Patterns of Outpatient Referral Cases before and after Implementation of National Health Coverage Program

Objective: To understand the pattern of referral cases (accuracy of referral diagnosis, the accuracy of referral health facility and consistency of referral diagnosis) in obstetrics and gynaecology outpatient clinic before and after the implementation of JKN.Methods: This is an observational cross-sectional study using medical records of patients who were referred to obstetrics and gynaecology outpatient clinic in Dr. Cipto Mangunkusumo General Hospital in 2013 and 2014. Data were analyzed with bivariate analysis with chi-square, consisting of the accuracy of referral cases, accuracy of referral health facility, and consistency of referral cases before and after implementation of JKN.Results: There is a growing number of patients in obstetrics and gynaecology outpatient clinic after the implementation of JKN in 2014, which is 4.311 patients. Subjects were 222 cases, 104 cases from 2013 and 118 cases from 2014. From the analyzed data, the accuracy of referral diagnosis before JKN is 81.7% and after JKN 72.9%. (p=0.118), the accuracy of referral health facility before JKN is 63.5% and after JKN 71.2% (p=0.220), and the consistency of referral diagnosis before JKN is 89.4% and after JKN 84.7% (p=0.302).Conclusion: There is no statistically significant difference between the accuracy of referral diagnosis, the accuracy of referral health facility, and consistency of referral diagnosis before and after the implementation of JKN.