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All Journal International Journal of Public Health Science (IJPHS) Jurnal Kebijakan Kesehatan Indonesia Majalah Kedokteran Gigi Indonesia Jurnal Manajemen Kesehatan Indonesia Jurnal Farmasi Sains dan Komunitas Policy & Governance Review Berkala Ilmiah Kedokteran Duta Wacana Jurnal Ners The Journal of Hospital Accreditation (JHA) Jurnal Jaminan Kesehatan Nasional Indonesian Journal of Cancer Berita Kedokteran Masyarakat Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management) JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Academic Hospital Journal
Andreasta Meliala
Departemen Kebijakan Dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, Dan Keperawatan, Universitas Gadjah Mada
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Social Sciences Other

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The Caesarean Sections Claims of National Health Insurance in the East Java Region Hospital Mustofa, Tika Rahhmatillah; Meliala, Andreasta
Jurnal Jaminan Kesehatan Nasional Vol. 4 No. 1 (2024): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v4i1.188

Abstract

WHO (2015) sets the standard for sectio caesarea at 10-15%. The proportion of SC deliveries in East Java was 22.4% in 2018, higher than the national average of 17.6%. The burden of JKN financing on childbirth is increasing and is among the top 10 most CBGs cases nationally. As an effort to control quality and control costs, BPJS Health in coordination with the Quality Control Cost Control Team (TKMKB) issued guidelines and self-assessment instruments for cesarean section (SC) in 2020. This study was conducted to explore the picture of SC before and during the implementation of the SC Self-Assessment Instrument in National Health Insurance patients in East Java. Of the 837,809 study subjects, 247,508 (60.5%) had SC delivery. Sectio Caesarea delivery of National Health Insurance patients at FKRTL in East Java is associated with individual factors, namely age and type of JKN membership and service factors, namely SC Self-Assessment Instrument, class of care, severity level, and hospital type. Implementation of the SC Self-Assessment Instrument has not been optimal in reducing the SC rate. A comprehensive strategy is needed to reduce the rate of sectio caesarean delivery, including interventions for pregnant women and families; health workers, health facilities, and professional organizations.
Oxygen Systems in Indonesian Hospitals: Cross- Sectional Study and Strengthening Roadmap Meliala, Andreasta; Olivia Frans, Sandra; Hidayah, Widy; Nurfadillah, Siti; Rarasati, Srimurni; Nisa, Iztihadun; Krautmann, Michael; Magnanni, Robert
Policy & Governance Review Vol 9 No 3 (2025): September
Publisher : Indonesian Association for Public Administration

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30589/pgr.v9i3.1288

Abstract

Medical oxygen is a life-saving medicine essential to modern healthcare; however, ensuring its availability remains a critical policy challenge in low- and middle-income countries. Weaknesses in production, distribution, and preparedness often translate into inequities in access, while the COVID-19 pandemic demonstrated how governance and logistical failures can rapidly escalate into a national emergency. This study aimed to assess the oxygen system readiness in Indonesian hospitals and highlight priority gaps for reform. A cross-sectional survey was conducted in 2022 across 96 hospitals in 18 districts across five provinces. Using an adapted WHO Biomedical Equipment for COVID-19 Case Management Inventory, seven domains of oxygen readiness were evaluated: oxygen source, distribution, regulation, delivery, monitoring, power supply, and maintenance. Findings revealed that only 65% of hospitals had a complete oxygen system, with better readiness among hospitals on Java, public hospitals, and higher-class facilities (A and B). Significant disparities persist, particularly among referral hospitals outside Java and among lower-class hospitals. This study underscores the importance of embedding oxygen management explicitly into health system reform and governance frameworks. Strengthening oxygen supply mechanisms offers practical and managerial opportunities to enhance resilience, equity, and preparedness for future health emergencies.
Analysis of Physician Leadership and Leadership Development in Government-Owned Healthcare Institutions: A Mixed-Method Study Arifatul Khorida; Kartini Hasballah; Andreasta Meliala; Nurjannah Nurjannah
Jurnal Ners Vol. 9 No. 4 (2025): OKTOBER 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v9i4.50689

Abstract

Background: Physician involvement in leadership roles within healthcare institutions has been declining worldwide, despite evidence linking physician leadership with improved healthcare outcomes. Objective: To examine physicians’ leadership roles, individual characteristics, and factors influencing their leadership effectiveness in government-owned healthcare institutions in Indonesia, and to propose a contextually appropriate leadership development model. Methods: A mixed-method design was used. Phase I was a qualitative study conducted through in-depth interviews and focus group discussions with 49 physicians from 31 institutions, analyzed using thematic framework analysis (NVivo 12, COREQ guidelines). Phase II was a quantitative survey involving 358 physicians from 25 institutions, analyzed using structural equation modeling with partial least squares (SEM-PLS). Results: Qualitative findings revealed structural, personal, and managerial barriers to leadership engagement, including time constraints, administrative burdens, inadequate incentives, and political influences. However, physicians were perceived as strategic leaders due to their technical expertise, tiered experiences, and credibility in clinical management. The quantitative model demonstrated strong reliability and validity. Individual differences (experience, efficacy) significantly influenced motivation to lead (β=0.577), leadership behavior (β=0.496), and leadership outcomes (β=0.176, p<0.001). Motivation (β=0.197) and behavior (β=0.604) also significantly predicted leadership outcomes. Conclusion: Despite low participation, physicians possess leadership characteristics that positively contribute to leadership effectiveness. Physician leadership development should be institutionally driven, integrating managerial competencies with technical expertise, while addressing structural and motivational barriers.
KLAIM TIDAK LAYAK BAYAR PESERTA JAMINAN KESEHATAN NASIONAL DI LAYANAN RAWAT JALAN RUMAH SAKIT JIWA PROF. DR. SOEROJO, MAGELANG Vera Otifa; Andreasta Meliala; Yulita Hendrartini
Journal of Health Service Management Vol 19 No 4 (2016)
Publisher : Departemen of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpk.v19i4.2033

Abstract

Background: The hospital payment mechanism in National Health Insurance era used INA-CBG's package tarif. The service payment which had given by hospital was paid by Indonesian National Health Insurance Agency with claiming mechanism. There were several factors and causes that affected unfeasible payment claim which could harm the hospital. Objective: Identify the factors that caused the unfeasible payment claim, identify the cause of the unfeasible payment claim, describe the attitude of doctors, the attitude of the leader ship of the hospital, the attitude of the administration RSJS, attitude BPJS Health Magelang and describe RSJS leadership communication to the cause of the unfeasible payment claim in the outpatient service RSJS. Method: This research was an exploratory case study research with single holistic case study design. Analysis unit in this research was outpatient services in Prof. dr. Soerojo Magelang Mental Health Hospital. Research informants were specialized doctor and general practitioner RSJS, Prof. dr. Soerojo Magelang Mental Health Hospital's leaders, Prof. dr. Soerojo Magelang Mental Health Hospital's administrators, and Indonesian National Health Insurance Agency branch in Magelang City. The informant selection used purposive sampling. Data collection used in-depth interview and document observation. Result: The cause of unfeasible payment claim consisted of medical services cause and administrative cause. The cause of medical services most that one episode of outpatient, one episode of inpatient and diagnosis is not emergency. The data difffference between BPJS Kesehatan and medical record, non-emergency diagnosis that considered as emergency diagnosis, one episode of outpatient/inpatient considered as two episodes of outpatient/inpatient. The communication RSJS leaders about unfeasible payment claim is not optimal, the attitude doctor's with less information, the rules have not been clearly linked specifificity RSJS in healthcare delivery, indifffference claim services were they have rendered to the participant JKN, understanding verififier BPJS about medically less in determining the unfeasible payment claim into inconsistencies, too tight in the verifification process and the workload verififier BPJS in RSJS large enough can increase in unfeasible payment claim .The attitude of the leadership of RSJS own conduct follow-up but followup information was not communicated to the doctor RSJS, the attitude of the administration RSJS who respond positively to minimize the unfeasible payment claim. Conclusion: The leaders' communication, doctor's attitude, Indonesian National Health Insurance Agency's attitude and the unpresented operational standard, and procedure in determining steps of unfeasible payment claim were factors that could enhance the incidence of unfeasible payment claim.
Strengthening intensive care training in response to COVID-19: lessons for medical education Helmi, Mochamat; Sari, Djayanti; Sulistyowati, Yenny; Meliala, Andreasta; Nurrobi, Tjahja; Ratmono, Tugas; Trisnantoro, Laksono
International Journal of Public Health Science (IJPHS) Vol 15, No 1: March 2026
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v15i1.22918

Abstract

Frequent updates to clinical guidelines during the COVID-19 pandemic have posed significant challenges for audit processes, quality improvement, and the preparedness of healthcare professionals, particularly in intensive care settings. This study aimed to explore the impact of COVID-19-related demands on medical education and training from the perspective of healthcare teams working in intensive care units (ICUs) in Indonesia during the first wave of the pandemic. A qualitative design was employed using semi-structured interviews and focus group discussions with medical personnel directly involved in the care of COVID-19 patients at national referral hospitals. Purposive sampling was applied to recruit participants, including general practitioners, interns, residents, anesthesiologists, and ICU consultants. A total of 66 participants were included across eight focus group discussions, each consisting of eight to nine participants. Data collection continued until thematic saturation was achieved. Transcripts were analyzed using content analysis to identify key themes and subthemes. The analysis revealed five major themes: i) the need for continuous upgrading of knowledge and competencies, ii) the importance of innovative education and training approaches, iii) the role of professional organizations, iv) challenges encountered during training implementation, and v) time constraints. These findings highlight the urgent need for adaptive, continuous, and technology-supported training strategies to strengthen intensive care workforce preparedness during public health emergencies.
Co-Authors Abdul Azis Aditya Lia Ramadona Agustino, Rizki Anang Anang Andi Sulaimana Anggita Ratna Damayanti Anggoro Budi Hartopo Anggrahini, Dyah Wulan Arifandi Arifandi Arifatul Khorida Armanda Prima Astri Ferdiana Bhintani Embriana Darwito, Darwito Dina Anjayani Dira Mediani Djayanti Sari Dwi Handono Dwi Handono Sulistyo Dwi Handono Sulistyo Dyah Anggraini Fajarwati, Prahesti Faridha Hanum Firman Firman Firman Firman Firman Fitri Haryanti Fitrina Rachmadanty Siregar Gunadi Gunadi Gustina Fajarwati Sihombing Hapsari, Wulandari Indri Henny Marchelina Hidayah, Widy Hilda Mutia Hanum Husna Yulianingsih Ika Widyastuti Arumsari Irene Waine Iwan Dwiprahasto Julita Hendrartini Kartini Hasballah Katherina Adisaputro Khonsa, Oni Krautmann, Michael Laksono Trisnantoro Laksono Trisnantoro Laksono Trisnantoro Likke Prawidya Putri Lisma Evareny, Mohammad Hakimi, Retna Siwi Padmawati Lucia Kris Dinarti Lutfan Lazuardi Magnanni, Robert Mariane Erika Pay Mochamat Helmi Mochamat Helmi Mubasysyir Hasanbasri Muhammad Reyhan Hadwiono Mustofa, Tika Rahhmatillah Nilasari Nisa, Iztihadun Nurfadillah, Siti Nurjannah Nurjannah Nurrobi, Tjahja Olivia Frans, Sandra Pratiwi, Citra Sari Prima, Armanda Purwoadi Sujatno Qaimamunazzala, Hayu Rarasati, Srimurni Ratmasari, Dewi Ratna Budi Setiani Resti Dewi Rina K. Kusumaratna Rina Kusumaratna Rizaldy T. Pinzon Rizaldy Taslim Pinzon Rizaldy Taslim Pinzon Ruth Reza Hanggraini Sarto Setyowati Siti Ayu Putriasih Sito Meiyanto Sudirman Sugianto Adisaputro Sulistyowati, Yenny Suryanti Klase Sutena, Marthinus Teny Tjitra Sari, Teny Tjitra Tjahjono Kuntjoro Tri Juli Wati Trismayanti, Ni Made Rika Tugas Ratmono, Tugas Valentina Dwi Yuli Siswianti Vena Jaladara Vera Otifa Visnu, Jodi Widyawati Wiradhika, Abdul Majid Halim Wiranto Yasmine, Rosanna Yohan Wenas Gunawan Yohana Puji Dyah Utami Yulita Hendrartini Yulita Hendrartini