Analysis of the Implementation of the Referral System for National Health Insurance Participants at Susut II Community Health Center

Abstract

The health care referral system is a system for organizing health care services that regulates the reciprocal delegation of duties and responsibilities for health care services, both vertically and horizontally. The purpose of this study was to determine the implementation of the BPJS Kesehatan patient referral system, human resources, patient referral procedures, and standard operating procedures (SOPs) at Susut II Community Health Center. This study used a descriptive qualitative approach. Five subjects participated in this study: general practitioners, dentists, nurses, pharmacists, and laboratory staff. Data were collected through observation and interviews. The results of this study, regarding the implementation of the BPJS Kesehatan patient referral system, indicate that the Pcare application has been used. The high referral rate is attributed to the lack of referral letters from hospitals and a lack of medical equipment. The conclusion of this study is that the BPJS Kesehatan patient referral system uses the Pcare application and that the referral procedures are implemented in accordance with established BPJS procedures.