Electronic Theses and Dissertation

Latar Belakang: Pelaksanaan sistem rujukan mengatur alur pelayanan pasien dari fasilitas kesehatan pertama ke fasilitas kesehatan yang lebih tinggi atau sebaliknya. Pelaksanaan sistem rujukan belum sesuai dengan peraturan yang ada yang menyebabkan peningkatan rasio rujukan di puskesmas. Adanya sistem rujukan adalah salah satu contoh kontrol pembiayaan pelayanan kesehatan perseorangan. Apabila sistem rujukan tidak berjalan maka akan menyebabkan biaya perawatan yang meningkat pada tingkat lanjut dan tingginya rujukan pasien BPJS ke Rumah Sakit Tujuan: Untuk mengetahui bagaimana Implementasi Sistem Rujukan Pasien BPJS di Puskesmas Kabupaten Pidie Metode: Penelitian ini merupakan penelitian kualitatif dengan 12 orang informan yang ditentukan dengan teknik Purposive Sampling terkait penerapan sistem rujukan di puskesmas Hasil: Pelaksanaan sistem rujukan di Puskesmas Pidie, Puskesmas Peukan Baro, dan Puskesmas Tangse mengalami kendala seperti adanya permintaan rujukan oleh pasien BPJS, proses rujuk balik pasien yang kurang berjalan, serta pengawasan dari Dinas Kesehatan yang masih kurang. Sosialisasi sistem rujukan telah berjalan, jumlah dokter umum yang masih kurang, adanya keterbatasan dan kekosongan obat tertentu di puskesmas, komitmen pimpinan puskesmas dan dokter/ dokter gigi dalam implementasi sistem rujukan sudah berjalan, dan ketiga puskesmas telah mempunyai SOP tentang sistem rujukan. Kesimpulan: Pelaksanaan sistem rujukan masih terkendala akibat permintaan pasien, rujuk balik pasien serta kurang pengawasan dari Dinas Kesehatan. Jumlah ketersediaan dokter yang belum sesuai dengan jumlah peserta BPJS di wilayah puskesmas ditambah keterbatasan obat di puskesmas menyebabkan tingginya angka rujukan. Perlu peningkatan komitmen pimpinan puskesmas melalui monitoring dan evaluasi untuk dapat melakukan tindakan intervensi dalam upaya menurunkan rasio rujukan.
Kata kunci: Implementasi, Puskesmas, BPJS, Sistem rujukan, Rujuk balik

Background: The implementation of a referral system regulates the flow of patient services from the first health facility to a higher health facility or vice versa. The implementation of the referral system is not in accordance with existing regulations, which has resulted in an increase in the referral ratio at community health centers. The existence of a referral system is one example of controlling the financing of individual health services. If the referral system does not work, it will cause treatment costs to increase at advanced levels and high levels of BPJS patient referrals to hospitals. Objective: To find out how the BPJS Patient Referral System is implemented at the Pidie Regency Health Center. Method: This research is a qualitative study with 12 informants who were determined. using Purposive Sampling techniques related to the implementation of the referral system at community health centers. Results: The implementation of the referral system at Pidie Community Health Center, Peukan Baro Community Health Center, and Tangse Community Health Center experienced obstacles such as requests for referrals by BPJS patients, poor patient referral processes, as well as supervision from the Health Service. still not enough. Socialization of the referral system has been ongoing, the number of general practitioners is still insufficient, there are limitations and vacancies in certain medicines at the community health centers, the commitment of community health center leaders and doctors/dentists in implementing the referral system is already underway, and the three community health centers already have SOPs regarding the referral system. Conclusion: The implementation of the referral system is still hampered by patient requests, patient referrals and lack of supervision from the Health Service. The number of doctors available does not match the number of BPJS participants in the community health center area, plus the limited availability of medicines at the community health center causes the high number of referrals. It is necessary to increase the commitment of community health center leaders through monitoring and evaluation to be able to carry out intervention measures in an effort to reduce the referral ratio. Keywords: Implementation, Primary Health Center, BPJS, referral system, back (return) referral