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Abstract. The right to health is an integral part of human rights guaranteed by the Constitution and further reinforced by Law Number 17 of 2023 on Health, which places the state as the party responsible for ensuring the provision of safe, high-quality, and non-discriminatory health services for all citizens. However, in practice, the fulfillment of the right to health continues to face various challenges, particularly in the delivery of health services for participants of BPJS Kesehatan. This study aims to analyze the legal protection of the right to health in Indonesia and to examine the refusal of medical services to BPJS patients that resulted in death in Papua from a human rights perspective. The research employs a normative legal research method using statutory, conceptual, and case approaches. The findings indicate that although the national legal framework has clearly regulated the obligations of the state and health care facilities in providing emergency services, its implementation remains weak due to administrative barriers, unequal access to health services, and inconsistent law enforcement. The refusal of medical services to BPJS patients in Papua reflects a tension between hospitals’ administrative compliance and the professional obligation of medical personnel to save human lives. The implications of this study emphasize the need to strengthen supervision, ensure consistent law enforcement, and improve health service governance so that the right to health is truly protected as part of human dignity within the Indonesian rule of law. 

BPJS Ketenagakerjaan aims to protect workers and ensure their welfare. However, in reality, many companies do not register some or all of their workers, which affects the welfare of workers and has the potential to impact the social security system as a whole. The research questions are: How does the non-payment of BPJS Ketenagakerjaan contributions affect workers' rights in relation to the theory of legal protection in Decision Number 40/Pdt.G.S/2023/PN Pbr and How the mechanism for fulfilling workers' rights when a company that has previously defaulted on its contributions has paid off its obligations. This research is normative-empirical, using three approaches, namely legislation, case studies, and legal sociology. The results show that the arrears in this case not only caused workers to lose access to JKK, JKM, JHT, and JP program benefits, but also placed them in economic and social vulnerability because they did not receive compensation when employment risks occurred. After the company has fulfilled its obligations, the membership and service team will verify the payment and reactivate the participant's status so that workers can reapply for claims, thereby ensuring that workers' rights are promptly fulfilled both administratively and substantively.

This study is motivated by the increasing complexity of financing coordination between the National Health Insurance (BPJS Kesehatan) and supplementary health insurance providers under the Coordination of Benefits (KAPJ) scheme, which creates potential claim disputes and administrative risks for hospitals. Although Minister of Health Decree No. HK.01.07/MENKES/1117/2025 regulates payment allocation and membership verification mechanisms, it does not explicitly recognize pre-admission confirmation as a preventive legal protection instrument. This research aims to analyze the normative position of pre-admission confirmation within the KAPJ framework, conceptualize it as a preventive legal protection mechanism, and formulate a proportional implementation model. The study employs a normative juridical method using statutory and conceptual approaches through literature review of relevant regulations and scholarly works. The findings indicate that pre-admission confirmation possesses implicit normative legitimacy through membership verification obligations and system integration requirements, and functions as a risk allocation mechanism that clarifies payment responsibilities prior to service delivery. Its implementation enhances legal certainty, reduces fraud potential, and minimizes claim disputes, provided that access to emergency medical services remains guaranteed.

Although JKN aims to provide equitable and quality health services, fraudulent practices, such as phantom billing and diagnosis manipulation, continue to grow, harming BPJS Kesehatan and participants. This study aims to examine the effectiveness of legal sanctions against JKN claim fraud in FKRTL and identify gaps in their implementation. Although regulations are in place, law enforcement remains weak, with administrative sanctions failing to provide sufficient deterrence. The gap in this research lies in the lack of application of criminal sanctions in fraud cases, especially in existing regulations. The novelty of this research is its comparative approach between current administrative sanctions and the potential application of criminal sanctions in the context of healthcare fraud. The research method uses a normative-descriptive approach, analyzing regulations and fraud audit results, and identifying gaps in the implementation of legal sanctions. The results of the study indicate that strengthening criminal sanctions and integrating technology in claim monitoring can increase the effectiveness of fraud prevention. These findings are expected to strengthen regulations and improve the integrity of the JKN system, as well as provide policy recommendations for more effective law enforcement.

The high cost of colloid fluids and the large number of patients are concerns in determining which treatment standard should be chosen from several treatment alternative, where the total cost for 43 cases with a combination of crystalloid colloid fluids is IDR 209.370.993 while the total cost for 45 cases of crystalloid fluids is only UDR 146.492.268 which causes hospital losses. This study aims to determine the difference in the cost-effectiveness between crystalloid fluids and crystalloid-colloid combinations in hospitalized dengue fever patients without shock at Tangerang City Hospital. The research design used was cross-sectional with a comparative quantitative analysis method, where cost effectiveness was analyzed using the Average Cost Effectiveness Ratios (ACER) method. There were two groups of study samples: the first group, 25 patients who received crystalloid fluids, and the second group, 23 patients who received crystalloid-colloid combination fluids. This study showed a difference in the average hospitalization costs for dengue patients between crystalloid fluid therapy and crystalloid-colloid combination therapy. Hospitalization costs for dengue patients were lower in the crystalloid fluid group, with a significant difference (p=0.000). It was also found that crystalloid fluids were more cost-effective than the crystalloid-colloid combination. The implications of the study results consist of theoretical implications and practical implications. Based on the results of the analysis carried out, the crystalloid solutions are more cost-effective than crystalloid-colloid combinations. This finding can be used as a consideration in making decisions and policies that are in accordance with quality control and cost control for patients covered by the National Health Insurance (BPJS Health insurance).

Compliance in paying contributions is an important factor in ensuring the sustainability of the National Health Insurance (JKN) program, especially in the Non-Wage Workers (PBPU) segment who make payments independently. However, the level of compliance of PBPU participants in Jakarta City is still low, as indicated by the high rate of contribution arrears and the large number of deactivated memberships. This study aims to analyze the factors that influence compliance in paying National Health Insurance (JKN) contributions in the Non-Wage Workers (PBPU) segment in Jakarta City in 2025. The research design used was quantitative with a cross-sectional approach, involving 180 respondents. Bivariate analysis using the Chi-Square test showed that there was a significant relationship between perception and compliance (p = 0.002), income with compliance (p = 0.046), and motivation with compliance (p = 0.000). However, there was no significant relationship between knowledge (p = 0.291) and sanctions (p = 0.103) on compliance in paying contributions. These findings indicate that psychological and economic aspects have a strong influence on driving compliance with JKN premiums. Therefore, efforts to improve compliance need to focus on enhancing positive perceptions, internal motivation, and sustainable income for participants. Perception is the most dominant factor influencing compliance among PBPU participants. Strategies to increase education and improve services are needed to boost compliance and ensure the sustainability of the JKN program.

The JKN Mobile application is an electronic-based service innovation introduced by BPJS Health to facilitate JKN participants in accessing healthcare services and managing their membership information. This study aims to explore the experiences and perspectives of outpatient patients regarding the effectiveness of the JKN Mobile online registration system at Baubau City Regional General Hospital. A qualitative phenomenological approach was employed, with informants selected through purposive sampling. Data were collected to capture the meanings of patients’ experiences in using the application. The findings show that most patients are satisfied with the practicality, speed, and flexibility of the online registration system. However, technical problems, particularly unstable internet connectivity, remain a major challenge. Furthermore, the online registration system has contributed to improved service efficiency and patient satisfaction. These findings indicate the importance of continuous evaluation and improvement of the JKN Mobile online registration system to enhance service quality and health information system development at Baubau City Regional General Hospital.

The Maternal Mortality Rate (MMR) is closely related to the low number of pregnant women visiting the Community Health Center (Puskesmas). This situation can occur due to patient dissatisfaction with the quality of services provided by health facilities, which can lead to patients deciding not to undergo check-ups at the Puskesmas or going to non-medical personnel, which can lead to complications in pregnant women. The purpose of this study was to analyze the effect of health service quality on patient satisfaction among third-trimester pregnant women at Pucakwangi 2 Pati Community Health Center. This study adopted a quantitative, observational, analytical, cross-sectional approach. This study was conducted at Pucakwangi 2 Pati Community Health Center in October 2023. The sample size was 42 third-trimester pregnant women using BPJS services. The sampling method used was total sampling, and the results were analyzed using the Mann-Whitney statistical test. The results showed that the dimensions of tangible, reliability, responsiveness, and empathy were related to patient satisfaction with a p-value of 0.000. Meanwhile, the assurance dimension was not related to patient satisfaction because the p-value was 0.356. Four quality dimensions were found to be related to patient satisfaction, namely tangible, reliability, responsiveness, and empathy dimensions on the satisfaction of pregnant women in the third trimester at Pucakwangi 2 Community Health Center, Pati. Meanwhile, no relationship was found between the assurance dimension and the satisfaction of pregnant women in the third trimester at Pucakwangi 2 Community Health Center, Pati. This finding indicates that improving the quality of health services, especially in the aspects of tangible, reliability, responsiveness, and empathy, is very important to increase the satisfaction of pregnant women. The Community Health Center needs to conduct continuous evaluation and improvement in maternal health services to encourage regular visits by pregnant women, reduce the risk of complications, and contribute to reducing maternal mortality in the Pucakwangi 2 Community Health Center's working area.

Healthcare financing for patients covered by BPJS Kesehatan in hospitals is carried out through a claims mechanism. Delayed BPJS Kesehatan claims represent a critical issue within the healthcare service context in Indonesia. The aim of this study is to identify management strategies that can expedite the eligibility of BPJS Kesehatan claims at Restu Ibu Hospital in Balikpapan. This research is conducted using a descriptive qualitative approach, with data collection through interviews and Focus Group Discussions (FGD). The informants consisted of one doctor, three coders, and one verifier. The study begins by identifying the claim service system situation, focusing on both internal aspects (Strengths and Weaknesses) and external aspects (opportunities and Threats), also known as SWOT analysis. This study identifies several strategies, including: 1) Enhancing the competence of staff and medical personnel through regular training; 2) Developing a more advanced and integrated information system; 3) Improving communication with BPJS Kesehatan; 4) Improving documentation and data verification; and 5) Strengthening coordination with relevant units.

This study aims to calculate the unit Cost of echocardiography services at RSAL dr. Oetojo Sorong, West Papua, using the Activity-Based Costing (ABC) method and compare it with the applied INA-CBG’s tariff. The research method employed is a quantitative descriptive approach focusing on direct Cost analysis, overhead Costs, and Cost allocation based on activities. The data used includes primary data obtained from direct observation and interviews, as well as secondary data such as financial reports and hospital medical records. The results show that the unit Cost of echocardiography services calculated using the ABC method is higher than the INA-CBG’s tariff, indicating a disparity between the standard tariff and actual Costs. The application of the ABC method provides significant benefits to RSAL dr. Oetojo Sorong, such as identifying Cost-intensive activities, improving operational efficiency, and providing transparency in Cost management. This study also recommends that hospital management evaluate service tariffs and that BPJS Kesehatan review the alignment of INA-CBG’s tariffs with the actual Costs of healthcare services.

The Maternal Mortality Rate (MMR) in Indonesia is still high and is a major challenge in the health system, especially in the labor phase. This study aims to analyze the implementation of the BPJS patient labor referral system in reducing MMR at the Gunung Tinggi Health Center. The study used a qualitative method with a case study approach to health workers at the Gunung Tinggi Health Center. The results of the study showed that the availability of competent health workers, adequate facilities and infrastructure, and a referral system integrated with BPJS have made a positive contribution to labor services. However, challenges were still found in the form of late responses from referral hospitals, geographical constraints, and low public health literacy regarding the importance of referrals. This study concludes that strengthening the coordination system between facilities and educating the community is very important in increasing the effectiveness of the referral system and reducing maternal mortality.  

This study aims to identify forms of violations of the right to health services in the implementation of BPJS Kesehatan, analyze the factors that cause them, and formulate preventive and limiting solutions. The research used a descriptive qualitative approach with in-depth interviews with six informants who were active BPJS Health participants in Tanjung Sari, East Jambi. The results showed that there was service discrimination in the form of different treatment between BPJS patients and general patients, patient rejection, administrative obstacles in emergency situations, and unavailability of drugs and medical facilities. Contributing factors include unequal distribution of health facilities, limited human resources, and a weak monitoring system. The experiences of BPJS participants confirm the gap between the program's objectives and the reality on the ground, reflecting a denial of the state's obligation to guarantee citizens' health rights. Comprehensive efforts are needed, including public education, administrative simplification, equitable distribution of health facilities, enforcement of strict sanctions, and active community involvement to realize quality and equitable health services.

The BPJS Employment Program is one of the crucial aspects of providing socio-economic protection for Indonesian society, especially Generation Z (Gen Z), who are entering the workforce. This service aims to enhance understanding of the BPJS Employment Program through education conducted within the Young Helper community, a volunteer organization committed to creating positive societal changes and part of Gen Z. This service also aims to increase the participatory role of Gen Z in the BPJS Employment Program, which provides socio-economic security. The method employed in this service is educational, involving interactive material presentation with data sources from literature studies, questionnaires, interviews, and field observations. Our service includes educating about the BPJS Employment Program such as eligibility criteria, technical implementation, program types, and registration procedures. The education we provide yields outputs such as pamphlets, PowerPoint presentations, educational videos, and posters, each of which highlights crucial information about the BPJS Employment Program. Our service results indicate an improvement in understanding and participatory willingness among participants to enroll in the BPJS Employment Program.

Government policy changes and drug price fluctuations related to e-catalog can affect drug costs and types purchased between 2022 and 2023. This research aimed to analyze the differences in drug procurement using the e-catalog system and its interaction with hospital financial and operational variables. The study employed a mixed-methods approach to understand the dynamics of drug procurement at Pharmacy Department of X Hospital through the e-catalog system between 2022 and 2023. This research evaluated changes in purchasing volume, costs, cost efficiency, and service speed. Quantitative data were obtained from e-catalog documentation, focusing on the types, volumes, and prices of chronic medications, as well as BPJS claims. Statistical analysis was used to compare the study periods, while qualitative data from in-depth interviews with 15 respondents, observations and document analysis enriched the understanding of procurement process changes through data triangulation analysis.  The results demonstrated an increased use of e-catalog, with policy changes leading to supplier diversification and price flexibility. Quantitative findings indicated a 25% increase in the volume of drug purchases through the e-catalog from 2022 to 2023, accompanied by a 15% reduction in average drug prices due to heightened competition among suppliers. Additionally, procurement efficiency improved by 30%, as reflected in the reduction of the procurement cycle time from 45 days to 31 days. These findings indicated shifting needs and procurement strategies, affecting budget efficiency and the speed of fulfilling drug requirements. In conclusion, strategic adaptations and ongoing evaluations in managing e-catalog are essential to address financial and logistical challenges, ensuring patient satisfaction and drug availability.    

This research delves into the socio-economic conditions of Batu Alang Hamlet in Moyo Hulu District, Sumbawa Regency, NTB in 2023. A quantitative method with a descriptive analysis approach was utilized, involving 100 respondents through questionnaires, observation, and documentation. The results of this research the majority of the population exhibits a high level of educational awareness, with most having at least a bachelor's degree, and some are still in the learning process. The productivity of the community is evident in their ability to meet daily needs with an average of two children. About 85% have BPJS insurance, while only 6% have the KIS insurance. Infrastructure and the environment, including access to clean water, sanitation, wells, and toilets, are considered adequate. Waste management is still basic without recycling facilities. Security is relatively good, with only 7% witnessing conflicts, while theft (67%) and narcotics-related crimes (25%) are common. The entire population adheres to Islam, with a 95% belief in religious figures. The economy of Batu Alang Hamlet is supported by various occupations such as farmers, traders, and blacksmiths. Average income ranges from < 1 million to 30 million, while expenditure levels, both for food and non-food items, range from < 1 million to 5 million. The economic infrastructure is considered quite adequate by 90%, but entrepreneurial interest remains low, with 35% expressing no interest.

This study aims to identify the factors influencing delays in the claim process of theRetirement Savings Scheme (JHT) at the BPJS Employment Branch Office in Medan. Aqualitative approach was employed through in-depth interviews with BPJS employees,rticipants,andbranch managers.The findingsrevealthatinternalfactorssuch asincomplete documentation, human resource limitations, and technological system disruptionsplay a significant role in causing claim delays. Additionally, external factors includingsuddengovernmentregulatorychangesand inadequateparticipantinformation alsocontribute to these delays. The impact of claim delays on participant satisfaction is profound,necessitating improvements in claim management administration. Based on these findings, itis recommended to enhanceparticipant education and awareness, strengthen humanresources, improve technological system reliability, and develop adaptive mechanisms forregulatory changes to enhance efficiency and participant satisfaction in the JHT claimprocessattheBPJS EmploymentBranchOfficein Medan

Pharmaceutical Services at the Hospital is an integral part of the Hospital's health care system that is patient-oriented, providing Pharmaceutical Preparations Medical Devices, and Medical Materials that are quality and affordable for all levels of society including clinical pharmacy services (Anonymous, 2016) Besed on the Decree of the Minister of Health of the Republic of Indonesia No 179 Menkes/SK/11/2008, the SPM indicator of hospital pharmacy services includes the waiting time for drug services to be a maximum of 30 minutes while the maximum concoction drug is 60 minutes, the absence of medication errors, stalaction customers at least 80% and prescription writing all must refer to the Hospital formulary This study aims to find out the Waiting Time (Respond Time) of Prescription Services for Finished Medicines and drugs mixed with BPJS patients Outpatient in Bangil Hospital. This research is a non-experimental research with descriptive approach, namely the type of research approach to obtain an overview of the state of a group of data based on observations the real thing is, data collection is done in the Outpatient Pharmacy Service at Hangil Hospital, and is carried out for three months. The total mumber of prescription samples erered in the pharmacy installation for three months a 12.587 prescriptions with details of 10,770 prescriptions of JKN BPJS 85.27% 1,808 peral recipes 14 66% and 9 other insurance recipes 0.07% Among the recipe for JKN BPIS obtained during the study were 90.23% of non-concoction recipes and 9.77% of recipe recipes. The results of the study were obtaining results, the number of prescriptions from patients was 85.27% more than prescriptions from general patients 14 66% and other insurance 0.07%. The average waiting time for non-concoction recipe services in 25 minutes, and concoctions are 62 minutes

One of the easiest ways to detect cervical cancer early is with a visual examination of acetic acid. Early detection of cervical cancer by visual examination with acetic acid is guaranteed by the government, namely BPJS Kesehatan, and is included in the national health insurance program. The purpose of the study was to determine the low participation of women of childbearing age in acetic acid visual examination by UPT Puskesmas Timpah. The method used in this study is descriptive research. Questionnaires made by purposive sampling technique are used as data collection instruments; The maximum number of samples in the study sample is 30 samples. The respondents of this study were women of childbearing age. The results showed that based on respondents' knowledge of information, 26 respondents were uninformed (86.66%), 20 respondents (93.33%) did not support men. In the field of education, 21 people were found to have elementary and junior high school education as much as 70%, in the support of officers it was found that 20 people did not support (66.67%). Regarding access to information, it is known that 22 people did not get any assistance to get information (73.33%).    

Patient satisfaction is a factor that can be used as a reference in determining the success of a service program. Patient satisfaction will arise when it is supported by good quality service. There are five dimensional aspects known as service quality (SERVQUAL), reliability, responsiveness, assurance, empathy, and tangible. These five dimensions influence patient satisfaction. This research aims to provide an overview of the level of satisfaction of outpatient BPJS patients at Hermina Bitung Hospital, Tanggerang Regency in 2023. This research uses a descriptive method with a quantitative approach with the data that has been collected being processed using SPSS (statistical packagen for the social sciences) then the results analyzed by measuring the average percentage for each patient criterion and a sample size of 76 respondents, from this research it can be concluded that patient satisfaction through the reliability dimension is 56.58%, the responsiveness dimension is 55.26%, the assurance dimension was 53.95%, the empathy dimension was 56.58%, while the direct evidence (tangible) was 51.32%. Thus, the researchers concluded that the number of BPJS patients in outpatient registration services was 52.63%. This result still does not reach the minimum service standard set by the Indonesian Ministry of Health in 2008, which is ≥90%.

Outpatient services are an important part of health services provided by hospitals. However, some BPJS hospitals experience obstacles in providing efficient and quality outpatient services, such as long queues, long waiting times, and lack of a good management system. the application of Lean Management to the outpatient services of BPJS patients in hospitals can help hospitals improve operational performance, so as to increase public trust in BPJS Health. This study aims to analyze the application of Lean Management to the outpatient services of BPJS patients in hospitals. This research uses a literature study method or Systematic Literature Review using the Google Scholar search engine and journal databases, such as Researchgate. The results showed that most outpatient service activities for BPJS patients still have patient waiting times below the established service standards. In analyzing the flow that patients go through, each activity is identified into two groups, namely Value Added (VA) as an activity that is considered necessary and profitable and Non Value Added (NVA) as an activity that is considered unnecessary. Based on the percentage of waste in the form of the largest waiting time can be described, namely, 35.1% in the registration process, 30.2% in the poly examination process, and 20.7% in the process of receiving drugs in the pharmaceutical installation