Analisis Pola Layanan Kesehatan Rawat Jalan pada Tahun Pertama Implementasi Program Jaminan Kesehatan Nasional (JKN)

Wahyu Pudji Nugraheni, Risky Kusuma Hartono

Abstract


Outpatient treatment is one of the benefits guaranteed by the National Health Insurance (JKN) program. The main objective of JKN program is to increase public accessibility to health services that suits their needs. Utilization of outpatient services are getting better by all levels of society is an indicator to the ideal image of the JKN program. The purpose of this study was to determine the pattern of outpatient health care at health facilities (physician practices/clinics, public health center, public and private hospitals) in the first year implementation of JKN program. This study used secondary data to analyze the data of Indonesia Family Life Survey (IFLS) in 2014 as the first year of implementation JKN program. The data in this study using a descriptive analysis which was deeply reviewed.The results showed that in the span of one year of JKN program implementation, the age population who get access to outpatient health care at the most in the range 0-18 years, the people of the urban areas more access outpatient health services compared to rural residences, and the population in the range of quintile (rich economic status) as much as 26.73%. Health facilities are the most widely used for outpatient services is physician practice or clinic amounted to 4.55%. The results of this study can be used as an evidence-based evaluation of the improvement of health care access for the public to pay more attention to the economic status of poor and be a proactive improvement of access to health services for people in rural areas.

 

Abstrak

Pelayanan rawat jalan merupakan salah satu manfaat yang dijamin oleh program Jaminan Kesehatan Nasional (JKN). Tujuan utama program JKN adalah meningkatkan aksesibiltas masyarakat terhadap pelayanan kesehatan yang sesuai dengan kebutuhan. Pemanfaatan layanan rawat jalan yang semakin baik oleh semua lapisan masyarakat merupakan gambaran ideal dan indikator tercapainya program JKN. Tujuan penelitian ini adalah untuk mengetahui pola pelayanan kesehatan rawat jalan pada fasilitas kesehatan (dokter praktik/klinik, puskesmas, RS pemerintah, dan swasta) di tahun pertama implementasi program JKN. Penelitian ini menggunakan data sekunder dengan menganalisis data Indonesia Family Life Survey (IFLS) 2014 sebagai tahun pertama implementasi program JKN. Teknik analisis dalam penelitian ini menggunakan analisis deskriptif yang diulas secara mendalam. Hasil penelitian menunjukkan bahwa pada rentang satu tahun implementasi program JKN, usia penduduk yang melakukan akses ke pelayanan kesehatan rawat jalan paling banyak pada rentang usia 0–18 tahun,masyarakat daerah perkotaan lebih banyak mengakses pelayanan kesehatan rawat jalan dibandingkan dengan penduduk pedesaan, dan penduduk pada kisaran kuintil 5 (status ekonomi kaya) sebanyak 26,73%. Fasilitas kesehatan yang paling banyak digunakan untuk layanan rawat jalan adalah dokter praktik/klinik sebesar 4,55%. Hasil penelitian ini dapat digunakan sebagai evidence based evaluasi perbaikan akses pelayanan kesehatan untuk lebih memperhatikan masyarakat berstatus ekonomi miskin dan jemput bola peningkatan akses pelayanan kesehatan bagi masyarakat di daerah pedesaan.


Keywords


outpatient; JKN; IFLS 2014; health service

References


United Nations. Universal Declaration of Human Rights. Un [Internet]. 2015;72. Available from: http://www.un.org/en/udhrbook/pdf/udhr_ booklet_en_web.pdf

Republik Indonesia. Undang-Undang Dasar Negara Republik Indonesia Tahun 1945. Sekretariat Jenderal MPR RI; 2002.

Republik Indonesia. Tahun 1999 tentang Hak Asasi Manusia. Vol. 165, Lembaran Negara Republik Indonesia Nomor. Republik Indonesa; 1999.

Kementerian Kesehatan RI. Rencana Strategis Kementerian Kesehatan Tahun 2015-2019 KepMenKes RI Nomor HK 02 02 MENKES 52 2015. Republik Indonesia; 2015.

Dyakova M, Laaser U, Commission E. Health Determinants in the Scope of New Public Health. 2005. 1-633 p.

Breu F, Guggenbichler S, Wollmann J. Health Care in America:Trends in Utilization. Vasa. 2008;

Feldstein P. Health care economics. USA: Cengage Learning; 2012.

Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;1–10.

Grabovschi C, Loignon C, Fortin M, Masi R, Smedley B, Stith A, et al. Mapping the concept of vulnerability related to health care disparities: a scoping review. BMC Health Serv Res [Internet]. 2013;13(1):94. Available from: http://bmchealthservres.biomedcentral.com/ articles/10.1186/1472-6963-13-94

Rosero-Bixby L. Spatial access to health care in Costa Rica and its equity: a GIS-based study. Soc Sci Med. 2004;58(7):1271–84.

Kementerian Kesehatan RI. Permenkes No. 5 Tahun 2014 tentang Panduan Praktik Klinis Bagi Dokter di Fasilitas Pelayanan Kesehatan Primer. Jakarta: Kementrian Kesehatan; 2014.

KKI. Peraturan Konsil Kedokteran Indonesia No. 11 Tahun 2012 tentang Standar Kompetensi Dokter Indonesia. Jakarta: Konsil Kedokterran Indonesia; 2012.

Tseng YH, Khan MA. Where do the poorest go to seek outpatient care in Bangladesh: Hospitals run by government or microfinance institutions? PLoS One. 2015;10(3):1–15.

Quimbo S, Florentino J, Peabody JW, Shimkhada R, Panelo C, Solon O. Underutilization of social insurance among the poor: Evidence from the Philippines. PLoS One. 2008;3(10):1–4.

Strauss J, Witoelar F, Sikoki B, Wattie AM. The fourth wave of the Indonesia Family Life Survey: Overview and field report. RAND Labor and Population Working Paper WR-675/1-NIA/ NICHD. Santa Monica, CA: RAND; 2009.

WHO. The world health report 2013: Research for universal health coverage. World Health Organ Press. 2013;146.

Republik Indonesia. Undang-Undang Nomor 40 tahun 2004 tentang Sistem Jaminan Sosial Nasional. Jakarta: Republik Indonesia; 2004.

Republik Indonesia. Undang-Undang Nomor 24 tahun 2011 tentang Badan Pelaksana Jaminan Sosial. Jakarta: Republik Indonesia; 2012.

Flatø H, Zhang H. Inequity in level of healthcare utilization before and after universal health coverage reforms in China: evidence from household surveys in Sichuan Province. Int J Equity Health [Internet]. 2016;15(1):96. Available from: http://equityhealthj.biomedcentral.com/ articles/10.1186/s12939-016-0385-x

Reich MR, Harris J, Ikegami N, Maeda A, Cashin C, Araujo EC, et al. Moving towards universal health coverage: Lessons from 11 country studies. Lancet[Internet].2016;387(10020):811–6. Available from: http://dx.doi.org/10.1016/S0140- 6736(15)60002-2

Strauss J, Sikoki B, Witoelar F. The Fifth Wave of the Indonesia Family Life Survey (IFLS5): Overview and Field Report. 2014;1(March).

United Nations Development Programme (UNDP). Human Development Report 2015 Work for Human Development. Geneva: United Nations; 2015.

Prinja S, Bahuguna P, Pinto AD, Sharma A, Bharaj G, Kumar V, et al. The cost of universal health care in India: A model based estimate. PLoS One. 2012;7(1).

Sparrow R, Suryahadi A, Widyanti W. Social health insurance for the poor: targeting and impact of Indonesia’s Askeskin program. Citeseer; 2010.

Hidayat B, Thabrany H, Dong H, Sauerborn R. The effects of mandatory health insurance on equity in access to outpatient care in Indonesia. 2004;19(5):322–35.

Tim Presiden RI. Akselerasi Mewujudkan Indonesia Sentris. Jakarta: Kantor Staf Presiden Republik Indonesia; 2016.

Yiengprugsawan V, Carmichael GA, Lim L-Y, Seubsman S, Sleigh AC. Explanation of inequality in utilization of ambulatory care before and after universal health insurance in Thailand. Health Policy Plan. 2010;czq028.

Kemeterian Kesehatan RI. Buku Pegangan Sosialisasi Jaminan Kesehatan Nasional dalam Sistem Jaminan Sosial Nasional. Jakarta: Kementrian Kesehatan; 2014.

van Herpen GWEB. Public Private Partnerships, the advantages and disadvantages examined. Assoc Eur Transp [Internet]. 2002; Available from:http://abstracts.aetransport.org/paper/ download/id/1466.


Full Text: PDF

Refbacks

  • There are currently no refbacks.


Media Penelitian dan Pengembangan Kesehatan (Media of Health Research & Development)Indexed on:

p-ISSN: 0853-9987
e-ISSN: 2338-3445
Published by: Badan Penelitian dan Pengembangan Kesehatan
Jalan Percetakan Negara No.29
Jakarta Pusat 10560
Indonesia



Visitor of MPK : View My Stats
Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Media Penelitian dan Pengembangan Kesehatan
Copyright©2016-Badan Penelitian dan Pengembangan Kesehatan