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Didit Setiawan; Achmad Fauzan Rachman

Journal of Educational Innovation and Public Health 2026 Pusat Riset dan Inovasi Nasional

The implementation of Hospital Management Information Systems (HMIS) has become a strategic imperative to enhance operational efficiency amidst the ongoing global digital health transformation era. This study aims to analyze the determinants of successful HMIS implementation and its impact on service efficiency and patient outcome quality. Employing a narrative review approach with thematic synthesis of literature from PubMed, Scopus, and ScienceDirect databases between 2016-2026, the study evaluates the relationship between technology investment and organizational performance. The synthesis results indicate that while HMIS significantly reduces administrative burdens and medication errors, a "digital paradox" exists where technical efficiency may disrupt interpersonal interactions between healthcare providers and patients if systems are not user-centered. Key success factors include data interoperability (HL7/FHIR standards), human resource readiness, and governance policy support. This study concludes that a patient-centered efficiency model is the fundamental basis for ensuring technology investments yield sustainable added value within the healthcare delivery system.

Muhammad Natsir Mallawi; Nurasia Natsir

International Journal of Management 2026 Asosiasi Riset Ilmu Manajemen Kewirausahaan dan Bisnis Indonesia

Healthcare institutions worldwide are undergoing digital transformation to improve efficiency and patient experiences. While many studies focus on clinical applications of information technology (IT), its impact on administrative service quality remains limited, even though administrative services are patients’ primary point of contact. This study examines how IT adoption influences administrative service quality in Indonesian healthcare institutions, focusing on relationships between IT implementation levels and service quality dimensions, as well as mediating and moderating factors. Using a mixed-methods sequential explanatory design, quantitative data were collected from 385 patients and 127 administrative staff across 24 hospitals, supported by 32 in-depth interviews. Service quality was measured using SERVQUAL dimensions: tangibles, reliability, responsiveness, assurance, and empathy. The findings show significant positive relationships between IT adoption and all service quality dimensions, with the strongest effects on reliability and responsiveness. Staff digital competency and system usability partially mediate these relationships, while implementation quality acts as a key moderating factor. Well-implemented systems yield substantially higher service improvements than poorly implemented ones. Most patients prefer digital services when functioning properly, although many report frustration when systems fail or staff lack competency. This study highlights the importance of effective IT implementation to enhance administrative service quality and offers practical insights for healthcare management.

Desvilia Desvilia

Jurnal Sistem Informasi dan Ilmu Komputer 2026 International Forum of Researchers and Lecturers

This research aims to design an Information Systems and Information Technology (IS/IT) strategic plan for Wyndham OPI Hotel Palembang to support operational efficiency and enhance the quality of five-star hotel services. The study applies the Ward and Peppard framework, supported by analytical methods including Value Chain,PEST,SWOT,Critical Success Factors (CSF), MOST and McFarlan Strategic Grid. Through these approaches, the current IS/IT condition, challenges, and opportunities for digital system development within the hotel environment were mapped. The analysis reveals that although the hotel has implemented technologies such as SiteMinder and the Rhapsody management system, there is a need to improve self-service check-in capabilities, strengthen IT infrastructure, and maximize digital technology utilization. The proposed strategy recommends the development of an integrated self check-in system, enhancement of network infrastructure, and employee training through an LMS platform. This strategic plan is expected to support the hotel’s digital transformation to remain competitive in the modern hospitality industry.

Yusni Sulastri; Rina Mutiara; Tjipto Rini

International Journal of Management Science and Entrepreneurship 2026 International Forum of Researchers and Lecturers

The waiting time for outpatient pharmacy services at Permata Jonggol Hospital had not met the minimum service standards, potentially reducing service quality and patient satisfaction. This issue was suspected to be influenced by human resource (HR) competence, service regulations, and the utilization of the Hospital Management Information System (HMIS). This study aimed to analyze the effect of HR competence and service regulations on pharmacy waiting time, with HMIS utilization as an intervening variable. The study used a quantitative approach with a cross-sectional design. Data were collected at a single point in time using instruments that had been tested for validity and reliability. The data were analyzed using Structural Equation Modeling–Partial Least Squares (SEM-PLS). The results showed that HR competence, service regulations, and HMIS utilization simultaneously had a significant effect on pharmacy waiting time. Partially, HR competence and service regulations significantly affected HMIS utilization and waiting time. HMIS utilization also significantly influenced waiting time and mediated the relationship between HR competence, service regulations, and pharmacy waiting time. In conclusion, improving pharmacists’ competence, strengthening service regulations, and optimizing HMIS utilization in an integrated manner were important strategies to reduce waiting time and improve service efficiency and quality

Rini Novia; Rina Mutiara; Idrus Jus'at

International Journal of Management Science and Entrepreneurship 2026 International Forum of Researchers and Lecturers

Drug stockouts in hospitals pose significant risks to service quality, patient safety, and operational efficiency. This study aimed to analyze how drug demand planning and procurement processes at Johar Baru Regional General Hospital contribute to stockout occurrences and to develop data-driven recommendations based on supply chain management principles. A qualitative descriptive design was employed using data triangulation. Data were collected through in-depth interviews with the Head of the Pharmacy Installation, procurement staff, and warehouse pharmacists, complemented by direct observation and analysis of 2024 planning and procurement documents. Thematic analysis was conducted with the support of NVivo software to identify patterns and relationships among key variables, including drug demand planning, procurement, and inventory management.Findings reveal that stockouts stem from interconnected weaknesses in planning accuracy, procurement coordination, and inventory control systems. Effective stock management depends not only on increasing supply but also on improving data quality, integrating inventory information systems with operational workflows, and enhancing cross-functional collaboration. Recommended strategies include implementing a minimum stock alert system integrated with the Hospital Management Information System (HMIS), strengthening standard operating procedures for stockout response and procurement confirmation, improving integration between HMIS, the National Formulary, and budgeting systems, and applying consumption based planning methods combined with ABC VEN analysis to optimize inventory control.

Siska Karma Gianti; Agusdini Banun Saptaningsih; Johanes Johanes

International Journal of Management Science and Entrepreneurship 2026 International Forum of Researchers and Lecturers

Medical personnel compliance in prescribing drugs according to the National Formulary (ForNas) is essential to ensure rational therapy, improve service quality, and enhance efficiency in health financing at government health facilities. However, compliance remains a challenge at Johar Baru Regional General Hospital, Central Jakarta. This study aimed to analyze factors influencing medical personnel compliance with ForNas-based prescribing, including drug availability, management policies, and the knowledge, attitudes, norms, and perceptions of medical staff.A qualitative approach was used through in-depth interviews with medical personnel, heads of supporting service sections, and pharmacy unit leaders. The study also involved observation and review of hospital formulary documents, minimum service standards reports for 2024, and monitoring and evaluation reports on prescribing compliance for 2024 and January June 2025. Data were analyzed using thematic analysis supported by NVivo software.The findings indicate that compliance is influenced by medical personnel’s understanding of ForNas policies, clinical experience, and professional attitudes toward prescribing standards. Management factors such as supervision, technological support, and procurement systems also play important roles. Limited drug stocks and suboptimal control systems were identified as major obstacles.The hospital is recommended to strengthen compliance by updating clinical practice guidelines, developing a ForNas-based hospital formulary, improving management support, optimizing information technology systems, ensuring drug availability, and proposing additional ForNas drugs to the Ministry of Health.

Rosida Siboro; Andry Andry; MF Arrozi Adhikara

International Journal of Management and Digital Sciences 2026 International Forum of Researchers and Lecturers

Rapid global environmental changes, especially due to advances in technology and information, have had a significant impact on various sectors of life, including the health sector. In the context of modern health services, hospitals are no longer just places of healing, but also institutions that are required to provide high-quality services, based on patient safety, and are able to adapt to the dynamics of community needs. This change requires a transformation in human resource management, especially related to the interpersonal and psychosocial competencies of nurses as the spearhead of medical services.Purposes:​ to analyze the effect of effective communication and Assertive Attitude on Nurses' Work Productivity in hospitals, with Work Fatigue as a mediating variable.Methods: This type of research is quantitative, using statistical figures to measure the influence of independent variables on dependent variables. The research design is a cross-sectional study.Results: The results of this study indicate that effective communication, assertiveness, and job fatigue collectively significantly influence nurses' work productivity. Communication and assertiveness positively contribute to job fatigue, which in turn affects productivity. Job fatigue is also shown to be a significant mediator in the relationship between communication and assertiveness on work productivity .Conclusion : The importance of strengthening effective communication as a strategy to increase productivity. Organizations need to design communication systems that support openness, transparency, and clarity of information and culture-based assertiveness training, so that employees can express their opinions appropriately without causing resistance in the team.

Aristya Indah Widiyanti; Ediansyah Ediansyah; Yanuar Ramadhan

International Journal of Management 2026 Asosiasi Riset Ilmu Manajemen Kewirausahaan dan Bisnis Indonesia

This study investigates the optimization of claims under the Indonesian Case-Based Groups (INA-CBGs) payment mechanism within the National Health Insurance Program (Jaminan Kesehatan Nasional) at Hospital X in Serang. The research aims to analyze the influence of managerial competence, digital adoption, and organizational behavior on claim effectiveness, with policy implementation serving as a moderating variable. Employing a quantitative explanatory approach, data were collected from 144 respondents comprising management staff, casemix teams, and medical record officers through questionnaires and structured interviews. Structural Equation Modeling–Partial Least Square (SEM-PLS) was applied to examine the relationships among variables. Findings reveal that managerial competence, digital adoption, and organizational behavior significantly and positively affect the optimization of INA-CBGs claims. Furthermore, the implementation of the National Health Insurance Program policy strengthens these relationships, enhancing claim efficiency and equity. The results align with the Resource-Based View theory, highlighting the strategic role of internal resources in achieving organizational performance. Managerial implications include capacity building for managers, integration of hospital information systems (SIMRS) with e-Claim platforms, and fostering collaborative organizational culture. Overall, the study underscores the importance of managerial, technological, and behavioral factors, moderated by policy implementation, in improving hospital claim optimization under the INA-CBGs system.

Didit Setiawan

Jurnal Riset Rumpun Ilmu Kesehatan 2026 Pusat riset dan Inovasi Nasional

Patient safety is often viewed exclusively as the responsibility of clinical personnel. However, administrative errors occurring during the admission process and documentation stages constitute major contributors to medical risk. This study aims to explore the strategic role of administrative staff in strengthening patient safety culture and mitigating medical risks through effective communication coordination. A narrative literature review was conducted extensively using the Scopus, PubMed, and Web of Science databases, covering publications from 2014 to 2024. Data were analyzed using a thematic synthesis approach. The findings identify four main themes: administrative staff as information gatekeepers, the role of health information technologies (HIS/EMR) in bridging communication gaps, collaboration barriers arising from hierarchical structures, and the need for an Interprofessional Shared Governance framework. Administrative accuracy in the early phases of care is proven to be critical in preventing latent errors with potentially fatal consequences. Strengthening patient safety culture requires the integration of administrative staff through cross-departmental training, standardized communication protocols, and non-punitive incident reporting systems. Administrative staff are not merely bureaucratic support personnel but are key actors within the modern hospital patient safety ecosystem.

Aurora Rahma Koesdinar; Dede R Oktini; Diamonalisa Sofianty

DIAGNOSA: Jurnal Ilmu Kesehatan dan Keperawatan 2025 International Forum of Researchers and Lecturers

Digital transformation in the health sector requires hospitals to improve service effectiveness through the use of Hospital Management Information Systems (HMIS). Berkah Pandeglang Regional General Hospital, as a regional hospital, still faces challenges in utilizing HMIS, such as limitations in infrastructure and user competence. This study aims to analyze the effect of SIMRS implementation and evaluation on the effectiveness of healthcare services. The research method uses a quantitative approach with a descriptive-verificative design. The research population consists of 278 healthcare workers, and 74 respondents were selected using proportionate stratified random sampling. Data were collected through closed questionnaires and analyzed using multiple linear regression to test the influence of variables. The results of the analysis show that the implementation and evaluation of SIMRS have a positive and significant effect on the effectiveness of health worker services. The most dominant components in implementation are the availability of hardware and human resource competence, while in evaluation, the most decisive aspects are the perception of usefulness and ease of use of the system. The conclusion of this study confirms that the success of SIMRS depends on the synergy between optimal implementation and systematic evaluation. Improvements in technological facilities, user training, and periodic monitoring are recommended to strengthen the effectiveness of health worker services at Berkah Pandeglang Regional General Hospital.

Wildan Anwar Adi Wibowo; Indah Yuni Astuti; Iing Sri Hardiningrum

Jurnal Manajemen Bisnis Digital Terkini 2025 Asosiasi Riset Ilmu Manajemen Kewirausahaan dan Bisnis Indonesia

Hospitals are a crucial sector in a country due to their functions encompassing various aspects of healthcare provision. Factors supporting smooth operations and quality healthcare services in hospitals include human resources, facilities and infrastructure, health information systems, financial management, good customer service, security, occupational health, and other supporting factors. This study aims to determine the effect of compensation, work environment, and work stress on employee work productivity at Bhayangkara Level II Hospital in Kediri City. The research method used is a quantitative approach with multiple linear regression analysis techniques. The sample in this study amounted to 40 respondents who were employees of Bhayangkara Level II Hospital in Kediri City. The results of the analysis show that partially compensation, work environment, and work stress have a positive and significant effect on employee work productivity. Compensation has a calculated t value of 2.500 with a significance of 0.015, work environment is 6.170 with a significance of <0.001, and work stress is 5.305 with a significance of <0.001. Simultaneously, these three variables also have a significant effect on work productivity with a calculated F value of 35.438 and a significance of <0.001. Based on these findings, it is recommended that the hospital management continue to evaluate the compensation system, create a conducive work environment, and manage employee work stress through training and counseling facilities. Further research is expected to add other variables such as internal communication, job satisfaction, and career development to obtain more comprehensive results.

Khoiri Nur Kholis; Ellynia Ellynia; Ria Efkelin

Jurnal Riset Rumpun Ilmu Kedokteran 2025 Pusat riset dan Inovasi Nasional

Long outpatient waiting time is an indicator of suboptimal hospital administrative systems. The Hospital Management Information System (SIMRS) is designed to improve administrative efficiency; however, in practice, complaints about long patient waiting time still persist. This study aims to examine the relationship between the registration administrative system using SIMRS and the waiting time for outpatient services at RS Patria IKKT in 2025. A quantitative approach with a cross-sectional analytical design was employed. The sample consisted of 100 outpatient respondents selected using purposive sampling. Data were collected through questionnaires and analyzed using the Chi-Square test and Spearman correlation to determine the relationship between variables. The results show that the system quality, information quality, and service quality of SIMRS at RS Patria IKKT are categorized as good. Spearman correlation analysis reveals no significant relationship between system quality (p=0.281) and information quality (p=0.910) to waiting time. However, the Chi-Square test indicats a significant relationship between service quality (p=0.001) and outpatient waiting time. The implementation of SIMRS at RS Patria IKKT contributes to accelerating administrative processes and reducing outpatient waiting time. Nevertheless, improvements in service quality are necessary to achieve more optimal results.

Ahmad Fauzi; Hatta, Muhammad; Fahrudin, Rifqi

Teknik: Jurnal Ilmu Teknik dan Informatika 2025 LPPM Sekolah Tinggi Ilmu Ekonomi - Studi Ekonomi Modern

The development of information technology has encouraged institutions, including hospitals, to adopt digital systems to improve operational efficiency. One important aspect is the employee attendance system, which previously relied on fingerprints. This method has limitations, such as difficulty detecting when fingers are not in ideal condition and causing queues during peak hours. This research aims to design and implement an Android-based attendance system using the Eigenface facial recognition method as a faster, safer, and more accurate alternative. Eigenface works by extracting facial features using Principal Component Analysis (PCA), thus being able to efficiently recognize individual identities. The system was developed with MySQL database integration and tested on employees of Khalishah General Hospital. The implementation results showed that the system can recognize faces with a good level of accuracy and increase the effectiveness of attendance recording. Furthermore, the use of facial-based attendance can minimize the potential for fraud and increase user comfort because it does not require physical contact. Thus, the Eigenface method has proven feasible to be implemented as a modern attendance solution to support employee attendance management in hospital work environments and other institutions.

Anita Sriwaty Pardede

Jurnal Inovasi Riset Ilmu Kesehatan 2025 Pusat Riset dan Inovasi Nasional

The evaluation of information systems becomes important to ensure the effectiveness of the Hospital Information System (SIMRS) application and its positive impact in producing information that meets the standards of data quality with the HOT fit theory, which includes the core elements of the information system: human, organization, Technology and net benefits. The research was conducted using a cross-sectional design and involved 78 SIMRS users in X Hospital as the sample. Data were analysed using the partial least squares (PLS) structural equation modelling (SEM) method. The results of the study showed that user satisfaction, information quality, service quality, system quality, organizational environment, system utilization level, and organizational structure had significant relationships with SIMRS based on hypothesis testing. The significant findings included user satisfaction, net benefits, system utilization, service quality, system quality, organizational environment, and information quality. This study emphasizes the importance of routine and periodic maintenance, monitoring of SIMRS by relevant units, attention to factors influencing SIMRS adoption by users, and regular training related to the operation of the SIMRS application. Efforts to improve operational skills in the aspects of system quality, information quality, service quality, organizational structure, and organizational environment of SIMRS are crucial to optimize the net benefits generated by SIMRS.

Suparman Suparman; Aris Sunarya; Sarwani Sarwani; Sri Kamariyah

Jurnal Hukum, Administrasi Publik dan Negara 2025 Asosiasi Peneliti Dan Pengajar Ilmu Sosial Indonesia

This study explores the potential and contribution of hotel and restaurant taxes to Regional Original Revenue (PAD) in Surabaya, Indonesia. Using a qualitative descriptive approach, data were obtained from both primary and secondary sources. Primary data came from the Regional Government of Surabaya and the Regional Revenue Agency, while secondary data included academic literature, statistical reports, and regulatory documents. Data analysis employed McNabb’s (2002) framework, which consists of grouping information by relevant constructs, identifying interpretive bases, generating generalizations, testing alternative interpretations, and refining theory from case evidence.The findings reveal that the hotel and restaurant sectors in Surabaya possess considerable growth potential, supported by increasing investment, a steady rise in tourist arrivals, and the growing public interest in the property and culinary industries. Hotel taxes have contributed an average of 4.96% of PAD annually, while restaurant taxes contributed 8.06%, reflecting their critical role in strengthening local fiscal capacity. Revenue performance has been further enhanced by the implementation of a self-assessment tax system, improvements in taxpayer compliance, and supportive local economic infrastructure. Despite these positive contributions, several challenges remain. These include unregistered lodging facilities, limited enforcement mechanisms, and a shift in consumer demand toward smaller-scale hospitality businesses, which can reduce taxable capacity. Addressing these challenges requires optimizing the hospitality tax base, expanding tourism promotion, strengthening compliance monitoring, and advancing digital-based tax management systems to ensure efficiency and transparency. In conclusion, hotel and restaurant taxes play a vital role in ensuring Surabaya’s fiscal independence and financing public welfare initiatives. Strengthening governance and adopting adaptive policies are essential for maximizing their potential contribution to sustainable local development.

Monika Monika; Rara Dilla Permatasari; Nadia Salim Bin Usman; Ulhamdiati Ulhamdiati; Edy Susena

Jurnal Ilmu Kesehatan Umum, Psikolog, Keperawatan dan Kebidanan 2025 Asosiasi Riset Ilmu Kesehatan Indonesia

The implementation of Electronic Medical Records (EMR) represents a major advancement in health information systems, playing a vital role in improving service efficiency, data security, and the quality of medical documentation. This study utilizes a literature review approach to assess EMR implementation in hospitals by analyzing findings from 20 relevant journals. Literature sources were obtained from indexed national scientific publications, with a focus on the benefits, challenges, and critical success factors of EMR adoption. The results reveal that EMR use can enhance service efficiency by up to 40%, expedite medical decision-making, and increase the accuracy of patient data. Additionally, EMR reduces the risk of data loss, facilitates coordination among healthcare professionals, and supports more effective integration of medical information. Despite these benefits, EMR implementation encounters several challenges, such as inadequate technological infrastructure, resistance from some healthcare personnel toward digital systems, and the need for ongoing training to ensure optimal use. If not addressed properly, these barriers may limit the system’s effectiveness. Key factors influencing successful implementation include strong management commitment, early involvement of end-users during the planning phase, and system flexibility to meet specific clinical requirements. Therefore, EMR implementation should adopt a holistic approach that integrates human resource readiness, technological capacity, and clear regulatory frameworks. With well-structured strategies, consistent institutional support, and comprehensive training programs, EMR has the potential to be a driving force in the digital transformation of healthcare. This transformation can lead to sustainable improvements in service quality, patient data security, and operational efficiency in hospital settings.

Roki Mahendra; Wahyu Wijaya Widiyanto

International Journal of Health and Medicine 2025 Asosiasi Riset Ilmu Kesehatan Indonesia

The implementation of Hospital Management Information Systems (SIMRS) has become a strategic necessity to improve healthcare service quality and operational efficiency. This study focuses on evaluating the performance of SIMRS in the outpatient registration unit of Nur Hidayah Hospital Bantul, where system disruptions, inconsistent SOP application, and limited user training were identified as core issues. The research aims to assess how well the SIMRS aligns with the Human, Organization, and Technology components through the HOT-Fit model framework. A descriptive qualitative method was employed using purposive sampling to select five informants directly involved in SIMRS operations, including registration officers, IT staff, and the head of the medical records unit. Data were collected through in-depth interviews, direct observation, and documentation, and analyzed thematically based on the HOT-Fit model. The findings show that SIMRS contributes positively to workflow efficiency and data management; however, human factors such as inconsistent training and input errors remain prevalent. Organizational support is visible but lacks structured evaluation routines, and although the technological infrastructure is generally stable, peripheral device and network issues persist. The study synthesizes that effective SIMRS performance requires not only technological readiness but also consistent organizational commitment and continuous human resource development. It concludes that strengthening user competence, formalizing SOP usage, and improving infrastructure are essential to optimize the system's functionality and alignment with the HOT-Fit model.

Kasmianti Kasmianti; Dwi Iskandar

International Journal of Public Health 2025 Asosiasi Riset Ilmu Kesehatan Indonesia

The adoption of Hospital Information Systems (HIS) is a crucial step toward improving healthcare service delivery, especially in public hospitals in developing countries. RSUD Prof. Dr. H. Aloei Saboe, a referral hospital in Gorontalo, Indonesia, has implemented the SIMRS Khanza system to digitize inpatient registration and medical documentation. However, limited evaluation has been conducted to assess its effectiveness beyond technical performance. This study aims to evaluate the implementation of SIMRS Khanza using the Human-Organization-Technology Fit (HOT-Fit) framework, which examines the alignment between users, institutional support, and system quality. A qualitative descriptive method was employed, involving in-depth interviews, non-participatory observations, and document reviews with eight informants, including medical record officers, system coordinators, and hospital management. The findings reveal that although most users reported improved efficiency and satisfaction, several issues persist: incomplete training, limited adherence to SOPs, and system performance lags during peak hours. Organizational support was present but inconsistent, and documentation policies lacked specificity for digital contexts. Technologically, the system demonstrated stable output, but responsiveness and integration require enhancement. The synthesis of findings suggests that success in HIS implementation is contingent upon not only system reliability but also continuous user engagement, structured training, and dynamic policy support. Therefore, a holistic strategy integrating human, organizational, and technological components is essential to optimize SIMRS performance and sustainability.

Dola Veronica Agustia; Agusdini Banun Saptaningsih; Natsir Nugroho

International Journal of Health and Medicine 2025 Asosiasi Riset Ilmu Kesehatan Indonesia

Non-formulary drug utilization in Harapan Kita Children’s and Mother’s Hospital presents a substantial challenge in healthcare cost management, especially for patients enrolled in the BPJS health insurance program. Given its status as a national referral hospital, Harapan Kita Children’s and Mother’s Hospital encounters a high prevalence of complex maternal and child health cases requiring the use of medications beyond the scope of the national formulary. This research endeavor seeks to examine the patterns and consequences of non-formulary drug use within this context. This study adopted a quasi-experimental design, incorporating both quantitative and qualitative methods, to evaluate the impact of an sosialisation intervention and audit clinic on physician compliance with formulary drug use. A pre-test and post-test design was employed to measure changes in non-formulary drug utilization. Findings indicated a statistically significant decrease in non-formulary drug use from 18% to 13% post-intervention. The integration of a clinical pathway and tailored physician training was instrumental in achieving improved formulary adherence. Given these results, it is recommended to broaden training and surveillance programs, strengthen technological support through the implementation of formulary information systems, and undertake longitudinal research to assess the long-term sustainability of the intervention's effects..

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.