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All Journal Jurnal Keperawatan Journal of Language and Health Asmara
Shafitri Nire Pangestika
Universitas Muhammadiyah Gombong
Humanities Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Health Professions Languange, Linguistic, Communication & Media Nursing Public Health Social Sciences Other

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Efektivitas Sistem Rujukan Berjenjang Jaminan Kesehatan Nasional pada Fasilitas Kesehatan Tingkat Pertama: Tinjauan Sistematis Aspek Manajerial dan Operasional Shafitri Nire Pangestika; Aidatul Mufidah; Riski Yudhi Prasongko
Journal of Language and Health Vol. 6 No. 4 (2025): Journal of Language and Health: December 2025
Publisher : CV. Global Health Science Group

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/jlh.v6i4.1381

Abstract

Sistem rujukan berjenjang dalam program Jaminan Kesehatan Nasional merupakan komponen strategis dalam menjamin kontinuitas pelayanan kesehatan yang efektif dan efisien, khususnya pada Fasilitas Kesehatan Tingkat Pertama sebagai gerbang awal pelayanan. Dalam implementasinya masih ditemukan berbagai kendala baik dari sisi manajerial maupun operasional yang berpotensi mempengaruhi efektivitas sistem rujukan. Tujuan untuk menganalisis efektivitas sistem rujukan berjenjang Jaminan Kesehatan Nasional  pada Fasilitas Kesehatan Tingkat Pertama ditinjau dari aspek manajerial dan operasional melalui pendekatan tinjauan sistematis literatur. Penelitian ini menggunakan literature review dengan penelusuran artikel ilmiah yang relevan pada basis data nasional dan internasional, seperti Google Scholar, PubMed, ScienceDirect, Garuda (Garba Rujukan Digital) dan Portal jurnal nasional terakreditasi (SINTA) yang dipublikasikan dalam rentang waktu tahun 2010 sampai tahun 2020 dan didapatkan 13 artikel. Seleksi artikel dilakukan berdasarkan kriteria inklusi dan eksklusi yang telah ditetapkan. Hasil seleksi didapatkan 6 artikel yang dianalisa. Analisis dilakukan secara deskriptif dan tematik. Tinjauan menunjukkan bahwa efektivitas sistem rujukan berjenjang di Fasilitas Kesehatan Tingkat Pertama dipengaruhi oleh faktor manajerial, meliputi perencanaan, kebijakan, ketersediaan sumber daya manusia, serta sistem informasi rujukan, dan faktor operasional yang mencakup kepatuhan terhadap alur rujukan, kelengkapan sarana prasarana, koordinasi antar fasilitas kesehatan, serta pemahaman peserta Jaminan Kesehatan Nasional  terhadap prosedur rujukan. Ketidakefisienan pada aspek tersebut berdampak pada tingginya rujukan yang tidak sesuai indikasi medis dan beban pelayanan di fasilitas kesehatan rujukan lanjutan. Sistem rujukan berjenjang Jaminan Kesehatan Nasional pada Fasilitas Kesehatan Tingkat Pertama belum berjalan optimal. Tingginya angka rujukan dipengaruhi oleh keterbatasan sumber daya manusia, ketidakoptimalan penerapan standar operasional prosedur, keterbatasan sarana prasarana dan obat-obatan, serta rujukan yang tidak sepenuhnya didasarkan pada indikasi medis.
PEMBERDAYAAN KADER KESEHATAN DALAM SOSIALISASI SISTEM RUJUKAN JKN DI PUSKESMAS GOMBONG Shafitri Nire Pangestika; Eka Oktavia
Aspirasi Masyarakat Vol 3 No 1 (2026): Maret
Publisher : ICON Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71154/1ty4c426

Abstract

The National Health Insurance Program aims to improve equitable access to health services through a tiered referral system. However, many people still do not understand the referral mechanism, so they often go directly to advanced health facilities without first visiting primary health facilities. This community service activity aims to increase public understanding of the National Health Insurance referral system and to strengthen the role of health cadres in delivering health information. The implementation method was carried out through health education activities for community members visiting the Bayan Community Health Center in Purworejo Regency. The activities were conducted using lectures, discussions, and question-and-answer sessions with simple, easy-to-understand language, supported by basic educational media. The participants totaled 50 people, consisting of housewives, fathers, pregnant women, adolescents, and parents of toddlers. The analysis technique was descriptive, based on evaluating participants’ understanding after the health education sessions. The results showed that participants were enthusiastic, and most were able to better understand the flow of the health service referral system. Around 95 percent of participants demonstrated improved comprehension of health service procedures and the correct referral steps. This activity indicates that direct health education through counseling can enhance community health literacy and support the proper utilization of health services in accordance with the applicable referral system.
Digitalization of National Health Insurance (JKN) claims and hospital operational efficiency in BPJS Kesehatan partner hospitals: A Systematic Literature Review with Conditional Meta-Analysis Shafitri Nire pangestika; Ernawati Ernawati; Rita Rahmawati; Lazuardi Fatahilah Hamdi; Cahyu Septiwi
Jurnal Keperawatan Vol. 17 No. 2 (2026): May
Publisher : University of Muhammadiyah Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22219/jk.v17i2.45167

Abstract

Introduction: Digitalization of National Health Insurance (JKN) claims is a major administrative health reform in Indonesia; since JKN's 2014 launch, transaction volumes have exceeded 1.37 million claims per day, straining conventional paper-based systems. No prior review has systematically synthesized digitalization's cumulative impact on operational efficiency in BPJS Kesehatan partner hospitals.Objectives: This study aimed to synthesize evidence on the relationship between JKN claim digitalization and hospital operational efficiency, and to estimate the pooled effect on claim cycle time where study homogeneity permits.Methods: A Systematic Literature Review using the PRISMA 2020 protocol searched five databases—PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, and Garuda—for publications from January 2014 to December 2024. Quality was assessed using STROBE, CASP, MMAT, and AMSTAR 2, and a conditional random-effects meta-analysis targeted claim cycle time, the outcome with adequate homogeneity across studies.Results: From 438 records, 25 articles met the inclusion criteria, reporting six efficiency dimensions: claim cycle time, first-pass rejection rate, cash flow/days in accounts receivable, staff utilization, ICD coding accuracy, and administrative cost per claim. Meta-analysis of 11 homogeneous studies showed a pooled mean reduction in claim cycle time of 19.6 days (95% CI: 14.2–25.1) post-implementation, with high heterogeneity (I² = 78.4%).Conclusions: The integrated TAM-UTAUT-RBV framework explains this evidence: systems combining automated bridging with real-time validation outperform partial digitalization, with human resource competency and IT infrastructure as key contextual factors. Findings carry implications for future research and for BPJS Kesehatan, the Ministry of Health, and hospitals in prioritizing capacity-adjusted digitalization strategies.
Co-Authors Aidatul Mufidah Cahyu Septiwi Eka Oktavia Ernawati Ernawati Lazuardi Fatahilah Hamdi Riski Yudhi Prasongko Rita Rahmawati