Fraud in healthcare facilities: A Narrative Review

Every country needs to develop Universal Health Coverage (UHC) to promote optimal levels of public health. But in realizing UHC, there must be some problems, one of which is fraud. Based on the Corruption Eradication Commission (KPK) data, potential fraud is detected from 175,774 claims of Advanced...

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Main Authors: Sarah Mauren Michaela, Mieke Nurmalasari, Hosizah Hosizah
Format: Article
Language:English
Published: YCAB Publisher 2021-12-01
Series:Public Health of Indonesia
Subjects:
Online Access:https://stikbar.org/ycabpublisher/index.php/PHI/article/view/465
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author Sarah Mauren Michaela
Mieke Nurmalasari
Hosizah Hosizah
author_facet Sarah Mauren Michaela
Mieke Nurmalasari
Hosizah Hosizah
author_sort Sarah Mauren Michaela
collection DOAJ
description Every country needs to develop Universal Health Coverage (UHC) to promote optimal levels of public health. But in realizing UHC, there must be some problems, one of which is fraud. Based on the Corruption Eradication Commission (KPK) data, potential fraud is detected from 175,774 claims of Advanced Referral Health Facilities (FKRTL) or worth Rp. 440 billion until June 2015. This review article describes the incidence of fraud in health care facilities. Out of a total of 12,736 cases of fraud, readmission occupies the most cases of fraud, which is 4,827 cases or 37.9%.
format Article
id doaj-art-ba45b676980c4d46aae6d292a1a9aaf2
institution Kabale University
issn 2528-1542
2477-1570
language English
publishDate 2021-12-01
publisher YCAB Publisher
record_format Article
series Public Health of Indonesia
spelling doaj-art-ba45b676980c4d46aae6d292a1a9aaf22025-08-20T03:44:55ZengYCAB PublisherPublic Health of Indonesia2528-15422477-15702021-12-017410.36685/phi.v7i4.465336Fraud in healthcare facilities: A Narrative ReviewSarah Mauren Michaela0Mieke Nurmalasari1Hosizah Hosizah2Department of Health Information Management, Faculty of Health and Sciences, Universitas Esa Unggul, Jakarta,IndonesiaDepartment of Health Information Management, Faculty of Health and Sciences, Universitas Esa Unggul, Jakarta, IndonesiaDepartment of Health Information Management, Faculty of Health and Sciences, Universitas Esa Unggul, Jakarta, IndonesiaEvery country needs to develop Universal Health Coverage (UHC) to promote optimal levels of public health. But in realizing UHC, there must be some problems, one of which is fraud. Based on the Corruption Eradication Commission (KPK) data, potential fraud is detected from 175,774 claims of Advanced Referral Health Facilities (FKRTL) or worth Rp. 440 billion until June 2015. This review article describes the incidence of fraud in health care facilities. Out of a total of 12,736 cases of fraud, readmission occupies the most cases of fraud, which is 4,827 cases or 37.9%.https://stikbar.org/ycabpublisher/index.php/PHI/article/view/465fraudhealthcareuniversal health insurancedelivery of health carehealth facilities
spellingShingle Sarah Mauren Michaela
Mieke Nurmalasari
Hosizah Hosizah
Fraud in healthcare facilities: A Narrative Review
Public Health of Indonesia
fraud
healthcare
universal health insurance
delivery of health care
health facilities
title Fraud in healthcare facilities: A Narrative Review
title_full Fraud in healthcare facilities: A Narrative Review
title_fullStr Fraud in healthcare facilities: A Narrative Review
title_full_unstemmed Fraud in healthcare facilities: A Narrative Review
title_short Fraud in healthcare facilities: A Narrative Review
title_sort fraud in healthcare facilities a narrative review
topic fraud
healthcare
universal health insurance
delivery of health care
health facilities
url https://stikbar.org/ycabpublisher/index.php/PHI/article/view/465
work_keys_str_mv AT sarahmaurenmichaela fraudinhealthcarefacilitiesanarrativereview
AT miekenurmalasari fraudinhealthcarefacilitiesanarrativereview
AT hosizahhosizah fraudinhealthcarefacilitiesanarrativereview