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Purnawan Junadi
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INDONESIA
Journal of Indonesian Health Policy and Administration
Published by Universitas Indonesia
ISSN : 24601330     EISSN : 24773832     DOI : https://doi.org/10.7454/ihpa
Core Subject : Health, Science,
Decision Sciences, Operations Research & Management Health Professions Medicine & Pharmacology Public Health
Journal of Indonesian Health Policy and Administration is a journal that presents scientific articles mainly in the field of health policy, programs, and administration. This journal is intended to disseminate research from students, lecturers, or researchers in general who are concerned about improving health efforts through program evaluation and preparing policy recommendations. The articles or manuscripts contained in the Journal of Indonesian Health Policy and Administration include the realm of research, case studies, or conceptual, and limited to literature review. It is an online open-access, blindly peer-reviewed journal that is published every 4 (four) months or 3 (three) times a year, usually in January, May, and September. This journal is published by the Department of Health Administration and Policy, Faculty of Public Health, University Indonesia . Journal of Indonesian Health Policy and Administration is also supported by the Indonesian Public Health Association / Ikatan Ahli Kesehatan Masyarakat Indonesia (IAKMI).
Arjuna Subject : Profesi Kesehatan - Profesi Kesehatan (Lain-Lain)
Articles 140 Documents
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The Effects of Input and Characteristic Factors on Contact Rate Achievement among Puskesmas in Indonesia Makarim, Iqbal Andri; Pujiyanto, Pujiyanto
Journal of Indonesian Health Policy and Administration Vol. 10, No. 3
Publisher : UI Scholars Hub

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Abstract

The contact rate is the lowest-performing indicator in the Performance-Based Capitation Payment system initiated by BPJS Kesehatan. Analysis of the 2019 National Health Facility Research (Rifaskes) data showed that less than half of Puskesmas in Indonesia achieved the target. This cross-sectional study analyzed 5,384 Puskesmas from the 2019 Rifaskes to examine the effect of input and characteristic factors on achieving the contact rate. Independent variables included health worker ratios (doctors, nurses, midwives per 5,000 participants), completeness of essential medical equipment, communication facilities, P-Care application use, and Puskesmas characteristics. Multivariate logistic regression identified four significant factors: doctor ratio (OR=1.06; p<0.0001), midwife ratio (OR=1.01; p=0.033), completeness of essential medical equipment (OR=1.16; p=0.029), and BLUD-based financial management (OR=1.13; p=0.029). These factors explained only 2.6% of the variance (Nagelkerke R²=0.026), suggesting other unmeasured influences. Policy implications include equitable distribution of health personnel, targeted procurement of essential equipment, strengthening financial autonomy through BLUD, and optimizing P-Care data utilization to improve service accessibility and performance.
Overview Of a Hospital Management Information System Using The Hot-Fit Method in Medan Hospitals in 2025 Laia, Grace Putri; Gaol, Hotmarina Lumban; Boris, Jev
Journal of Indonesian Health Policy and Administration Vol. 10, No. 3
Publisher : UI Scholars Hub

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Abstract

Hospital Management Information System (SIMRS/HMIS) is crucial in ensuring efficiency and quality in hospital services by integrating clinical and administrative functions. This study aims to evaluate the implementation of HMIS at Medan Adventist Hospital in 2025 using the Human-Organization-Technology Fit (HOT-Fit) framework. A descriptive design with total sampling was employed, involving 70 respondents comprising medical records staff, inpatient and outpatient registration staff, and ward officers. Data were collected through a structured questionnaire adapted from a validated instrument (validity 0.690–0.900; reliability 0.841–0.911) and analyzed using descriptive statistics. The results showed a high level of implementation in all HOT-Fit domains: system use (85.7%), user satisfaction (84.3%), organizational structure (82.9%), organizational environment (87.1%), system quality (92.9%), information quality (91.4%), service quality (90.0%), and net benefit (87.1%). These findings indicate that HMIS has improved efficiency, coordination, and service quality at Medan Adventist Hospital. However, challenges remain, such as incomplete data entry, occasional system downtime, and limited IT support. Continuous improvement through training, infrastructure strengthening, and organizational commitment is needed to ensure the continued benefits of HMIS.
Harmonization and Ambiguity in Regulations for Physicians with Family Medicine Competence Post-Law No. 17 of 2023 Katon, Danar Wahyu Giwang; Ayuningtyas, Dumilah; Junadi, Purnawan; Sulistiadi, Wahyu; Pattiselanno, Roberth J.; Fitria, Fitria; Alfiani, Ika Fitri
Journal of Indonesian Health Policy and Administration Vol. 11, No. 1
Publisher : UI Scholars Hub

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Abstract

Strengthening primary care services in Indonesia requires that community health centers, namely Pusat Kesehatan Masyarakat (Puskesmas), involve medical personnel with family medicine competence. However, the fulfillment of physicians with this competence, especially Primary Care Family Medicine Specialists or Spesialis Kedokteran Keluarga Layanan Primer (Sp.KKLP), still face significant obstacles. This qualitative research uses the integrated Easton's System Model and Buse's Policy Framework to analyze the dynamics of this policy. The findings reveal a gap between the strong legal foundation and weak implementation mechanisms on the ground. First, there is ambiguity in terminology and lack of harmonization among regulations, especially concerning the Sp.KKLP nomenclature, which creates confusion in terms of legal status and professional recognition. Second, an implementation gap (policy–practice gap) exists because the central government has not yet issued technical derivative regulations (technical guidelines, compensation mechanisms). Furthermore, the decentralization of authority and limited regional budgets impede the equitable placement of the Sp.KKLP. The success of the policy relies heavily on the synergy among the Ministry of Health, Health Council, Family Medicine Collegium, educational institutions such as Program Pendidikan Dokter Spesialis (PPDS) and Recognition of Prior Learning (RPL), and professional organizations such as Pengurus Besar Ikatan Dokter Indonesia (PB IDI). Recommendations include the development of technical implementation regulations, clarification of the Sp.KKLP definition, and establishment of inclusive pathways for competence enhancement such as PPDS and RPL.
Private Sector Healthcare Investment in Indonesia: Leveraging Australia-Indonesia Partnerships for Health System Transformation Neuhaus, Susan Josephine
Journal of Indonesian Health Policy and Administration Vol. 11, No. 1
Publisher : UI Scholars Hub

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Abstract

Australia and Indonesia are strategic partners with expanding bilateral trade valued at AUD 26.7 billion (2022-23). Health care partnerships between the two countries offer significant opportunities for private sector engagement. Indonesia’s large population, rapidly growing middle class, and implementation of Universal Health Coverage (UHC) through the Jaminan Kesehatan Nasional (JKN) present partnership opportunities to strengthen health system capacity, address infrastructure gaps and workforce shortages, and contribute to shared economic and prosperity goals. This study explores how Australian private healthcare investment can complement government initiatives in supporting Indonesia’s UHC while advancing Australia’s regional engagement. A descriptive qualitative analysis was conducted using Indonesian and Australian government documents, Indonesia–Australia Comprehensive Economic Partnership Agreement (IA-CEPA), Katalis Program materials, peer-reviewed literatures from Google Scholar and PubMed, industry reports (EY, Oliver Wyman, and the World Bank), and publications from international organizations (WHO, ASEAN, and OECD). The study focused on four domains: hospital infrastructure, workforce development, aged care, and digital health innovation. The study identified key investment opportunities in hospital infrastructure, workforce development, aged care, supply chain resilience, and digital health innovation. Public–private partnerships (PPP), such as Aspen Medical’s “green hospital” in Depok and Icon Group’s Bali investment, demonstrate viable case studies. The IA-CEPA provides a framework for investment, workforce mobility, and technology transfer. Strategic Australian engagement offers viable pathways to strengthen Indonesia’s health infrastructure, ease pressure on public systems and the JKN deficit burden, and advance regional health equity through coordinated, capacity-building partnerships.
Analysis of Coverage of Tuberculosis Prevention Therapy (TPT): Literature Review Rahmalina, Septia; Darmawan, Ede Surya
Journal of Indonesian Health Policy and Administration Vol. 11, No. 1
Publisher : UI Scholars Hub

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Abstract

Tuberculosis Preventive Therapy (TPT) is a crucial intervention for tuberculosis (TB) control, particularly among high-risk groups such as household contacts of TB patients and people living with Human Immunodeficiency Virus (HIV). Despite being recommended by the World Health Organization (WHO), TPT implementation still faces challenges at the primary care level. This study employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method to review 11 articles published between 2021 and 2025 that were relevant to TPT implementation in various high-TB burden countries, including Indonesia. The main barriers identified were input (logistics, training), process (tracing, education, monitoring), and output (low TPT initiation and completion coverage). A community-based approach, integrated policy support, and the use of short regimens have been shown to increase program success. These findings underscore the need to strengthen input systems, community education, and harmonize national and regional policies to support optimal TPT implementation in primary care.
The Relationship Between Accessibility Factors and Post-Inpatient Control Visits Among Non-JKN Participants at Hospital X Candaika, Putri; Ningsih, Desy Kartika; Hartono, Risky Kusuma
Journal of Indonesian Health Policy and Administration Vol. 11, No. 1
Publisher : UI Scholars Hub

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Abstract

The rate of post-inpatient control visits remains relatively low due to various factors, including accessibility. At Hospital X, 220 of non-Jaminan Kesehatan Nasional (JKN) participants scheduled for post-inpatient control visits between January and March 2025, 71.82% attended, and 28.18% did not. Patients who did not attend control visits were twice as likely to be readmitted. This study aimed to determine the relationship between accessibility and post-inpatient control visits for non-JKN participants at Hospital X. This quantitative study employed an analytical cross-sectional design, with a population of 220 patients and a sample of 142 patients selected using probability sampling. Bivariate and multivariate analyses were performed using the chi-square test and binary logistic regression analysis. The results showed a significant relationship between distance to the hospital (p = 0.000), availability of transportation (p = 0.000), and the condition of service infrastructure (p = 0.000) with post-inpatient control visits among non-JKN participants at Hospital X. The results also showed that the factor with the highest probability of increasing post-inpatient control visits was walking as a mode of transportation, which increased the likelihood by 11.759 times. In conclusion, distance accessibility, transportation availability, and the condition of service infrastructure were significantly associated with post-inpatient control visits among non-JKN participants at Hospital X. The hospital should consider providing telemedicine services for patients who live at a considerable distance. In addition, the hospital could provide free pick-up and drop-off services within a certain radius.
Accessibility and Daily Cigarette Consumption among Indonesian Adolescents: A Descriptive Study Lathifah, Noviana; Rachman, Istiqomah Hanifah; Isnaini, Anisa; Simatupang, Gloria Threesia Piliphinsa
Journal of Indonesian Health Policy and Administration Vol. 11, No. 2
Publisher : UI Scholars Hub

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Abstract

Despite restrictive regulations, Indonesia faces a high prevalence of adolescent smoking, facilitated by easy access to tobacco products. This descriptive study aims to describe cigarette accessibility patterns and daily consumption trends among Indonesian adolescents. A cross-sectional study was conducted using secondary data from the 2019 Global Youth Tobacco Survey (GYTS) involving 9,208 respondents. Descriptive analysis was performed to examine the distribution of age at smoking initiation, daily cigarette consumption, and purchasing accessibility. The majority of respondents started smoking at ≥14 years of age. Daily cigarette consumption showed an increasing trend with age, with older adolescents more likely to consume more than five cigarettes per day. Regarding accessibility, 10.78% of adolescents reported purchasing single cigarettes, and 12.27% were not refused purchase by vendors despite being underage. Overall trends indicate that greater ease of access is associated with increasing age and smoking intensity. Access to cigarettes remains largely unimpeded for Indonesian adolescents, contributing to higher consumption patterns as they age. Strict enforcement of regulations prohibiting cigarette sales to minors is therefore imperative.
Referral Patterns from Primary Care to Referral Care by ICD-10 Codes in Indonesia: Cross-Sectional Analysis of National Claims Data (2017–2024) Ayu, Della Dwi; Hasibuan, Syarif Rahman; Pradnyani, Putu Erma; Widyasanti, Nisrina
Journal of Indonesian Health Policy and Administration Vol. 11, No. 2
Publisher : UI Scholars Hub

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Abstract

Primary health care (PHC) facilities serve as gatekeepers within Indonesia’s tiered health system. However, PHC referral patterns to hospitals still show substantial variation and remain insufficiently characterized by disease groupings based on the International Classification of Diseases, 10th Revision (ICD-10). This study aimed to identify the most frequently referred diagnoses from PHC to secondary or tertiary care facilities and to determine the participant characteristics associated with referrals. This observational study employed a cross-sectional design using secondary data from the National Health Insurance (Jaminan Kesehatan Nasional – JKN) claims database for the period 2017–2024. The unit of analysis was each patient visit to a PHC facility. The outcome variable was referral status (referred vs. not referred), with ICD-10 diagnostic codes as the main independent variable, while age and sex were covariates. Descriptive and inferential analyses, including binary logistic regression, were conducted to identify factors associated with referral likelihood. Of 1.2 billion visit episodes, 14% resulted in referrals to higher-level facilities. The most frequent diagnoses were classified under ICD-10 Code J (respiratory system diseases, 21.5%), yet referrals were most common among cases under Code C (neoplasms). Referrals were also more frequent among older adults and male patients.
Prophylactic Antibiotic Analysis in Obs-Gyn, Orthopedics, Gastrointestinal Surgery at a South Tangerang Hospital, January-March 2024 Nurjaman, Evelina Endang; Andriani, Helen
Journal of Indonesian Health Policy and Administration Vol. 11, No. 1
Publisher : UI Scholars Hub

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Abstract

Inappropriate use of prophylactic antibiotics (PAs) remains a primary driver of antimicrobial resistance (AMR); however, global adherence to established prescribing guidelines remains suboptimal. This study aimed to analyze the compliance and rationality of PA prescription and to evaluate the underlying causes of physician non-adherence in obstetrics, orthopedic, and gastrointestinal surgeries at a hospital in South Tangerang City, Indonesia. Adopting a mixed-methods approach, this investigation combined a quantitative assessment of 208 surgical patient records (January–March 2024) with qualitative exploratory interviews conducted with three specialist peer group heads. This design allowed the triangulation of prescribing data with underlying clinical perspectives. PA rationality was assessed based on four criteria: indication, agent type, timing, and duration. Univariate analysis was used to examine the relationship between physician characteristics and compliance. The qualitative findings were analyzed using the Capability, Opportunity, Motivation – Behavior (COM-B) behavioral model. Overall compliance with all four PA criteria was poor, at only 9% (18 of 208 surgeries). Low adherence was particularly noted in agent selection (33%) and administration timing (42%). Orthopedic surgery showed the lowest compliance in terms of indication and duration. Univariate analysis indicated that only surgical procedure type significantly influenced compliance (p = 0.039). Qualitative analysis revealed that non-adherence was primarily driven by the fear of surgical site infection (SSI) and the belief that broad-spectrum agents are more effective. Notably, despite poor compliance, no incidence of SSI (0%) was reported during the 30–90-day post-procedure follow-up. Consistently poor compliance highlights significant gaps in procedural implementation and physician motivation regarding reasonable PA use. Targeted interventions focusing on standardized procedures, evidence-based education, and systemic monitoring are essential to improve prescription practices and mitigate the risk of AMR development.
Deadline-Chasing in Digital Health: Forecasting EMR Adoption Dynamics and Regulatory Impact in Indonesian Primary Care Satrio, Suryo; Aqid, Bukhori Muhammad
Journal of Indonesian Health Policy and Administration Vol. 11, No. 2
Publisher : UI Scholars Hub

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Abstract

Indonesia is accelerating digital health adoption under Minister of Health Regulation No. 24/2022, which mandates the use and integration of Electronic Medical Records (EMRs) with SATUSEHAT. However, evidence on how quickly primary health care facilities (Fasilitas Kesehatan Tingkat Pertama – FKTP) are adopting EMRs and what the adoption curve looks like remains limited. Survey findings also suggest key barriers and enablers, including security and data migration concerns, as well as human resource and infrastructure constraints. This observational study used provider-network data from a single EMR vendor. Key measures included cumulative registered facilities, monthly registrations, same-month activation (total_active/monthly inflow) as a proxy for onboarding readiness, and the estimated national pool of eligible FKTPs. The study applied descriptive analysis, logistic growth modeling, and Autoregressive Integrated Moving Average (ARIMA) forecasting for short-term projections. Over 39 months, cumulative registrations increased from 2 to 3,803 facilities. Same-month activation remained consistently high (median 0.969, IQR 0.744–0.999). By June 2025, the vendor network captured a 10.3% share of the estimated eligible FKTP pool (3,803/36,784). Logistic modeling suggested convergence to a carrying capacity of approximately 4,034 facilities (95% CI 3,953–4,115), while ARIMA projected around 4,030 facilities by December 2025 (95% CI 3,467–4,593). EMR adoption continues to increase, with rapid activation after registration, although growth slows over time. Localized increases near enforcement milestone windows are consistent with “deadline-chasing” behavior. Policy makers and vendors should combine deadline calendars with streamlined onboarding, secure migration support, clear technical-support SLAs, and region-specific interventions to address workforce and infrastructure gaps.

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