GAMBARAN PELAYANAN JKN

DI FKRTL TAHUN 2017

Bidang Penjaminan Manfaat Rujukan

BPJS Kesehatan Cabang Malang

1
 Data Utilisasi KC Malang tahun 2017

Tingkat Utilisasi FKRTL Target: Realisasi:

Rate RJTL (permil) 30,69 56,74
UC RJTL (rupiah) 305.060 322.454
Rate RITL (permil) 4,4 6,21
UC RITL (rupiah) 4.886.236 5.506.054
Realisasi Biaya Pelkes Des 2016-Nov 2017

Total: 1.094.156.270.223
 AKSES PELAYANAN FKRTL KASUS RJTL KC MALANG
BUPEL SEPTEMBER – NOVEMBER 2017

JUMLAH PESERTA (JIWA)

BULYAN UGD FKTP INTERNAL ANTAR RS TOTAL
Sep-17 3.995 55.193 1.290 93 60.571
Okt-17 5.010 61.173 1.514 123 67.820
Nov-17 4.133 62.120 1.346 95 67.694
 AKSES PELAYANAN FKRTL KASUS RJTL KC MALANG
BUPEL SEPTEMBER – NOVEMBER 2017

JUMLAH KASUS (KUNJUNGAN)

BULYAN UGD FKTP INTERNAL ANTAR RS TOTAL
Sep-17 4.432 108.724 2.274 223 115.653
Okt-17 5.546 126.876 2.799 292 135.513
Nov-17 4.561 129.438 2.501 194 136.694
 AKSES PELAYANAN FKRTL KASUS RJTL KC MALANG
BUPEL SEPTEMBER – NOVEMBER 2017

PROSENTASE KUNJUNGAN RJTL

BULYAN UGD FKTP INTERNAL ANTAR RS
Sep-17 3,83% 94,01% 1,97% 0,19%
Okt-17 4,09% 93,63% 2,07% 0,22%
Nov-17 3,34% 94,69% 1,83% 0,14%
 PELAYANAN FKRTL KASUS IGD RS ........
BUPEL SEPTEMBER – NOVEMBER 2017
Sep-17 Okt-17 Nov-17
NO
Row Labels Count of nosjp Row Labels Count of nosjp Row Labels Count of nosjp
1 0002073947995 6 0001388282409 5 0000110919644 8
2 0000110467552 5 0000784882348 4 0001309755486 5
3 0001194109121 4 0001106927471 4 0001404251324 4
4 0001540735176 4 0001318470952 4 0001875416769 4
5 0000343785554 3 0001539030341 4 0002239197636 4
6 0001108975138 3 0001656360911 4 0000110199475 3
7 0001270745144 3 0002212790949 4 0000110467552 3
8 0001327784174 3 0000110467552 3 0001194109121 3
9 0001409399278 3 0001194109121 3 0001327784736 3
10 0001436890904 3 0001204931654 3 0001380014932 3
11 0001520798207 3 0001435129839 3 0001727664941 3
12 0001728970301 3 0001450717479 3 0002036951008 3
13 0001798415199 3 0001468006187 3 0002047465293 3
14 0001807619883 3 0001539071627 3 0002087773244 3
15 0002080809202 3 0001639825514 3 0002196576505 3
 PELAYANAN FKRTL KASUS IGD RS ......
BUPEL SEPTEMBER – NOVEMBER 2017
Sep-17 Okt-17 Nov-17
NO
Row Labels Count of nosjp Row Labels Count of nosjp Row Labels Count of nosjp
1 0002254366991 9 0001380460904 5 0001814344626 5
2 0001870294454 4 0001380541116 4 0000170184778 4
3 0001961372193 4 0001619788498 4 0001380460904 4
4 0001038527616 3 0002254366991 4 0001284454449 3
5 0001098444598 3 0000170184778 3 0001380040042 3
6 0001105495277 3 0001380463751 3 0001380330786 3
7 0001380330786 3 0001814344626 3 0001380444489 3
8 0001380411033 3 0001967998419 3 0001870294454 3
9 0001380463751 3 0002085670247 3 0001883898549 3
10 0001380497398 3 0000110366403 2 0002073466912 3
11 0001871419465 3 0000110611618 2 0002085670247 3
12 0002195069264 3 0000110699223 2 0002254366991 3
13 0000111179597 2 0000198100506 2 0000110216564 2
14 0001295732226 2 0001038527616 2 0000110326329 2
15 0001379773721 2 0001284454449 2 0000110517399 2
 20 DIAGNOSA PRIMER ASAL UGD
BULAN PELAYANAN SEPTEMBER-NOVEMBER 2017
NO DIAGNOSA ∑ KASUS
1 Fever, unspecified 1.734
2 Asthma, unspecified 947
3 Follow-up examination after other treatment for other conditions 719
4 Other and unspecified abdominal pain 700
5 Acute upper respiratory infection, unspecified 477
6 Dyspepsia 426
7 Nausea and vomiting 411
8 Gastroenteritis and colitis of unspecified origin 403
9 Other acute gastritis 316
10 Gastritis, unspecified 282
11 Bronchitis, not specified as acute or chronic 250
12 Essential (primary) hypertension 239
13 Typhoid fever 233
14 Chronic obstructive pulmonary disease, unspecified 218
15 Retention of urine 191
16 Headache 190
17 Chest pain, unspecified 172
18 Acute bronchitis, unspecified 168
19 Acute pharyngitis, unspecified 155
20 Other and unspecified gastroenteritis and colitis of infectious origin 151
 TINDAK LANJUT KASUS IGD

1. Melaporkan harian kasus-kasus IGD ke verifikator

2. Memisahkan tagihan klaim yang berasal dari IGD
3. Mengurutkan klaim IGD
4. BPJS Kesehatan tidak membayar kasus non gawat darurat
yang masuk melalui IGD baik RJTL maupun RITL
 DATA JENIS DIAGNOSA POTENSI PRB
BULAN PELAYANAN SEP-NOV 2017

JENIS DIAGNOSA
NO JENIS PRB Diagnosa Diagnosa Total % ∑ JIWA
Primer Sekunder
1 Hipertensi 732 4.405 5.137 38,98% 3.435
2 Diabetes Mellitus 464 1.390 1.854 14,07% 1.446
3 Penyakit Jantung 443 1.250 1.693 12,85% 1.266
4 Asma 1.110 345 1.455 11,04% 1.130
5 PPOK 543 835 1.378 10,46% 926
6 Epilepsy 177 564 741 5,62% 502
7 Stroke 91 518 609 4,62% 372
8 Skizofrenia 153 107 260 1,97% 175
9 Sindroma Lupus 13 39 52 0,39% 33
Grand Total 3.726 9.453 13.179 9.285
 PERATURAN TENTANG RUJUK BALIK

63_Ed_1217_Surat_Edaran_Dirjampelkes (2).pdf
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