Governing Effective Rehabilitation Coverage: An Integrated Health-Service Accountability Model for BPJS-Funded Physiotherapy in Indonesia
DOI:
https://doi.org/10.55927/marcopolo.v4i4.35Keywords:
Rehabilitation Governance, Physiotherapy, Proportional Accountability, Effective Access, IndonesiaAbstract
Rehabilitation is an essential health-system function, yet financial entitlement under Indonesia's JKN scheme does not guarantee effective access to physiotherapy. This article develops an integrated governance framework for BPJS-funded physiotherapy rehabilitation, shifting from retrospective liability towards prospective risk governance. Adopting a normative legal and conceptual health-service management approach, it synthesises Indonesian legislation, WHO frameworks and peer-reviewed literature to map the rehabilitation pathway and identify institutional control points. The framework comprises five interconnected domains—effective access and coverage, service organisation, clinical quality, safety and continuity, and proportional accountability—operationalised through a quality and accountability dashboard. Responsibility is analysed through authority, risk exposure, control capacity, preventability and evidence of causal contribution, rather than institutional visibility or proximity to the patient. The article argues that accountability should be differentiated across professional, institutional, financing and system-level responsibilities, while remaining proportionate and evidence-based.
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