Sharia-Integrated Healthcare: A Comprehensive Analysis of Islamic Hospitals' Preparedness for the KRIS Policy in Indonesia
DOI:
https://doi.org/10.71164/socialmedicine.v19i3.2026.1973Keywords:
Infrastructure Readiness, Islamic Hospitals, Standardized Inpatient Class (KRIS), Sharia Healthcare Industry, National Health Insurance (JKN), Health Policy, IndonesiaAbstract
The Standardized Inpatient Class (KRIS) policy aims to improve healthcare quality and equity in Indonesia, specifically supporting the National Health Insurance (JKN) program. This study evaluates the readiness of Islamic hospitals and the sharia healthcare ecosystem for KRIS implementation. Through a mixed-methods approach involving 29 hospitals, the study assessed readiness based on 12 KRIS criteria, including infrastructure, medical facilities, and the integration of sharia principles. Findings show significant progress in physical facility standards; however, challenges remain regarding limited inpatient capacity and insufficient isolation and ICU spaces. While sharia-compliant features—such as wudhu facilities and halal materials—are largely implemented, improvements in spiritual services are needed. Furthermore, regulatory uncertainties regarding tariff adjustments and human resource constraints in remote areas pose additional hurdles. The study recommends enhanced government support, policy harmonization, and specialized training to ensure successful KRIS implementation.
standards, but challenges remain, including limited inpatient room capacity, insufficient isolation rooms, and ICU space. While sharia integration in healthcare services, like wudhu facilities and halal materials, is mostly implemented, improvements are needed in spiritual services. Regulatory uncertainties, such as tariff adjustments and BPJS participant segmentation, as well as human resource and infrastructure issues, especially in remote areas, pose further challenges. The study recommends enhanced government support, policy harmonization, infrastructure development, and human resource training to ensure successful KRIS implementation.References
G. P. Afonso, D. C. Ferreira, and J. R. Figueira, “A Network-DEA model to evaluate the impact of quality and access on hospital performance,” Ann Oper Res, vol. 342, no. 3, pp. 2169–2199, 2024, doi: 10.1007/s10479-023-05362-x.
Z. Sun, Y. Sun, X. Liu, Y. Tu, S. Chen, and D. Qian, “A Refined Evaluation Analysis of Global Healthcare Accessibility Based on the Healthcare Accessibility Index Model and Coupling Coordination Degree Model,” Sustainability (Switzerland), vol. 14, no. 16, Aug. 2022, doi: 10.3390/su141610280.
L. M. E. Vaz, L. Franco, T. Guenther, K. Simmons, S. Herrera, and S. N. Wall, “Operationalising health systems thinking: a pathway to high effective coverage,” Health Res Policy Syst, vol. 18, no. 1, p. 132, 2020, doi: 10.1186/s12961-020-00615-8.
B. Yanful, A. Kirubarajan, D. Bhatia, S. Mishra, S. Allin, and E. Di Ruggiero, “Quality of care in the context of universal health coverage: a scoping review,” Health Res Policy Syst, vol. 21, no. 1, p. 21, 2023, doi: 10.1186/s12961-022-00957-5.
J. Braithwaite et al., “Transformational improvement in quality care and health systems: the next decade,” BMC Med, vol. 18, no. 1, p. 340, 2020, doi: 10.1186/s12916-020-01739-y.
N. Mboi, “Indonesia: on the way to universal health care,” Health Syst Reform, vol. 1, no. 2, pp. 91–97, 2015, doi: 10.1080/23288604.2015.1020642.
A. Yuditia, Y. Hidayat, and S. Achmad, “Pelaksanaan Jaminan Kesehatan Nasional Oleh BPJS Berdasarkan Undang-Undang No. 40 Tahun 2004 Tentang Sistem Jaminan Sosial Nasional,” Jurnal Magister Ilmu Hukum, vol. 6, no. 1, pp. 43–61, 2023.
K. Anindya, J. T. Lee, B. McPake, S. A. Wilopo, C. Millett, and N. Carvalho, “Impact of Indonesia’s national health insurance scheme on inequality in access to maternal health services: A propensity score matched analysis,” J Glob Health, vol. 10, no. 1, Jun. 2020, doi: 10.7189/JOGH.10.010429.
A. B. Pratiwi, H. Setiyaningsih, M. O. Kok, T. Hoekstra, A. G. Mukti, and E. Pisani, “Is Indonesia achieving universal health coverage? Secondary analysis of national data on insurance coverage, health spending and service availability,” BMJ Open, vol. 11, no. 10, p. e050565, 2021.
D. Nurmila Siliwadi and H. Subhandi Bakhtiar, “Medicine and Nursing www.iiste.org ISSN,” 2017. .Online Available: www.iiste.org
A. D. Harahap, A. D. Fitriani, and D. Teo, “Analysis of Participants Waiting Payment of JKN Mandiri Premium in the Working Area of the Helvetia Community Health Center,” Journal La Medihealtico, vol. 2, no. 1, pp. 47–52, Jan. 2021, doi: 10.37899/journallamedihealtico.v2i1.292.
R. Amelia Saleh and M. Syamsu Hidayat, “Analysis Of Hospital Readiness For The Implementation Of Standard Inpatient Care Class (KRIS): Literature Review,” vol. 15, 2024, doi: 10.54209/eduhealth.v15i04.
.13 F. Meidiawaty, “The Standard Inpatient Class (KRIS) Policy In Hospitals And Its Impact On The Decline In Bed Availability For BPJS,” 2024. doi: https://doi.org/10.22515/jurnalalhakim.v6i1.8948.
A. Yazid, S. Aminah, D. K. Ariadni, T. Y. Utsman, and A. Sugitanata, “Istiḥsān Theory and Its Application in the Standard Inpatient Class (KRIS) Initiative by the National Health Insurance Program (JKN),” Jurnal Al-Hakim: Jurnal Ilmiah Mahasiswa, Studi Syariah, Hukum dan Filantropi, pp. 1–14, May 2024, doi: 10.22515/jurnalalhakim.v6i1.8948.
Y. Choudhary and H. Kumar, “Green and resilient health infrastructure,” in Climate Change and the Health Sector, Routledge India, 2021, pp. 131–138.
L. Vali, M. H. Mehrolhasani, S. Mirzaei, and N. Oroomiei, “Challenges of implementing the accreditation model in military and university hospitals in Iran: a qualitative study,” BMC Health Serv Res, vol. 20, no. 1, pp. 1–9, 2020.
V. Wardhani, J. P. van Dijk, and A. Utarini, “Hospitals accreditation status in Indonesia: associated with hospital characteristics, market competition intensity, and hospital performance?,” BMC Health Serv Res, vol. 19, no. 1, pp. 1–10, 2019.
D. Agatha, “Begini Roadmap implementasi KRIS JKN, Akan dilakukan bertahap mulai 2022-2024.” Accessed: Jan. 14, 2024. .Online Available: https://www.liputan6.com/health/read/4927001/begini-road-map-implementasi-kris-jkn-akan-dilakukan-bertahap-mulai-2022-2024?page=3
J. W. Creswell and M. Inoue, “A process for conducting mixed methods data analysis,” J Gen Fam Med, 2024.
J. W. Creswell, “My 35 Years in Mixed Methods Research,” J Mix Methods Res, p. 15586898241253892, 2024.
F. Nyimbili and L. Nyimbili, “Types of Purposive Sampling Techniques with Their Examples and Application in Qualitative Research Studies,” British Journal of Multidisciplinary and Advanced Studies, vol. 5, no. 1, pp. 90–99, 2024.
D. Afni and A. Bachtiar, “Analisis Kesiapan Implementasi Kelas Rawat Inap Standar: Studi Kasus di RS Wilayah Kabupaten Tangerang (PP NO 47 Tahun 2021),” Syntax Literate; Jurnal Ilmiah Indonesia, vol. 7, no. 5, pp. 6634–6655, 2022.
A. Yazid, S. Aminah, D. K. Ariadni, T. Y. Utsman, and A. Sugitanata, “Istiḥsān Theory and Its Application in the Standard Inpatient Class (KRIS) Initiative by the National Health Insurance Program (JKN),” Jurnal Al-Hakim: Jurnal Ilmiah Mahasiswa, Studi Syariah, Hukum dan Filantropi, pp. 1–14, 2024.
P. Mwine et al., “Readiness of health facilities to manage individuals infected with COVID-19, Uganda, June 2021,” BMC Health Serv Res, vol. 23, no. 1, p. 441, 2023, doi: 10.1186/s12913-023-09380-0.
R. Ammoun, W. M. Wami, P. Otieno, C. Schultsz, C. Kyobutungi, and G. Asiki, “Readiness of health facilities to deliver non-communicable diseases services in Kenya: a national cross-sectional survey,” BMC Health Serv Res, vol. 22, no. 1, p. 985, 2022, doi: 10.1186/s12913-022-08364-w.
M. A. Peters et al., “Resilience of front-line facilities during COVID-19: evidence from cross-sectional rapid surveys in eight low- and middle-income countries,” Health Policy Plan, vol. 38, no. 7, pp. 789–798, Aug. 2023, doi: 10.1093/heapol/czad032.
B. Farah, M. Pavlova, and W. Groot, “Hospital disaster preparedness in sub-Saharan Africa: a systematic review of English literature,” BMC Emerg Med, vol. 23, no. 1, p. 71, 2023, doi: 10.1186/s12873-023-00843-5.
J. C. Acharya et al., “Strengths, weaknesses, opportunities, and threats for the nation’s public health information systems infrastructure: synthesis of discussions from the 2022 ACMI Symposium,” Journal of the American Medical Informatics Association, vol. 30, no. 6, pp. 1011–1021, Jun. 2023, doi: 10.1093/jamia/ocad059.
A. Füszl et al., “Provision of safe patient care during the COVID-19 pandemic despite shared patient rooms in a tertiary hospital,” Antimicrob Resist Infect Control, vol. 11, no. 1, p. 61, 2022.
M. Mead and A. M. Ibrahim, “Strategies to evaluate the quality of hospital design with clinical data,” J Hosp Med, vol. 18, no. 6, pp. 538–543, 2023.
A. Dinis et al., “Association between service readiness and PMTCT cascade effectiveness: a 2018 cross-sectional analysis from Manica province, Mozambique,” BMC Health Serv Res, vol. 22, no. 1, p. 1422, 2022.
D. K. Thapa, K. Acharya, A. Karki, and M. Cleary, “Health facility readiness to provide antenatal care (ANC) and non-communicable disease (NCD) services in Nepal and Bangladesh: Analysis of facility-based surveys,” PLoS One, vol. 18, no. 3, p. e0281357, 2023.
M. Colombini, S. H. Mayhew, C. Garcia-Moreno, A. F. d’Oliveira, G. Feder, and L. J. Bacchus, “Improving health system readiness to address violence against women and girls: a conceptual framework,” BMC Health Serv Res, vol. 22, no. 1, p. 1429, 2022.
J. King et al., “Readiness of health facilities to provide safe childbirth in Liberia: a cross-sectional analysis of population surveys, facility censuses and facility birth records,” BMC Pregnancy Childbirth, vol. 22, no. 1, p. 952, 2022.
A. Kabir, M. N. Karim, and B. Billah, “The capacity of primary healthcare facilities in Bangladesh to prevent and control non-communicable diseases,” BMC Primary Care, vol. 24, no. 1, p. 60, 2023.
S. Ghimire, S. Ghimire, P. Khanal, R. A. Sagtani, and S. Paudel, “Factors affecting health insurance utilization among insured population: evidence from health insurance program of Bhaktapur district of Nepal,” BMC Health Serv Res, vol. 23, no. 1, Dec. 2023, doi: 10.1186/s12913-023-09145-9.
D. Bintabara and D. Ngajilo, “Readiness of health facilities for the outpatient management of non-communicable diseases in a low-resource setting: an example from a facility-based cross-sectional survey in Tanzania,” BMJ Open, vol. 10, no. 11, p. e040908, 2020.
S. A. C. Clemens, A. K. Sekine, F. Tovar-Moll, and R. Clemens, “COVID-19 site readiness initiative: building clinical trial capacity for vaccine efficacy trials in Latin America in response to the pandemic,” Vaccine X, vol. 12, p. 100238, 2022.
L. Cusack, R. Munt, N. Verdonk, T. Schultz, and J. Maben, “Comparison of experiences of nursing staff and patients before and after move to 100% single-bed room hospital in Australia: mixed methods,” BMC Health Serv Res, vol. 23, no. 1, p. 81, 2023, doi: 10.1186/s12913-023-09073-8.
D. Stojanovic and M. Vujovic, “Indoor Positioning Simulation for Examination and Correction of Occupancy Density Limits in Architectural Design,” Buildings, vol. 12, no. 7, Jul. 2022, doi: 10.3390/buildings12070966.
.41 S. Grimaz, E. Ruzzene, and F. Zorzini, “Situational assessment of hospital facilities for modernization purposes and resilience improvement,” International Journal of Disaster Risk Reduction, vol. 66, p. 102594, 2021, doi: https://doi.org/10.1016/j.ijdrr.2021.102594.
A. Stiller, F. Salm, P. Bischoff, and P. Gastmeier, “Relationship between hospital ward design and healthcare-associated infection rates: a systematic review and meta-analysis,” Antimicrob Resist Infect Control, vol. 5, no. 1, p. 51, 2016, doi: 10.1186/s13756-016-0152-1.
.43 C. Cubukcuoglu, P. Nourian, M. F. Tasgetiren, I. S. Sariyildiz, and S. Azadi, “Hospital layout design renovation as a Quadratic Assignment Problem with geodesic distances,” Journal of Building Engineering, vol. 44, p. 102952, 2021, doi: https://doi.org/10.1016/j.jobe.2021.102952.
P. J. Bueno de Mesquita, W. W. Delp, W. R. Chan, W. P. Bahnfleth, and B. C. Singer, “Control of airborne infectious disease in buildings: Evidence and research priorities,” Indoor Air, vol. 32, no. 1, p. e12965, Jan. 2022, doi: https://doi.org/10.1111/ina.12965.
M. López-García and T. Kypraios, “A unified stochastic modelling framework for the spread of nosocomial infections,” J R Soc Interface, vol. 15, no. 143, p. 20180060, 2018.
V. Puro et al., “Pillars for prevention and control of healthcare-associated infections: an Italian expert opinion statement,” Antimicrob Resist Infect Control, vol. 11, no. 1, p. 87, 2022.
S. J. Rajakaruna, W.-B. Liu, Y.-B. Ding, and G.-W. Cao, “Strategy and technology to prevent hospital-acquired infections: lessons from SARS, Ebola, and MERS in Asia and West Africa,” Mil Med Res, vol. 4, pp. 1–6, 2017.
M. Alfarizi and R. Arifian, “Patient satisfaction with Indonesian sharia hospital services: Halal healthcare tool and implications for loyalty-WoM,” Asian Journal of Islamic Management (AJIM), pp. 18–35, 2023.
I. Khairunnisa and K. Kusbaryanto, “Implementation Of Sharia Law On Patient Medical Services In Certified Sharia Hospitals: A Literature Review,” Jurnal Aisyah: Jurnal Ilmu Kesehatan, vol. 8, no. 2, 2023.
.50 A. Zakaria, N. M. Isa, T. Hairudin, and H. N. Ismail, “The satisfaction of the users with the islamic design quality in instant hospitals for non-critical covid-19 patients in malaysia,” Journal of Islamic Thought and Civilization, vol. 11, no. 1, pp. 355–373, 2021.
M. M. Gashoot, “Revisiting healing environments: Islamic interior elements in hospital rooms in north Africa,” HERD: Health Environments Research & Design Journal, vol. 15, no. 1, pp. 315–332, 2022.
I. P. Salsabila, N. Rokhman, and E. Etylusfina, “Evaluasi Kelengkapan Data Informasi terkait Survei Kelas Rawat Inap Standar (KRIS) untuk Mendukung Keputusan Kesehatan di Dinas Kesehatan Sleman,” Jurnal Rekam Medis dan Informasi Kesehatan, vol. 7, no. 1, pp. 32–39, Mar. 2024, doi: 10.31983/jrmik.v7i1.11255.
O. Ino, F. Firdhaus, A. Sriatmi, and A. Suryoputro, “Challenges and Strategies For Implementing Performance-Based Capitation in Indonesian Community Health Center : A Scoping Review,” Community Health Center : A Scoping Review. Journal Eduvest, vol. 4, no. 10, pp. 9173–9187, 2024, .Online Available: http://eduvest.greenvest.co.id
E. Marlina, H. Prasetyo, and H. S. Bakhtiar, “Dilemmatics of the Program for Equating Specialist Doctors with the Readiness of Educational Hospitals through Reconstruction of Regulations on the Role of Private Hospitals,” International Journal of Social Science and Human Research, vol. 7, no. 07, Jul. 2024, doi: 10.47191/ijsshr/v7-i07-97.
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