Aisyah Putri Amanda, . (2025) EVALUASI PELAKSANAAN SISTEM RUJUKAN BERJENJANG PASIEN BPJS KESEHATAN DI PUSKESMAS KELAPA GADING JAKARTA UTARA. Skripsi thesis, Universitas Pembangunan Nasional Veteran Jakarta.
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Abstract
The tiered referral system plays an important role in ensuring structured and efficient healthcare services. Community Health Centers (Puskesmas) play a role as gatekeepers in the tiered referral system, but the implementation of the tiered referral system at Puskesmas Kelapa Gading still faces various obstacles such as disruptions in the referral information system, limited facilities, and low patient understanding of the referral policy. This study aims to evaluate the implementation of the tiered referral system for BPJS Kesehatan patients at Puskesmas Kelapa Gading based on Permenkes No. 16 of 2024 and BPJS guidelines. This research employs a qualitative descriptive method with an Input-Process-Output evaluation approach through in-depth interviews, observations, and document reviews. The results show that the referral system has been implemented according to procedures, such as the utilization of SISRUTE, the execution of the referral flow, and the clear division of tasks among healthcare workers. The referral ratio is in the range of 9.1% to 9.8%, still below the maximum limit of 15% set by BPJS, and most referrals are made based on appropriate medical indications. However, there are still obstacles such as limited Human Resources, lack of patient understanding, and digital system disruptions. Therefore, continuous improvements are needed through increased patient outreach, optimization of the digital system, and resource addition so that the referral system runs more effectively and in accordance with regulations.
| Item Type: | Thesis (Skripsi) |
|---|---|
| Additional Information: | [No.Panggil: 2110713082] [Pembimbing: Riswandy Wasir] [Penguji 1: Putri Permatasari] [Penguji 2: Een Kurnaesih] |
| Uncontrolled Keywords: | Evaluation, BPJS Health Insurance Patients, Puskesmas, Tiered Referral System |
| Subjects: | Q Science > Q Science (General) R Medicine > RZ Other systems of medicine |
| Divisions: | Fakultas Ilmu Kesehatan > Program Studi Kesehatan Masyarakat (S1) |
| Depositing User: | AISYAH PUTRI AMANDA |
| Date Deposited: | 16 Jul 2025 04:28 |
| Last Modified: | 16 Jul 2025 04:28 |
| URI: | http://repository.upnvj.ac.id/id/eprint/37732 |
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