Doctors in Primary Health Care (PHC) Ngesrep were found to be disappointed with their workload that is related to the implementation of Badan Penyelenggara Jaminan
Abstract. In managed care, primary healthcarecare facilities acts as the gatekeepers, and its success is judged from the number of visits. In the year 2016, the Healthcare Centers in Tangerang was unable to meet the targets set by BPJS healthcare, ideally the visit rate should reach >150‰ and the referral ratio <10%. However, the visit rate only reachd 41‰ and the referral ratio was 29%. In addition, most healthcare centers the nonspecialised referral ratio was above 5%. The purpose of this research is to analyze the healthcare service system as the gatekeepers in managed care. This research is a descriptive analytical study with a qualitative approach. The data was collected through in-depth interviews, examination of documents and observations. Research conducted at healthcare centers and clinics Pedurenan Pabuaran Tumpeng from May-June 2018. From this research we discovered that the low contact lrate was caused be the low first contact levels, continuity, and comprehensiveness. The registering process was also complicated. We also discovered that the lack of human resources also influences the low contact rate. Abstrak. Dalam managed care, pelayanan primer bertugas sebagai gatekeeper, dan keberhasilannya dinilai dari tingginya angka kunjungan dan angka rujukan. Di tahun 2016, Puskesmas Kota Tangerang memiliki pencapaian yang tidak sesuai dengan target yang ditetapkan oleh BPJS Kesehatan, karena tingkat kunjungan hanya mencapai 41‰, idealnya >150‰; dan rasio rujukannya sebesar 29%, sedangkan idealnya adalah 10%. Selain itu, sebagian besar Puskesmas memiliki rasio rujukan nonspesialistik diatas 5% yang berarti berada di zona tidak aman. Tujuan penelitian ini adalah menganalisis sistem pelayanan puskesmas sebagai gatekeeper di Kota Tangerang pada tahun 2018. Penelitian ini merupakan penelitian deskriptif analitik dengan menggunakan pendekatan kualitatif. Data dikumpulkan dengan melakukan wawancara mendalam, telaah dokumen dan observasi. Penelitian dilakukan di Puskesmas Pedurenan dan Puskesmas Pabuaran Tumpeng dari bulan Mei-Juni 2018. Dari penelitian ini ditemukan bahwa output angka kontak masih rendah. Pada variabel proses, yang menyebabkan angka kontak rendah adalah angka first contact, continuity, dan comprehensiveness yang rendah, serta proses pendaftaran pasien yang masih rumit. Sedangkan pada variabel input yang menjadi masalah adalah kurangnya sumber daya manusia.
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