Mapping Research on BPJS Claims Management and Hospital Reimbursement: A Bibliometric Analysis

Abstract

 In Indonesia, however, the near-universal coverage achieved by BPJS Kesehatan has not been matched by efficient claims governance: reimbursement deficits and administrative bottlenecks persist, while evidence remains fragmented across separate epidemiological, economic, and administrative research streams that rarely intersect. This fragmentation is especially consequential during 2020-2025, the post-pandemic transition when claim volumes surged and digital verification expanded, yet no synthesis has mapped how research responded. Consolidating this evidence is therefore essential for guiding hospital management and BPJS Kesehatan policy. This study applied bibliometric analysis to Scopus-indexed, Indonesia-affiliated publications from 2020 to 2025, narrowing 25,270 initial records to 50 documents analysed in VOSviewer through keyword co-occurrence mapping. Unlike earlier Indonesian bibliometric studies on health policy or bibliometrics broadly, this study is the first to chart specifically the intellectual structure of BPJS claims and hospital reimbursement research. Five thematic clusters emerged: health outcomes and disease burden (32%), economic evaluation and cost analysis (21%), hospital reimbursement systems and financial management (19%), health policy and UHC (15%), and healthcare access and service delivery (13%), with annual publications rising from seven-eight to thirteen by 2025. Operational aspects, including digital claims verification and reimbursement governance, remain underexplored and should guide future research and hospital practice.