Pengembangan Model Manajemen Dan Regulasi Klinik Kesehatan Pada Bpjs Kesehatan Berkelanjutan

Zulkarnaen, Iskandar (2026) Pengembangan Model Manajemen Dan Regulasi Klinik Kesehatan Pada Bpjs Kesehatan Berkelanjutan. Doctoral thesis, Institut Teknologi Sepuluh Nopember.

Text 7010202001-Doctoral-.pdf - Accepted Version Restricted to Repository staff only Download (4MB) | Request a copy

Abstract

Penelitian ini untuk mengembangkan model manajemen dan regulasi klinik kesehatan pada fasilitas kesehatan tingkat pertama (FKTP) dalam sistem BPJS Kesehatan yang berkelanjutan, permasalahan defisit pembiayaan, ketidak efisienan sistem rujukan, serta rendahnya kualitas layanan. Pendekatan yang digunakan kombinasi metode Analytic Network Process (ANP), Soft System Methodology (SSM) dan Interpretive Structural Modeling (ISM) menghasilkan model yang komprehensif dan terintegrasi .Tahapan penelitian dimulai dengan pengembangan model konseptual merepresentasikan hubungan antar variabel utama seperti premi, kapitasi, biaya layanan, kepesertaan dan kualitas layanan. Model kemudian diuji statistik dan dianalisis melalui simulasi, memahami perilaku sistem eksisting, dilakukan pengembangan model usulan melalui eksperimen perubahan sistem rujukan dan mekanisme pembiayaan. Analisis ANP menentukan Prioritas indikator dalam pengembangan FKTP, SSM dan ISM mengidentifikasi struktur permasalahan dan hubungan antar aktor dalam sistem. Hasil penelitian menunjukkan bahwa faktor utama dalam peningkatan kualitas layanan FKTP adalah Akreditasi Fasilitas Kesehatan, kualitas sumber daya manusia, ketersediaan infrastruktur, dan kepatuhan terhadap standar operasional prosedur, mekanisme rujukan yang kompleks menjadi penyebeab utama inefisiensi sistem. Model usulan yang dikembangkan mampu memberikan alternatif strategi berupa pemerataan distribusi peserta, peningkatan kualitas SDM, penyederhanaan sistem rujukan dan penyesuaian mekanisme pembiayaan berbasis kebutuhan layanan. Penelitian ini menegaskan bahwa keberlanjutan sistem BPJS Kesehatan sangat dipengaruhi oleh integrasi antara penguatan kelembagaan FKTP, optimalisasi pembiayaan kapitasi, serta peningkatan kualitas layanan berbasis standar akreditasi. Model digunakan sebagai dasar dalam perumusan kebijakan kesehatan untuk meningkatkan efisiensi dan keberlanjutan sistem jaminan kesehatan nasional
===================================================================================================================================
This study aims to develop a management and regulation model of health clinics in firstlevel health facilities (FKTP) in the sustainable BPJS Kesehatan system, financing deficit problems, inefficiency of referral systems, and low service quality. The approach used is a combination of Analytic Network Process (ANP), Soft System Methodology (SSM) and Interpretive Structural Modeling (ISM) methods resulting in a comprehensive and integrated model. The research stage begins with the development of a conceptual model representing the relationship between key variables such as premiums, capitation, service costs, membership and service quality. The model is then statistically tested and analyzed through simulations, understanding the behavior of the existing system, and developing a proposed model through experiments on changes to the referral system and financing mechanism. The ANP analysis determines the priority of indicators in the development of FKTP, SSM and ISM identifying the problem structure and relationships between actors in the system. The results of the study show that the main factors in improving the quality of FKTP services are Health Facility Accreditation, quality of human resources, availability of infrastructure, and compliance with standard operating procedures, complex referral mechanisms are the main causes of system inefficiency. The proposed model developed is able to provide alternative strategies in the form of equitable distribution of participants, improving the quality of human resources, simplifying the referral system and adjusting the financing mechanism based on service needs.This study shows that the sustainability of the BPJS Kesehatan system is greatly influenced by the integration between institutional strengthening of FKTP, optimization of capitation financing, and improving the quality of services based on accreditation standards. The model is used as a basis in the formulation of health policies to improve the efficiency and sustainability of the national health insurance system

Item Type:	Thesis (Doctoral)
Uncontrolled Keywords:	BPJS Kesehatan, FKTP, ANP, SSM, ISM, Kapitasi, Sistem Rujukan, Keberlanjutan BPJS Kesehatan, FKTP, ANP, SSM, ISM, Capitation, Referral System, Sustainability
Subjects:	T Technology > T Technology (General) > T58.6 Management information systems
Divisions:	Faculty of Industrial Technology and Systems Engineering (INDSYS) > Industrial Engineering > 26001-(S3) PhD Thesis
Depositing User:	ISKANDAR ZULKARNAEN
Date Deposited:	03 Aug 2026 22:57
Last Modified:	03 Aug 2026 22:57
URI:	http://repository.its.ac.id/id/eprint/143763

Actions (login required)

View Item