Proceedings of the 5th International Public Sector Conference, IPSC 2023, October 10th-11th 2023, Bali, Indonesia

Research Article

Critical Evaluation of Social Health Insurance Administration Body Services: Case Study at Undata Hospital in Palu City

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  • @INPROCEEDINGS{10.4108/eai.10-10-2023.2342139,
        author={Alda  Alfiani and Andi Anhalma  Wati and Haryono Pasang  Kamase},
        title={Critical Evaluation of Social Health Insurance Administration Body Services: Case Study at Undata Hospital in Palu City},
        proceedings={Proceedings of the 5th International Public Sector Conference, IPSC 2023, October 10th-11th 2023, Bali, Indonesia},
        publisher={EAI},
        proceedings_a={IPSC},
        year={2023},
        month={12},
        keywords={local goverment bpjs health services undata hospital},
        doi={10.4108/eai.10-10-2023.2342139}
    }
    
  • Alda Alfiani
    Andi Anhalma Wati
    Haryono Pasang Kamase
    Year: 2023
    Critical Evaluation of Social Health Insurance Administration Body Services: Case Study at Undata Hospital in Palu City
    IPSC
    EAI
    DOI: 10.4108/eai.10-10-2023.2342139
Alda Alfiani1,*, Andi Anhalma Wati1, Haryono Pasang Kamase1
  • 1: Universitas Tadulako
*Contact email: aldaalfiani2728@gmail.com

Abstract

This study critically evaluates the BPJS card services at Undata Hospital, analyzing strengths, weaknesses, and implementation challenges. Data from archival records, direct observations, and in-depth interviews with 13 informants (10 patients and 3 medical personnel) was employed. The findings reveal critical challenges. First, the complex BPJS card registration and verification cause patient service delays. Second, inadequate information technology infrastructure hinders BPJS card's effective use. Third, suboptimal RSUD Undata-BPJS coordination creates obstacles in claims and payments. This research offers valuable policy insights for Undata Hospital managers and Central Sulawesi regional policymakers. It aims to improve Health BPJS Card services, aligning with patient rights and needs. The study complements social security research, emphasizing the significance of optimizing BPJS card services and overall healthcare provision.