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All Journal Journal of Health Service Administration and Hospital Management
Sulaiman Putra Nagaring
Universitas Negeri Gorontalo
Health Professions

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Analysis of Disparities in INA-CBGs Claim Verification Turnaround Time: A Case Study in Type C and B Regional Government-Owned Hospitals Maya Kasmita; Sulaiman Putra Nagaring
Journal of Health Service Administration and Hospital Management Vol. 1 No. 1 (2025): January, 2025
Publisher : CV. Get Press Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69855/jhsah.v1i1.368

Abstract

This study investigates disparities in the Turnaround Time (TAT) for INA-CBGs claim verification between Type B and Type C Regional Public Hospitals (RSUDs) under the National Health Insurance Program (JKN). Although the regulatory TAT standard is 15 days, verification time often deviates, impacting hospital liquidity. The research quantifies the influence of Hospital Type on TAT, controlling for Case Mix Index (CMI) (Type B CMI ≈ 1.75 vs. Type C ≈ 1.25) and Pending Claim Ratio (Type C ≈ 12.5% vs. Type B ≈ 8.5%). Employing a quantitative comparative design on secondary data from 50 RSUDs (20 Type B, 30 Type C) (2021–2024), results confirm a statistically significant disparity. Type B RSUDs achieved a mean TAT of 14.2 days (near standard), significantly shorter than Type C RSUDs at 17.8 days (exceeding standard). Multivariate analysis showed that hospital type is a strong negative predictor of TAT, suggesting administrative resources and process maturity outweigh case complexity. Policy implications emphasize the need for targeted capacity-building and improving the coder-to-bed ratio in Type C RSUDs and utilizing Type B hospitals for benchmarking best practices to optimize JKN efficiency and financial sustainability.
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.
Co-Authors Agnes Ratna Saputri Maya Kasmita