|dc.description.abstract||Background: In 2014, National Health Insurance Program (BPJS Kesehatan) implemented Back-Referral
Program (BRP) to facilitate access to health care for patients with chronic diseases in stable conditions. However,
the program did not run well at District General Hospital of Balung which had the lowest back-referral program (6
participants) in 2015-2016.
Aim: The study aims to examine the BRP at Balung District General Hospital of Jember in 2017.
Methods: This study is designed as qualitative case study. The informants consisted of head of treasury
verification, secretary of JKN service controlling, officers of local government’s free care scheme, coordinator of
internal and neurological disease, specialists in internal and neurological diseases, officers of Social Security
Agency for Health, officers of patient eligibility verification, and participants of Back-Referral Program. The study
was conducted from October to December 2017.
Results: Results show that the attendance of BPJS Kesehatan officers has no contribution to the services of
BPJS Kesehatan in the hospital. Participants also find it difficult to follow the steps of BRP due to unavailability of
drugs at primary healthcare centers. Moreover, neurologists have not written any referral recommendation since
2016, so there was no patient admittance.
Conclusions: The BRP at Balung District General Hospital did not achieve its target (<5 cases/week). In the
contrary, the average number of patients referred to the hospital was 86 patients per week. Balung District
General Hospital should implement Standard Operating Procedure for letters signed by responsible physician for
patients and evaluate the BRP.||en_US