Implementasi Program Rujuk Balik (PRB) di Rumah Sakit Umum Madani Medan Tahun 2024

Abstract

BPJS has a Referral Back Program (PRB), which provides healthcare services to patients with certain stable chronic diseases who still require long-term treatment at Primary Healthcare Facilities upon referral from the treating specialist/subspecialist. Referral Healthcare Facilities in PRB acts as a referrer of participants with stable conditions back to health center. Based on the initial survey, Madani General Hospital Medan has a PRB participation of 60-70 participants/semester, which has never reached the BPJS target of 80-100 participants/semester. This study aims to analyze the implementation of the Referral Back Program at Madani General Hospital Medan in 2024 based on aspects of communication, resources, disposition, and bureaucratic structure. This research is a qualitative study with 12 informants. Data were collected through in-depth interviews, observations, and document reviews. The research results showed that Madani General Hospital Medan had not identified potential PRB participants and public health center has not been assertive in responding PRB patient non-compliance. In the communication aspect, policy communication is carried out through circular letters and the absence of supporting information media and elderly patient companions leads to miscommunication. In terms of resources, the availability of BPJS registration staffs and pharmacists is insufficient compared to the number of patients, the existing PRB corner is not in accordance with the recommendations, and there there is a limited supply of medications in the PRB pharmacy. In the disposition aspect, the staffs showed a positive attitude, but the commitment of the implementers in dealing with patients rejection was not optimal. In the disposition aspect, the staff showed a positive attitude, but were constrained by the patient's refusal to do PRB. In terms of bureaucratic structure, Madani General Hospital Medan does not have a PRB PIC and a specific PRB SOP. From the results of this study, it is expected that Madani General Hospital can evaluate the implementation of PRB, for public health center to act decisively regarding PRB patient compliance, and for PRB Pharmacy to complete the availability of PRB medications in accordance with the applicable formulary