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Jurnal JKN
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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 79 Documents
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Efisiensi dan Produktivitas BPJS Kesehatan Tahun 2014 – 2021 (Metode Data Envelopment Analysis dan Malmquist Index) Selvia Rustyani; Diah Sofiawati; beti rahmawati
Jurnal Jaminan Kesehatan Nasional Vol. 3 No. 2 (2023): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v3i2.145

Abstract

Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS Kesehatan) is a legal entity formed to administer the National Health Insurance program (named JKN) with the principles of social health insurance. Management of social security funds (named DJS) carries high risks. To measure the sustainability of the JKN program, BPJS Kesehatan is required to perform efficiently and productively. This study aims to measure Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS Kesehatan) 's efficiency and productivity from 2014 to 2021. The calculations in this study are relative, not absolute. This non-parametric quantitative research uses Data Envelopment Analysis (DEA) and Malmquist Productivity Index (MPI) methods. This study uses an intermediation approach with BPJS Operational Expenses (X1) as input variables, then Contribution Income (Y1) and Health Insurance Expenses (Y2) as output variables. The results showed that BPJS Kesehatan had inefficiencies in 2014, 2016, 2017 and 2018. As for 2015, 2019, 2020, and 2021, BPJS Kesehatan has achieved an optimal efficiency value of 100%. The Malmquist Index measurement shows that BPJS Kesehatan has experienced an increase in productivity with a score of > 1, except in the second year (2015 – 2016).
Korelasi Disparitas Tenaga Kesehatan Puskesmas Terhadap Pelayanan Kesehatan Primer Peserta Jaminan Kesehatan Nasional Kabupaten Poso Ryandti Ruslang Ruslang; Diah Ayu Puspandari
Jurnal Jaminan Kesehatan Nasional Vol. 3 No. 2 (2023): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v3i2.162

Abstract

Poso Regency is one of the regions that has achieved universal health coverage. However, based on the data from BPJS Kesehatan in 2022, the percentage of participants referred with non-specialistic diagnoses from Primary Health Care Facilities (FKTP) is still significant. This is related to the role of FKTP as a gatekeeper in primary care services. This research aims to describe the performance of Puskesmas as gatekeepers in controlling referrals by linking the availability of healthcare personnel to referral rates. This research is a quantitative approach with secondary data sourced from BPJS Kesehatan. It was found that the p-value for the ratio of doctor is very borderline (0.05) concerning the number of referrals. Additionally, there were 586 referrals with specialized diagnoses that were eventually coded as non-specialistic diagnoses in hospitals, with 210 of them coded as H.521, which should have been managed at the Puskesmas. It is recommended that the central government consider the distribution of healthcare personnel from outside the region through temporary work agreements. Furthermore, based on the significant number of non-specialistic referrals, particular attention should be given to referrals to the eye clinic (Poli mata), which may be indicative of eyeglass services. Therefore, it is advisable to consider policy changes so that participants seeking eyeglasses can undergo examinations at the community health centers according to the standard competency of doctors, supplemented by supporting training to ensure certified practitioners conduct the examinations.
Strategi Pemerintah Desa dari Berbagai Tingkat Cakupan Peserta Menuju UHC di Kabupaten Karimun Endang Lestari; Diah Ayu Puspandari
Jurnal Jaminan Kesehatan Nasional Vol. 3 No. 2 (2023): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v3i2.165

Abstract

The government issued Presidential Instruction No. 1 of 2022 concerning Optimizing the Implementation of the JKN Program. Coverage of JKN participants in Karimun Regency is 83.28%. This study aims to explore village government strategies with various levels of participant coverage in achieving UHC in Karimun Regency. The method used in this research is a qualitative approach based on thematic analysis. Data was collected through Focus Group Discussions, in-depth interviews, and literature reviews. The research subjects were village governments with the highest, medium, and lowest UHC achievements on Karimun Island in Karimun Regency. The village government's strategy in achieving UHC included data collection and identification of individuals whom JKN does not cover; actively involving the participation of cadres of Posyandu, Posbindu and village midwives; providing education and advice; proposing JKN for poor society to the local government, and collaborating with sub-district offices and the Health Office in submitting PBIs. Implementation of this strategy is constrained by the absence of regulations regarding using village funds for JKN registration, limited funds, and JKN budgeting requires significant funds. There is a gap between the highest and lowest UHC village government strategies, including the active involvement of community cadres in the highest UHC village government. It is recommended that the most subordinate UHC village government involve the active participation of cadres from the community. The BPJS Kesehatan are advised to socialize Presidential Instruction No. 1 of 2022 to the village government
Kualitas Hidup Peserta Prolanis Diabetes Melitus Tipe II: A Systematic Review Feby Febriany Feby Febriany
Jurnal Jaminan Kesehatan Nasional Vol. 3 No. 2 (2023): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v3i2.169

Abstract

Indonesia is facing a triple burden of diseases, where non-communicable diseases experience an increase in incidence every year, one of which is Diabetes Mellitus. One program for preventive measures and further complications is prolanis as a form of improving the quality of life of diabetes mellitus type 2 sufferers. The aim of this research is to see a picture of the quality of life of prolanis participants, especially diabetes mellitus type 2. Articles were searched using the GARUDA and Google Scholar databases. The flow of the systematic review method used PRISMA which ultimately resulted in 10 articles relevant to the research. The results showed that the majority of prolanis diabetes mellitus type 2 participants had a moderate quality of life, which was influenced by several factors such as prolanis club activity, environmental support, and adherence to taking medication.
Analisa Deskriptif Google Review Untuk Mengukur Kepuasan Peserta di Kantor Cabang Lingkup Kedeputian Wilayah XII Teguh Wijaya teguh wijaya; fanny Wiramijaya; yulisna christin
Jurnal Jaminan Kesehatan Nasional Vol. 3 No. 2 (2023): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v3i2.171

Abstract

BPJS Kesehatan as a public institution mandated to organize the National Health Insurance has a big challenge related to participant satisfaction as it has entered a decade of implementing the National Health Insurance (JKN), BPJS Kesehatan is required to continue to improve satisfaction to participants, Currently, there are many ways or methods used by participants to express satisfaction or dissatisfaction with services, one of which is providing reviews through social media in the form of google reviews, related to this, researchers researched the level of participant satisfaction with BPJS Health services at branch offices throughout Deputy Region XII. This research uses descriptive research methods, namely research with an approach based on symptoms systematically and accurately regarding the characteristics of certain populations or regions, and combined with document analysis research or content analysis. The purpose of this study is to determine the level of branch office services based on the results of reviews conducted by participants through Google reviews, based on research participants who get services at the Branch Office give a rating of 4. 6 with a maximum rating scale of 5, then for the reviews given by participants, researchers categorized them according to the dimensions of the quality of participant services, namely Physical Evidence (Tangibles), Reliability, Responsiveness, Assurance, Empathy Emphaty, based on these dimensions there were 110 reviews for the July 2022-July 2023 period with the results of 106 reviews or 96.36% of participants expressing their satisfaction by giving the maximum rating of 5.
JESAYA Innovation for Reducing MMR and IMR in Barito Utara Regency (Case Study) Nancy Nancy; vanny Frida; Widiantoto saputro; zhafirah yanzli anisah; achmad zainuddin; frit tarong; erna susanti
Jurnal Jaminan Kesehatan Nasional Vol. 3 No. 2 (2023): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v3i2.173

Abstract

A major strategic priority of Barito Utara Regency is maternal and neonatal health issues since the maternal mortality rate (MMR) and infant mortality rate (IMR) have fluctuated with an increasing trend from 2016 to 2022. This case discusses innovation at Kandui Public Health Centre in Gunung Timang Subdistrict as the only thriving area that brought down IMR and MMR to zero for five consecutive years (2019-2023). Despite the benefits of JESAYA (Jembatan Bersalin Sayang Anak/Child-Friendly Maternity Bridge) innovation being recognised, its adoption rate by other public health centres remained low. This study aims to identify the intrinsic factors influencing the diffusion of JESAYA. To study these issues adequately, a qualitative case study with a phenomenological approach was selected using various data collection techniques, including interviews with nine research subjects, observation, and documentation. The results suggest that adopting innovation is not straightforward, and its intrinsic factors play a crucial role in its success. Additionally, it appears that the process of adopting JESAYA has a social component, which collegial interactions and discussions may facilitate.
Analisis Komunikasi Efektif Terhadap Capaian Kapitasi Berbasis Kinerja di Fasilitas Kesehatan Tingkat Pertama Kabupaten Bengkayang Nanda Elok Juwita; Dwi Santoso
Jurnal Jaminan Kesehatan Nasional Vol. 3 No. 2 (2023): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v3i2.175

Abstract

The achievement of Performance-Based Capitation (KBK) at the First Level Health Facility (FKTP) of Bengkayang Regency has increased from June 2020 to June 2023. Of the total 24 FKTPs that work together, there are 13 FKTPs that have achieved 100% KBK. This achievement was obtained through effective communication carried out between BPJS Kesehatan Bengkayang and FKTP. The purpose of this study is to analyze the success of effective communication applied, then associated with the theory of the REACH (Respect, Emphaty, Audible, Clarity, Humble) principles that have been applied and interpersonal communication. The method used was qualitative research in-depth interview, with the informant's selection technique based on the inclusion criteria set by researchers. 13 FKTP leaders and PICs who have 100% KBK as informants were obtained, then used qualitative data analysis from Matthew et al followed by the validity of theoretical triangulation related to the results of interviews with the REACH principle theory and 3 interpersonal communication theories namely Dual Process Theory, Advice Response Theory (ART) and Attachment Theory. The results of the study found important points from the interview including understanding, teamwork, strategy, feedback, openness, attention, responsiveness, support, communicative, friendly, and respect. These important points correspond to the REACH principles and the 3 theories of interpersonal communication analyzed.
Comparison of Operating Costs and LOS of Cesarean Section Patients Using ERACS and Non-ERACS Method Puspitasari, Cinthya Dwi Cahyani; Paripurna, Yoga; Trianasari, Nurvita
Jurnal Jaminan Kesehatan Nasional Vol. 4 No. 1 (2024): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v4i1.142

Abstract

The rate of births with cesarean section delivery in Indonesia is increasing. Along with the increasing rate, various clinical methods are used to reduce maternal morbidity and mortality, one of which is the Enhanced Recovery After Cesarean Section (ERACS). ERACS aims to speed up recovery, reduce postoperative complications, shorten length of stay (LOS) and lower patient care operational costs of cesarean section. The purpose of this study is to compare operational costs and LOS of cesarean section patients with ERACS and non-ERACS methods.The reseach used was case-control study which was carried out at RSUD dr. Rehatta Kelet from October-December 2022. This study involved 71 patients who met the inclusion criteria. Data were obtained from the patients’ medical records. The data were analyzed by mann Whitney Test using SPSS software. The result shows that the difference in LOS and operational costs using ERACS and non-ERACS was statistically significant at P=0.0001. The study concludes that ERACS method reduces LOS and operational costs compared to non-ERACS methods. The authors recommend that the association of obstetricians and gynaecologists should encourage its members to apply EARCS whenever possible.
ANALISIS KUALITAS LAYANAN MOBILE JKN MENGGUNAKAN METODE E-SERVICE QUALITY, CUSTOMER SATISFACTION INDEX (CSI) DAN IMPORTANCE PERFORMANCE ANALYSIS (IPA) SAPUTRA, HADI; ISTIQOMAH, RINITA
Jurnal Jaminan Kesehatan Nasional Vol. 4 No. 1 (2024): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v4i1.180

Abstract

Mobile JKN is an application facilitating remote access to services under the national health insurance program managed by BPJS Kesehatan, offering numerous features for participant convenience. As of June 2023, registrations in the Surakarta area reached 92,101. This study evaluates the service quality of the Mobile JKN application using e-service quality, Customer Satisfaction Index (CSI), and Importance-Performance Analysis (IPA) methodologies. A quantitative approach focused on 100 participants visiting the Surakarta BPJS Kesehatan branch. The results of this research are that participants who use the Mobile JKN application are satisfied with the Mobile JKN application service, with an average gap value of 0.06 (positive value), and a CSI value of 81.4%, which indicates that participants are satisfied with the Mobile JKN service. IPA results identified three indicators as top priorities for further enhancement and quality improvement.
Fraud Prevention System with Whistleblowing System in Health Services: A Systematic Review Ridwan, Ridwan; Munadi, Said; Fahlevi, Heru; Nadirsyah, Nadirsyah
Jurnal Jaminan Kesehatan Nasional Vol. 4 No. 1 (2024): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v4i1.182

Abstract

The objective of this study is to ascertain the strategies employed in mitigating fraudulent activities within the realm of health services through the utilization of a whistleblowing mechanism. Methods: The present study employed a systematic review approach to examine relevant literature by utilizing specific keywords such as "whistleblowing system" and "fraud Healthcare." These keywords were then used to search for publications in the Scopus database, focusing on journals that mostly relied on secondary data. The search was conducted using the publish or perish tool. 8. Subsequently, a curation of scholarly publications and articles was conducted, employing a criterion centered on the thematic relevance of their titles. The selected publications have the objective of mitigating fraudulent activities within the healthcare industry and other interconnected industries that contribute to research endeavors. The findings of this study suggest that the implementation of a fraud reporting system is vital inside an organization, particularly within the context of health services. To enhance the caliber of healthcare services, internal healthcare staff and participants may report well, it is imperative to establish a system that ensures the preservation of reporter confidentiality, hence facilitating an increase in the volume of reports.

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