BACK REFERRAL PROGRAM IN THE ERA OF NATIONAL HEALTH INSURANCE AT BALUNG DISTRICT GENERAL HOSPITAL OF JEMBER IN 2017

Abstract

Background: In 2014, National Health Insura nce Program BPJS Kesehatan implement ed Back Referral Program ( to facilitate access to health care for patients with chronic diseases in stable conditions However , the program did not run well at District General Hospital of Balung which ha d the low est back referral program (6 participants in 2015 2016 Aim: Th e study aim s to examine the BRP at Balung District General Hospital of Jember in 2017. Methods: This study is designed as qualitative case study. The informant s consisted of h ead of treasury verification secretary of JKN service controlling officers of local government’s free care scheme coordinator of internal and neurological disease, specialist s in internal and neurological diseases , officers of Social Security Agency for Health , officer s of patient eligibility verification and participants of Back Referral Program T he study was conducted from October to December 2017. Results: R esults show that the attendance of BPJS Kesehatan officers has no contribution to the services of BPJS Keseh atan in the hospital . Pa rticipants also find it difficult to follow the steps of BRP due to unavailability of drugs at primary healthcare centers Moreover, neurologists have not written any referral recommendation since 2016, so there was no patient admit tance Conclusion s The BRP at Balung District General Hospital did not achieve its target (<5 cases/week). In the contrary , the average number of patients referred to the hospital was 86 patients per week. Balung District General Hospital should implemen t Standard Operating Procedure for letters signed by responsible physician for patients and evaluate the BRP .