Examining the Implementation of JKN Patients References at the 2017 Galang Health Center

Oct 13, 2025 by windailys.com 114 views

Implementation of Patients Participants in the National Health Insurance (JKN) at the Galang Health Center in 2017

Examining the Implementation of JKN Patients References at the 2017 Galang Health Center

The referral system is a crucial process in the healthcare industry, involving the delegation of authority and responsibility in dealing with cases of disease or health problems. This process can be done vertically, between levels of health services, or horizontally, between levels of the same level. The referral system plays a vital role in ensuring that patients receive the necessary medical attention and care.

At the Galang Health Center, there was a significant increase in referral rates, with a percentage of 27.6% in 2015 and 31.2% in 2016. This phenomenon seemed contradictory to the National Health Insurance Program (JKN) which aims to maximize the function of the Puskesmas as a service First level health. The JKN program is designed to provide comprehensive health insurance coverage to all citizens, ensuring that they have access to quality healthcare services.

Background of the Study

This qualitative research aims to dig deeper into the referral system of JKN participating patients at the Galang Puskesmas in 2017. This study involved 10 informants, including the Head of Puskesmas, Head of Administration, Doctors, Midwives, Nurses, Drug Managers, BPJS Managers, and Patients participating in JKN. The study aimed to identify the challenges and limitations faced by the Galang Health Center in implementing the referral system, and to provide recommendations for improvement.

Methodology

The study used a qualitative approach, involving in-depth interviews with 10 informants. The data collected was analyzed using thematic analysis, to identify patterns and themes related to the referral system. The study also involved a review of existing literature and policies related to the JKN program and the referral system.

Results

The results of the study showed that health services at the Galang Health Center, especially in terms of referrals, are still not in accordance with established standards. This can be seen from several aspects:

Human Resources

The number of health workers in the Galang Puskesmas is in accordance with the standards, but has not been supported by adequate competence in implementing a referral system. This limitation can result in delays and inefficiencies in the referral process.

Medical Devices

Medical device facilities at the Galang Puskesmas are incomplete and are not in accordance with the compending of medical devices, thereby limiting the ability of the Puskesmas in providing optimal services. This limitation can result in a lack of access to necessary medical equipment and technology.

Medicines

Types and Amount of Drugs in Galang Puskesmas are not in accordance with the needs and standard of drugs in the National Formulary. This limitation can result in a lack of access to necessary medications and treatments.

Flow of Service

The flow of referral services in the Galang Health Center has not fully followed the existing technical instructions. This limitation can result in delays and inefficiencies in the referral process.

Discussion

The limitations identified in the study can result in an increase in referral rates, which in turn can burden the upper level health system. The study highlights the need for improvement in the referral system, including training and competency improvement, improvement of facilities, evaluation of drug needs, and socialization and education.

Recommendations

Based on the results of the study, there are several recommendations that need to be followed up by the Galang Health Center:

Training and Competency Improvement

Galang Puskesmas needs to hold training to improve the understanding and competence of health workers in implementing a referral system, especially in terms of screening patients who need referrals.

Improvement of Facilities

Galang Puskesmas needs to complete medical device facilities in accordance with the needs and standards set in the Compendium of Medical Devices. This is important to support quality health services at the first level.

Evaluation of Drug Needs

Galang Health Center needs to periodically evaluate the type and amount of drug needs based on patient data and standards set in the National Formulary. This will ensure the availability of adequate drugs and in accordance with patient needs.

Socialization and Education

Galang Puskesmas needs to conduct socialization to the public about the tiered referral system in the JKN era. This is important to increase public understanding of applicable referral procedures, so as to reduce referral abuse and increase the efficacy of health services.

Conclusion

The implementation of this recommendation is expected to improve the quality of health services in the Galang Health Center, minimize the referral rates, and support the success of the JKN program in achieving its goals. The study highlights the need for improvement in the referral system, and provides recommendations for improvement. The study also emphasizes the importance of training and competency improvement, improvement of facilities, evaluation of drug needs, and socialization and education in improving the referral system.

Limitations of the Study

The study has several limitations, including the small sample size and the qualitative approach used. The study also relies on the perceptions and experiences of the informants, which may not be representative of the entire population.

Future Research Directions

Future research should focus on evaluating the effectiveness of the recommendations provided in this study, and on identifying the challenges and limitations faced by other health centers in implementing the referral system. Future research should also focus on developing a more comprehensive and standardized referral system, and on improving the quality of health services at the first level.

References

[1] World Health Organization. (2019). Referral Systems in Health Care.
[2] Ministry of Health. (2017). National Health Insurance Program (JKN).
[3] Galang Health Center. (2017). Annual Report.
[4] BPJS. (2017). Annual Report.

Appendices

[1] List of Informants
[2] Interview Protocol
[3] Data Analysis Procedure
[4] Results of the Study
Frequently Asked Questions (FAQs) about the Implementation of Patients Participants in the National Health Insurance (JKN) at the Galang Health Center in 2017

Q: What is the National Health Insurance (JKN) program?

A: The National Health Insurance (JKN) program is a comprehensive health insurance program designed to provide universal health coverage to all citizens of Indonesia. The program aims to ensure that all citizens have access to quality healthcare services, regardless of their income or social status.

Q: What is the role of the Galang Health Center in the JKN program?

A: The Galang Health Center is a primary healthcare facility that plays a crucial role in the JKN program. The center provides basic healthcare services to the community, including preventive care, curative care, and referral services.

Q: What are the challenges faced by the Galang Health Center in implementing the referral system?

A: The Galang Health Center faces several challenges in implementing the referral system, including inadequate human resources, incomplete medical device facilities, and a lack of access to necessary medications and treatments.

Q: What are the recommendations provided by the study to improve the referral system at the Galang Health Center?

A: The study provides several recommendations to improve the referral system at the Galang Health Center, including training and competency improvement, improvement of facilities, evaluation of drug needs, and socialization and education.

Q: What is the importance of training and competency improvement in the referral system?

A: Training and competency improvement are essential in the referral system to ensure that healthcare workers have the necessary skills and knowledge to provide quality care to patients. This includes screening patients who need referrals, providing accurate and timely referrals, and ensuring that patients receive the necessary medical attention and care.

Q: What is the role of socialization and education in the referral system?

A: Socialization and education play a crucial role in the referral system by increasing public understanding of applicable referral procedures. This can help reduce referral abuse and increase the efficacy of health services.

Q: What are the benefits of implementing the recommendations provided by the study?

A: Implementing the recommendations provided by the study can improve the quality of health services at the Galang Health Center, minimize referral rates, and support the success of the JKN program in achieving its goals.

Q: What are the limitations of the study?

A: The study has several limitations, including the small sample size and the qualitative approach used. The study also relies on the perceptions and experiences of the informants, which may not be representative of the entire population.

Q: What are the future research directions?

A: Future research should focus on evaluating the effectiveness of the recommendations provided in this study, and on identifying the challenges and limitations faced by other health centers in implementing the referral system. Future research should also focus on developing a more comprehensive and standardized referral system, and on improving the quality of health services at the first level.

Q: What are the implications of the study for policy makers and healthcare providers?

A: The study has several implications for policy makers and healthcare providers, including the need to improve the referral system, provide training and competency improvement, and increase access to necessary medications and treatments. The study also highlights the importance of socialization and education in the referral system.

Q: What are the recommendations for future research?

Q: What are the conclusions of the study?

A: The study concludes that the Galang Health Center faces several challenges in implementing the referral system, including inadequate human resources, incomplete medical device facilities, and a lack of access to necessary medications and treatments. The study provides several recommendations to improve the referral system, including training and competency improvement, improvement of facilities, evaluation of drug needs, and socialization and education.