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PURPOSE: Whether the provision of online health care referral systems by the Indonesia National Health Insurance Agency has ensured healthcare referral compliance raises much concern due to the continuing deficit. This study examines the pattern of healthcare referral process, regional and referral compliance from 2015 to 2016. To provide comprehensive analysis on how people seek treatment, this study also aims to understand health-seeking behavior in Indonesia, the utilization of alternative treatment, and health information-seeking behavior on social media. METHOD: The data come from three data files, namely the National Health Insurance membership master data, the First Level Health Facilities transaction data and the Advanced Referral Health Facilities transaction data of 1,697,452 individuals. The regional compliance applies a logit regression model, while referral compliance applies descriptive statistics of the referral pathway. This study also follows a quantitative approach using an online questionnaire, with 463 respondents who have National Health Insurance which applies an ordered logit model. RESULT: We found that several demographic variables and regional health facility availability affect regional compliance. Moreover, we found 19.3% of the transactions did not comply with the prescribed referral sequence. The prescribed referral sequence was mostly followed for patients with malignant diseases. We also found men who perceive that their health condition is healthy will less likely seek health services compared to women. Further, the tendency of alternative treatment increases health-seeking behavior, and the tendency of seeking health information on social media increases the frequency seeking health services. CONCLUSION: We recommend the prescribed referral sequence to be re-evaluated especially for patients with malignant disease; the referral process should not be based on hospital classes but on the competency of the healthcare facility which may indirectly address the deficit issue. It is imperative that the government evaluate health promotion approaches to men and women, both direct and indirect through their significant others.
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OBJECTIVE: The purpose of this study was to design a suitable mobile application for high mobility medical staff to support the health referral system of Indonesian universal health coverage. METHODS: Design science research (DSR) approach were conducted with two iterations. The first iteration was conducted by designing a high-fidelity mockup and evaluating the design using the System Usability Scale (SUS) framework to evaluate the overall usability of the system (n = 48). The second iteration was conducted by designing a running prototype and evaluating the design using the Post-Study System Usability Questionnaire (PSSUQ) framework to evaluate the system's usefulness, information quality, and interface quality (n = 31). For designing the user interface, the eight golden rules guided the process. RESULTS: The results found that the design for the first iteration was good and the second iteration's design was satisfactory to the respondents. The information quality aspects underwent several changes such as the implementation of local language as the users deemed it to be important to help them easily understand and use the system and eventually support their mobility at the health facility.
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OBJECTIVES: In this study an enterprise architecture (EA) was developed for a health referral information system (HRIS) for individual healthcare in Indonesia with reference to the Open Group Architecture Framework (TOGAF) 9.1. The HRIS includes patient referrals for vertical and horizontal references (internal and external), specimen referrals, and health personnel referrals. METHODS: This research was a qualitative study that used the interview and observation method of the Primary Health Care Information System (SIMPUS) application developed by the Agency for Assessment and Application of Technology (BPPT). The interviews were conducted at South Tangerang City Government Health Office with five resource persons who were responsible for conducting health referral processes. RESULTS: The EA of the HRIS includes the principles of architecture, business, application, data, and technology architecture. Twelve principles, four referral processes, and three application reference modules and centralized applications comprise the architecture of the HRIS. The HRIS is a centralized integrated application that uses application program interface (API) to integrate with SIMPUS. CONCLUSIONS: The proposed architecture was developed in an integrated and comprehensive manner for the individual healthcare referral process, which can be implemented by regulators and healthcare facilities. This architecture can also help regulators and healthcare facilities to standardize and integrate health referral data and related processes.
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PURPOSE: Mobile-based technology health services in Indonesia are experiencing significant growth. However, the implementation of m-health in Indonesia is at a stand-still because the numbers of users or medical personnel who use m-health applications are still low. Given this fact, this study aims to identify critical success factors (CSFs) in the implementation of a mobile health applications in Indonesia. This research covers the following four dimensions: system quality, information quality, service quality, and organizational. METHOD: This study uses a quantitative research approach with the entropy method to analyze system quality, information quality, and service quality, and it uses a qualitative approach for the organizational dimension. A total of 127 respondents completed the questionnaire (quantitative approach) and interviews were performed with three personnel from the Social Security Agency for Health (BPJS-K) (qualitative approach). RESULTS: The highest weights for each dimension were as follows: ease of access for the system quality dimension; adequate and relevant information for the information quality dimension; user service convenience for the service quality dimension; and top management support for the organizational dimension. CONCLUSIONS: Based on the results of this study, the regulator, health facilities management, and mobile health provider should ensure a long-term commitment to support the implementation of mobile health applications. In order to reach a wider market, all mobile health applications should be as user friendly as possible for the patients.
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OBJECTIVES: This study aims to identify a user acceptance model for the health referral system in Indonesia. The following factors classified into dimensions of organization, technology, process, and individual, were examined: patient centricity, regulation, data security, integration, responsiveness, effectiveness, efficiency, personal beliefs, and social influence. METHODS: Quantitative data processing methods were used, including the online distribution of questionnaires to a total of 283 valid respondents who had previously used health referrals. Data processing was performed according to the ordinal logistic regression method using IBM SPSS Statistics 24.0 software. RESULTS: The user acceptance model fit with a significance of 0.084, while only regulation, data security, integration, responsiveness, effectiveness, efficiency, personal beliefs, and social influence significantly influenced the patients' acceptance of health referrals. CONCLUSIONS: This study may build awareness in the community regarding the health referral system along with the ideal factors that encourage patients to utilize health referrals. In addition, the provision of health services by health facilities and regulators may take these factors into account so they may provide fair and equitable services for all the people of Indonesia; for example, providers and regulators can improve the utilization of information technology and guidebooks on the health referral system to facilitate communication and standardization among health facilities.
