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ANALISIS FAKTOR PENYEBAB KETIDAKLENGKAPAN RESUME MEDIS RAWAT INAP PASIEN BPJS KESEHATAN DI RSI AISYIYAH KOTA MALANG Kania, Salwa Adira Kania Adira; Ningrum, Herlinda Dwi; Wildan, Moh
Jurnal Informasi Kesehatan Indonesia (JIKI) Vol. 10 No. 1 (2024): Jurnal Informasi Kesehatan Indonesia
Publisher : Politeknik Kesehatan Kemenkes Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31290/jiki.v10i1.4427

Abstract

Analysis of Factors Causing Incompleteness of Inpatient Medical Records of BPJS Health Patients at RSI Aisyiyah Malang City The incompleteness in filling out medical records often occurs in the handwriting of the attending physician (DPJP) that is difficult to read. Therefore, the casemix staff have to ask the responsible doctor again about it. When the doctor is in the room, errors in filling out the medical records can be corrected by the doctor directly, but sometimes the responsible doctor is not present, so no correction can be made to the medical records filling, resulting in pending claims. The research method used in this study is descriptive with an approach. Factors causing incompleteness of inpatient medical records of BPJS Health patients: a. Human Factors are caused by non-compliance, busyness of DPJP, and the handwriting of DPJP on the medical record form that is difficult to understand and read even though black ink ballpoints have been used. B. Method Factors are caused by procedures that are still not well implemented, resulting in incomplete medical records and no sanctions for this matter. C. Material Factors: no obstacles found for all materials or tools used are adequate. D. Machine Factors: there are no serious obstacles; even if there are obstacles in internet connection, it does not significantly affect the filling or claiming process. E. Environmental Factors: no obstacles found. F. Problem priority lies in human and method factors that cause incompleteness of medical records at RSI Aisyiyah. Keywords: Incompleteness of Medical Records, Inpatient Care, BPJS Health, Pending Claims, Hospital
GAMBARAN PENYEBAB KLAIM PENDING RAWAT JALAN PASIEN JAMINAN KESEHATAN NASIONAL (JKN) DI RSUD KANJURUHAN MALANG: GAMBARAN PENYEBAB KLAIM PENDING RAWAT JALAN PASIEN JAMINAN KESEHATAN NASIONAL (JKN) DI RSUD KANJURUHAN MALANG Rahmah, Aurelia; Ardhiasti, Anggi; Ningrum, Herlinda Dwi
JURNAL TEKNOLOGI KONSEPTUAL DESAIN Vol 2 No 2 (2025): JTKD- Maret 2025
Publisher : CV.G-Techsolutions

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.1980/jurnalteknologikonseptualdesign.v2i2.83

Abstract

Pemerintah pusat dan daerah bertanggung jawab memastikan pelayanan kesehatan yang bermutu, aman, efisien, dan terjangkau, termasuk melalui rumah sakit yang memberikan layanan rawat jalan, inap, dan gawat darurat. Kerja sama rumah sakit dengan BPJS Kesehatan penting untuk menjamin akses layanan medis bagi peserta JKN, meskipun klaim sering tertunda akibat kendala administratif, kurangnya tenaga, dan kesalahan koding. Penundaan ini menjadi hambatan signifikan bagi rumah sakit, terutama yang mayoritas pasiennya adalah peserta JKN, karena memengaruhi alur keuangan dan operasional. Metode Penelitian: penelitian menggunakan metode deskriptif, lokasi penelitian di RSUD Kanjuruhan Malang, meneliti berkas klaim pending rawat jalan periode Januari – Juli 2024, sampel penelitian diambil dengan simple random sampling sebanyak 367 berkas, yang di analisis penyebab klaim pending bedasarkan aspek administrasi, koding, dan medis. Hasil penelitian menunjukkan penyebab klaim pending rawat jalan dari aspek administrasi sebesar (38%), aspek koding sebesar (22%), dan aspek medis sebesar (40%). Kesimpulan Faktor dominan dari penyebab klaim pending adalah pada aspek medis, saran untuk RSUD Kanjuruhan Malang perlu menyusun SOP yang lebih rinci untuk menangani pasien gawat darurat, meningkatkan akurasi pencatatan diagnosa, serta mengoptimalkan proses screening awal. Selain itu, koordinasi dengan BPJS Kesehatan dan evaluasi rutin terhadap klaim pending harus diperkuat agar pelayanan lebih efisien dan klaim tertunda dapat diminimalkan.
EDUKASI DAN PELATIHAN KADER KESEHATAN UNTUK MENINGKATKAN KEPATUHAN PESERTA PROLANIS Fadila, Rizki; Retnaningtyas, Ekowati; Dewiyani, AAI Citra; Ningrum, Herlinda Dwi; Purnamasari, Ayu Tyas
Jurnal IDAMAN (Induk Pemberdayaan Masyarakat Pedesaan) Vol. 9 No. 1 (2025): Jurnal IDAMAN (Induk Pemberdayaan Masyarakat Pedesaan)
Publisher : Politeknik Kesehatan Kemenkes malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31290/j.idaman.v9i1.5248

Abstract

The Chronic Disease Management Program (Prolanis) is an effort to improve the quality of life for chronic disease sufferers through regular health monitoring and proper management. However, the level of adherence of Prolanis participants to follow the program remains a major challenge. One way to improve participant adherence is by involving health cadres who act as a link between participants and healthcare facilities. This Community Service activity aims to implement education and training for health cadres to increase participant adherence in following Prolanis. The results of the Community Service activity show an increase in cadres' knowledge about Prolanis and their skills in communicating with participants. In addition, cadres were educated to carry out measurements of height, weight, Body Mass Index (BMI), as well as blood sugar and blood pressure measurements. It can be concluded that training health cadres plays an important role in improving Prolanis participants' adherence, and this activity is expected to support the success of Prolanis implementation.
Capitation Management Through Performance-Based Capitation Mechanism of Primary Health Care in Malang, Indonesia Purnamasari, Ayu Tyas; Ningrum, Herlinda Dwi; Ardhiasti, Anggi; Zahroh, Asri Hikmatuz
Kesmas Vol. 19, No. 5
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Primary health care (PHC) has one of the largest funding sources, capitation, which BPJS Healthcare Security transfers monthly. Capitation fund receipts were frequently insufficient due to failure to meet performance-based capitation/Kapitasi Berbasis Kinerja (KBK) targets, including for PHC in Malang City, Indonesia. This study aimed to examine the management and utilization of capitation funds through a KBK mechanism. This descriptive study used a qualitative approach supported by quantitative data. This study was conducted from July to August 2023 and purposely selected nine informants from BPJS Healthcare Security, the local health office, and PHC. The interviews were transcribed verbatim and analyzed using a thematic analysis approach. Three themes were identified from data analysis: revenue allocation, utilization allocation, and budget expenditure appropriateness. The use of capitation follows the Mayor's regulations, which allocate service and operational costs. However, remaining capitation funds always occur due to unavoidable conditions. Separating accounts between capitation and other funding sources is necessary to track capitation utilization. Therefore, BPJS Healthcare Security needs to participate in capitation reporting and monitoring.
Implementasi Program Pengelolaan Penyakit Kronis (Prolanis) di Masa Pandemi COVID-19 pada FKTP di Kota Malang Purnamasari, Ayu Tyas; Ningrum, Herlinda Dwi
Jurnal Kebijakan Kesehatan Indonesia Vol 12, No 2 (2023): June
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.81641

Abstract

Penyakit kronis seperti hipertensi dan diabetes melitus tipe II menempati tiga penyakit tidak menular tertinggi di Indonesia yang dapat menyebabkan kematian. Pasien COVID-19 dengan komorbid hipertensi dan diabetes melitus tipe II berisiko mengalami gejala berat seperti gagal napas hingga kematian. Oleh karena itu, pelaksanaan kegiatan program pengelolaan penyakit kronis (Prolanis) selama masa pandemi tetap harus terlaksana melalui berbagai penyesuaian. Tujuan penelitian ini untuk mengeksplorasi bagaimana implementasi kegiatan Prolanis pada masa pandemi COVID-19 di FKTP di Kota Malang. Penelitian ini menggunakan metode kualitatif dengan teknik pengambilan data melalui wawancara mendalam, telaah dokumen, dan focus group discussion. Hasil penelitian menunjukkan aspek sumber daya manusia, sarana prasarana, anggaran, dan SOP di FKTP sudah memadai. Beberapa kegiatan mengalami perubahan selama pandemi, seperti kegiatan senam yang ditiadakan dan edukasi serta konsultasi medis dilaksanakan secara online untuk menghindari kerumunan. Output kegiatan Prolanis adalah terdapat Puskesmas yang sudah memenuhi capaian Rasio Peserta Prolanis Terkendali dan ada Puskesmas yang belum mencapai target tersebut.
Pemberian Edukasi Program Pengelolaan Penyakit Kronis (Prolanis) bagi Peserta Jaminan Kesehatan Nasional (JKN) di Wilayah Kerja Puskesmas Dinoyo Kota Malang Ningrum, Herlinda Dwi; Purnamasari, Ayu Tyas
Abdimas Galuh Vol 6, No 1 (2024): Maret 2024
Publisher : Universitas Galuh

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25157/ag.v6i1.13678

Abstract

Penyakit Diabetes Mellitus dan Hipertensi menempati peringkat tiga tertinggi penyakit tidak menular yang menyebabkan kematian di Indonesia. Pemerintah bersama dengan BPJS Kesehatan menetapkan Program Pengelolaan Penyakit Kronis (Prolanis) untuk mengontrol kesehatan pasien Diabetes Mellitus dan Hipertensi. Sasaran Prolanis adalah pasien Diabetes Mellitus dan Hipertensi yang terdiagnosa di Fasilitas Kesehatan Tingkat Pertama yang mayoritas berusia lansia. Namun tingkat partisipasi kegiatan Prolanis masih rendah. Oleh karena itu, tujuan kegiatan ini untuk meningkatkan pemahaman dan partisipasi lansia di wilayah kerja Puskesmas Dinoyo pada program Prolanis. Hasil kegiatan menunjukkan peningkatan pengetahuan peserta terkait rangkaian kegiatan Prolanis dan manfaat berpartisipasi aktif dalam kegiatan Prolanis. Peserta kegiatan juga termotivasi untuk ikut serta aktif dalam kegiatan Prolanis. Kualitas hidup yang baik bagi pasien Diabetes Mellitus dan Hipertensi dapat terwujud dengan meningkatkan partisipasi Prolanis sehingga dibutuhkan kerjasama berbagai pihak untuk mencapai tujuan.