National Health Insurance Era Research Articles

Relationship Between Working Length of Pharmacy Personnel, Working Length of Doctors and Treatment Length of Patients with the Availability of Medicine in the Era of National Health Insurance (JKN) in the Hospital Grandmed Lubuk Pakam in 2024

Background: Quality public health services must have sufficient quantities and varieties of medicines when needed. The availability of these medicines can be ensured through good pharmaceutical standards and regulations. Optimal availability of medicines is the availability of medicines that can meet patient needs. One important step in medication management is the purchase of medicines. If the purchase of medicines is not managed carefully and responsibly, for example buying more medicines than needed, it will result in wasteful budget, increased purchasing and storage costs, and medicines or goods cannot be distributed. or expired.Objectives: To find out what factors influence the availability of drugs in the health insurance era (JKN) at the Grandmed Lubuk Pakam Hospital in 2024.Research method: This type of research is quantitative and is descriptive quantitative with a cross-sectional time approach. Results: There is a relationship between the length of service of pharmacists. The length of service of doctors and the length of treatment of patients with the availability of drugs in the era of JKN at the Grandmed Hospital in Lubuk Pakam in 2024. Conclusion: The availability of medicine for the community is one of the government's commitments in implementing public health services. The efforts made by the government are certainly aimed at maintaining public health.

The Role of Indonesia’s National Health Insurance Cadre: A Case Study in Bali

The management of informal sector participants poses the most significant difficulty to universal coverage attempts throughout Indonesia's National Health Insurance era. As a result, in April 2017, BPJS Kesehatan established the JKN Cadre Program. This program intends to expand the number of participants while also improving the collectability of contributions from the informal sector. This study aims to investigate the role of the cadre and explore the supporting, and inhibiting factors of such a program. This study is a qualitative descriptive case study, with data gathered through in-depth interviews. Informants were chosen purposefully. Thematic Analysis was utilized to examine the data, which Source Triangulation subsequently confirmed. The study found that the JKN KIS cadre has five functions, the most important of which is to remind people and collect contributions. Cadre activities included education and outreach, as well as collecting payment arrears receipts. The study also identified three inhibiting and supportive elements for the role of cadre namely individual, environmental, and organisational factors. To reduce unfavourable perceptions of JKN-KIS, it is vital to increase cadre self-actualization, self-esteem, information dissemination, synergy, and quality.

Cost determinant of chemotherapy in breast, cervical, and lung cancer in the era of National Health Insurance

Cost determinant of chemotherapy in breast, cervical, and lung cancer in the era of National Health Insurance

SWOT Analysis of the Marketing Mix Strategy of Integrated Heart Services of Pku Muhammadiyah Gamping Hospital in the Era of National Health Insurance

The referral system in the National Health Insurance policy is a challenge for class B hospitals. This research aims to analyze the marketing mix strategy for Cardiac Vascular Center carried out by the PKU Muhammadiyah Gamping hospital in the National Health Insurance era. The research approach used is qualitative with a case study type of research. The subjects of this research are internal hospital informants and were selected based on purposive sampling criteria, namely those related to the marketing strategy of the hospital's superior services. Based on the results of the SWOT analysis, an alternative strategy was obtained, namely a growth oriented strategy. This strategy maximizes the strengths you have to take advantage of existing opportunities or can also be called an SO (strength-opportunity) strategy. The strategies resulting from the SWOT analysis are improving human resources, adding services, developing facilities and infrastructure, increasing promotions, collaborating, improving IT systems, providing HR training and studies, and providing appropriate remuneration. It is hoped that the results of this research can be used as a consideration for strategic decisions for Cardiac Vascular Center at PKU Muhammadiyah Gamping Hospital and for other researchers to make strategic priorities according to hospital needs.

Evaluation of Drug Procurement Pattern and Drug Availability for JKN Patients at X Hospital and Y Hospital, Cirebon District, January-December 2022 Period

The era of National Health Insurance (JKN) brought changes in the health care system, which required hospital pharmacists to adapt to drug regulations and planning. Procurement planning and procedures have a significant impact on the availability of drugs and the financial situation of the hospital in drug management. One of the most crucial aspects of the hospital is the availability of guaranteed goods and sufficient drug supplies in order to provide the best service. This research was conducted to evaluate the procurement and availability of drugs at X Hospital as a public hospital and Y Hospital as a private hospital in Cirebon Regency. The analysis used in this study is descriptive-evaluative, namely the research method used to obtain data in a descriptive form and a systematic analysis is carried out to evaluate based on the descriptive data. Data collection was carried out by means of in-depth interviews with the hospital and distributors as external parties who also contributed to fulfilling the availability of drugs. The data is also complemented by the results of field observations and review of document reports related to the National Formulary (Fornas), Hospital Formulus (Forkit), and Drug Needs Plan (RKO). The results of this study found that the Drug Needs Plan, procurement and availability of drugs at X Hospital and Y Hospital were in accordance with the standards. This shows that most of the drugs available and given to patients are in accordance with the drugs listed in the National Formulary. There is a difference in the pattern of procurement. Hospitals conduct procurement twice a month, but private hospitals conduct procurement patterns twice a week. The two hospitals both use the SIMRS and Teramedik management information systems for the evaluation process of drug procurement and availability

Analysis of Marketing Strategies For Health Services in The National Health Insurance Era in Hospital Muhammadiyah Bandung

The National Health Insurance (JKN) has brought significant changes to the healthcare industry. The programme provides financial protection to Indonesians to meet their basic health needs. In the JKN era, hospitals are also faced with challenges and intense competition, so they need to improve service quality and implement effective marketing strategies. The purpose of this study is to analyse the application of the marketing mix in the marketing strategy implementation process as well as the selected marketing strategy in the JKN era at Muhammadiyah Bandung Hospital. This study used a descriptive research method with a qualitative approach, which involved interviews with the head of the marketing unit and the hospital's marketing executive staff. The results showed that well-targeted marketing strategies can strengthen the hospital's image, increase visibility and public awareness of the hospital's healthcare offerings, thus helping to reach more potential patients, and improve patient satisfaction. The implications of this study emphasise the important role of effective marketing strategies in improving healthcare services at Rumah Sakit Muhammadiyah Bandung in the era of the National Health Insurance (JKN).

Dilemma of Local Health Service Policy in the Era of National Health Insurance: A Political Perspective Analysis

The strengthening of political priorities in terms of developing health policies for various parties needs to be carried out both for the doctor and for the recipients of health services. Various health policies are influenced by various things based on certain contextual factors. In the Minister of Health Number 59 of 2014, it is stated that the amount of capitation funds is for first-level dental health services in independent practices, but it is not stated how much the capitation rate is for dental health services at community health centers. This research uses quantitative descriptive methods. The calculation method used is the Activity-Based Costing (ABC) method. The results of this study show that the average unit cost of dental health services at the Community Health Center is IDR. 104714. The largest unit cost is the GIC patching action. By using the activity-based cost calculation method, it can be seen that the largest costs for dental health services at the Community Health Center come from employee costs. And this shows that the situation is not fair for various parties. This raises a dilemma that is important to be discussed. The capitation rates set by the government are considered inappropriate for dentists in first-level health facilities. This can cause a decrease in the quality of health services provided by dentists at community health centers.

Continuous Ambulatory Peritoneal Dialysis Cost-Effectiveness in National Health Insurance Era of Indonesia

Essential treatments for patients with end-stage renal disease include Renal Replacement Therapy (RRT) consisting of hemodialysis, peritoneal dialysis, and kidney transplantation. In 2014, dialysis coverage in Indonesia was more than 1.5 trillion, making it the second highest expense in the National Health Insurance (BPJS) expenses. This study compared the cost-effectiveness between Continuous Ambulatory Peritoneal Dialysis (CAPD) and Hemodialysis (HD) in patients treated in Dr. Hasan Sadikin General Hospital. Data were collected from the Urology Department from 2014 to 2017. This was a retrospective observational study on 3 groups of patients: patients with effective CAPD each year as the first group; patients who had experienced repair of CAPD and continued to use it as the second group; and patients who discontinued CAPD due to complications and returned to hemodialysis as the third group. Each group expense was calculated with standard cost insurance for one year in the hospital. The expense was then be compared to the expense of hemodialysis for one year. A total of 89 patients in the CAPD program from 2014–2017 were treated at the department. When compared to HD, the first, second, and third group of CAPD patients experienced a cost reduction of IDR 23.227.857/person, IDR 18.127.857/person, and IDR 1.661.972.000, respectively. Total savings from the CAPD program in the hospital was IDR 1.661.972.000 from 2014. It is then concluded that CAPD could reduce the burden of government insurance in a cost-effective manner and is considered a treatment of choice in the National Health Insurance Era.

Unit Cost Perawatan Gigi di Klinik Fanisa Kota Pariaman dengan Metode Activity Based Costing

Objective: To find out unit cost of dental health service in Pariaman City Fanisa Clinic using the Activity Based Costing method in era of national health insurance. Method : This research was a quantitative descriptive study that used was Activity Based Costing (ABC) used mathematical calculations. Results : The results of this study indicated there was 8 dental health service in Fanisa Clinic in Pariaman City in 2018 and the unit cost for each service was consultation Rp.55.945, permanent tooth extraction Rp.127.825, extraction of deciduous teeth Rp.79.311, composit resin patching Rp.156.384, GIC patching Rp.145.843, scalling Rp.131.358, premedication Rp.61.291 and pulp capping Rp.107.729. Conclusion: The highest unit cost for dental health services at the Fanisa Clinic in Pariaman City was composite resin patching service and the lowest was consulting services. The average unit cost of dental health services at the Fanisa Clinic in Pariaman City was Rp.108.211. The biggest cost in the production unit was the cost of employee salary.

The Role of Stress and Job Satisfaction Among Frontline Nurses in the National Health Insurance Era: The Mediating Role of Self-Efficacy

The study aimed to analyze the effect of role stress (role ambiguity and role conflict) on the self-efficacy and job satisfaction of nurses implementing the National Health Insurance (JKN) era at Panembahan Senopati Hospital, Bantul. The research design used was an analytic survey design using a cross-sectional study approach. The population of this study was all nurses at the Panembahan Senopati Hospital, Bantul, with a sample size of 105 executive nurses. Data analysis used Spearman correlation analysis to see the effect of the independent variables on the dependent variable with a significance limit (α) of 5%. The results indicated no effect of role ambiguity on nurses' self-efficacy in the JKN era at Panembahan Senopati Hospital, Bantul (p=0.236). Further, there was an effect of role conflict on the self-efficacy of nurses in the JKN era at Panembahan Senopati Hospital, Bantul (p=0.000). There is an effect of self-efficacy on the job satisfaction of nurses in the JKN era at Panembahan Senopati Hospital, Bantul (p=0.000). It can be concluded that there is a complex relationship between role ambiguity, role conflict, self-efficacy, and nurse job satisfaction. Although not all relationships have a significant effect, this study provides an initial understanding of the factors that influence the self-efficacy and job satisfaction of nurses at Panembahan Senopati Hospital, Bantul, in the JKN era.

The Role of Organizational Culture in Mediation Dimensions of Good Corporate Governance in The Era of National Health Assurance on Performance the Blud of Hm Djafar Harun Hospital Kolaka Utara District

This study aims to look at the role of organizational culture in mediating the dimensions of GCG in the era of national health insurance on performance at the BLUD HM Djafar Harun Hospital, North Kolaka Regency, using quantitative research. The population of this study was civil servants and non-PNS employees who worked at the BLUD of the HM Djafar Harun Hospital, North Kolaka Regency, Southeast Sulawesi Province, namely 286 people who were selected based on Presidential Decree No. 77 of 2015. A Result the transparency dimension is formed by seven indicators and patient rights is the strongest indicator in forming the transparency dimension. In the accountability dimension, there are four indicators and the one that contributes the most to this dimension is the responsibility indicator. The dimension of responsibility has three indicators and the strongest in shaping this dimension are the indicators of obligation, ethics and rational decisions. The independence dimension is formed by five indicators and the strongest form of independence is the indicator of not having personal interests. In the fairness dimension, there are five indicators and the strongest form of this dimension is the cost balance indicator. Organizational culture in this study is composed of three indicators and the strongest in shaping this dimension are innovative and supportive. The performance in this study is composed of seven indicators, where the claim return indicator gives the greatest contribution to this variable. Good Corporate Governance based on the transparency dimension has an indirect effect on hospital performance in the JKN era. Good Corporate Governance based on the dimension of accountability has an indirect effect on hospital performance in the JKN era. Good Corporate Governance based on the dimension of responsibility besides having a direct influence is also a dimension that strengthens organizational culture on hospital performance in the JKN era. Good Corporate Governance based on the independence dimension has a direct effect on hospital performance in the JKN era. Good Corporate Governance based on the dimension of fairness has an indirect effect on hospital performance in the JKN era. Organizational culture directly has a significant effect on hospital performance.

Evaluation of Outpatient Satisfaction with Pharmaceutical Services in the Era of National Health Insurance

Background: The National Health Insurance (JKN) system has been able to improve the health status of the Indonesian people. However, efforts are still needed to accelerate the achievement of health indicators to catch up with other countries. Therefore, the researchers were interested in conducting research related to evaluating outpatient satisfaction with pharmaceutical services in the era of national health insurance at the PKU Muhammadiyah Gamping Hospital. Aim: The purpose of this study is to determine the profile of outpatient satisfaction and at what dimensional pointes outpatients are less satisfied with pharmaceutical services by using national health insurance at PKU Muhammadiyah Gamping hospital Method: This research is a non-experimental descriptive study with a cross sectional approach. Sampling is carried out prospectively by the purposive sampling method through questionnaires given to the target population. The number of statement items in this study is 29 satisfaction items and 29 expectations items in terms of 5 dimensions. Findings: The level of satisfaction of outpatients with pharmaceutical services in national health insurance users at PKU Muhammadiyah Gamping included the responsiveness dimension of 95.52%, the empathy dimension of 90.49%, the assurance dimension of 90.32%, the reliability dimension of 87.12%, and the tangible dimension of 86.40%. The result of the average value of the respondent's overall satisfaction level was 89.97%. Based on the average results of the value of the outpatient satisfaction level with the pharmaceutical services of national health insurance users at PKU Muhammadiyah Gamping Hospital, this value is included in the category of "very satisfied."

Cost Analysis of Therapy of Chronic Kidney Disease Inpatient In Indonesia

Impaired kidney function is one of the main public health problems in Indonesia. In the era of National Health Insurance (JKN) health financing at Advanced Level Referral Facilities (FKRTL) used the Indonesian Case Based Group (INA-CBGs) rate, but hospital costs were often higher than the costs of INA-CBGs. This study aims to determine the difference in costs. in real terms with INA-CBGs rates for hospitalization in Indonesia. This study used a cross-sectional analytic study design with a hospital perspective. Collecting data using a retrospective method with data collection in the form of medical records of patients with chronic kidney failure on hemodialysis and data on patient treatment costs. The study was conducted in regional I and regional III, each region represented by class A, B, and private hospitals so that a total of 6 hospitals were involved in this study. The data is presented descriptively. The difference between the real cost and the cost of INA-CBGs using the Mann-Whitney test SPSS analysis. The results showed that the average real cost in class A hospitals was higher than the average real cost in class B and private class hospitals. Of the 6 hospitals studied, 5 hospitals showed that the total real cost for treating chronic kidney disease in Indonesia was still higher than the INA-CBGs rates. The highest average real cost for hospitals in regional 1 is in class A hospitals with a value of up to Rp. 13,709,812 per patient/year, these costs are in accordance with the INA-CBGs rates. Meanwhile in regional 3, the highest average real cost of Rp. 33,000,450 patients/year is in a class A hospital. This cost is much higher than the INA-CBGs rate. The results of statistical tests showed that there was a significant difference between the average real cost and the INA-CBGs tariff (p=0.000). The total difference caused is Rp. 13,851,798 so that it becomes a loss and a burden for the hospital.

The ethical dilemma of medical specialists in the era of national health insurance in Semarang

Purpose: The National Health Insurance (JKN) implemented by the Indonesian government since 2014 has brought Indonesia to a new phase in realizing the right to health for its people. The social insurance system managed by Social Health Insurance Administration Body (BPJS) is felt to bring many benefits to the community despite many obstacles in its implementation. This study seeks to find the ethical dilemmas experienced by surgical and non-surgical specialists in implementing the JKN program in hospitals. Methods: The study was conducted using the qualitative method with the phenomenological approach by conducting in-depth interviews with five surgical specialists (an obstetric and gynecology, an otolaryngologist specialist, a surgeon, an eye specialist, and an anaesthesiologist) and six non-surgical specialists (children, mental health, internal medicine, medical rehabilitation, nerves, and skin specialists) in Semarang, Indonesia. In each specialization, there are two respondents interviewed. The data were analyzed using a qualitative approach. Results: Some problems still exist when specialist doctors treat BPJS patients in hospitals, which include: 1) lack of socialization, making doctors as implementers find it difficult to implement the rules; 2) different implementations in various hospitals, making doctors find it difficult to adjust when they practice at type C hospitals because the number of claims is often insufficient to provide services to patients; 3) the JKN program that has increased the number of patients, resulting in doctors' concerns about lawsuits if they make mistakes; moreover, doctors also have to adjust to existing cost claims; and 4) doctors still trying to uphold the doctor's oath and The Indonesian Medical Ethics Code (KODEKI) and always do the best for patients whatever the problem. Conclusion: The implementation of JKN must always be evaluated continuously, and the government still has to pay attention to the obstacles faced by doctors in the field. In carrying out their practice full of dilemmas, doctors must always receive adequate legal and ethical protection.

Breast, cervical, and lung cancer: A comparison of real healthcare costs and INA-CBGs rates in the era of national health insurance.

In Indonesia, the cost of cancer treatment has been determined by the Indonesian Case Base Groups (INA-CBGs) based on a code called the INA-CBG's rates. However, a fair claim should be based on the severity of the disease and the class of treatment in the hospital, not on the rates of code. In fact, the real cost of therapy for cancer is influenced by several factors including stage, comorbidity, and severity (INA-CBGs coding, type of hospital, hospital class, treatment grade, side effects, and length of stay), so in many cases, there are reported differences between the real costs and the INA-CBGs rates charged to patients. This study aims to investigate the difference between real treatment costs and INA-CBG's rates for cases of lung cancer, cervical cancer, and breast cancer at a cancer center hospital in Indonesia. This work uses an observational study, and the data were taken retrospectively from hospital financial data and patient medical records. The data were then analyzed using a one-sample t-test to determine the difference between real costs and INA-CBGs costs. The results showed that there was no significant difference between real costs and INA-CBG's cost on stage II lung cancer treatment in grade 2 with a sig. value of 0.683; code C-4-13-II in grade 3 with a sig. value of 0.151; and code C-4-13-III in grade 3 with a sig. value of 0.650; where the significance level (t alpha) is more than 0.05. Furthermore, the treatment costs for cervical cancer with codes C-4-13-I and C-4-13-II in grade 1 had sig. values of 0.155 and 0.720 respectively. Lastly, the treatment cost for breast cancer patients with codes C-4-12-II in grade 3 had a sig. value of 0.145 and code C-4-13-II in grade 3 showed a sig. value of 0.091. Although statistical evaluation showed a significant difference for some cases and not significant for other cases, in real conditions, there is a difference between the INA-CBGs and the real costs that must be evaluated by the government and stakeholders to provide justice for cancer patients.

STUDY OF THE PATTERNS OF HEALTH FINANCE UTILIZATION IN THE NATIONAL HEALTH SECURITY (JKN) ERA OF NON-PBI PARTICIPANTS AT H. ABDUL MANAP HOSPITAL

The National Health Insurance is a mechanism designed to protect individuals and families in providing health services to their citizens, especially the poor, in order to reduce financial barriers to obtaining health services. It is known that Non-PBI Mandiri participants who have been late paying premiums for at least six months show that 70.5% of respondents register as BPJS participants on the grounds that they need health financing guarantees in the near future, either on their own or according to directions from doctors or paramedics. Therefore, the aim of this research is to look at the pattern of health financing utilization in the era of National Health Insurance (JKN) for non-PBI participants at H.Abdul Manap Hospital. This study uses a qualitative research method with a phenomenological approach. Data were obtained from 9 informants by conducting in-depth interviews at H.Abdul Manap Hospital with qualitative data analysis. The results of this study (1) Psychological factors found a pattern of moral hazard phenomena with a tiered referral system, because there was a tendency to use BPJS membership benefits only to finance expensive or high-cost health services identified in research informants, (2) Personal factors found an alleatory pattern , because they feel they have benefited from the sustainability of the program and there are differences in understanding from the demand side.
 

Quality Control of Health Services of The National Health Insurance Era in East Java - Indonesia: Barriers and Strategy

The National Health Insurance ( JKN) system is designed to provide the availability of quality health services, but until now JKN participant have not felt the quality health care. The purpose of this study is to identify threats and weaknesses in health care quality control and formulate the implications of its strategy. The study was conducted at four Regional General Hospital (RSUD) in East Java - Indonesia, namely RSUD IbnuSina Gresik, RSUD NgudiWaluyoWlingiBlitar, RSUD dr. H. SlametMartodirdjoPamekasan, and RSUD dr. H. KoesnadiBondowoso. The sampling of research samples was conducted by purposive sampling and data retrieval with questionnaires and interviews. Analysis techniques used are external factor analysis, internal factor analysis, and SWOT analysis. The results of the study found that the barriers to quality control of JKN health services are the delay in payment of hospital claims by the Social Security Regulatory Agencyof Health (BPJS Health), INA-CBGs rate, BPJS Health Regulations and low people awareness for a healthy lifestyle. In terms of internal hospitals, fraud prevention systems have not been affective. The implication of the strategy is that hospitals must develop and implement fraud prevention information systems properly.
 Keywords: JKN; BPJS; quality control; health services

Implementation of lean thinking in healthcare services: Why is it importance

Background: : Indonesia has implemented National Health Insurance since 2014 through quality improvement and cost efficiency strategy. In the early implementation, many hospitals suffered a loss due to the absence of efficiency in operational health services. In the other hand, few hospitals have implemented lean as an attempt of quality improvement and cost efficiency in National Health Insurance era. There is not enough evidence in Indonesia to support management tools implementation such as Lean for improving efficiency. Aims: This study aims to develop scientific knowledge and goodwill of Lean implementation in healthcare services in many countries. This study also becomes evidence-based to implement lean in Indonesia. Methods: This study used a systematic literature review and searched PubMed, Scopus, Clinical key, Sciencedirect, EBSCO, and other related journals from 2009 to 2018 with syntax keywords for each database. Twenty-two articles were included in the reviewed. Results: The result showed that most journals discussed Lean reducing lead time and ALOS to improve the patient value and patient safety, as well as the amount of journal discussed about Lean made cost reduction in healthcare operational to improve efficiency. Conclusion: Lean implementation should be adopted by Indonesian hospitals as quality improvement and cost containment strategy and enhance patient safety under National Health Insurance era.

Health Workers' Job Satisfaction in the Era of National Health Insurance: Services and Working Conditions

Background: A person's perception of their level of justice (equity) at work is reflected in their level of job satisfaction. The nature of the work, salary, supervision, and relationships among coworkers are all factors that affect how satisfied one is with one's job. The number of patients treated by the Puskesmas in the National Health Insurance (JKN) is rising, with 586,893 persons (94.55%) in Jambi City enrolled as JKN participants at the Puskesmas. This study aimed to ascertain the relationship between services and working circumstances and the job satisfaction of healthcare professionals at the Jambi City Health Center in 2021 during the National Health Insurance (JKN) era. Methods: A cross-sectional design method was used in this investigation. The study's population comprised six hundred fifty-three healthcare professionals, and 92 respondents were nurses. Services and working circumstances are the study's independent variables, while job conditions are its dependent variable. Questionnaires are measurement devices. Univariate and bivariate data analyses were performed (using the chi-square test = 0.05). Results: Determine the association between the independent and dependent variables using bivariate Chi-Square analysis. The findings indicated that the relationship between job satisfaction and services had a p-value of 0.037, where 0.05. The correlation between favourable working conditions and job satisfaction is 0.023, with 0.05 as the reference value. Conclusion: In conclusion, there is a correlation between the services provided and the job happiness of healthcare professionals at the Jambi City Health Center and between working circumstances and job satisfaction.

Utilization Review (Preadmission) Dental Services Before And After Implementation Online Referral System

Problem statement : The online tiered referral system is a digitalized referral system which has been implemented since October 1, 2018. The objective of this research is to find a general overview of the dental and oral health services in the era of national health insurance, before and after the online tiered referral system is implemented by looking at the diagnoses of Social Security Administrator for Health patients at Raden Mattaher Regional Hospital in Jambi Province. Method : Descriptive analytic research was conducted in this research by analyzing preadmission form and referral data of Social Security Administrator for Health patients at Raden Mattaher Regional Hospital in Jambi Province, which were received before and after the implementation of online tiered referral system. Results : Based on the distribution of patient referral data that came to Raden Mattaher Regional Hospital, it was shown that the number before the implementation was higher compared to after, with a total of 135 referrals and 85 referrals. In addition, the value of p 0.05 showed that there was no effect of the online tiered referral system on dental and oral health services at Raden Mattaher Regional Hospital which had been tested by SPSS Paired T-test with a significance value of 0.311 ( 0.05). Conclusion : The conclusion of this research is that the implementation of the online tiered referral system does not affect the dental and oral health services, especially in Raden Mattaher Regional Hospital in Jambi Province Keyword : Online Tiered Referral System; Utilization Review; Preadmission Certification