cover
Article Per Year (5 Year)
All
Home Page
OAI Link
Editorial Team
Contact
Reviewer
Google Scholar
Contact Name
Jurnal JKN
Contact Email
jurnal-jkn@bpjs-kesehatan.go.id
Phone
+6281280885541
Journal Mail Official
jurnal-jkn@bpjs-kesehatan.go.id
Editorial Address
Jl. Letjen Suprapto Kav. 20 No.14, Cempaka Putih PO BOX 1391/JKT. Jakarta Pusat 1051 - Indonesia
Location
Kota adm. jakarta pusat,
Dki jakarta
INDONESIA
Jurnal Jaminan Kesehatan Nasional
Published by Badan Penyelenggara Jaminan Sosial Kesehatan
ISSN : 27987183     EISSN : 27986705     DOI : 10.53756
Core Subject : Health, Science,
Decision Sciences, Operations Research & Management Dentistry Health Professions Medicine & Pharmacology Public Health
Jurnal Jaminan Kesehatan Nasional merupakan salah satu bentuk upaya pengembangan dan menjadi rujukan ilmiah bagi para akademisi dan praktisi terkait Jaminan Kesehatan Nasional. Jurnal ini memuat artikel-artikel terkait bidang Jaminan Kesehatan Nasional melalui berbagai pendekatan ilmiah yang berfokus pada pembahasan mengenai Risk Pooling, Strategic Purchasing, Revenue Collection yang dapat menjadi pengayaan ilmu di bidang Jaminan Sosial Kesehatan. Selain itu, jurnal ini juga memuat berbagai aspek lainnya yang relevan, yakni Stakeholder Engagement dan Institutional Capability terkait penyelenggaraan Jaminan Kesehatan Nasional
Arjuna Subject : Umum - Umum
Articles 94 Documents
 6   7   8   9   10 
Comparative Analysis of Type 2 Diabetes Mellitus Association Patterns in Primary and Referral Care Muhtar, Muhammad Solihuddin; Hafidh, Kasyfil Azis; Ningrum, Dina Nur Anggraini; Hsu, Min-Huei
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.v5i2.389

Abstract

Understanding differential comorbidity patterns for Type 2 Diabetes Mellitus (T2DM) across healthcare levels is crucial for targeted prevention strategies in tiered systems. In this cross-sectional study, we analyzed 2023 BPJS Kesehatan claims data to examine ICD-10-coded comorbidities associated with T2DM between basic primary care facilities (FKTP) and advanced referral care facilities (FKRTL), using weighted and unweighted odds ratios. Distinct patterns emerged reflecting both appropriate care distribution and coding artifacts. FKRTL showed the highest associations with specialized diagnostic: abnormal glucose tolerance (R73, OR: 41.089), unspecified diabetes (E12, OR: 53.023), and insulin-dependent diabetes (E10, OR: 33.807). FKTP demonstrated unexpected associations with conditions beyond its diagnostic capability, notably pulmonary embolism (I26; OR: 112.912), absent in FKRTL’s top 20, suggesting follow-up coding rather than primary diagnosis. Common diabetic complications appeared in both settings: retinopathy (FKTP: OR 44.145 vs FKRTL: OR 25.980) and polyneuropathy (FKTP: OR 25.807 vs FKRTL: OR 26.482), though FKTP lacks specialized diagnostic equipment. Findings reveal appropriate healthcare distribution where FKRTL handles specialized care, while complex diagnostic codes in FKTP likely reflect monitoring of conditions initially diagnosed at referral facilities. This highlights critical interpretation challenges in administrative claims data across tiered healthcare systems managing Indonesia’s millions of T2DM cases.
Linkage Between Hospital Accessibility and Health Insurance Ownership in East Kalimantan Province Rahayu, Eka Putri; Ariyanti, Rea; Rahayu, Agustin Putri
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.v5i2.390

Abstract

Healthcare accessibility remains a persistent challenge in Indonesia, particularly in resource-limited regions where geographical barriers, transportation constraints, and financial limitations create significant disparities in health service utilization. Hospital accessibility encompasses multiple dimensions that collectively influence healthcare utilization patterns. The physical presence of healthcare facilities, commonly referred to as hospital existence, serves as the fundamental prerequisite for healthcare access. This study seeks to analyze how dimensions of hospital accessibility correlate with health insurance ownership in East Kalimantan.   2023 Indonesian Health Survey. This research was quantitative approach with cross sectional design. The population in this research refers to the population of 2023 Indonesian Health Survey, with total  . Chi square analysis was used to determine the relationship between the independent variable and dependent variable. The result shows that the independent variables that are significantly related to the health insurance ownership with p-value < 0.005, namely marital status, age group, education level and occupation. Meanwhile, sex (p-value= 0.185), residence (p-value= 0.093) and hospital accessibility (p-value= 0.134) showed no significant associations with health insurance ownership with p-value > 0.005. The lack of association between hospital accessibility and insurance ownership indicates that physical proximity to healthcare facilities is not a primary determinant of insurance enrolment decisions.
Visit Patterns of Human Immunodeficiency Virus Patients at Referral Health Facilities Zain, Paisal; Arifin, Aya Yuriestia; Hansur, Lismayana; Sjatha, Fithriyah
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.v5i2.393

Abstract

Human Immunodeficiency Virus (HIV) infection remains a health problem in Indonesia, with cases increasing annually. HIV care services in Indonesia involve Primary Health Facilities (PHF) and Referral Health Facilities (RHF). This study aims to identify patterns of HIV patient visits to RHF. This cross-sectional study used secondary data from the National Health Insurance (NHI) for 2015–2023. HIV patients were identified based on ICD-10 diagnosis codes (B20–B24), with referral status as the independent variable. Analysis was performed using chi-square tests, and visit patterns were visualized using Sankey diagrams. Of the more than one million patients, 2,532 were identified as having HIV, resulting in more than 38,000 visits. Most patients were referred from community health centers to general hospitals, primarily for outpatient care. Age was significantly associated with referral status, while other demographic factors showed no association. Overall, the referral system is functioning effectively, but strengthening service capacity in PHF remains crucial to reduce the referral burden on hospitals.
Enhancing Clinical Coding Expertise in Indonesia’s National Health Insurance Program Gultom, Novianti Br.; Saputra, Arisandy; Surini, Dwi; Erwinsyah; Novelia, Elsa; Johana; Dosiema, Vernanda; Corina, Intan; Ratnafuri, Miranti; Adi Wijayanti, Fallah; Setyawan, Dedy; Januar Prakarsa, Egar; Pali'padang, Sarman; Wardanu, Gilang Yoga; Surosa, Lia Yulianti; Langenbrunner, Jack; Blake, John
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.v5i2.408

Abstract

Coding medical records using classification systems can cause inconsistencies, sometimes leading to claim disputes. In January 2021, 440,749 disputed cases were reported, with a total disputed cost amounting to Rp873,111,325,287 for referral healthcare facility claims under the National Health Insurance (JKN). In May 2021, BPJS Kesehatan established the Clinical Coding Expert/Tim Ahli Pengodean Klinis (TAPK) for enhancing clinical coding expertise. The objective of this study was to examine the impact of establishing TAPK. We hypothesize that TAPK affects the decrease in disputed cases in 12 regions of Indonesia. We used data from the JKN Program prior to the establishment of TAPK in January 2021 as controls. We followed up on 86,272 cases for two years after its implementation (as of April 2023). Paired data from 12 regions were compared using descriptive statistics, inferential statistics (paired sample t-test), and boxplot visualization. We also described the knowledge management of clinical coding through Knowledge Spiral of Nonaka and Takeuchi. The finding showed a decrease in the number of claim dispute cases in April 2023 compared to January 2021 (by 80.43%). The average claim cases decreased from 36,729.08 (Before TAPK) to 7,189.33 (After TAPK; t = 2.620, p = 0.0238). TAPK has contributed to standardized coding practices in hospitals across regions. This study reinforces the importance of action to improve competence and organizational learning in TAPK through Knowledge Spiral Model and recommends that TAPK be more widely known to all JKN’s healthcare facilities. Future research should optimize AI-driven clinical coding while ensuring human oversight.

Page 10 of 10 | Total Record : 94

 6   7   8   9   10 

Filter by Year

2021 2025


Reset
Filter By Issues
All Issue Vol. 5 No. 2 (2025): Jurnal Jaminan Kesehatan Nasional Vol. 5 No. 1 (2025): Jurnal Jaminan Kesehatan Nasional Vol. 4 No. 2 (2024): Jurnal Jaminan Kesehatan Nasional Vol. 4 No. 1 (2024): Jurnal Jaminan Kesehatan Nasional Vol. 3 No. 2 (2023): Jurnal Jaminan Kesehatan Nasional Vol. 3 No. 1 (2023): Jurnal Jaminan Kesehatan Nasional Vol. 2 No. 2 (2022): Jurnal Jaminan Kesehatan Nasional Vol. 2 No. 1 (2022): Jurnal Jaminan Kesehatan Nasional Vol. 1 No. 2 (2021): Jurnal Jaminan Kesehatan Nasional Vol. 1 No. 1 (2021): Jurnal Jaminan Kesehatan Nasional