Published date: Feb 07 2022

Journal Title: KnE Life Sciences

Issue title: 5th International Conference in Nursing (IVCN)

Pages: 766–778

DOI: 10.18502/kls.v7i2.10377

Meridian GeodesiPloso Regional General Hospital, Jombang, East Java, Indonesia

Ratna Wardaniasmarawan.ratna08@gmail.comHealth management and service policy, Master of Health, Strada Institute of Health Sciences, Indonesia

Health facilities, in collaboration with BPJS Kesehatan, must organize health care efforts that are promotive, preventative, curative and rehabilitative. BPJS Kesehatan must collaborate with health facilities to implement a service quality control system and payment system for the efficiency and effectiveness of health insurance. The purpose of this research was to evaluate the performance of Puskesmas services in Jombang Regency, and to evaluate patient contact numbers, the ratio of non-specialist outpatient referrals and the ratio of Prolanis participants at health center services in Jombang Regency. This was qualitative research with a case study design. There were nine informants, including the Head of BLUD Puskesmas. Puskesmas contact numbers in Jombang Regency did not reach the target (150 permil). The outpatient referral ratio of non-specialist cases reached the target (less than 1%). The ratio of regular Prolanis participants visiting FKTP reached the target (≥ 50%), but in January-March 2021 this ratio decreased. The home visit ratio has not been implemented due to inadequate means of transportation. This research can be used as a reference to find ways to improve the components of KBKP so that it can maximize capitation payments.

Keywords: BPJS Kesehatan, FKTP, capitation based on service commitment, community health center

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