ANALISA IMPLEMENTASI PROGRAM RUJUK BALIK DI RSUD BAGAS WARAS KLATEN

DEWI WARASTUTI, Dr. dr. Andreasta Meliala, DPH., M.Kes., MAS

2021 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar belakang: Masih rendahnya capaian angka rujuk balik pasien penyakit kronis di RSUD Bagas Waras pada tahun 2020 yaitu hanya sebesar 24% dari target yang ditentukan oleh BPJS Kesehatan yaitu sebesar 100% Capaian PRB ini merupakan syarat perpanjangan kerjasama di tahun berikutnya. Tujuan: mendeskripsikan pelaksanaan program rujuk balik di RSUD Bagas Waras klaten, mengukur persepsi manajemen RS dalam implementasi pelaksanaan Program Rujuk Balik di RSUD Bagas Waras dan mengukur pengetahuan dan persepsi dokter spesialis terhadap program rujuk balik. Metode: desain penelitian adalah studi kasus eksploratoris, dilakukan wawancara mendalam terhadap subyek penelitian. Hasil: Pelaksanaan PRB di RSUD Bagas Waras Klaten belum sesuai target, persepsi dokter spesialis terhadap PRB cukup baik, menurut dokter PRB adalah program yang baik untuk mengurangi antrian di RS dan mendekatkan akses pengobatan kepada pasien, namun tingkat pengetahuan tentang PRB masih kurang, karena kurangnya sosialisasi dan regulasi BPJS kesehatan yang berubah-ubah. Persepsi manajemen RS terhadap PRB juga sudah baik,dimana PRB ini sangat bermanfaat untuk pengelolaan penyakit kronis peserta JKN, mengurangi antrian di Rumah sakit dan untuk kendali mutu kendali biaya. Kesimpulan: pelaksanaan PRB di RSUD Bagas Waras belum sesuai target dari potensi rujuk balik.Persepsi dokter spesialis dan manajemen RS terhadap PRB sudah cukup baik namun adanya beberapa kendala menyebabkan dokter spesialis enggan untuk merujuk balik pasiennya ke FKTP. Kendala tersebut antara lain belum adanya panduan tentang kriteria stabil, kurangnya pemahaman dokter spesialis tentang regulasi PRB, sosialisasi yang kurang dari manajemen dan tidak adanya evaluasi rutin terhadap pelaksanaan PRB.

Background: The achievement of the referral rate for chronic disease patients at the Bagas Waras Hospital is still low in 2020, which is only 24% of the target set by Health BPJS which is 100% The achievement of this referral program is a condition for the extension of the cooperation in the following year. Objective: Describe the implementation of back referral program at the Bagas Waras Klaten Hospital, describe the perception of hospital management in the implementation of the Referback Program at Bagas Waras Hospital and describe the knowledge and perceptions of specialists on back referral program. Method: research design is an exploratory case study, conducted in-depth interviews with research subjects. Result: Specialists' perception of the back referral program is quite good, according to them the back referral program is a good program to reduce queues at hospitals and bring access to treatment closer to patients, but knowledge about the back referral program is still lacking, due to the lack of socialization and the changing regulations of health BPJS. Hospital management's perception of the back referral program is also quite good, according to them, this back referral program is very useful for managing chronic diseases of JKN participants, reducing queues at hospitals and for quality control of cost control. Conclusion: The implementation of the back referral program at the Bagas Waras Hospital has not met the target of the potential for referrals. Hospital management's perception of the back referral program is quite good, the specialist's perception of the back referral program is quite good but there are several obstacles that cause specialists to be reluctant to refer their patients back to the FKTP. These obstacles include the absence of guidance on stable criteria, lack of specialist understanding of back referral program regulations, lack of socialization from management and the absence of regular evaluations of the implementation of back referral programs.

Kata Kunci : Program Rujuk Balik, persepsi dokter spesialis, persepsi manajemen Rumah Sakit, Back referral program, perception of specialist, perception of hospital management