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All Journal Journal of Health Service Administration and Hospital Management
Agnes Ratna Saputri
STIKes Fatmawati
Health Professions

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Effect of the SISRUTE Online Referral System on Reducing Inappropriate Referrals at Advanced-Level Healthcare Facilities in Indonesia Sulaiman Putra Nagaring; Agnes Ratna Saputri
Journal of Health Service Administration and Hospital Management Vol. 1 No. 2 (2025): July, 2025
Publisher : CV. Get Press Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69855/jhsah.v1i2.399

Abstract

This study addresses the widespread administrative inefficiency caused by inappropriate referrals within Indonesia’s tiered healthcare system, threatening the sustainability of the Jaminan Kesehatan Nasional (JKN) program. The purpose of this research was to quantitatively evaluate the impact of the Online Referral System (SISRUTE) implementation on reducing the inappropriate referral rate at Advanced-Level Healthcare Facilities (FKRTLs). Using a quantitative Segmented Time Series Regression Model (SRM), the analysis utilized national aggregated secondary data, defining the High Utilization Threshold (HUT) (75% adoption) as the intervention point. The results show a highly significant structural improvement post HUT, confirmed by a sustained decline in the inappropriate referral rate (β₃ = -1.15, p < 0.001), leading to a 55.2% overall decrease. Key administrative failures, such as incomplete data entry and mismatched service tiers, dropped by 79.4% and 72.2% respectively, validating SISRUTE’s role as a digital administrative gatekeeper. This evidence establishes SISRUTE’s effectiveness in optimizing resource allocation and enhancing patient flow, thereby directly supporting the financial sustainability of the JKN system. The study strongly recommends prioritizing and expanding mandatory digital referral systems like SISRUTE as a core strategy for robust national health governance and efficiency.
Operational Efficiency and Profitability: A Comparative Financial Performance Analysis of Listed Hospital Corporations (MIKA, SILO, HEAL) on the Indonesia Stock Exchange During the JKN Era Made Dewi Sariyani; Agnes Ratna Saputri
Journal of Health Service Administration and Hospital Management Vol. 1 No. 2 (2025): July, 2025
Publisher : CV. Get Press Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69855/jhsah.v1i2.407

Abstract

This study analyzes the operational efficiency and profitability of three leading hospital corporations listed on the Indonesia Stock Exchange: PT Mitra Keluarga Karyasehat Tbk (MIKA), PT Siloam International Hospitals Tbk (SILO), and PT Medikaloka Hermina Tbk (HEAL) during the National Health Insurance (JKN) era. The research addresses the empirical gap where, despite a 20-30% surge in patient volume under JKN, hospitals face a potential 15-20% margin compression due to INA-CBG’s fixed-rate tariffs. The study focuses on the impact of cost structure (Operating Expense Ratio/OER) and capital efficiency (Asset Turnover Ratio/ATR) on profitability. Using a quantitative approach over the 2019–2023 period, the study employs secondary data and applies descriptive and non-parametric statistical analyses (Kruskal-Wallis). Results reveal two distinct strategic models: MIKA’s margin quality strategy, achieving a superior Net Profit Margin (average 18.5%) and the lowest OER (48.34%) through selective non-JKN focus. Conversely, SILO and HEAL adopted a volume-driven strategy, evidenced by higher ATR (0.85x and 0.81x respectively) and BOR (up to 72.1%), but with lower profit margins. Statistical tests confirm significant differences in Return on Assets (p < 0.01) among the three corporations. These findings highlight the critical trade-off between cost control and asset utilization. The study suggests future research focus on granular cost factors and strategic decision-making processes to navigate financial sustainability under universal health coverage systems.
Co-Authors Made Dewi Sariyani Sulaiman Putra Nagaring