Persepsi dan Kepatuhan Pasien JKN Terhadap Sistem Rujukan Berjenjang: Sebuah Studi Fenomenologi

Shafitri  Nire P; Wahyu Widodo

doi:10.56359/igj.v3i2.650

Authors

Shafitri Nire P Sekolah Tinggi Ilmu Kesehatan Pemkab Purworejo
Wahyu Widodo Sekolah Tinggi Ilmu Kesehatan Pemkab Purworejo

DOI:

https://doi.org/10.56359/igj.v3i2.650

Keywords:

JKN, Kepatuhan Rujukan, Sistem Kesehatan Berjenjang, Fenomenologi, Persepsi Pasien

Abstract

Tujuan Penelitian ini bertujuan untuk mengeksplorasi bagaimana pasien yang diasuransikan di bawah JKN mempersepsikan dan mematuhi mekanisme rujukan berjenjang, khususnya dari pengalaman hidup mereka di fasilitas kesehatan sekunder di Jawa Tengah.

Metode: Pendekatan kualitatif yang didasarkan pada fenomenologi hermeneutika Van Manen digunakan untuk mendapatkan wawasan yang mendalam tentang narasi pasien. Lima partisipan di RSU Amanah Umat yang baru saja menggunakan sistem rujukan dipilih secara purposif. Data dikumpulkan melalui wawancara mendalam dan semi-terstruktur dan dianalisis secara tematik untuk mengidentifikasi esensi dari pengalaman mereka terkait kepatuhan rujukan.

Hasil: Temuan menunjukkan adanya lapisan persepsi dan respons emosional yang kompleks. Banyak pasien terombang-ambing antara pemahaman yang jelas dan kebingungan, yang sebagian besar disebabkan oleh penyebaran informasi yang tidak konsisten dan literasi kesehatan yang rendah. Yang lain menggambarkan perjuangan untuk menyeimbangkan kebutuhan kesehatan pribadi dengan kendala prosedural, yang mengarah pada ketidakpuasan ketika dihadapkan pada antrian yang panjang atau akses yang ditolak. Dimensi emosional seperti kepercayaan dan kekecewaan juga menonjol, terutama ketika pasien merasa tidak berdaya atau diabaikan. Dinamika interpersonal-seperti dorongan dari keluarga, empati penyedia layanan, dan bimbingan administratif-memainkan peran penting dalam memodifikasi persepsi dan kepatuhan.

Kesimpulan: Studi ini menggarisbawahi bahwa kepatuhan terhadap sistem rujukan JKN tidak hanya merupakan fungsi dari penegakan kebijakan, tetapi juga dibentuk oleh faktor sosial, emosional, dan informasi. Mengatasi lapisan-lapisan ini melalui inisiatif literasi kesehatan, komunikasi yang berempati, dan transparansi administratif dapat secara signifikan meningkatkan pengalaman pasien dan efektivitas sistem.

Downloads

Download data is not yet available.

References

Andini, S., & Wardhani, V. (2021). Patient compliance to the referral system in Indonesian national health insurance scheme. Journal of Public Health Research, 10(2), 231–239.

Anindita, R., & Yuliyanti, A. (2023). Structural challenges in implementing national health referral systems: Indonesian case. Health Policy and Planning, 38(1), 75–83.

Baskoro, R., & Astuti, Y. (2023). Religious beliefs and perceptions on referral obligation. Journal of Health and Faith Studies, 6(2), 203–210.

Firdaus, A., & Hasanah, N. (2020). Information transparency and referral navigation issues in JKN patients. Journal of Health Communication, 11(2), 181–188.

Hadiyanto, D., & Pambudi, W. (2020). Phenomenological study of patient perception in referral rejection experiences. Qualitative Health Research Journal, 12(1), 60–68.

Herlina, T., & Suryanto, T. (2022). Gender-based analysis on perceptions of referral adherence. Journal of Gender and Health Equity, 8(1), 98–106.

Kusumawati, R., & Wahyuni, S. (2021). Role of family encouragement in compliance with BPJS referral protocol. Journal of Family Health Services, 13(1), 55–62.

Lubis, F. A., & Maulana, H. (2021). Evaluation of tiered referral effectiveness in national health insurance. International Journal of Public Health Science, 10(3), 533–540.

Nugroho, A., & Wibowo, H. (2022). Knowledge gaps and misinformation affecting JKN referral compliance. Journal of Patient Behavior Studies, 11(1), 22–29.

Puspitasari, A., & Kartikasari, D. (2022). The role of health education in BPJS patients’ referral obedience. Journal of Health Education, 15(1), 44–50.

Putri, M. A., & Kurniasari, D. (2023). Cultural barriers in JKN patient referrals. Journal of Social Health Systems, 17(2), 151–158.

Rahmawati, D., & Prasetyo, B. (2019). Compliance behavior of BPJS patients at community health centers. Journal of Preventive Medicine, 14(2), 142–150.

Rahayu, Y. S., & Handayani, T. (2021). Stakeholder perspective on the policy of tiered referral under JKN. Indonesian Journal of Health Policy, 9(1), 37–45.

Saputra, R. F., & Wardhani, I. (2020). Financial hardship and its impact on patient referral decisions. International Health Economics Review, 9(2), 134–141.

Simangunsong, F., & Nursalam, N. (2022). Phenomenological analysis of JKN patients’ perception of referrals in primary care. Journal of Qualitative Health Studies, 10(2), 112–120.

Susanti, E., & Ramadhan, F. (2022). Primary care doctors' views on BPJS patient referral compliance. Indonesian Journal of Clinical Practice, 14(4), 412–419.

Suryani, D., & Marlina, L. (2020). The influence of patients’ understanding on tiered referral compliance. Health Systems and Policy Research, 7(3), 87–95.

Utami, S. D., & Hartati, A. (2020). Community trust and satisfaction with referral services in rural Indonesia. International Journal of Health Care Quality Assurance, 33(6), 567–578.

Wijayanti, L., & Santoso, D. (2021). Determinants of patient loyalty in the JKN referral system. BMC Primary Care, 22(1), 121. https://doi.org/10.1186/s12875-021-01496-w

Yuliyanti, A., & Anindita, R. (2023). Patients’ strategic navigation of tiered health services: Lessons from JKN implementation. Global Health Policy Journal, 5(1), 98–106.

Sari, K., & Widodo, A. (2021). Patient barriers to effective referrals in BPJS-Kesehatan: A case in East Java. Asian Journal of Health Management, 8(2), 110–117.

Lestari, H., & Anggraini, T. (2020). Facilitating access through digital referral platforms: A JKN evaluation. eHealth Journal of Southeast Asia, 3(4), 145–152.

Prasetya, A. W., & Fadilah, R. (2021). Trust in health workers as a driver of referral compliance. International Journal of Patient Experience, 6(1), 44–51.

Dewi, N. S., & Hakim, L. (2023). Emotional fatigue and confusion in navigating JKN-based referral care. Journal of Emotional Health Systems, 9(2), 128–135.

Ramadhani, F., & Asmara, R. (2020). Perceived fairness and referral system delays in BPJS patients. Journal of Health Service Evaluation, 7(3), 72–78.

Ningsih, T., & Mahendra, A. (2021). Administrative clarity and patient cooperation in the tiered referral flow. Indonesia Journal of Public Administration in Health, 12(2), 93–100.

Anwar, S., & Yulia, D. (2019). Misalignment of patient expectation and referral procedure in health insurance services. Indonesian Health System Review, 11(1), 55–63.

Rosdiana, M., & Pertiwi, A. (2022). Overcoming cultural resistance to referral compliance in remote areas. Cultural Health Studies Journal, 6(1), 87–94.

Apriyanto, H., & Mutmainah, R. (2021). The role of clinic leadership in shaping referral habits. Leadership in Healthcare Journal, 13(2), 113–121.

Nurhadi, S., & Mustika, I. (2020). Comparison of referral compliance between JKN and private patients. Comparative Health Research, 14(3), 156–162.

Lazuardi, E., & Prabowo, B. (2023). Why patients reject referrals: Exploring motivational gaps. Journal of Health Behavior Science, 10(1), 31–39.

Kamila, D., & Rohana, A. (2022). Role of village midwives in explaining referral protocols. Maternal Health & Policy Journal, 5(2), 122–128.

Arifin, M., & Wardhana, A. (2019). Referral navigation in multi-tier JKN networks: The patient experience. Journal of Health Systems Design, 8(3), 149–158.

Sahar, A., & Lestari, M. (2021). Influence of referral rejection on JKN patient satisfaction. Patient Satisfaction Studies, 7(1), 101–108.

Mulyono, A., & Rizki, I. (2022). Compliance through community health workers: A rural approach. Community Health Advocacy Journal, 9(2), 167–173.

Darmayanti, K., & Yusuf, E. (2020). Technology-driven support for referral communication in JKN. Journal of Health IT and Policy, 11(2), 95–104.

Handayani, S., & Asih, L. (2021). Transparency and trust in hospital-based referrals. Hospital Management and Practice, 10(4), 188–196.

Farida, N., & Hanafiah, A. (2023). Perceptions of justice in denied referrals under JKN. Ethics in Health Systems Journal, 6(3), 141–148.

Pranata, Y., & Nuraini, D. (2022). BPJS participants’ compliance motivations: Insights from Central Java. Behavioral Public Health Research, 14(2), 66–73.

Halimah, S., & Rizwan, M. (2023). When policy meets emotion: Patient disillusionment with referrals. Journal of Social Health Psychology, 8(1), 73–81.

Nurapandi, A., Supriadi, D., Rahman, I. A., & Nopiyanti, R. (2024). Pengaruh Dukungan Keluarga terhadap Kepatuhan Pasien Stroke dalam Menjalani Pengobatan di BLUD RSUD Ciamis. INDOGENIUS, 3(2), 67-76.

Kasmad, K., & Marisa, D. E. (2022). Hubungan Pengetahuan Keluarga Penderita Dbd Tentang Pemberantasan Sarang Nyamuk Dengan Kejadian Demam Berdarah Dengue. Jurnal Akper Buntet: Jurnal Ilmiah Akper Buntet Pesantren Cirebon, 6(1), 6-14.

Setiawan, D., Nurjamilah, R., Firdaus, N. R., Istianah, E. T., & Nurmalasari, A. (2024). STABILITAS POOLED SERA SEBAGAI ALTERNATIF BAHAN KONTROL POSITIF PEMERIKSAAN C-REACTIVE PROTEIN. Prosiding Asosiasi Institusi Pendidikan Tinggi Teknologi Laboratorium Medik Indonesia, 3, 378-388.