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All Journal Jurnal Keterapian Fisik Public Health of Indonesia Jurnal Manajemen Pelayanan Publik Darmabakti Cendekia: Journal of Community Service and Engagements Mitra Mahajana: Jurnal Pengabdian Masyarakat Narra J Jurnal Jaminan Kesehatan Nasional Berita Kedokteran Masyarakat Jurnal Fisioterapi dan Kesehatan Indonesia Jurnal Kesehatan Reproduksi Journal of Indonesian Health Policy and Administration Jurnal Ekonomi Kesehatan Indonesia Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan Jurnal Ilmu Kesehatan Masyarakat Academia Open
Syarif Rahman Hasibuan
Faculty Of Medicine, Universitas Pembangunan Nasional Veteran Jakarta
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Education Engineering Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Medicine & Pharmacology Nursing Physics Public Health Social Sciences Transportation

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Referral Patterns from Primary Care to Referral Care by ICD-10 Codes in Indonesia: Cross-Sectional Analysis of National Claims Data (2017–2024) Ayu, Della Dwi; Hasibuan, Syarif Rahman; Pradnyani, Putu Erma; Widyasanti, Nisrina
Journal of Indonesian Health Policy and Administration Vol. 11, No. 2
Publisher : UI Scholars Hub

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Abstract

Primary health care (PHC) facilities serve as gatekeepers within Indonesia’s tiered health system. However, PHC referral patterns to hospitals still show substantial variation and remain insufficiently characterized by disease groupings based on the International Classification of Diseases, 10th Revision (ICD-10). This study aimed to identify the most frequently referred diagnoses from PHC to secondary or tertiary care facilities and to determine the participant characteristics associated with referrals. This observational study employed a cross-sectional design using secondary data from the National Health Insurance (Jaminan Kesehatan Nasional – JKN) claims database for the period 2017–2024. The unit of analysis was each patient visit to a PHC facility. The outcome variable was referral status (referred vs. not referred), with ICD-10 diagnostic codes as the main independent variable, while age and sex were covariates. Descriptive and inferential analyses, including binary logistic regression, were conducted to identify factors associated with referral likelihood. Of 1.2 billion visit episodes, 14% resulted in referrals to higher-level facilities. The most frequent diagnoses were classified under ICD-10 Code J (respiratory system diseases, 21.5%), yet referrals were most common among cases under Code C (neoplasms). Referrals were also more frequent among older adults and male patients.
The Association Between Sociodemographic Factors and The Return Visits Among Pediatric Tuberculosis Patients at Primary Health Care Facilities in DKI Jakarta Province Putu Erma Pradnyani; Syarif Rahman Hasibuan; Gede Wirabuana Putra
Jurnal Ilmu Kesehatan Masyarakat Vol. 17 No. 1 (2026): Jurnal Ilmu Kesehatan Masyarakat (JIKM)
Publisher : Faculty of Public Health, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26553/jikm.2026.17.1.12-21

Abstract

Indonesia is the second-largest contributor to global tuberculosis (TB) casesin 2023. Tuberculosis in children can significantly affect a child's nutritional status and growth and development. This study aimed to examine the association between sociodemographic factors and return visits among pediatric TB patients to primary health care facilities in DKI Jakarta Province. This study utilized secondary data obtained from the Indonesian Health Insurance Agency (BPJS Kesehatan) for the years 2021-2022. The sample consisted of BPJS Kesehatan participants aged ≤18 years who had been diagnosed with TB (ICD-10 A15, A16, A17, A18, and A19), had active BPJS Kesehatan membership status, and had visited an primary health care in 2021. After weighting, the sample size was 6,729 participants. The independent variables were age group, place of residence, gender, participant segmentation, and BPJS Kesehatan class. The primary outcome variable was return to visit (identifying whether patients who visited a primary healthcare facility in 2021 returned to the primary care in 2022 for a follow-up or control visit). Analysis using logistic regression. The results showed that of the 6,729 pediatric patients, 5,648 (83.9%) still had TB in 2022. Statistical analysis revealed that sociodemographic factors age category, gender, place of residence, and BPJS care class significantly correlate with return visit childhood TB in Jakarta. The results of this study are expected to serve as a basis for developing policies for the prevention and early detection of TB in children within families and communities.
SKIN HEALTH SCREENING FOR FEMALE STUDENTS AT DAARUL RAHMAN ISLAMIC BOARDING SCHOOL: SKRINING KESEHATAN KULIT UNTUK REMAJA SANTRIWATI DI PESANTREN DAARUL RAHMAN Putu Erma Pradnyani; Ima Maria; Syarif Rahman Hasibuan; Dela Riadi; Yanti Harjono; Sri Wahyuningsih
Darmabakti Cendekia: Journal of Community Service and Engagements Vol. 8 No. 1 (2026): JUNE 2026
Publisher : Faculty of Vocational Studies, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/dc.V8.I1.2026.37-43

Abstract

Background: Skin health is an important aspect of overall health because the skin is an organ that protects against the external environment. Skin diseases can spread through the living environment, especially in crowded living spaces. Screening can help identify skin problems before they become more serious conditions. Objective: The purpose of community service at Pesantren Daarul Rahman is to conduct skin health screenings for female high school students to improve their health. Method: This implementation involves health screening, specifically for skin problems, by directly observing the skin conditions of female students who reported itching, skin spots, and skin discomfort. Methods screening is a two-stage method using (1) a self-administered questionnaire on skin conditions, and (2) physical examination. Results: Of 180 female high school students, 12.2% had skin problems. They revealed several skin problems: 15 female students had scabies, 5 had a fungal infection, 1 had chicken skin, and 1 had irritant contact dermatitis. The average level of knowledge regarding the symptoms, prevention, and transmission of skin diseases was 9.05 before the educational session and increased to 9.84 after the session. Conclusion: It is hoped that the screening conditions from this community service will serve as initial data for the health of female students in the pesantren. Early screening for skin health issues will help Islamic boarding schools prevent the spread of skin diseases, such as scabies.
Cancer Survival Under Universal Health Coverage: Evidence from Indonesia's National Health Insurance System Ambo Sakka; Ede Surya Darmawan; Dumilah Ayuningtyas; Dewi Gayatri; Syarif Rahman Hasibuan
Public Health of Indonesia Vol. 12 No. 2 (2026): April - June
Publisher : YCAB Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36685/phi.v12i2.2041

Abstract

Background: Universal health coverage (UHC) aims to ensure equitable access to quality healthcare services. Indonesia's National Health Insurance (BPJS Kesehatan), covering 248.8 million people, provides unprecedented opportunities to examine cancer survival patterns under UHC implementation. However, survival outcomes and factors influencing mortality among cancer patients within this system remain underexplored. Objective: To analyze survival outcomes and identify factors associated with mortality among cancer patients covered by Indonesia's National Health Insurance from 2017-2023. Methods: A retrospective longitudinal cohort study was conducted using BPJS Kesehatan administrative data. From a database of 2.501.251 JKN participants, 2.444 patients with cancer diagnoses (ICD-10: C00-C97) were identified. After applying eligibility criteria, 330 patients diagnosed since 2017 were eligible, with 316 patients included in final analysis after excluding incomplete data. Cox proportional hazards regression was employed to identify factors associated with survival time. Variables analyzed included comorbidity status, insurance scheme type, regional healthcare access, regional setting, age groups, and gender. Results: The analysis included 316 cancer patients with overall mortality rate of 52.8%. Female patients comprised 64.9% of the cohort, with 47.8% in the 40-59 years age group. Urban (Kota) patients represented 77.5%. Patients with documented mild complications showed significantly better survival (HR=0.360, 95% CI: 0.331-0.392, p<0.001) compared to those without complications. Severe complications also demonstrated improved survival (HR=0.482, 95% CI: 0.440-0.527, p<0.001). Insurance scheme type emerged as a critical factor, with PBI APBN patients showing 2.3-fold increased death hazard (HR=2.306, 95% CI: 2.086-2.548, p<0.001), while PBPU patients had 55% reduced hazard (HR=0.445, 95% CI: 0.412-0.479, p<0.001). Substantial regional variations were observed, with Regional 3 showing 3-fold increased death hazard (HR=2.957, 95% CI: 2.682-3.260, p<0.001). Age group 40-59 years demonstrated optimal survival (HR=0.553, 95% CI: 0.514-0.596, p<0.001). Female patients showed 26% increased death hazard (HR=1.259, 95% CI: 1.185-1.338, p<0.001), and rural (Kabupaten) patients had 54% increased survival (HR=1.535, 95% CI: 1.426-1.653, p<0.001) compared to urban patients. Conclusion: Cancer survival outcomes under Indonesia's universal health coverage system are significantly influenced by insurance scheme type, complication documentation status, regional healthcare access, urban-rural disparities, age, and gender, revealing substantial inequities within the UHC framework that require targeted policy interventions to achieve equitable cancer care.
Analysis of Equity in Access to Cataract Surgery Services Among BPJS Kesehatan Participants Ikhsan, M; Hasibuan, Syarif Rahman; Widyasanti, Nisrina; Utomo, Wahyudi; Akbar, Taufik
Jurnal Manajemen Pelayanan Publik Vol 10, No 2 (2026): Jurnal Manajemen Pelayanan Publik
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jmpp.v10i2.69399

Abstract

Cataract is the leading cause of avoidable blindness worldwide, yet equitable access to surgery remains a challenge despite universal health coverage. This study examines equity in cataract surgery utilization among participants of Indonesia’s national health insurance program using logistic regression and a multilayer perceptron (MLP) model. Findings show that age, sex, marital status, place of residence, and insurance segment are significantly associated with surgery utilization. Male participants, older age groups, and certain insurance segments are more likely to undergo surgery, indicating structural inequities in access. These findings underscore the need to strengthen referral mechanisms, reduce access barriers, and improve public service management policies within JKN to advance equity in essential eye care services.
HEALTH EDUCATION IN THE PREVENTION OF WORM INFESTATION USING BOOKLETS FOR TODDLERS Dela Riadi; Yanti Harjono Hadiwiardjo; Syarif Rahman Hasibuan; Putu Erma Pradnyani; Melly Kristanti; Dwi Arwandi Yogi Saputra; Gita Aprilicia
Mitra Mahajana: Jurnal Pengabdian Masyarakat Vol. 7 No. 1 (2026): Volume 7 Nomor 1 Maret 2026
Publisher : LPPM Universitas Flores

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37478/mahajana.v7i1.7435

Abstract

In Indonesia, soil-transmitted worm infestation remains a serious public health problem, especially for young children. The high incidence of worms increases the risk of stunting, anemia, and malnutrition in children. Prevention efforts are hampered by low public awareness and the belief that worms are not a serious disease. The objective of this community service project is to educate mothers of toddlers and Integrated Health Post cadres about worm prevention. Counselling and health education through booklets are among the techniques used at integrated health post Kemuning A, Ratu Jaya Community Health Center. Participants in this activity consisted of 17 mothers of toddlers and 9 cadres from the integrated health post. On December 17, 2025, the activity was carried out through counselling, discussions, and a question-and-answer session. The results of a qualitative evaluation showed that mothers' awareness of risk factors and how to prevent worms had increased, as had the cadres' knowledge, awareness, and confidence in educating the community. It was concluded that by using Integrated health post-based education strategies, this program succeeded in empowering the community to prevent worms in toddlers.
Pola Rujukan Penyakit Saluran Pernapasan di Fasilitas Kesehatan Tingkat Pertama: Tantangan Gatekeeper Program Jaminan Kesehatan Nasional di Jakarta Hasibuan, Syarif Rahman; Natasha, Melrose Holy; Ramadan, Fatih Jihadi
Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan
Publisher : UI Scholars Hub

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Abstract

Program Jaminan Kesehatan Nasional yang diselenggarakan oleh Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan mewajibkan Fasilitas Kesehatan Tingkat Pertama (FKTP) untuk menyeleksi kasus yang memerlukan rujukan. Penyakit saluran pernapasan yang menjadi penyebab utama kunjungan ke FKTP memiliki pola rujukan yang masih belum banyak diteliti. Oleh karena itu, dilakukan penelitian untuk melihat pola rujukan penyakit saluran pernapasan di FKTP dan mengetahui faktor yang berasosiasi dengan keputusan rujukan. Penelitian potong lintang ini dilakukan terhadap 89.225 klaim FKTP di Jakarta pada periode 2017-2023, dengan kriteria inklusi semua kunjungan dengan diagnosis ICD-10 diseases of the respiratory system. Uji regresi logistik dilakukan untuk mengidentifikasi faktor rujukan. Sebanyak 2,9% dirujuk ke rumah sakit, dengan kelompok diagnosis chronic lower respiratory diseases yang paling banyak dirujuk (37,1%). Sementara kelompok diagnosis acute upper respiratory infections mencakup 88,3% dari total kunjungan, hanya 0,7% yang dirujuk. Dibandingkan dengan kelompok diagnosis other acute lower respiratory infections, kelompok diagnosis chronic lower respiratory diseases memiliki kemungkinan rujukan yang lebih tinggi (OR=1,66; 95% CI=1,63–1,70), sedangkan kelompok diagnosis acute upper respiratory infections memiliki kemungkinan lebih rendah (OR=0,01; 95% CI=0,01–0,01). Disimpulkan bahwa sebagian besar kasus respirasi dapat ditangani di FKTP, namun variasi rujukan antarkelompok diagnosis, jenis fasilitas, dan wilayah mengindikasikan perlunya penguatan kapasitas layanan primer yang merata.
Co-Authors Adang Bachtiar Adisasmito, Wiku Bakti Bawono Ambo Sakka Candi, Cicilya Damayanti, Elok Dela Riadi Della Dwi Ayu Dewi Gayatri Diah Rohmatullailah Dian Kusuma Dieta Nurrika Dumilah Ayuningtyas Dwi Agustina Dwi Arwandi Yogi Saputra Ede Surya Darmawan Ede Surya Darmawan Ede Surya Darmawan Erma Pradnyani, Putu Fariz Rahmansyah Gede Wirabuana Putra Gita Aprilicia Ima Maria M Ikhsan M Ikhsan Melly Kristanti Nadia Trisna K Natasha, Melrose Holy Nisrina Widyasanti Novia Anasta Permanasari, Vetty Yulianty Prasetyo, Chandra Istanti Ramadan, Fatih Jihadi Rifa Fauziyyah Rinka Citra Awinda Sabarinah Prasetyo Sabarinah Sabarinah Santoso, Mahar Sri Wahyuningsih Taufik Akbar Ulfi Hida Zainita Utomo, Wahyudi Widyasanti, Nisrina Yanti Harjono Yanti Harjono Hadiwiardjo Yeni Mahwati Yudha Asy'ari