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Integrasi Sistem Pendaftaran melalui Platform Mobile JKN di RSUD. Daha Husada Kediri Cici Nila Ardila; Anggia Dini Marsaroha Panggabean; Krisnita Dwi Jayanti; Eva Firdayanti Bisono; Luthfiana Nur
Journal of Innovative and Creativity Vol. 5 No. 3 (2025)
Publisher : Fakultas Ilmu Pendidikan Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/joecy.v5i3.5524

Abstract

Currently, BPJS Kesehatan is implementing digital transformation through the Mobile JKN application. This application is expected to provide easier access and improve the quality of services for participants. However, in practice, there are still challenges, one of which is the accuracy of staff in checking patient labels, which causes difficulties in identifying patient forms. This study aims to determine the implementation of the patient registration system through the Mobile JKN application at RSUD Daha Husada Kediri. The research used a descriptive design with a quantitative approach and employed simple random sampling involving 75 patients. at RSUD Daha Husada Kediri. The research used a descriptive design with a quantitative approach and employed simple random sampling involving 75 patients. Data were collected using questionnaires. The results showed that RSUD Daha Husada Kediri has established policies regarding the Medical Record Service Guidelines and Standard Operating Procedures (SOP) for Online Registration via Mobile JKN. The implementation of registration through Mobile JKN generally runs well, as indicated by 96% of the 75 samples being in accordance with the procedures. However, some discrepancies still occur, particularly in the stage where staff have not checked patient labels before printing the SEP. It is recommended that RSUD Daha Husada Kediri provide training and socialization for registration staff regarding the registration flow via Mobile JKN, as well as education for patients to understand the registration procedures according to the SOP, so that the implementation can be more orderly and optimal.
Analisis Komparatif Biaya Klaim Pasien Diabetes Melitus Berdasarkan Tingkat Keparahan: Studi Big Data Jaminan Kesehatan Nasional Zulkifli Walangadi; Siti Qomaria Usu; Marhawati Marhawati; Cici Nila Ardila; Luthfiana Nur
Sehat Rakyat: Jurnal Kesehatan Masyarakat Vol. 5 No. 2 (2026): Mei 2026
Publisher : Yayasan Pendidikan Penelitian Pengabdian Algero

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54259/sehatrakyat.v5i2.7316

Abstract

Diabetes Mellitus (DM) poses a substantial financial burden on Indonesia’s National Health Insurance (JKN), particularly for inpatient services at Advanced Referral Health Facilities (FKRTL). The INA-CBGs payment system classifies cases by severity level to determine BPJS Kesehatan reimbursement. This study aimed to examine differences in BPJS Kesehatan claim costs according to DM severity levels among hospitalized patients. A quantitative comparative design was applied using the 2025 BPJS Kesehatan Sample Data. A total of 58,101 inpatient DM claims were analyzed using total sampling. The independent variable was INA-CBGs severity level, and the dependent variable was total BPJS Kesehatan claim cost. Data were analyzed descriptively and inferentially using the Kruskal–Wallis test followed by post-hoc Mann–Whitney U tests with Bonferroni correction. The results indicated a consistent increase in length of stay and median claim costs with higher severity levels. Median claim costs were IDR 4,038,200 for mild cases, IDR 5,748,650 for moderate cases, and IDR 8,627,650 for severe cases. Differences in claim costs across severity levels were statistically significant (p < 0.05). In conclusion, DM severity level is significantly associated with BPJS Kesehatan claim costs, indicating that the INA-CBGs system adequately differentiates reimbursement based on case complexity.
Optimasi Anggaran UHC JKN melalui Kebijakan Mapping Kepesertaan Sih Retno Widiyati; Luthfiana Nur; Mustofa Haris; Novi Anggraeni; Eny Susanti
Jurnal Ventilator Vol. 4 No. 2 (2026): Juni : Jurnal Ventilator
Publisher : Stikes Kesdam IV/Diponegoro Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59680/ventilator.v4i2.2455

Abstract

Universal Health Coverage (UHC) through Indonesia’s National Health Insurance (JKN) program aims to ensure equitable access to quality healthcare without causing financial hardship. In Bangkalan Regency, the PBPU and Local Government Contribution (BP Pemda/PBI D) segment represented around 19% of JKN participants in 2024. However, the rapid increase in membership was not supported by adequate regional budget capacity for premium payments. This study analyzed how participant mapping policies through verification and validation processes could improve budget efficiency and support the sustainability of the UHC JKN program. A descriptive qualitative approach was applied using purposive sampling involving 10 heads of primary health centers (puskesmas) and one informant from the Population and Civil Registration Office. Data were collected through questionnaires and document reviews related to JKN membership and health financing regulations, then analyzed thematically. The number of PBPU and BP Pemda participants increased from 108,779 in January to 130,097 in July 2024, while the allocated budget ceiling decreased compared to 2023. Key challenges identified included invalid participant data, weak implementation of local JKN regulations, moral hazard among financially capable residents shifting to subsidized schemes, and limited monitoring mechanisms. The study found that membership mapping through systematic verification and validation could improve targeting accuracy, reduce inefficient premium payments, and strengthen budget sustainability. Strengthened local regulations, intersectoral coordination, and funding support from DBHPR, DBHCHT, and earmarked DAU are crucial for effective implementation.