PERILAKU DOKTER PUSKESMAS DEMPO KOTA PALEMBANG DALAM MERUJUK PASIEN JAMINAN KESEHATAN NASIONAL KE RUMAH SAKIT

NATALIA, NATALIA and Idris, Haerawati (2018) PERILAKU DOKTER PUSKESMAS DEMPO KOTA PALEMBANG DALAM MERUJUK PASIEN JAMINAN KESEHATAN NASIONAL KE RUMAH SAKIT. Undergraduate thesis, Sriwijaya University.

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Abstract

Physician referral decisions are important in supporting the system reference to the era of National Health Insurance (JKN). The high level of referral can lead to an increase in the burden of BPJS Health claim costs and increase hospital workload. The purpose of the study was to determine the behavior of physicians in referring JKN patients to the hospital. This study used a qualitative design, the informants were selected using purposive sampling technique. Data were analyzed using content analysis. The results of the study indicate that physicians refer patients when cases cannot be handled, there are indications of illness, and require further examination. Vulnerable physicians refer to JKN patients based on consideration of the patient's condition and needs for further examination. The hospital was chosen with the consideration that it was supported by a close distance between the patient's house and the hospital. The physician did not feel the negative impact of the referral, but some physicians felt the services obtained were reduced due to the implications of the negative impact of referral on the Puskesmas namely poor performance assessment, and decreased capitation. Obstacles in referring JKN patients come from within the physician that some physicians feel pressured to refer to JKN patients. As well as obstacles from outside in the form of technical barriers such as lights off, internet interference, and patient diagnoses are different from the ICD code 10. Physicians have confidence in their abilities and understanding their competencies and limitations so that they refer patients. The physician will also conduct an examination and ascertain the condition of the patient before making a referral. Physicians in referring JKN patients have behaved according to the existing terms, procedures and referral criteria. However, a high level of referral is caused by requests for patients who are forced to be referred, patients present with complaints that the patient feels cannot be treated at the health center, the patient has been examined by a hospital, and some cases should not be referred but still referred, by entering a diagnosis similar to a patient's disease into the ICD 10. It is hoped that the BPJS will educate JKN participants regarding tiered referral procedures in referral health services.

Item Type: Thesis (Undergraduate)
Uncontrolled Keywords: National Health Insurance, Health Belief Model, Refer Patient
Subjects: R Medicine > R Medicine (General)
Divisions: 10-Faculty of Public Health > 13201-Public Health (S1)
Depositing User: Mrs Kharisma Afrianti
Date Deposited: 15 Jul 2019 07:47
Last Modified: 26 Jul 2019 16:32
URI: http://repository.unsri.ac.id/id/eprint/271

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