Konfigurasi Kombinasi Faktor yang Mendorong Efisiensi Operasional Rumah Sakit di Era Bpjs: Analisis Fuzzy-Set Qca Pada RSUD Tipe B dan C

Zhafira Zhafira, Nabila Nabila, Willy Sanjaya, Vip Paramarta

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ABSTRACT

 

Hospital operational efficiency is a strategic issue in the National Health Insurance (JKN) system managed by BPJS Kesehatan, especially for type B and C regional public hospitals (RSUD) operating under INA-CBGs tariff pressure and public service demands. This study aims to identify the combination of factors that drive hospital operational efficiency using a Systematic Literature Review (SLR) and fuzzy-set Qualitative Comparative Analysis (fsQCA) approach. Scientific articles were collected from the PubMed, Scopus, ProQuest, Ovid, Web of Science, SINTA databases. Inclusion criteria consisting of peer-reviewed articles in Indonesian/English published between 2015 and 2025 and relevant to hospital efficiency and BPJS policies. A total of 16 articles were analyzed. The results of the study indicate that efficiency is not determined by a single factor, but rather emerges from a configuration that includes human resource capacity, organizational structure, policy support, information technology use, and managerial governance. The fsQCA approach can reveal various causal pathways to efficiency, making it a relevant method for complex analysis in health care systems. This study suggests the use of a configurative and contextual approach in developing hospital efficiency strategies in the JKN era.

 

Keywords: Hospital Operational Efficiency, BPJS, Fsqca, Health System, Factor Configuration.

 

 

ABSTRAK

 

Efisiensi operasional rumah sakit menjadi isu strategis dalam sistem Jaminan Kesehatan Nasional (JKN) yang dikelola BPJS Kesehatan, khususnya bagi RSUD tipe B dan C yang beroperasi dalam tekanan tarif INA-CBGs dan tuntutan pelayanan publik. Studi ini bertujuan mengidentifikasi konfigurasi kombinasi faktor yang mendorong efisiensi operasional rumah sakit dengan menggunakan pendekatan Systematic Literature Review (SLR) dan fuzzy-set Qualitative Comparative Analysis (fsQCA). Artikel ilmiah dikumpulkan dari database PubMed, Scopus, ProQuest, Ovid, Web of Science, SINTA. Kriteria inklusi berupa artikel peer-review berbahasa Indonesia/Inggris yang terbit antara 2015–2025 dan relevan dengan efisiensi RS dan kebijakan BPJS. Sebanyak 16 artikel dianalisis. Hasil kajian menunjukkan bahwa efisiensi tidak ditentukan oleh satu faktor tunggal, melainkan muncul dari konfigurasi yang mencakup kapasitas SDM, struktur organisasi, dukungan kebijakan, penggunaan teknologi informasi, dan tata kelola manajerial. Pendekatan fsQCA mampu mengungkap berbagai jalur kausal menuju efisiensi, menjadikannya metode yang relevan untuk analisis kompleks dalam sistem layanan kesehatan. Studi ini menyarankan penggunaan pendekatan konfiguratif dan kontekstual dalam pengembangan strategi efisiensi rumah sakit di era JKN.

 

Kata Kunci: Efisiensi Operasional Rumah Sakit, BPJS, Fsqca, Sistem Kesehatan, Faktor Konfirgurasi.


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DOI: https://doi.org/10.33024/mahesa.v6i6.23207

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