Penelitian ini bertujuan untuk menganalisis utilisasi dan biaya pelayanan hipertensi serta faktor-faktor yang berhubungan pada peserta BPJS Kesehatan di Fasilitas Kesehatan Rujukan Tingkat Lanjut (FKRTL) di Indonesia tahun 2024. Penelitian ini menggunakan desain deskriptif-analitik dengan pendekatan kuantitatif menggunakan data klaim BPJS Kesehatan periode Januari–Desember 2024. Analisis dilakukan secara univariat dan bivariat untuk melihat hubungan antara karakteristik peserta, fasilitas pelayanan kesehatan, dan kondisi klinis dengan utilisasi serta biaya pelayanan hipertensi. Hasil penelitian menunjukkan bahwa pelayanan hipertensi lebih banyak dimanfaatkan dalam bentuk tanpa rawat inap (65,2%) dibandingkan rawat inap (34,8%). Namun, median biaya pelayanan rawat inap per individu (Rp2,16 juta) jauh lebih tinggi dibandingkan pelayanan tanpa rawat inap (Rp198 ribu). Variabel wilayah FKRTL (p-value=0,000), tipe FKRTL (p-value=0,000), dan kondisi klinis (p-value=0,000) menunjukkan perbedaan biaya pelayanan hipertensi yang signifikan. Penelitian ini menyimpulkan bahwa variasi utilisasi dan biaya pelayanan hipertensi dipengaruhi oleh karakteristik fasilitas pelayanan kesehatan, pola pemanfaatan layanan, dan kondisi klinis pasien. Pelayanan rawat inap menjadi kontributor utama pembiayaan hipertensi dalam sistem JKN.

This study aimed to analyze the utilization and healthcare costs of hypertension services, as well as the associated factors among BPJS Kesehatan participants at Advanced Referral Healthcare Facilities (FKRTL) in Indonesia in 2024. A descriptive-analytic study design with a quantitative approach was employed using BPJS Kesehatan claims data from January to December 2024. Univariate and bivariate analyses were conducted to examine the relationships between participant characteristics, healthcare facility characteristics, clinical conditions, and the utilization and costs of hypertension services. The results showed that hypertension services were utilized more frequently in non-inpatient care (65.2%) than inpatient care (34.8%). However, the median cost of inpatient care per individual (IDR 2.16 million) was substantially higher than that of non-inpatient care (IDR 198 thousand). FKRTL region (p-value=0.000), FKRTL type (p-value=0.000), and clinical condition (p-value=0.000) were significantly associated with differences in hypertension healthcare costs. This study concludes that variations in the utilization and costs of hypertension services are influenced by healthcare facility characteristics, healthcare utilization patterns, and patients’ clinical conditions. Inpatient care was identified as the main contributor to hypertension-related healthcare expenditures within Indonesia’s National Health Insurance (JKN) system.