INTEGRASI SISTEM PELAYANAN JANTUNG DAN PEMBIAYAAN BPJS KESEHATAN: UPAYA PENINGKATAN EFEKTIVITAS DAN KEBERLANJUTAN LAYANAN KARDIOLOGI
DOI:
https://doi.org/10.51878/healthy.v5i3.11163Keywords:
Integrasi Sistem Kesehatan, Pelayanan Kardiologi, BPJS Kesehatan, Efektivitas Layanan, Keberlanjutan Pembiayaan, Jaminan Kesehatan NasionalAbstract
The high rate of cardiovascular disease in Indonesia places cardiology services as the largest budget absorber in the National Health Insurance program. This catastrophic burden demands regulatory alignment to avoid fragmented operational flows and financial overruns. This study focuses on analyzing the importance of integrating the cardiac care system with the BPJS Kesehatan financing mechanism to improve the effectiveness of cardiology services. A descriptive qualitative approach was applied through a systematic literature review of policy documents and scientific publications published over the past five years. The study findings indicate that synchronizing the tiered referral system, utilizing electronic medical records, and updating the INA-CBGs claims platform can accelerate medical care while significantly reducing operational cost inefficiencies. However, current implementation in the field is considered partial due to unequal distribution of facilities and unequal interoperability of national digital data. The main conclusion emphasizes that comprehensive integration between clinical, digital, and financial aspects is a crucial strategy for maintaining the quality of cardiology services. Policymakers are recommended to strengthen real-time data governance to achieve claims transparency and ensure long-term sustainability of health financing.
ABSTRAK
Tingginya angka penyakit kardiovaskular di Indonesia menempatkan layanan kardiologi sebagai penyerap anggaran terbesar dalam program Jaminan Kesehatan Nasional. Besarnya beban katastropik ini menuntut keselarasan regulasi demi menghindari fragmentasi alur operasional dan pembengkakan finansial. Fokus penelitian ini adalah menganalisis pentingnya integrasi sistem pelayanan jantung dengan mekanisme pembiayaan BPJS Kesehatan guna meningkatkan efektivitas layanan kardiologi. Pendekatan kualitatif deskriptif diterapkan melalui studi literatur sistematis terhadap dokumen kebijakan serta publikasi ilmiah terbitan lima tahun terakhir. Temuan penelitian menunjukkan bahwa sinkronisasi sistem rujukan berjenjang, pemanfaatan rekam medis elektronik, dan pembaruan platform klaim INA-CBGs mampu mempercepat penanganan medis sekaligus mereduksi inefisiensi biaya operasional secara signifikan. Namun, implementasi di lapangan saat ini dinilai masih parsial akibat ketimpangan distribusi fasilitas serta belum meratanya interoperabilitas data digital nasional. Simpulan utama menegaskan bahwa integrasi menyeluruh antara aspek klinis, digital, dan finansial merupakan strategi krusial untuk menjaga kualitas pelayanan kardiologi. Pemangku kebijakan direkomendasikan untuk memperkuat tata kelola data waktu nyata (real-time) guna mewujudkan transparansi klaim dan menjamin keberlanjutan pembiayaan kesehatan jangka panjang.
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