QUALITY ANALYSIS OF ADMINISTRATIVE AND MEDICAL SERVICES AT ROYAL PROGRESS INTERNATIONAL JAKARTA INTERNATIONAL HOSPITAL IN THE IMPLEMENTATION OF THE BPJS HEALTH PROGRAM

Based on patient visit data, the number of people who need outpatient health services through the BPJS Health program has increased since 2017. However, based on the results of a patient satisfaction survey in 2019, it appears that the health services provided are not optimal even though most patients are quite satisfied. There are still complaints that are submitted regarding the service procedure is considered complicated and long because it has to go through several administrative stages and the length of time to take care of registration. This study aims to analyze the quality of administrative and medical services at the Royal Progress International Hospital in Jakarta to patients participating in the BPJS Health program, the obstacles faced and the efforts made, using a qualitative approach with the type of case study. The results showed that the quality of health services provided included aspects of speed, pleasant service, free from errors and not all of the established procedures were met. There are still some aspects that need attention and improvement. The obstacles faced in providing health services for patients participating in the BPJS Health program come from patients who do not understand the procedures that must be passed and the incomplete requirements that must be met to obtain health services. Various efforts have been made by the management of the Royal Progress International Hospital Jakarta to overcome the obstacles faced so that health services continue to run well and are of higher quality.


INTRODUCTION
BPJS Health is a health insurance program, in the form of health protection and maintenance for participants who pay their own contributions or those paid by the government.Seeing the benefits and advantages that can be obtained through this program, many people are interested in registering as participants in the BPJS Health program to get health services, one of the services that the community needs the most.The definition of health services according to paragraph (1) of PP Number 19 of 2016 is all health facilities from the first level to the advanced level which includes outpatient services, inpatient care, dental care and obstetric services by midwives and nurses as well as other health facilities including other supporting facilities.determined by the government and BPJS Health.Royal Progress International Hospital Jakarta is one of the providers of advanced outpatient services for BPJS Health partners.
Based on patient visit data from the Royal Progress International Hospital in Jakarta, it can be seen that the number of people who need outpatient health services through the BPJS Health program has increased since 2017.However, based on the results of a patient satisfaction survey conducted in 2019, it appears that the health services provided through the BPJS Health program are not optimal The level of patient satisfaction is measured as a whole based on health services according to the procedures and procedures that have been determined in the BPJS Health program.Based on the results of the survey above, patients participating in the BPJS Health program are quite satisfied with the health services provided by the hospital's administrative and medical personnel.Royal Progress International Jakarta, although not yet optimal.The Community Satisfaction Index achieved was 3.83 from the target of 3.90, so that the realization of the achievements in 2019 only reached 98.21% of the target.The failure to achieve the 2019 IKM target shows that there is still patient dissatisfaction with the health services provided by the hospital's administrative and medical staff.Royal Progress International Jakarta.This can be seen from the complaints submitted.Several research results that have been carried out by previous researchers also show that the service quality of the BPJS Health program is quite good even though it has not met the expectations and desires of the patients.This is the reason the author conducted this research.

RESEARCH METHODS
This study uses a qualitative approach, allowing the researcher to explain the entire phenomenon through the use of words.This type of research is a case study, which is a method of studying, explaining or interpreting cases in a natural environment without any pressure from third parties.Therefore, this study aims to analyze the implementation of the BPJS Health program and the quality of health services.
The scope of this research is 1) Implementation of the BPJS Health program, 2) Quality of health services provided to patients participating in the BPJS Health program, 3) Constraints faced and solutions made to overcome these obstacles.The location of this research is RS.Royal Progress International Jakarta, which was chosen because the hospital is an advanced level health facility (Type B) and has collaborated with BPJS Health.
The operationalization of the concept in this study relates to the concept of implementing the BPJS Health program which includes: a) implemented programs, b) target groups, c) implementing elements (Korten in Akib and Tarigan, 2008: 19) and quality service delivery which includes aspects: a) Speed of service, b) Pleasant service, c) Free from errors and d) predetermined procedures (Lupiyoadi, 2014:8) Data collection techniques in the study consisted of interviews, observation and documentation.The analysis process is carried out starting from data reduction, namely selecting, focusing attention so that the data can be simplified, abstracted and transformed into research.Then the author analyzes the feasibility so that the data that is really needed can be selected.
The next step is to present the data.The author limits the data by collecting information that has been adjusted and clarified in order to facilitate data mastery.The last stage is drawing conclusions in the form of meanings that will be tested for authenticity, rationality and applicability, so that conclusions are obtained with important research results and values.The author uses triangulation as a tool to test the validity of the data.

RESULTS AND DISCUSSION
After conducting interviews with informants, and conducting documentation studies and observations, the following results were obtained:

Implementation of the BPJS Health Program at the Hospital. Royal Progress International Jakarta
From the results of interviews with informants, information was obtained that the implementation of the BPJS Health program at the Royal Progress Hospital was in accordance with the provisions contained in the legislation, although in some aspects it still needed to be improved and perfected so that health services became better.The achievement of the target is right, where all Indonesian people have the right to get decent, easy and affordable health services.With the BPJS Health program, many underprivileged people find it helpful to get health services, ranging from doctor's examinations, actions to drugs needed to cure their illnesses.
The quantity and quality of human resources at the Royal Progress International Hospital Jakarta is adequate and quite good, although some employees still need to improve their abilities and skills by participating in training so that the quality of services, they provide will be better in the future.The patients feel quite satisfied even though there are still problems that become patient complaints and need to get attention and quick resolution from the management.The responsibility for providing health services has been carried out according to the main duties and functions of each employee, starting from the bottom level by making a report on every incident and action taken on that day and then reported to the management of Royal Progress International Hospital Jakarta to be known and if necessary, followed up.Every incoming complaint, whether submitted by employees or patients, is evaluated through regular monthly meetings.In addition, the existence of good supervision and communication makes all employees work comfortably so that they are able to provide quality health services to patients who seek treatment.
Thus, the implementation of the BPJS Health program at the hospital.Royal Progress International is considered successful because it has met the required criteria in the consistency of program implementation as explained by Korten (Akib and Tarigan, 2008: 19) that the adequacy of fulfilling aspects of the program itself, the targeted or targeted target group and the program implementing elements.These three elements become a benchmark for the success of program implementation.

Quality of Health Services Provided by Hospital Administration and Medical Personnel. Royal Progress International
From the results of interviews with informants, information was obtained that the speed of service and responses from administrative officers, especially registration officers, were still patient complaints.This indicates that access to fast service is still difficult to obtain.Patients feel comfortable going to the Royal Progress International Hospital because they get detailed explanations from medical personnel, especially the examining doctor, about the disease they are complaining about, giving encouragement to the patient's recovery and giving drugs that are quite effective and in accordance with the disease.However, there are still mistakes made by the administrative and medical staff of the Royal Progress International Hospital Jakarta, especially regarding information that must be conveyed clearly and accurately to patients.This indicates that not all of the provision of health services through the BPJS Health program is error free.From the observations, it can be seen that the clarity and implementation of service procedures is a priority for the administrative staff of the Royal Progress International Jakarta Hospital, especially regarding the requirements that must be met by patients participating in the BPJS Health program.

Constraints Faced in the Implementation of the BPJS Health Program and the Solutions Implemented
From interviews and observations of the author in the field, the main obstacle is the behavior of patients who can't wait in line at registration or treatment and forget to pay their dues so that the BPJS Health card cannot be used at the time of treatment.To overcome the obstacles faced, the Royal Progress International Hospital Jakarta has made efforts so that the health services provided to patients can continue to run well and satisfactorily.Among other things, by requiring IT employees to always be on standby at the registration counter to anticipate the program if they experience problems.Another effort is to give vouchers to patients who cannot be served on that day to come back for treatment on another day without having to queue.With regard to brokers,

CONCLUSIONS
Implementation of the BPJS Health program in hospitals.Royal Progress International Jakarta has been carried out properly and in accordance with the provisions that have been set.This is in accordance with the program's success criteria as described by Korten (Akib and Tarigan, 2008:19).The quality of health services provided by the administrative and medical personnel of the Royal Progress International Hospital Jakarta has not fulfilled all aspects.There are several aspects that need attention and improvement.
The obstacles faced in providing medical services for patients participating in the BPJS Health program arise from patients who do not understand the procedures that must be passed and the incomplete requirements that must be met to obtain health services at the Royal Progress International Hospital Jakarta.Various efforts have been made by the management of the Royal Progress International Hospital Jakarta to overcome the obstacles faced so that health services continue to run well and are of higher quality.

Figure 1 .
Figure 1.Graph of Patient Satisfaction Levels of Participants in the BPJS Health Program at the Hospital.Royal Progress International Jakarta in 2019 (Source: Results of the 2019 IKM survey)