p-Index From 2021 - 2026
17.844
P-Index
This Author published in this journals
All Journal International Journal of Public Health Science (IJPHS) International Journal of Evaluation and Research in Education (IJERE) Jambi Medical Journal : Jurnal Kedokteran dan Kesehatan Jurnal Kebijakan Kesehatan Indonesia VISIKES Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Jurnal Kesehatan Masyarakat Andalas (Andalas Journal of Public Health) Jurnal Administrasi Kesehatan Indonesia Jurnal Keperawatan dan Kesehatan Masyarakat CENDEKIA UTAMA Jurnal Kesehatan Masyarakat (JKM) CENDEKIA UTAMA Global Medical and Health Communication Jurnal Psikologi Integratif Jurnal Manajemen Kesehatan Indonesia JIMKesmas (Jurnal Ilmiah Mahasiswa Kesehatan Masyarakat) The Indonesian Journal of Public Health Indigenous: Jurnal Ilmiah Psikologi Ekonomi Bisnis Biomedical Journal of Indonesia HIGEIA (Journal of Public Health Research and Development) SELAPARANG: Jurnal Pengabdian Masyarakat Berkemajuan Jurnal Keperawatan Silampari Window of Health : Jurnal Kesehatan Jurnal Ilmu Kesehatan Medicinus : Jurnal Kedokteran GHIDZA: Jurnal Gizi dan Kesehatan B-Dent, Jurnal Kedokteran Gigi Universitas Baiturrahmah Jurnal Kreativitas PKM Indonesian Journal for Health Sciences (IJHS) Jurnal Kesehatan Global JIK- JURNAL ILMU KESEHATAN SRIWIJAYA JOURNAL OF MEDICINE Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Majalah Kedokteran Andalas Jurnal Kesehatan J-Dinamika: Jurnal Pengabdian Kepada Masyarakat Jurnal Kesehatan Jurnal Manajemen Informasi Kesehatan Indonesia (JMIKI) Jurnal Bidang Ilmu Kesehatan J-KESMAS: Jurnal Kesehatan Masyarakat Darmabakti Cendekia: Journal of Community Service and Engagements Afiasi : Jurnal Kesehatan Masyarakat Health Information : Jurnal Penelitian Jurnal Kesmas (Kesehatan Masyarakat) Khatulistiwa Jurnal Penelitian Transportasi Laut Malahayati International Journal of Nursing and Health Science PREPOTIF : Jurnal Kesehatan Masyarakat Journal of Community Empowerment for Health An-Nadaa: Jurnal Kesehatan Masyarakat Placentum: Jurnal Ilmiah Kesehatan dan Aplikasinya Nutrix Journal Jurnal Kesehatan Bubungan Tinggi: Jurnal Pengabdian Masyarakat Jurnal Integrasi Kesehatan dan Sains Indonesian Journal of Global Health research Jurnal Pengabdian Kesehatan Jurnal Abdimas Ilmiah Citra Bakti (JAICB) Jurnal Promotif Preventif Journal of Applied Data Sciences Mitra Raflesia (Journal of Health Science) J.Abdimas: Community Health KESANS : International Journal of Health and Science Jurnal Pengabdian Masyarakat Sasambo Media Publikasi Promosi Kesehatan Indonesia (MPPKI) International Journal of Health Science & Medical Research Jurnal Jaminan Kesehatan Nasional JUMANTIK (Jurnal Ilmiah Penelitian Kesehatan) Sehat Rakyat: Jurnal Kesehatan Masyarakat Borneo Community Health Sevice Journal Journal of Public Health Sciences Jurnal Kedokteran Ibnu Nafis Eduvest - Journal of Universal Studies Jurnal Keperawatan Pro Health Jurnal Ilmiah Kesehatan JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Jurnal Pelita Sriwijaya GEMASSIKA: Jurnal Pengabdian kepada Masyarakat Jurnal Medika: Medika Sasambo: Jurnal Abdimas (Journal of Community Service) Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal) Jurnal Kesehatan Jurnal Ilmu Kesehatan Masyarakat
Claim Missing Document
Check
Articles

The natural infection rates of vaccine-preventable diseases among children: A literature review Sri Yuliani Frisilia Dewi; Misnaniarti Misnaniarti; Rizma Adlia Syakurah; Najmah Najmah; Nur Alam Fajar
Malahayati International Journal of Nursing and Health Science Vol 6, No 6 (2023)
Publisher : Program Studi Ilmu Keperawata Fakultas Kedokteran Universitas Malahayati Bandar Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v6i6.13054

Abstract

Background: Indonesia currently faces a triple burden of various disease problems, outbreaks of infectious diseases, and an increase in long-standing infectious diseases, new infectious diseases, and non-communicable diseases (NCDs). A report released in 2020 by the United Nations International Children's Emergency Fund (UNICEF) and the World Health Organization (WHO) indicated that during the Covid-19 pandemic, the postponement of routine vaccinations resulted in approximately 80 million children aged less than or equal to 12 months being susceptible to diphtheria, measles, and polio.Purpose: To review previous research in analyzing the relationship between incomplete basic vaccination and the occurrence of vaccine-preventable disease (VPD) cases.Method: This study employed a literature review design, conducting a systematic review by selecting relevant articles pertaining to the research objective. The literature study selection process was adapted from the Preferred Reporting Items for Systematic Reviews (PRISMA-ScR). Inclusion criteria for this research encompassed originality, usage of both English and Indonesian languages, keywords covering basic vaccination, adverse events following vaccination, Integrated Healthcare Centervisits, education, and the role of Integrated Healthcare Centercadres.Results: Generally, community knowledge, attitudes, family support, and the role of cadres correlated with vaccination coverage achievement. However, some studies indicated no correlation between specific variables and the infants' basic vaccination status. To enhance vaccination coverage and client satisfaction, improving community knowledge, attitudes, family support, the role of healthcare workers and Integrated Healthcare Centercadres, as well as increasing vaccine availability and vaccination guidelines, are necessary.Conclusion: To improve vaccination coverage and client satisfaction, enhancements in community knowledge, attitudes, family support, the role of healthcare workers and Integrated Healthcare Centercadres, alongside increased vaccine availability and vaccination guidelines, are essential.Suggestion: It is advisable for the community to enhance knowledge, attitudes, and support for vaccination, especially among mothers and families. The active involvement of cadres in vaccination programs and public dialogue regarding the moral ethics of vaccination also need improvement.
Analisis Mekanisme Penanganan Pengaduan di Puskesmas Makrayu Kota Palembang Sakinah, Ambar Sahnanta; Munawarah, Siti Halimatul; Safriantini, Dian; Syakurah, Rizma Adlia
Jurnal Promotif Preventif Vol 8 No 6 (2025): Desember 2025: JURNAL PROMOTIF PREVENTIF
Publisher : Fakultas Kesehatan Masyarakat Universitas Pancasakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47650/jpp.v8i6.2140

Abstract

Peningkatan kualitas layanan puskesmas menjadi prioritas penting dalam upaya memenuhi harapan masyarakat dan meningkatkan kepuasan pasien. Puskesmas Makrayu memiliki jumlah kunjungan tertinggi di Kota Palembang pada Juni–Agustus 2024 sebanyak 16.947 kunjungan, yang berpotensi menimbulkan banyak keluhan. Penelitian ini bertujuan untuk menganalisis mekanisme penanganan pengaduan di Puskesmas Makrayu, termasuk respons dan umpan balik terhadap keluhan pasien. Penelitian ini menggunakan metode kualitatif dengan pendekatan deskriptif dan teknik purposive sampling. Data diperoleh melalui wawancara dengan tujuh informan, terdiri dari Kepala Puskesmas, dua tim penanganan pengaduan, staf BPJS Kesehatan, dan tiga pasien, serta diperkuat dengan observasi dan dokumentasi. Hasil penelitian menunjukkan bahwa Puskesmas telah membangun jalur komunikasi dengan BPJS Kesehatan dan pasien, namun masih terdapat kendala berupa strategi komunikasi yang belum konsisten, keterbatasan akses informasi bagi kelompok rentan digital, dan rendahnya partisipasi masyarakat dalam menyampaikan keluhan. Jumlah staf memadai, tetapi pelatihan dan sistem dokumentasi perlu ditingkatkan, sementara SOP pengaduan belum diperbarui. Temuan ini menunjukkan bahwa mekanisme pengaduan belum terlaksana secara optimal. Penelitian ini berkontribusi terhadap penguatan kebijakan pelayanan publik di sektor kesehatan, khususnya dalam pengembangan sistem penanganan pengaduan yang lebih responsif, inklusif, dan berorientasi pada kepuasan pasien.
LITERATUR REVIEW TENTANG TANTANGAN DAN STRATEGI IMPLEMENTASI KLAIM NON KAPITASI DI PUSKESMAS Nurlida, Bella; Syakurah, Rizma Adlia; Zulkarnain, Zulkarnain
PREPOTIF : JURNAL KESEHATAN MASYARAKAT Vol. 9 No. 3 (2025): DESEMBER 2025
Publisher : Universitas Pahlawan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/prepotif.v9i3.51823

Abstract

Jaminan Kesehatan Nasional (JKN) yang dikelola BPJS Kesehatan menggunakan mekanisme kapitasi dan non kapitasi di fasilitas kesehatan tingkat pertama (FKTP). Klaim non kapitasi dimaksudkan untuk menjamin layanan di luar kapitasi, seperti persalinan dan gawat darurat. Namun, implementasinya di Puskesmas sering terkendala masalah administratif, keterlambatan pembayaran, keterbatasan sumber daya manusia (SDM), dan dinamika kebijakan. Artikel ini bertujuan mengidentifikasi tantangan dan strategi implementasi klaim non kapitasi di Puskesmas melalui telaah literatur sistematis. Penelitian ini menggunakan systematic literature review dengan standar PRISMA. Artikel dicari melalui PubMed, Scopus, Google Scholar, Garuda, SINTA, dan Neliti. Dari 45 publikasi yang ditemukan, 23 artikel memenuhi kriteria inklusi dan dianalisis secara tematik. Tantangan utama meliputi ketidaklengkapan dokumen, keterlambatan verifikasi, keterbatasan pemahaman administrasi, serta sistem informasi yang belum optimal. Strategi yang dilaporkan mencakup digitalisasi, pelatihan SDM, penguatan manajerial, dan audit internal. Meskipun solusi ini membantu, hambatan infrastruktur dan beban kerja tetap berpengaruh. Implementasi klaim non kapitasi di Puskesmas masih menghadapi hambatan multidimensi. Strategi terpadu melalui peningkatan kapasitas SDM, digitalisasi, dan penguatan manajerial diperlukan untuk meningkatkan efektivitas klaim.
SYSTEMATIC REVIEW : EVALUASI IMPLEMENTASI TERAPI PENCEGAHAN TUBERKULOSIS (TPT) DALAM MENDUKNG ELIMINASI TB DI DAERAH ENDEMIS TINGGI Destriana, Destriana; Hasyim, Hamzah; Syakurah, Rizma Adlia
PREPOTIF : JURNAL KESEHATAN MASYARAKAT Vol. 9 No. 3 (2025): DESEMBER 2025
Publisher : Universitas Pahlawan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/prepotif.v9i3.51824

Abstract

Tuberkulosis (TB) masih menjadi masalah kesehatan global dengan beban tinggi di negara berkembang, termasuk Indonesia. Terapi Pencegahan Tuberkulosis (TPT) direkomendasikan WHO untuk mencegah perkembangan infeksi laten menjadi TB aktif, khususnya pada kelompok berisiko tinggi. Meskipun efektif hingga 90%, pelaksanaan TPT di daerah endemis tinggi masih menghadapi kendala dalam cakupan, kepatuhan, dan kesiapan sistem kesehatan. Penelitian ini bertujuan meninjau pelaksanaan TPT dan perannya dalam mendukung eliminasi TB. Metode yang digunakan adalah literature review terhadap artikel terbitan 2020–2024 dari database PubMed, Scopus, dan Google Scholar. Analisis dilakukan secara tematik untuk menggambarkan efektivitas, hambatan, dan strategi pelaksanaan TPT. Hasil menunjukkan keberhasilan TPT dipengaruhi oleh dukungan kebijakan, kapasitas tenaga kesehatan, dan partisipasi masyarakat. Penggunaan regimen 3HP, digitalisasi pemantauan, serta pendekatan berbasis komunitas menjadi strategi efektif dalam meningkatkan cakupan program. Kesimpulannya, pelaksanaan TPT perlu dilakukan secara terintegrasi dan berkelanjutan guna mempercepat pencapaian target eliminasi TB tahun 2035.
EFEKTIVITAS STRATEGI ACTIVE CASE FINDING DALAM PENEMUAN KASUS TB : KAJIAN SISTEMATIS DARI STUDI GLOBAL Ferotillah, Maqh; Hasyim, Hamzah; Syakurah, Rizma Adlia
PREPOTIF : JURNAL KESEHATAN MASYARAKAT Vol. 9 No. 3 (2025): DESEMBER 2025
Publisher : Universitas Pahlawan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/prepotif.v9i3.52129

Abstract

Penemuan kasus Tuberkulosis (TB) merupakan komponen penting dalam pengendalian penyakit. Studi ini menelaah faktor-faktor yang memengaruhi efektivitas strategi Active case finding (ACF) di Indonesia melalui analisis literatur kualitatif menggunakan wawancara mendalam, focus group discussion, dan observasi partisipatif. Sintesis data dilakukan secara naratif dengan thematic analysis dan convergent integrated approach untuk memahami keberhasilan dan hambatan pelaksanaan program secara holistik. Hasil kajian menunjukkan bahwa faktor individu, termasuk tingkat pengetahuan, persepsi risiko, dan perilaku pencarian pengobatan, serta stigma sosial berperan penting dalam deteksi kasus TB. Kondisi social ekonomi, seperti kemiskinan, kepadatan penduduk, dan rendahnya pendidikan, membatasi akses terhadap fasilitas kesehatan. Faktor lingkungan, termasuk sanitasi buruk dan ventilasi tidak memadai, meningkatkan risiko penularan, sementara kapasitas sistem kesehatan, pelatihan, supervisi, fasilitas diagnostik, serta dukungan kebijakan dan integrasi lintas sektor menjadi determinan penting dalam keberhasilan ACF. Temuan ini menegaskan perlunya pendekatan holistik yang menggabungkan pemberdayaan masyarakat, penguatan SDM, dan dukungan kebijakan untuk mempercepat penemuan kasus TB, sesuai dengan rekomendasi End TB Strategy WHO.
PELAKSANAAN UJI DIAGNOSTIK COVID-19 DENGAN UJI ANTINGEN DAN RT-PCR DI PUSKESMAS MULTIWAHANA KOTA PALEMBANG Puji Lestari; Rizma Adlia Syakurah
Jurnal Kesehatan Vol. 13 No. 2 (2022)
Publisher : Sekolah Tinggi Ilmu Kesehatan (STIKes) Cirebon

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.38165/jk.v13i2.285

Abstract

Kasus COVID-19 di Kota Palembang masih mengalami peningkatan. Salah satu upaya pencegahan penyebaran COVID-19 yaitu melakukan testing dengan swab antigen dan RT-PCR. Studi ini bertujuan menganalisis gambaran pelaksanaan uji diagnostik COVID-19 dengan swab antigen dan RT-PCR di Puskesmas Multiwahana. Sebuah desain kualitatif deskriptif dengan pendekatan studi kasus digunakan dalam artikel ini. Studi dilaksanakan dari 5 Juli−6 Agustus 2021 di Puskesmas Multiwahana. Objek yang diamati adalah pelaksanaan uji diagnostik COVID-19 dengan swab antigen dan RT-PCR di Puskesmas Multiwahana Kota Palembang berdasarkan pendekatan sistem yaitu input, proses, dan output. Hasil pengamatan menunjukan kesesuaian pada komponen input dan proses. Hasil uji diagnostik Antigen COVID-19 menunjukan 57,14% suspek dan 32,45% kontak erat dinyatakan positif. Sementara uji diagnostik RT-PCR menunjukan 70,67% suspek dan 44,47% kontak erat dinyatakan positif. Mayoritas kunjungan uji diagnostik yaitu uji diagnostik Antigen yaitu 226 kunjungan. Pelaksanaan uji diagnostik di Puskesmas Multiwahana sudah berjalan baik sesuai peraturan pemerintah dan panduan Kementerian Kesehatan RI. Pihak Puskesmas Multiwahana diharapkan dapat membuat informasi alur uji diganostik, dan menyedikan kontak khusus pendaftaran dan pemantauan.Kata Kunci: COVID-19; Uji diagnostik; Antigen; RT-PCR AbstractCOVID-19 cases continue to rise in Palembang. Testing for COVID-19 using an antigen swab and RT-PCR is one way to stop the spread of the virus. This study aimed to analyze the implementation of the COVID-19 diagnostic test with antigen swab and RT-PCR at the Multiwahana Health Center. This study conducted from 5 July to 6 August 2021 at the Multiwahana Health Center. A descriptive qualitative design with a case study approach used. The COVID-19 diagnostic test with swab antigen and RT-PCR was implemented using a systems approach, namely input, proses, output These findings showed the suitability of the input and process components. The COVID-19 Antigen diagnostic test showed 57.14% of suspects and 32.45% of close contacts were declared positive. Meanwhile, the RT-PCR diagnostic test showed 70.67% of suspects and 44.47% of close contacts were positive. Antigen diagnostic tests accounted for 226 of the majority of diagnostic test visits. The implementation of the diagnostic test at the Multiwahana Health Center has implemented well according to government regulations and Indonesian Ministry of Health guidelines. The Multiwahana Health Center is expected to be able to provide information on diagnostic test flow, and provide special contacts for registration and monitoring.Keywords: COVID-19; Diagnostic test;Antigen; RT-PCR
MANAJEMEN PROGRAM PENCEGAHAN DAN PENGENDALIAN INFEKSI COVID-19 DI RUMAH SAKIT DR. SOBIRIN KABUPATEN MUSI RAWAS Catherine Dwi Augusthi Putri; Rizma Adlia Syakurah
Jurnal Kesehatan Vol. 14 No. 2 (2023)
Publisher : Sekolah Tinggi Ilmu Kesehatan (STIKes) Cirebon

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.38165/jk.v14i2.361

Abstract

Rumah Sakit Dr. Sobirin mengupayakan “Pelayanan Prima dan Berkeadilan” terutama selama pandemi COVID-19. Namun, kasus penularan COVID-19 di Kabupaten Musi Rawas, yang mungkin terkait dengan penularan oleh petugas kesehatan dan kelemahan sistem skrining, menyoroti Pencegahan dan Pengendalian Infeksi (PPI) yang tidak optimal. Oleh karena itu, rumah sakit perlu membuat program IPC yang andal. Penelitian dilaksanakan di Rumah Sakit Dr. Sobirin Kabupaten Musi Rawas. Penelitian kualitatif deskriptif ini menggunakan pendekatan studi kasus untuk melihat program PPI di RSUD Dr. Sobirin pada masa pandemi Covid-19 di Kabupaten Musi Rawas. Informan meliputi berbagai tenaga kesehatan dan tenaga pengelola PPI, serta observasi kegiatan rumah sakit yang terkait dengan program Pencegahan dan Pengendalian Infeksi (PPI). Model pendekatan yang digunakan yaitu manajemen program. Inisiasi program melibatkan tiga tahap: permintaan dan analisis proyek, identifikasi pemangku kepentingan, dan otorisasi proyek. Perencanaan mencakup tujuh aspek: ruang lingkup, sumber daya, komunikasi, jadwal, tim, tim, rencana kerja, dan struktur rincian kerja. Kegiatan utama meliputi program PPI untuk staf, pasien COVID-19, keluarga/komunitas, dan lingkungan rumah sakit. Pemantauan mencakup anggaran dan manajemen risiko, dengan pelaporan data pengawasan harian. Evaluasi meliputi evaluasi proses dan hasil. Secara keseluruhan, Program PPI di RSUD Dr. Sobirin selama pandemi COVID-19 telah berhasil, terbukti dengan meningkatnya kepatuhan staf dalam hal kebersihan tangan, penggunaan APD, penanganan peralatan perawatan pasien, pengelolaan linen, dan pembuangan limbah berdasarkan hasil pemantauan dan audit. Diperlukan penerapan kewaspadaan standar dan peningkatan keamanan lingkungan melalui pengadaan sarana, pelatihan bagi petugas kesehatan, serta penyuluhan bagi pasien dan pengunjung.Kata Kunci: Covid-19; Infeksi; Manajemen Program; Pencegahan; PengendalianAbstract Dr. Sobirin Hospital strives for 'Excellent and Equitable Service,' especially during the COVID-19 pandemic. However, cases of COVID-19 transmission in Musi Rawas District, possibly related to healthcare workers and weaknesses in the screening system, highlight suboptimal Infection Prevention and Control (IPC). Therefore, hospitals need to establish a reliable IPC program. This descriptive qualitative research, conducted at Dr. Sobirin Hospital, Musi Rawas Regency, employs a case study approach to examine the IPC program during the Covid-19 pandemic. Informants include various health workers and PPI management personnel, alongside observations of hospital activities related to the Infection Prevention and Control (PPI) program. The program management model used involves three stages: project request and analysis, stakeholder identification, and project authorization. Planning covers seven aspects: scope, resources, communication, schedule, team, work plan, and work breakdown structure. Key activities include IOP programs for staff, COVID-19 patients, families/communities, and the hospital environment. Monitoring involves budget and risk management, with daily surveillance data reporting. Evaluation includes process and outcome evaluation. Overall, the IOP Program at RSUD Dr. Sobirin during the COVID-19 pandemic has been successful, as evidenced by increased staff compliance in hand hygiene, PPE use, patient care equipment handling, linen management, and waste disposal based on monitoring and audit results. It is necessary to implement standard precautions and improve environmental safety through facility procurement, health worker training, and counseling for patients and visitors.Keywords: Control; Covid-19; Infection; Program Management; Prevention
Comparative Analysis of INA-CBGs Tariffs and Unit Cost of Cesarean Section: A Systematic Review in Indonesian Hospitals Syakurah, Rizma Adlia; Frymaruwah, Edwin; Mufarikhah, Muhimatul; Izzatika, Meiliza
Journal of Public Health Sciences Vol. 4 No. 03 (2025): Journal of Public Health Sciences
Publisher : The Indonesian Institute of Science and Technology Research

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56741/IISTR.jphs.001257

Abstract

The National Health Insurance (JKN) requires efficient, equitable, and sustainable healthcare services. However, various studies indicate discrepancies between INA-CBGs tariffs and actual hospital service costs. One of the procedures with the highest claim rates is Cesarean Section (CS), which exhibits significant disparities. This study aims to analyze the average unit cost associated with Cesarean Sections (CS) across Indonesia using the Activity-Based Costing (ABC) method. A systematic literature review (SLR) approach was employed, analyzing articles published between 2017–2024. Relevant articles were retrieved through the Google Scholar database. Of the 79 articles initially identified, 37 passed the preliminary screening, and 12 articles met all inclusion criteria. Results indicate that INA-CBGs tariffs for CS procedures only cover 25%–54% of actual costs, varying by service class, hospital location, and operational efficiency. This mismatch contributes to financial deficits in hospitals, potentially compromising service quality, restricting medical equipment procurement, and increasing healthcare professionals’ workloads. Moreover, regional cost variations demonstrate that the current tariff system inadequately considers geographic factors and service complexity. Hospitals in major cities like Bandung report nearly double the unit costs compared to regions such as Yogyakarta or Lampung. Therefore, findings highlight the necessity of reformulating INA-CBGs tariffs to better reflect hospitals' actual conditions. Without updates based on cost-of-service, the financing system risks perpetuating service disparities and reducing the quality of national healthcare. The review findings indicate that the actual cost of Cesarean Section (CS) procedures in Indonesian hospitals is significantly higher than the INA-CBGs tariffs reimbursed by BPJS, with disparities ranging from 46% to 75%.
Managing Potential Fraud in Palembang Hospitals’ Health Insurance Implementation: A Qualitative Study in Indonesia Emilya, Melda; Misnaniarti, Misnaniarti; Syakurah, Rizma Adlia; Pratomo, Hadi
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.v5i2.387

Abstract

Fraud poses a major threat to the integrity of Indonesia’s National Health Insurance–Healthy Indonesia Card (JKN-KIS) program, affecting health financing, hospital quality, and institutional reputation. Despite continuous efforts to combat fraud, allegations persist, particularly in hospitals in Palembang. This study aimed to identify potential fraud in hospitals in Palembang and analyze management countermeasures. Using a descriptive qualitative design with a phenomenological approach, the study was conducted from March to July 2022 and involved three hospitals in Palembang, the City Health Office, and the local branch of the Social Security Administrative Body for Health (BPJS Kesehatan). Data were collected through in-depth interviews with 16 informants representing hospitals, BPJS Kesehatan, and anti-fraud teams, supported by observations and document reviews. Thematic analysis revealed several fraud risks, including diagnosis manipulation, unnecessary treatment, and overcharging. Weak internal and external monitoring mechanisms fostered opportunities for fraud, often driven by financial pressure, revenue targets, and personal motives, and influenced by tenure and position within the organization. Fraud countermeasures remain suboptimal, although BPJS Kesehatan’s management shows potential that requires further improvement. Applying the Hexagon Vousina theory, this study emphasizes the need for a more comprehensive and integrated approach to fraud risk management. Strengthening oversight, professional ethics, inter-agency coordination, and policy enforcement is crucial to maintain the sustainability and effectiveness of the JKN-KIS program.
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 Achirudin Achirudin Adinda Novelia Adinda, Havivi Rizky Adrina Esther Liaw Aerosta, Danny Aerosta, Danny Kusuma Agustianto, Nicko Agustien, Melawati Ahmad Ghiffari Ahmad Taher Ahmad Taher Ainun Hafilda, Shafira Alphiano, K M Dimas Alvera Noviyan Alvera Noviyani Alyssa Poh Jiawei Amayu, Rizka Amellia Sefti Lestari Amitya Kumara Amitya Kumara Andika Okparasta Anita Rahmiwati Annisa Wimaulia Ardhan, Jery Arifal, Dito Achmad Arnita Hotmauli Asmarani Ma’mun Asmaripa Ainy Asri Maharani Asri Novianty Ayu Kartika Putri Ayu Rahmayana Ayu Shintya, Ratri Azhar, Abdillah Adipatria B. Azlin Azlin Azzahra, Muthiara Adlin Bella Stevanny Berlin, Opel Bertha Aulia Bonita, Ilsyafitri Cahyani, Dini Catherine Dwi Augusthi Putri Catherine Dwi Augusthi Putri Catherine Dwi Augusthi Putri Cerah Puspinarti Corie , Andriyani Harizta Cynthia Cynthia Danny Aerosta Deasy Novia Debby Amanda Putri Dela Erjalia Dendy Riansyah Depit Kurniawan Deris Stiawan Destanti, Ruri DESTRIANA DESTRIANA, DESTRIANA Deviany, Nur Fadhilah Dewi, Aminah Aulia Dian Natalia Dian Safriantini Dian Safriantini Dian Safriantini, Dian Diana Dewi Sartika, Diana Dewi Diani, Maria Tri Dwi Atika Sari Dwi Marissa Eddy Roflin Edi Surya Negara Eka Febri Zulissetiana Elita Sari Ella Amalia, Ella Emilya, Melda Eni Nuraini Erika Pebriyanti Erwan Alfano Eviheryanto Eviheryanto Fadillah Sari Fajar , Nur Alam Fajar Ningsih, Windi Indah Fajarini, Dessy Faradillah Dillah Fathur Afif Moulana Fatimah azzahra Fatty Maulidira Fauzan Ditiaharman Febby Astria Ferotillah, Maqh Fianirazha Primesa Caesarani Fidia Paramitha Putri Fikri, M Zainal Fikri, M Zainal Florettira, Mutiara Tri Frymaruwah, Edwin Gabriela Eliza Fabrianne Tamba Galih Cahya Wijayanti Ghita Apriani Gusrinety Gusrinety Habibah, Umrohtul Hadi Pratomo Haerawati Idris Haerawati Idris, Haerawati Hamzah Hasyim Hatina Agsari Hendarmin Aulia Henny Herawati Idris Hisar Manalu Hizazun Niswah Ilsyafitri Bonita Indah Fasha Palingga Indah Puji Septeria indah Riani Indah Yuliana Indah Yuliana Wahyu Putri Inggi Rizky Mauludyah Ira Dewi Ramadhani Iswanto Iswanto Iwan Stia Budi Izzatika, Meiliza Jafar Arifin, Jafar Jesica Moudy Jesica Moudy Kartika Chandra Khairinnisa Maizal Gazali Khairiyah, Muthiah Kurniawan, Depit Lailfasha, Fafirra Latifa Puti Sentani Latius Hermawan Legiran Legiran Levanya Anbalagan Linda Amelia Lisa Pitrianti Lusi Rahmayani Maisaroh Maisaroh Maretha, Rika Mariatul Fadilah Mariatul Fadilah Mariatul Fadilah Masayu Meidiawani Mauliana, Resty Meilinda Meilinda Meiliza Ayu Qamarani Melissa Shalimar Lavinia Merry Natalia Panjaitan Merry Natalia, Merry Michael Chandra Misnaniarti Misnaniarti Misna Misnaniarti Misnaniarti Misnaniarti Misnaniarti Misnaniarti Misnaniarti Mohammad Hilal Atthariq Ramadhan Mohammad Zulkarnain Moudy, Jesica Mufarikhah, Muhimatul Muhamad Mardian Safitra MUHAMMAD FAHMI Muhammad Farid Rizqullah Muhammad Imam Mulia Muhammad Khairul Kahfi Pasaribu Muhammad Prima Cakra Muhammad Prima Cakra Randana Muhammad Qurhanul Rizqie Muhammad Syahrul Ramadhan Muhimatul Mufarikhah Mutiara Tri Florettira Nabilah Thifal Balma Najmah, Najmah Ni Wayan Puspa Pandani Nia Novita Sari Nindya Mahfuza Ningsih, Windi Indah Fajar Nirmalasari, Melisa Yuni Novrikasari Novrikasari, Novrikasari Nur Alam Fajar Nur Alam Fajar Nurlida, Bella Nurunnisa Arsyad Ocktariyana, Ocktariyana Octavia, Nurafni Opel Berlin Panjaitan, Merry Natalia Pariyana Pariyana - Pariyana Pariyana pariyana, Pariyana Patresia, Retta Permana Putra, Dicky Permata, Debby Yulinar Pratiwi, Rizky Putri Priska Yolanda Puji Lestari Purba, Jeannita Sri Agustini Puteri, Daniyah Fitriyah Putri Agustina Fiskal Putriana Fuji Safitri Rahma Nur Islam Rahmawati Rahayu Rahmayani, Lusi Rahmiwati, Anita Rahmiwati Ramadhani, Arya Pratama Ramayanti, Indri Refiza Ananda Resiana Citra Reynold Siburian Rhaptyalyani Herno Della, Rhaptyalyani Herno Riana Agny Betry Riche Octriza Syafti Rico Januar Sitorus Rico Januar Sitorus Rico Januar Sitorus Ridhatul Aulia Putri Rindang Senja Andarini Rio Yus Ramadhani Riska Nabila Risnawati Tanung Rizki Nurul Fatimah Rizki Nurul Fatimah Rizqullah, M Farid Rony Wiranto Rostika Flora Rostika Flora Rosyila Rosyila Rudy Chendra Sakinah, Ambar Sahnanta Salesika Samiah Fitri Sangalang, Reymart V Sari Bema Ramdika Satrio Pakhrizki Selly Tiyaningrum, Selvi Marcellia Selvia Rahayu Septeria, Indah Puji Sesa Magabe Silvalena Silvalena Silvalena Silvalena Siti Ahdina Putri Siti Halimatul Munawarah Sredaran Nair J. Muralidharan Nair Sri Yuliani Frisilia Dewi Syarifah Aini Syauki Ikhsan, Diyaz Tasya Lianda Sari Taufan Bramantoro Taufik Indrajaya Titien Kesuma Tri Hari Irfani Tuzzuhro, Siti Nuraziza Ully Febra Kusuma Umrohtul Habibah Utama Ningsih, R.E Solfitri Violantina Linardi Wati, Yeni Arsika Widyandana Widyandana Wulan Dri Puspita Yayi Suryo Prabandari Yayi Suryo Prabandari Yayi Suryo Prabandari Yuanita Windusari Yuanita Windusari Yuli Zulaikha Yuliarni Yuliarni Yunika Sabatini Putri Yusri Yusri Zoraya, Sabrina Intan Zulkarnain - Zulkarnain Zulkarnain Zulkarnain Zulkarnain Zulkarnain, M Zulkarnain, Mohammad