ABSTRAKLatar Belakang: Sistem pembayaran INA-CBGs adalah sistem pembayaranpelayanan kesehatan di Indonesia yang digunakan BPJS kesehatan untukmembayar kepada fasilitas kesehatan rujukan tingkat lanjutan. Berdasarkan teori,sistem pembayaran ini memiliki kelebihan kualitas pelayanan yang baik. Namunberdasarkan data penelitian terakhir menunjukan bahwa sistem ini dirasamembuat pelayanan menjadi lama dan menyulitkan. Selain menggunakan BPJS,Indonesia masih menerapkan sistem pembayaran langsung. Sistem inimengakibatkan ekspektasi provider terhadap pasien meningkat sehingga akanmemengaruhi pada dimensi kualitas pelayanan yang diberikan. Penelitian inibertujuan untuk mengetahui adakah hubungan antara sistem pembayaran langsungdan INA-CBGs dengan kualitas pelayanan kesehatan Pasien Rawat Jalan diRSUD Dr MoewardiMetode Penelitian: Penelitian ini merupakan penelitian observasional analitikdengan pendekatan cross-sectional, dilaksanakan di RSUD Dr Moewardi. Sampelterdiri dari 80 pasien rawat jalan yang diambil dengan teknik quota samplingdengan restriksi kriteria inklusi dan eksklusi. Semua responden diminta mengisikuesioner kualitas pelayanan kesehatan berdasarkan model SERVQUAL. Metodeanalisis yang digunakan adalah uji t berpasangan dan analisis regresi linierberganda .Hasil Penelitian: Uji t berpasangan antara persepsi harapan kualitas pelayanandengan persepsi kenyataan kualitas pelyanan diperoleh nilai mean kenyataan(100.36) lebih rendah dari harapan (114.30) dengan nilai P sebesar < 0.001. Hasilanalisis regresi linier berganda tentang hubungan sistem pembayaran langsungdan INA-CBGs dengan kualitas pelayanan rawat jalan RSUD Dr Moewardimenunjukkan bahwa hubungan antara sistem pembayaran terhadap kualitaspelayanan secara statistik tidak signifikan (p = 0.259)Simpulan: Terdapat kesenjangan antara kualitas pelayanan yang diharapkandengan kenyataan yang didapatkan. Perbedaan kualitas pelayanan kesehatanantara sistem pembayaran langsung dan INA-CBGs secara statistik tidaksignifikanKata Kunci: bayar langsung, INA-CBGs, kualitas pelayanan, BPJS.ABSTRACTBackground: INA-CBGs is a payment system used by BPJS Kesehatan, theIndonesian healthcare insurance provider to provide reimbursement to advancedreferral healthcare facilities (FKRTL). Based on the theory, this payment systemhas the advantage of providing a better service quality, but based on the latestresearch data, it was found that the system led to a prolonged and difficult serviceprovision instead. As of now, Indonesia still supplements BPJS with a directpayment system, causing an increased expectation of compensation from thepatient, which effects the service quality. The purpose of this research is todetermine whether or not a relationship is present between the direct paymentsystem and INA-CBGs with the quality of outpatient care in RSUD Dr Moewardi.Methods: The research was an analytic observational with a cross-sectionalapproach, performed in RSUD Dr Moewardi. The sample consisted of 80outpatients from which data was taken through a quota sampling technique, with arestriction through inclusion and exclusion criteria. All respondents were asked tofill a questionnaire of the hospital’s healthcare service quality based on theSERVQUAL model. The analysis method employed was a paired t-test and adouble linear regression analysis.Results: The paired t-test between the perception of service quality expectationwith a perception of the service quality reality produced a mean reality score(100.36) which was lower than expectation (114.30) with a P score of < 0.001.The double linear regression analysis results about the relationship between adirect payment method and INA-CBGs, with the quality of RSUD Dr Moewardioutpatient care showed that the relationship between the payment system andservice quality was statistically insignificant (p = 0.259).Conclusion: A disparity was found between expected service quality with theobtained reality. The healthcare service quality difference between a directpayment system and INA-CBGs was statistically insignificant.Keywords: direct payment, INA-CBGs, Service quality, BPJS