ABSTRACT:
The Social Security Agency (BPJS) Health is an institution established by the government to manage the National Health Insurance (JKN) or carry out health maintenance for BPJS participants. In performing health services, BPJS cooperates with First-Level Health Service Providers (PPK I) with payment using capitation system and Advanced Health Service Provider with payment using the InaCBGs system. Programs for people with chronic diseases are run in the form of back-referral program, so there is a guarantee of continuity of health services without having to spend money again. Hypertension is one of the chronic diseases that is covered by health care insurance, both in PPK I and back-referral stages. Using this policy, it is expected that blood pressure of all patients with hypertension who are BPJS participants become more controlled, considering hypertension cannot be cured and the patient must undergo lifelong treatment. The purpose of this study was to analyze the effect of BPJS participation on therapeutic success. An observational study was conducted on 186 hypertensive patients, who underwent routine checkups at Community Health Centers (Puskesmas) throughout Pamekasan Regency. The data were collected using questionnaires. The results showed no influence of BPJS participation on therapeutic success. The influencing factors were exercise, diet, and medication adherence. It is recommended that BPJS actively or in collaboration with practitioners such as Pharmacists at Pharmacy network or back-referral pharmacies to educate patients who are BPJS participants, especially those suffering from chronic diseases, to always exercise diligently, control their daily diet, adhere to medication use, and change their lifestyles.