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Resia Perwirani; Aries Widiyoko

Journal of Health Sciences, Public Health and Pharmacy 2025 International Forum of Researchers and Lecturers

The National Health Insurance (JKN) program, administered by BPJS Kesehatan, has significantly expanded public access to healthcare services, particularly inpatient care. This study aims to analyze inpatient JKN reimbursement patterns at Surakarta General Government Hospital during the period of 2020 to 2024. The analysis focuses on five main variables: INA-CBGs grouping codes, class of care, severity level, INA-CBGs tariff, and actual hospital costs. A descriptive-analytic method with a quantitative approach was employed, utilizing secondary data extracted from the INA-CBGs system. The results indicate that inpatient reimbursements were predominantly concentrated in Class 3 services (64%–70%) and severity level 1 (45%–59%). From 2020 to 2022, respiratory-related cases dominated, likely due to the COVID-19 pandemic, while in 2023–2024 a shift occurred toward non-communicable diseases such as cardiovascular and metabolic conditions. A consistent negative tariff gap was identified, particularly in Class 3 and severity level 1, where INA-CBGs reimbursements were insufficient to cover actual service costs. These findings underscore the importance of periodic review of INA-CBGs tariff structures, reinforcement of Quality and Cost Control (KMKB), and optimization of reimbursement management information systems to enhance service efficiency and ensure the financial sustainability of JKN, especially in Type C hospitals that serve as the primary level of healthcare delivery.

Andi Khairul Musyawir; Indrayanto Indrayanto

International Journal of Health and Medicine 2024 Asosiasi Riset Ilmu Kesehatan Indonesia

Background : The problem found at the Sayang Bunda Makassar General Hospital was a decrease in patients after the end of COVID-19 in 2023, there were visit data of 147 patients in January – July. Objective : The purpose of this study is to determine the role of Public Relations in increasing the existence of the hospital. Method : This type of research used qualitative research methods. Methods collected documentation data and in-depth interviews to Result : The research results obtained at the general hospital unfortunately have not been fulfilled in terms of social activities which were only held in 2020, as for the results of observations of social activities and published on social media, this provides satisfaction that the service at the general hospital unfortunately has not collaborated with BPJS insurance, as for communication through media, it has not been fulfilled so that the internet is widely used, social media such as Instagram, as well as the educational dimension when carrying out activities.   such as handling mass circumcisions or providing direct health services. Suggestion : The hospital needs to improve marketing management by digitalizing marketing, promoting health through electronic media as well as re-organizing social activities, improving facilities and infrastructure as well as access to payment via card (JKN-KIS) at Sayang Bunda General Hospital.

Wulan, Susilo

Jurnal Pengabdian kepada Masyarakat Wahana Usada (WUJ) 2023 Sekolah Tinggi Ilmu Kesehatan KESDAM IX/Udayana

Background: community needs an assurance of availability of healthcare services and health financing, both from the goverment, companies and their own abilities through the health insurance mechanism. Membership of National Health Insurance (NHS) in RT 37 is 65,4%. So it is necessary to increase knowledg about the importance owning JKN Card. Purpose: Increasing awarness to participate in NHS and receive benefits from this participation through outreach activities so that communities understand the importance of owning JKN Card. Methods: the subject/target of the activity are resident of RT 37 Kelurahan Sidomulyo. Data collection technique used interviews and observtion, the analyzed to find out the root cause of problem. The results of the analysis are used to the basis for intervention such as Communication, Information and Education. Results: The root cause of the problem of owning JKN Card due to doesn’t sick don’t need JKN Card, inability to pay the premius for low income groups, not availabel data JKN Card membership in RT 37 and never received socialization from varias stake holders. Conclusion: Low of knowledge people in RT 37 so resident unknown the importance benefits of JKN Card Ownership, therefore proactive socialization needed from all stakeholders to attract people to became JKN membership.

Gusti Agung Sri Guntari

Jurnal Inovasi Riset Ilmu Kesehatan 2023 Pusat Riset dan Inovasi Nasional

Every citizen has the right to guaranteed access to quality and affordable health services. Initially, all administrative matters related to JKN can be carried out at the BPJS Kesehatan office. However, the covid 19 pandemic situation requires people to limit social interactions to prevent the chain of transmission of covid 19 infection. Therefore, digital innovations such as the JKN mobile application are needed by the public, especially JKN participants. The JKN mobile application is an innovation developed to make it easier for participants who initially carried out administrative activities at the BPJS Kesehatan office, to switch to applications that can be accessed anytime and anywhere. This research is a qualitative research that aims to explore in depth how the use of the JKN mobile application, especially during the Covid-19 pandemic. The informants in this study consisted of 8 informants consisting of BPJS Kesehatan officers and 7 JKN participants who had used the JKN mobile application domiciled in Gianyar Regency, Bali. This study was conducted using the indepth interview method with purposive sampling technique. This research shows the results that the JKN mobile application is very helpful for participants in terms of checking or changing participant data, accessing contribution information and printing digital cards that can be used in health facilities. However, there are still many features that have not been utilized due to participants' ignorance of the existence of features such as online consultations and online queues. So that wider socialization is needed regarding the benefits of the JKN mobile application both on social media and electronic media.