Hipertensi dalam kehamilan merupakan salah satu penyebab utama morbiditas dan mortalitas ibu di Indonesia, namun pola pemanfaatan layanannya pada era Jaminan Kesehatan Nasional (JKN) masih terbatas. Penelitian ini bertujuan untuk menganalisis determinan pemanfaatan pelayanan hipertensi kehamilan (proporsi rawat inap versus rawat jalan) di Fasilitas Kesehatan Rujukan Tingkat Lanjut (FKRTL) menggunakan pendekatan Teori Andersen. Penelitian ini menggunakan desain cross-sectional melalui analisis data sekunder sampel klaim BPJS Kesehatan tahun pelayanan 2024 dengan total 3.645 kasus. Analisis regresi logistik ganda digunakan untuk menguji pengaruh faktor predisposisi, pemungkin, dan kebutuhan terhadap pemanfaatan pelayanan hipertensi kehamilan. Hasil penelitian menunjukkan proporsi intervensi rawat inap mendominasi sebesar 92,5%. Uji multivariat membuktikan bahwa faktor predisposisi (usia, status marital, domisili peserta) dan sebagian faktor pemungkin (segmentasi kepesertaan, kepemilikan FKRTL, dan domisili FKRTL) tidak berpengaruh signifikan (p>0,05). Pemanfaatan pelayanan hipertensi kehamilan untuk rawat inap dikendalikan oleh Tipe FKRTL (Tersier OR=3,21) dan faktor kebutuhan, yaitu diagnosis hipertensi kronis superimposed pre-eklampsia (OR=5,07) serta pre-eklampsia (OR=2,95). Penelitian ini menyimpulkan bahwa JKN telah berhasil menciptakan ekuitas (pemerataan) akses layanan tanpa adanya diskriminasi demografis, status sosial, maupun kesenjangan antar-regional wilayah. Tingginya angka rawat inap menunjukkan kepatuhan terhadap indikasi klinis kegawatdaruratan obstetri. Sebagai implikasi kebijakan, diperlukan transformasi pelayanan di Fasilitas Kesehatan Tingkat Pertama (FKTP) berupa penguatan skrining deteksi dini secara agresif, serta peningkatan kapasitas layanan intensif di Rumah Sakit Sekunder (Tipe C dan D) guna mengurai penumpukan rujukan darurat di fasilitas tersier.

Hypertension in pregnancy remains one of the leading causes of maternal morbidity and mortality in Indonesia. However, patterns of healthcare utilization under the National Health Insurance (JKN) scheme for this condition remain underexplored. This study aimed to analyze the determinants of healthcare utilization for hypertensive disorders in pregnancy specifically the proportion of inpatient versus outpatient care at Advanced Referral Health Facilities (FKRTL) using Andersen's Behavioral Model of Health Services Use. A cross-sectional design was employed through secondary data analysis of the 2024 BPJS Kesehatan claims sample, comprising 3,645 cases. Multiple logistic regression analysis was conducted to examine the influence of predisposing, enabling, and need factors on utilization of pregnancy hypertension services. The results revealed that the proportion of inpatient care was predominantly high at 92.6%. Multivariate analysis demonstrated that predisposing factors (age, marital status, and participant domicile) and certain enabling factors (membership segmentation, FKRTL ownership, and regional FKRTL domicile) had no statistically significant effect (p > 0.05). Utilization of pregnancy hypertension services on hospitalization decisions was primarily driven by the type of FKRTL (Tertiary; OR = 3,21) and need factors, particularly the diagnosis of chronic hypertension with superimposed pre-eclampsia (OR = 5,07) and pre-eclampsia (OR = 2,95). This study concludes that the JKN scheme has successfully achieved equity in healthcare access, eliminating demographic, socioeconomic, and regional disparities. The high hospitalization rate purely reflects adherence to clinical indications for obstetric emergencies rather than service overutilization. As a policy implication, service transformation at Primary Healthcare Facilities (FKTP) is recommended through aggressive early detection screening, alongside intensive care capacity building at secondary hospitals (Types C and D) to reduce the burden of emergency referrals on tertiary facilities.