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All Journal Mitra Raflesia (Journal of Health Science) Jurnal Jaminan Kesehatan Nasional
Amayu, Rizka
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Decision Sciences, Operations Research & Management Dentistry Health Professions Medicine & Pharmacology Public Health

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LITERATURE REVIEW : IMPLEMENTASI SISTEM PASIEN RUJUK BALIK (PRB) PADA PESERTA JKN DI FASILITAS KESEHATAN TINGKAT PERTAMA Amayu, Rizka; Hasyim, Hamzah; Syakurah, Rizma Adlia
Mitra Raflesia (Journal of Health Science) Vol 16, No 2 (2024)
Publisher : LPPM STIKES BHAKTI HUSADA BENGKULU

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51712/mitraraflesia.v16i2.451

Abstract

ABSTRAKLatar Belakang : Puskesmas sebagai fasilitator rujukan pasien, seringkali menerima rujukan balik pasien dari rumah sakit, Tujuan penelitian ini adalah untuk mengetahui gambaran pelaksanaan Program Rujuk Balik (PRB) di puskesmas meliputi penilaian beberapa aspek yang berperan dalam kelangsungan program rujuk balik. Tujuan PRB adalah meningkatkan aksesibilitas, kualitas pelayanan, dan efisiensi biaya kesehatan.  Undang-Undang Dasar 1945 memuat bahwa pemerintah harus memberikan rasa sejahtera dan sehat kepada seluruh kalangan masyarakat, hal ini diimplementasikan dalam Jaminan Kesehatan Nasional yang dilaksanakan oleh badan penyelenggara jaminan sosial (BPJS) kesehatan. FKTP sebagai garda terdepan dalam memberikan pelayanan kesehatan di Indonesia. Tujuan untuk mengetahui implementasi sistem rujukan jaminan kesehatan nasional pada FKTP. Metode : Literature Review menggunakan database Wiley Online Library, PubMed, dan serta google scholar.Metode : Desain penelitian yang digunakan pada penelitian ini yaitu literature review dengan menggunakan Google scholar dalam mencari artikel terkait terdahulu. Kriteria artikel terkait yang digunakan yaitu yang diterbitkan dari tahun 2017-2022.Hasil : Dari 79 artikel judul dan abstrak didapat 5 artikel dari yang relevan  judul dan abstrak didapat yang memenuhi kriteria inklusi dan eksklusi.terkumpul sebanyak 5 jurnal.Kesimpulan : Berdasarkan keenam jurnal tersebut didapatkan hasil bahwa sistem Rujukan Jaminan Kesehatan Nasional pada Fasilitas Kesehatan Tingkat Pertama (FKTP) sudah berjalan dengan baik di masyarakat walaupun dalam pelaksanaanya masih terdapat kekurangan di FKTP.Kata Kunci : PRB, Jaminan Kesehatan Nasional, Fasilitas Kesehatan Tingkat Pertama ABSTRACTBackground: Health centers as patient referral facilitators often receive patient referrals from hospitals. The purpose of this study was to determine the description of the implementation of the Referral Program (PRB) in health centers including an assessment of several aspects that play a role in the sustainability of the referral program. The purpose of PRB is to improve accessibility, quality of service, and efficiency of health costs. The 1945 Constitution states that the government must provide a sense of well-being and health to all levels of society, this is implemented in the National Health Insurance implemented by the health social security administration body (BPJS). FKTP as the front guard in providing health services in Indonesia. Purpose: to determine the implementation of the national health insurance referral system at FKTP. Method: Literature Review using the Wiley Online Library, PubMed, and Google Scholar. Method : The research design used in this study is a literature review using Google Scholar to search for previous related articles. The criteria for related articles used are those published from 2017-2023. Conclusion : From 79 articles with titles and abstracts, 5 articles with relevant titles and abstracts were obtained that met the inclusion and exclusion criteria. A total of 5 journals were collected. Based on the six journals, the results showed that the National Health Insurance Referral System at Primary Health Facilities (FKTP) had been running well in the community, although in its implementation there were still shortcomings at FKTP.Keywords: PRB, National Health Insurance, Primary Health Facilities
A Qualitative Study of Referral Back Programme Implementation in Palembang Health Centres for Chronic Disease hasyim, hamzah; Amayu, Rizka; Syakurah, Rizma Adlia; Misnaniarti, Misnaniarti; Windusari, Yuanita; Novrikasari, Novrikasari
Jurnal Jaminan Kesehatan Nasional Vol. 5 No. 2 (2025): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v5i2.388

Abstract

Despite the strategic intent of Indonesia’s National Health Insurance (NHI) to strengthen chronic disease management through the Referral Back Programme (PRB), its implementation at primary health centres (Puskesmas) continues to face operational and systemic barriers. This study aimed to analyse the implementation of the PRB for chronic non-communicable diseases in Palembang City. The research team employed a qualitative case study approach to explore key challenges in programme execution. The research team collected data from six purposively selected Puskesmas between July and September 2022, using in-depth interviews, focus group discussions, observations, and document reviews. They selected twenty-one informants—including BPJS Kesehatan officials, physicians, programme coordinators, and patients—using maximum-variation sampling to ensure diverse stakeholder representation. The team conducted a thematic analysis, identifying three key themes. First, organisational capacity constraints, such as staff shortages, dual workloads, inadequate training, and limited funding. Second, there are infrastructural and systemic barriers, including the lack of dedicated service corners, underdeveloped digital systems, medicine stockouts, and restricted distribution of referral tools. Third, communication and coordination gaps exist, including weak inter-agency reporting, inadequate feedback mechanisms, and limited outreach to JKN participants. These themes align with the input–process–output framework: input barriers reflected fragmented resources; process barriers involved absent guidelines and reactive supervision; output challenges included low patient adherence and insufficient reporting. These interlinked factors undermine the gatekeeping function of Puskesmas and disrupt the continuity of care for chronic conditions. Strengthening institutional capacity, aligning resources, and integrating digital infrastructure are crucial for enhancing the effectiveness and sustainability of the PRB, thereby supporting Indonesia's progress toward universal health coverage.
Co-Authors Hamzah Hasyim Misnaniarti Misnaniarti Novrikasari Novrikasari, Novrikasari Rizma Adlia Syakurah Yuanita Windusari