Analysis of Readiness for Implementing the Standard Inpatient Class Policy
DOI:
https://doi.org/10.26911/Abstract
Background: The implementation of the National Health Insurance Standard Class (KRIS JKN) policy began in stages on January 1, 2023, to achieve a sustainable JKN program and fulfill the equity principles mandated by the National Social Security System (SJSN) Law. This policy has significant implications for hospital governance, requiring adjustments in hospital resources and management in line with Ministry of Health Regulation No. 14 of 2021 and Directorate General Decree No. HK.02.02/I/1811.2022. PKU Muhammadiyah Gamping Hospital, a type C private hospital in Sleman Regency with 98.18% UHC coverage and a 68.94% bed occupancy rate, predominantly serves JKN patients. This study aimed to assess the readiness of hospital resources, management processes, and follow-up plans for KRIS JKN implementation.
Subjects and Method: This qualitative study used a case study design. Variables included facilities and infrastructure, funding, knowledge and attitudes of informants, implementation procedures, planning, organizing, readiness, supervision, and normative needs analysis. Data were collected through observations, document reviews, and in-depth interviews.
Results: The readiness of facilities and infrastructure to meet the 12 KRIS JKN criteria was 77%, with seven criteria requiring adjustment. Funding readiness and staff attitudes indicated strong support for implementation. However, the preparation of implementation procedures was incomplete, as no official decree had been issued to form a dedicated KRIS JKN preparation team, and clinical pathway achievements did not yet meet standards.
Conclusion: The hospital should establish a special KRIS JKN preparation team, plan for fulfillment of the 12 criteria with clear timelines and targets, and strengthen clinical pathway implementation and compliance evaluation.
Keywords:
health insurance, health policy, hospital administration, organizational innovation
How to Cite
References
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