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Program Keluarga Harapan (PKH) aims to improve the standard of living of the community by accommodating the utilization of health services. One health component that is required as a PKH Beneficiary Family (KPM) is that pregnant women must deliver in a health care facility. The purpose of this study is to look at the effect of PKH on the use of health facilities for delivery in Indonesia. This study used a cross sectional design using Susenas and Podes data in 2018 with a total sample of 8,636 mothers aged 15-49 who had had their last live deliver in the two-year period before the survey was conducted. The analysis uses the Propensity Score Matching (PSM) method with the Logit model that looks at the OR value. PKH has an influence on the use of maternity in health facilities. Dominant
factors that influence mothers in utilizing health facilities for deliveryh are urban residential areas, mothers and household heads with higher education, ownership of communication and information tools, ownership of transportation facilities and complementary assistance JKN-PBI. PKH implantation and other supporting factors have beneficial benefits quite large in order to help the community, especially the poor and vulnerable population to get the right to Utilize health care facilities for delivery.
The high cost of treatment is one of the obstacles in accessing affordable health services for the poor and vulnerable, so the Indonesian government created the JKN program through a guarantee scheme for contributions / subsidy assistance to ensure groups meet health care needs without difficulty paying. This study aims to determine the effect of health insurance on the utilization and cost of outpatient health services (OOP) for participants in subsidized and non-subsidized insurance. The study design was cross- sectional and quantitative approach of secondary data (data Susenas 2018) with the amount of research sampels which fit with inclusive criteria was 66,132 respondents. The analysis shows that the existence of health insurance can increase the utilization of outpatient health care services for subsidized is 49% and non-subsidized is 48% and from the results of the analysis there are still OOP in outpatient health services due to the dual role of providers and asymmetries. information that causes the supplier induced demand (SID). Therefore it is necessary to monitor and evaluate the BPJS Health control function so that the goal of health insurance can provide financial protection can be realized.
Health insurance is one of the factors that can influence individuals in utilizing health services. Aceh was the province with the highest health insurance coverage. Despite the high rate of health insurance ownership, the utilization of health services in Aceh has not been optimal. The purpose of this study was to determine the relationship between health insurance and utilization of formal outpatient facilities in the community in Aceh Province. This study was an observational study with a cross sectional design and uses a quantitative approach. The data source used was the 2020 National Socio-Economic Survey (Susenas) data for the Aceh Province region with a sample size of 4,204 respondents. The results showed that only 16.8% of Acehnese people utilized formal outpatient facilities. Respondents who utilized formal outpatient facilities the most were in the elderly (25.0%), female (19.1%), low education status (17.9%), married (19.0%), employed (18.6%), and rural (18.4%). There was a significant association between having health insurance (p value = 0.041, OR = 2.112) and utilization of formal outpatient facilities. The ownership of BPJS PBI health insurance has been very influential to increase utilization of formal outpatient facilities. Therefore, the results of this study suggested that BPJS Kesehatan & the Health Office to remain consistent in intensifying the Universal Health Coverage program, especially for people with low socioeconomic status, can increase promotion and socialization of the benefits of having health insurance, how to use health insurance, and the benefits received are equally fair. This study also suggested to improve equity of access, distribution of health services and health workers competencies in various regions to support quality of care especially at primarycare level as gatekeepers
ABSTRAK Nama : Ernawati Roeslie Program Studi : Ilmu Kesehatan Masyarakat Judul : Analisis Kesiapan Implementasi Program Indonesia Sehat dengan Pendekatan Keluarga (Indikator 8: Kesehatan Jiwa) di Kota Depok tahun 2018 Pembimbing : dr. Adang Bachtiar, MPH., DSc. Program Indonesia Sehat dengan Pendekatan Keluarga (PIS-PK) adalah program prioritas Kementerian Kesehatan yang dilaksanakan oleh Puskesmas. Indikator 8: Kesehatan Jiwa belum mendapat perhatian khusus di Kota Depok, kasus Orang dengan Gangguan Jiwa (ODGJ) berat mengalami peningkatan dari 3986 kasus pada tahun 2016 menjadi 5768 kasus pada tahun 2017, dimana kasus skizofrenia dan gangguan psikotik kronik lainnya mengalami kenaikan dari 1687 kasus pada 2016 menjadi 2342 kasus pada 2017. Analisis kesiapan implementasi PIS-PK (Indikator 8: Kesehatan Jiwa) di Kota Depok tahun 2018 merupakan tahapan penting sebagai penentu keberhasilan kinerja Pemerintah Daerah dalam bidang kesehatan. Penelitian ini adalah penelitian kualitatif dengan desain deskriptif. Tujuan penelitian ini adalah untuk mengetahui kesiapan implementasi program PIS-PK (Indikator 8: Kesehatan Jiwa) di Kota Depok Tahun 2018 dilihat dari variabel komunikasi, disposisi, sumber daya dan struktur birokrasi menggunakan Teori Edward III. Metode pengumpulan data dilakukan dengan wawancara mendalam, Focus Grup Discussion (FGD) dan telaah dokumen. Hasil penelitian didapatkan kesiapan implementasi PIS-PK (Indikator 8: Kesehatan Jiwa) di Kota Depok berdasarkan 4 (empat) variabel implementasi menurut teori Edward III, yaitu komunikasi, sumber daya, disposisi dan struktur birokrasi dinilai belum siap untuk dilaksanakan. Rekomendasi pada penelitian ini yaitu keberhasilan implementasi akan dicapai bila dilakukan perbaikan dari kekurangan, baik dari sisi komunikasi, sumber daya, disposisi dan struktur birokrasi. Di samping itu hambatan program yang ada bisa diatasi dengan tersedianya pendanaan yang cukup. Saran dari penelitian ini adalah agar meningkatkan pemberdayaan peran keluarga dan potensi masyarakat dengan metode pelatihan untuk peningkatan kesehatan jiwa dan mengurangi stigma di masyarakat. Kata kunci: Analisis Kesiapan Implementasi; Kebijakan; Kesehatan Jiwa; Program Indonesia Sehat; Teori Edward III.
ABSTRACT Name : Ernawati Roeslie Study Program : Public Health Science Judul : Analysis of Implementation Readiness of Healthy Indonesia Program with Family Approach (Indicator 8: Mental Health) in Depok City 2018 Counselor : dr. Adang Bachtiar, MPH., DSc. The Healthy Indonesia Program with Family Approach (PIS-PK) is the Ministry of Health's priority program implemented by the Puskesmas. Indicator 8: Mental Health has not received special attention in Depok City, severe case of people with mental disorder increased from 3986 in 2016 cases to 5768 cases in 2017, where schizophrenia cases and other chronic psychotic disorders increased from 1687 cases in 2016 to 2342 cases in 2017. Analysis of PIS-PK implementation readiness (Indicator 8: Mental Health) in Depok 2018 is an important stage as a success determinant of local government performance in the health sector. This research is a qualitative research with descriptive design. The purpose of this research is to determine the implementation readiness of PIS-PK (Indicator 8: Mental Health) in Depok 2018 reviewed from communication, disposition, resources and bureaucratic structure using Edward III theory. Data collection method was performed using in-depth interviews, Focus Group Discussion (FGD) and document review. The research result indicates that PIS-PK implementation (Indicator 8: Mental Health) in Depok were not ready based on 4 (four) implementation variables according to Edward III theory, ie communication, resources, disposition and bureaucracy structure. The research recommends to improve the all aspect of communication, resources, disposition and bureaucratic structure in order to achieve the successful implementation. In addition, the program contraints can be reduced by sufficient funding availability. The research suggests to increase the empowerment of family role and community contribution using training method in order to improve the mental health and reduce the stigma in society. Key words: Analysis of Implementation Readiness; Edward III Theory; Healthy Indonesia Program; Mental Health; Policy.
One of the reasons for the lack of optimal achievement related to the use of contraceptives in Indonesia is the unmet need for family planning that has not been fully addressed. Handling the unmet need for family planning requires not only measuring the magnitude of the number, but also an understanding of the factors causing it. This study aims to determine the direct effect, indirect effect, and the total effect of the determinants of the use of family planning services on the incidence of unmet need in Indonesia as the basis for effective program recommendations. This study uses secondary data from the 2017 IDHS using a cross sectional design with 33,635 respondents who are married women aged 14-59 years. The results of the analysis show that the incidence of unmet need in Indonesia is 11.68%, consisting of unmet need spacing (4.86%) and unmet need limiting (6.82%). The results of the GSEM analysis show that the variables of family planning service quality, socio-economic status, demographics, and ideal number of children have a significant effect on the incidence of unmet need in Indonesia's analysis, areas with high unmet need and low unmet need areas. The variable of women's autonomy has a significant effect on the incidence of unmet need in the analysis of Indonesia and low unmet need areas, and access problems have a significant effect on the incidence of unmet need in areas with low unmet need. It can be concluded that there is a significant influence on the determinants of the use of family planning services on the incidence of unmet need in Indonesia. It is necessary to improve the quality of family planning services, pay more attention to women with low socio-economic status, low women's autonomy, high access problems, and women with the ideal number of children 3 children. Post-partum family planning is the most effective way to reduce the incidence of unmet need for family planning. It is also necessary to increase the use of mass media in providing family planning information, especially regarding the side effects of the method
Implementation of the JKN program should be able to increase people's access to health services. However, disparities in health services still exist. The study aims to analyze the utilization of health services based on regional status for JKN participants in Indonesia from 2019 to 2021 and also examine the factors that influence the utilization of inpatient healthcare for JKN participants in Indonesia. This research uses Susenas secondary data for 2019, 2020 and 2021. Data were analyzed bivariately and multivariately using the Binary Regression method using a logit model. The results showed that regional status is significantly related (p-value 0.000 <0.05) to health utilization of JKN participants from 2019 to 2021. Respondents who live in urban areas in 2019 have 1,141 times, 1,127 times in 2020 and 1,127 times in 2021 higher odds ratio than respondents who live in rural areas. Age, gender, educational status, marital status, employment status, economic status and province are significantly related (p-value 0.000 <0.05) to the utilization of inpatient healthcare for JKN participants.
