Implementasi Rujukan Pasien Jaminan Kesehatan Nasional (BPJS Kesehatan) Di UPT Puskesmas Bahodopi Kabupaten Morowali

ABSTRACT

Wildayani. The Implementation of the National Health Insurance (BPJS Health) Patient Referral Policy at UPT Puskesmas Morowali Regency. (Supervised by Mr. Vidyanto)

Department of Health Administration and Policy Public Health Study Program Faculty of Public Health Tadulako University

The patient referral system is implemented with the purpose of providing quality health services so that aligned with the Indonesia’s National Long Term. However, if the referral system is not well implemented in accordance with teh existing regulations, there would be consequences affecting on the Community Health Centre. UPT Puskesmas Bahodopi known has the highest average referral ratio per month of the 9 Puskesmas in Morowali Regency with a percentage of 45.30%, while this ratio does not match the ratio set by BPJS Health, where in this case the referral ratio from FKTP to FKTL should be no more than 15%. This research, therefore, aims to determine the implementation of the National Health Insurance Patient Referral Policy at UPT Puskesma Bahodopi, Morowali Regency using Edward III's theory. This type of research is qualitative research with a case study approach where the research conducted using In-depth Interview technique. The research informants were 9 people selected by the Purposive Sampling Technique. The results show that communication variables including transmission, clarity and consistency are good. The human resource variable, including doctors is adequate, the infrastructure is still lacking on the health service supports and the authority to provide referrals is appropriate. The disposition variable where doctors carry out referrals is in appropriate with the existing policies. The bureaucratic official structure variable at UPT Puskesmas Bahodopi is effectively performed based on the written documents in the SOP’s referral.

Keywords: Policy Implementation, Referrals, BPJS Health Patients.