Skripsi

ANALISIS POTENSI FRAUD DALAM PELAKSANAAN JAMINAN KESEHATAN NASIONAL PADA PUSKESMAS DI KOTA PALEMBANG

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Penilaian

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In the implementation of the health insurance program, fraud in the National Health Insurance is an act that is carried out deliberately by obtaining profit. The impact of fraud can affect financial aspects, the quality of clinical services, and on the image and reputation of the perpetrator. This study is aimed to analyze the potential of fraud in the implementation of the National Health Insurance at Health Center in Palembang City. This research used qualitative method with a phenomenological approach, the research informants consisted of the heads of helath center, registration officers, BPJS Helath patients and heads of sections of the health office in Palembang City. Primary data was focus group discussion (FGD) on heads of the health center and registration officers. Then in-depth interviews with BPJS Helath patients and heads of section at the Health Office, indirect observation and document review at 14 health center. The results shown by, that the potential of fraud at health center is related to charging fees to patients, mistakes in referring patients, and transfer of patient membership. Potential fraud that occurs can be indicated from the factors influence, inadequate of external and internal controls, limited number of employees, constraints on infrastructure, complaints from patients, inadequate income due to late payment of non-capitation claims, unstable patient referral ratios, and less a given of training. The conclusion of this study is the potential of fraud in public health centers can occur, so that there is a need for increased internal and external control and the development of an anti-fraud prevention system for NHI in health center.

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Availability

Inventory Code	Barcode	Call Number	Location	Status
2007001253	T41002	T410022020	Central Library (Referens)	Available but not for loan - Not for Loan

Detail Information

Series Title

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Call Number

T410022020

Publisher

Inderalaya : Fak. Kesehatan Masyarakat., 2020

Collation

xix, 140 hlm+lamp,; ill.; 29 cm

Language

Indonesia

ISBN/ISSN

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Classification

368.507

Content Type

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Media Type

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Carrier Type

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Edition

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Subject(s)

Jurusan Ilmu Kesehatan Masyarakat
Analisis Potensi Fraud JKN-Jaminan Asuransi

Specific Detail Info

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Statement of Responsibility

MURZ

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