2016. https://doi.org/10.33603/hermeneutika. v4i1.3275

Ambarwati D, Pangesti WD, Dewi S. Pelaksanaan sistem rujukan pada kasus kegawatdaruratan maternal neonatal di puskesmas Kembaran I. Bidan Prada. J Publ Kebidanan Akbid YLPP Purwokerto. 2018;9(2):132-56.

Woro I, Endartiwi SS. Pelaksanaan kebijakan rujukan berjenjang bagi peserta BPJS kesehatan. J Ilmiah Ilmu Kesehatan. 2019;5(2):196-204. https://doi.org/10.33485/jiik-wk.v5i2.129

Aziz M. Sistem rujukan pasien badan penyelenggara sosial (BPJS) kesehatan (studi kasus di puskesmas Umbulharjo I Yogyakarta). J Kesehatan. 2015;2(1):165-265. https://doi. org/10.31850/makes.v1i3.106

Vendetti J, Gmyrek A, Damon D, Singh M, Mcree B, Del Boca F. Screening, brief intervention and referral to treatment (SBIRT): Implementation barriers, facilitators and model migration. Addiction. 2017;112(21):23-33. https://doi.org/10.1111/ add.13652 PMid:28074571

Mustainnah. Analisis sistem rujukan berdasarkan standar oprasional pelayanan di public health center Sarulangun. J Kesehatan. 2017;2(1):254-354.

Lestary H, Sugiharti S, Mujiati M. Sistem rujukan maternal dan neonatal di daerah kepulauan (studi kasus di Provinsi Papua dan Maluku). Med Penelitian dan Pengembangan Kesehatan. 2018;28(3):83-94. https://doi.org/10.22435/mpk.v28i2.177

Goniwala G. Gambaran pelaksanaan rujukan peserta BPJS kesehatan di public health center tikala baru dan public health center teling atas di Kota Manado. J Kesehatan. 2017;1(2):57- 66. https://doi.org/10.37148/arteri.v1i3.103

Amirul D, Mustofa A. Analisis kebijakan regionalisasi rujukan terhadap jumlah kunjungan dan kepuasan peserta jaminan kesehatan nasional di faskes rujukan tingkat lanjutan. J Health Stud. 2017;11(2):267-7. https://doi.org/10.31101/jhes.338

Kesumawati NI. Analisis sistem rujukan berdasarkan standar oprasional pelayanan di public health center Sarulangun. J Kesehatan. 2012;3(1):135-41.

Rukmini R. Pelaksanaan sistem rujukan maternal di public health center tambakrejo dan tanah kali kedinding Kota Surabaya. Bul Penelitian Sist Kesehatan. 2015;18(2):365-75. https://doi.org/10.22435/hsr.v18i4.4570.365-375

Syam A, Sari NP, Thaha AR, Suriah, Jafar N, Salam A, et al. The effect of pumpkin seed flour (Cucurbita moschata Durch) on zinc serum levels in malnourished Wistar rats. Enferm Clin. 2020;30(4):337-40. https://doi.org/10.1016/j.enfcli.2019.10.095

Palutturi S, Rutherford S, Davey P, Chu C. Comparison between healthy cities and Adipura in Indonesia. Malays J Med Health Sci. 2013;9(1):35-43.

Darmawansyah, Said M, Yunus R, Palutturi S. Increasing inpatient service quality of using quality function deployment method in Nene Mallomo hospital of sidrap regency, Indonesia. Indian J Public Health Res Dev. 2018;9(4):287-91 https://doi. org/10.5958/0976-5506.2018.00299.1