Factors That Influence The Reference Of Participants In The Social Security Organizing Agency (BPJS) At The Mandala Health Center In Medan Tembung District In 2018

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Factors Affecting the Referral Participants of the Social Security Organizing Agency (BPJS) at the Mandala Health Center in Medan Tembung District in 2018

Introduction

The referral system is a crucial process in the healthcare industry, where responsibility for health problems is transferred vertically and horizontally. The Social Security Organizing Agency (BPJS) plays a significant role in ensuring that healthcare services are provided efficiently and effectively. However, the referral rates at the Mandala Health Center in Medan Tembung District have been increasing over the years, which is contrary to the ideal standard determined by BPJS. This article aims to discuss the factors that influence the referral of participants in the BPJS at the Mandala Health Center in Medan Tembung District in 2018.

Background

The National Health Insurance Program (JKN) was implemented to maximize the function of Puskesmas in providing health services. However, the referral rates at the Mandala Health Center have been increasing, which is a concern. The referral rate in 2015 was 46.66%, in 2016 it was 43.22%, and in 2017 it was 47.18%. This is contrary to the ideal standard determined by BPJS, where the referral should not exceed 15%. Therefore, it is essential to identify the factors that influence the referral of participants in the BPJS at the Mandala Health Center in Medan Tembung District in 2018.

Methodology

This study uses the Explanatory Research approach, which aims to explain the factors that influence referrals at the Mandala Health Center. The research population consisted of patients referred to the period October to December 2017, with a sample of 85 respondents. Data was collected through direct interviews using a questionnaire.

Results

The results showed that there were several variables that affected BPJS participants' references. The respondent knowledge variables about referrals indicate the value of P = 0.028, which means significant. The attitude of health workers has a value of P = 0.239, and information about the referral with the value of P = 0.246. Because the P value for the variable knowledge, attitudes, and information is less than 0.25, these three variables can be continued for multivariate analysis. However, for the variable the availability of facilities and infrastructure that have a value of P = 0.531 (more than 0.25), it is not continued in multivariate analysis even though it is considered substantially important.

Discussion

Further analysis shows that the availability of facilities and infrastructure is the most influential variable on referral decisions. This shows that although statistically not further in multivariate analysis, the availability of adequate facilities is very important to expedite the referral system. The results of this study provide insight for Puskesmas managers to focus more on increasing officers' knowledge and attitudes and providing accurate information related to referrals. In addition, improving infrastructure and health facilities is also a priority to support the success of the National Health Insurance program.

Conclusion

Based on the results of this study, it is essential for the Mandala Health Center and health employees to continue to improve their service competencies. This is not only in order to meet the standards set by BPJS, but also to improve the quality of health services to the community. Thus, it is expected that the referral rate can be reduced and the health service system in the Puskesmas can function optimally in accordance with the objectives of the JKN program.

Recommendations

Based on the findings of this study, the following recommendations are made:

  1. Improving knowledge and attitudes of health workers: Puskesmas managers should focus on increasing officers' knowledge and attitudes related to referrals.
  2. Providing accurate information: Puskesmas managers should provide accurate information related to referrals to patients and health workers.
  3. Improving infrastructure and health facilities: Puskesmas managers should prioritize improving infrastructure and health facilities to support the success of the National Health Insurance program.

Limitations

This study has several limitations. Firstly, the sample size was limited to 85 respondents, which may not be representative of the entire population. Secondly, the study only focused on the Mandala Health Center in Medan Tembung District, which may not be generalizable to other Puskesmas. Finally, the study only examined the factors that influence referrals, and did not explore other factors that may affect the referral system.

Future Research Directions

Future research should focus on exploring other factors that may affect the referral system, such as patient characteristics, healthcare provider characteristics, and healthcare system characteristics. Additionally, future research should aim to increase the sample size and generalizability of the study.
Q&A: Factors Affecting the Referral Participants of the Social Security Organizing Agency (BPJS) at the Mandala Health Center in Medan Tembung District in 2018

Q: What is the referral system, and why is it important in healthcare?

A: The referral system is the process of transferring responsibility for health problems, both vertically and horizontally. It is a crucial process in healthcare, as it ensures that patients receive the necessary care and treatment. The referral system is important because it helps to prevent unnecessary hospitalizations, reduces healthcare costs, and improves patient outcomes.

Q: What is the National Health Insurance Program (JKN), and how does it relate to the referral system?

A: The National Health Insurance Program (JKN) is a government program that aims to provide universal healthcare coverage to all citizens. The JKN program requires that healthcare providers, including Puskesmas, provide high-quality healthcare services to patients. The referral system is an essential component of the JKN program, as it helps to ensure that patients receive the necessary care and treatment.

Q: What are the factors that influence the referral of participants in the BPJS at the Mandala Health Center in Medan Tembung District in 2018?

A: The study found that several variables affected the referral of participants in the BPJS at the Mandala Health Center in Medan Tembung District in 2018. These variables include:

  • Respondent knowledge variables about referrals: The study found that patients who had knowledge about referrals were more likely to be referred to other healthcare providers.
  • Attitude of health workers: The study found that the attitude of health workers towards referrals was a significant factor in determining whether patients were referred to other healthcare providers.
  • Information about the referral: The study found that patients who received accurate information about referrals were more likely to be referred to other healthcare providers.
  • Availability of facilities and infrastructure: The study found that the availability of facilities and infrastructure was a significant factor in determining whether patients were referred to other healthcare providers.

Q: What are the implications of the study's findings for Puskesmas managers?

A: The study's findings have several implications for Puskesmas managers. Firstly, Puskesmas managers should focus on increasing officers' knowledge and attitudes related to referrals. Secondly, Puskesmas managers should provide accurate information related to referrals to patients and health workers. Finally, Puskesmas managers should prioritize improving infrastructure and health facilities to support the success of the National Health Insurance program.

Q: What are the limitations of the study?

A: The study has several limitations. Firstly, the sample size was limited to 85 respondents, which may not be representative of the entire population. Secondly, the study only focused on the Mandala Health Center in Medan Tembung District, which may not be generalizable to other Puskesmas. Finally, the study only examined the factors that influence referrals, and did not explore other factors that may affect the referral system.

Q: What are the future research directions?

A: Future research should focus on exploring other factors that may affect the referral system, such as patient characteristics, healthcare provider characteristics, and healthcare system characteristics. Additionally, future research should aim to increase the sample size and generalizability of the study.