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Laporan International Diabetes Federation (IDF) melaporkan prevalensi diabetes melitus di Indonesia pada orang dewasa meningkat setiap tahunnya dan menyebabkan beban biaya kesehatan meningkat. Pelayanan kesehatan di tingkat Fasilitas Kesehatan Tingkat Pertama (FKTP) berfungsi sebagai gatekeeper dalam memberikan layanan promotif, preventif, kuratif, dan rehabilitative diharapkan dapat membantu menekan progresivitas penyakit, mencegah komplikasi, serta mengurangi beban rujukan ke fasilitas kesehatan tingkat lanjutan. Namun, pemanfaatan layanan FKTP masih dihadapkan dengan berbagai tantangan. Penelitian ini bertujuan untuk melihat faktor-faktor yang mempengaruhi layanan kesehatan di FKTP. Penelitian ini menggunakan data sekunder data sampel BPJS Kontekstual DM tahun 2017-2023. Data dianalisis secara univariat, bivariat, dan multivariat menggunakan regresi. Hasil analisis distribusi frekuensi pemanfaatan layanan kesehatan FKTP tahun 2017-2023 didominasi oleh Puskesmas (59,08%). Peserta BPJS dengan segmen peserta Bukan Pekerja, berjenis kelamin perempuan, status perkawinan cerai, lansia (>65tahun), memiliki hak kelas rawat I, dan berdomisili di DKI Jakarta memiliki kemungkinan lebih besar mengunjungi pelayanan FKTP. Faktor segmentasi kepesertaan, jenis kelamin, usia, status perkawinan, hak kelas rawat, dan provinsi FKTP memiliki pengaruh signifikan terhadap penggunaan layanan FKTP oleh peserta JKN dengan DM
The International Diabetes Federation (IDF) report reports that the prevalence of diabetes mellitus in Indonesia in adults increases every year and causes an increase in health costs. Health services at the Primary Health Facility (FKTP) level function as gatekeepers in providing promotive, preventive, curative, and rehabilitative services that are expected to help suppress disease progression, prevent complications, and reduce the burden of referrals to advanced health facilities. However, the use of FKTP services still faces various challenges. This study aims to examine the factors that influence health services at FKTP. This study uses secondary data from the Contextual BPJS DM sample data for 2017- 2023. Data were analyzed univariately, bivariately, and multivariately using regression. The results of the frequency distribution analysis of the use of FKTP health services for 2017-2023 were dominated by Community Health Centers (59.08%). BPJS participants with the Non-Worker participant segment, female, divorced, elderly (>65 years), have class I care rights, and are domiciled in DKI Jakarta are more likely to visit FKTP services. The factors of participant segmentation, gender, age, marital status, class care rights, and FKTP province have a significant influence on the use of FKTP services by JKN participants with DM
Pelaksanaan program Jaminan Kesehatan Nasional (JKN) telah berjalan sejak tahun 2014, dalam pelaksanaanya masih ditemui tantangan khususnya dari sisi pemanfaatan pelayanan kesehatan. Tuberkulosis merupakan penyakit pernafasan menular penyebab utama kematian akibat infeksi di dunia yang penyebarannya terus mengalami peningkatan, Indonesia sendiri berada pada posisi kedua kasus terbesar setelah India. Tujuan penelitian ini adalah melakukan analisis pemanfaatan pelayanan kesehatan serta mengkaji faktor-faktor yang mempengaruhi pemanfaatan pelayanan rawat jalan pada peserta JKN dengan diagnosis tuberkulosis paru. Penelitian ini menggunakan data sekunder data sampel BPJS Kesehatan kontekstual tuberkulosis tahun 2022. Data dianalisis secara univariat, bivariat dan multivariat dengan model regresi Negative Binomial. Hasil uji statistik menunjukan terdapat hubungan yang signifikan antara kelompok umur, status pernikahan dan status pulang pada pelayanan FKTP dengan pemanfaatan layanan rawat jalan. Pengaruh jenis kepesertaan terhadap pemanfaatan layanan rawat jalan signifikan pada pelayanan RJTP dan RJTL dimana peserta PBI lebih banyak dalam memanfaatkan pelayanan RJTP sedangkan pada peserta Non PBI lebih banyak dalam memanfaatkan pelayanan RJTL.
The implementation of the National Health Insurance (JKN) program has been running since 2014, in its implementation there are still challenges, especially in terms of the use of health services. Tuberculosis is an infectious respiratory disease that is the main cause of death due to infections in the world whose spread continues to increase, Indonesia itself is in the second position with the largest cases after India. The purpose of this study is to analyze the use of health services and examine the factors that affect the use of outpatient services in JKN participants with a diagnosis of pulmonary tuberculosis. This study uses secondary data from BPJS Kesehatan contextual tuberculosis sample data in 2022. The data were analyzed univariately, bivariately and multivariate with a Negative Binomial regression model. The results of the statistical test showed that there was a significant relationship between age groups, marital status and discharge status in FKTP services and the use of outpatient services. The effect of the type of membership on the utilization of outpatient services was significant in RJTP and RJTL services where PBI participants were more in utilizing RJTP services while Non-PBI participants were more in utilizing RJTL services.
Non-communicable diseases (NCDs) contribute to more than 87.14% of total deaths in Indonesia. One of the non-communicable diseases that has gained attention is diabetes. Its high prevalence and its role as a primary factor for the development of other diseases as comorbidities make DM a chronic disease with widespread impacts. The low utilization of primary healthcare services for diabetes mellitus patients, such as Primary Healthcare (RJTP), is considered to contribute to the high referral rates to advanced healthcare facilities, resulting in higher healthcare costs. This study analyzes the utilization of Primary Healthcare (RJTP) services among JKN participants with diabetes mellitus in 2023 based on BPJS sample data from 2024. This research is non-experimental with a cross-sectional approach. The results show that the majority of JKN participants with diabetes mellitus use RJTP services irregularly, at 88.4%, while only 11.6% of participants, or 75,165 individuals, made regular visits (≥12 times per year), with 2,402 participants with type 1 diabetes and 72,763 participants with type 2 diabetes. Factors significantly related to service utilization include age, gender, care class, membership segmentation, family relationship, type of FKTP, FKTP regional area, and place of residence. Meanwhile, marital status showed no significant relationship (p-value >0.05). The conclusion of this study is that innovative approaches are needed to target communities with high disparities who have low utilization of RJTP healthcare services.
Lack of dental health services utilization in Indonesia became a problem aslong as it becomes a constraint in increasing degree movies health in Indonesiabecause according to Undang-undang no 36 tahun 2009 that oral health servicesdone to nurture and increases public health degree movies. Data from the sudyshowed poor dental health service utilization whereas the prevalence of dentalcaries in Indonesia is quite high. Researchers would like to see the dental healthservice utilization determinants in Indonesia.This research is analysis of data secondary susenas 2012 that is researchquantitative to a draft cross sectional. This research see determina the utilizationof health services of health services teeth in Indonesia.The result analysis shows that a factor of age, gender, the status ofmarriage, the status of education, the status of the job and the satatus of thedwelling place of not show a very strong in the harness of health services inIndonesia, the teeth insurance, while a factor of possession economic status, theregion of domicile, and any disturbance activity showed a very strong against theutilization of health services teeth in Indonesia.Advice from this study is due to the powerful relationship betweeninsurance with the utilization of health service should tooth-reinsurance coveragesexpanded especially for the poor health services so that the utilization rise, canalso distribution dentist must be distributed properly.Key words :Determinant, Unmet Need, Utilization, Susenas 2012.
Seven years since the national health insurance scheme (JKN) was introduced, coverage in DKI Jakarta Province has reached 85% of the population, but the average out-of-pocket (OOP) health expenditure of DKI Jakarta residents is twice that of the national expenditure. The high JKN coverage was accompanied by an increase in OOP in DKI Jakarta Province. This study focuses on understanding how health insurance ownership relates to health service utilization and cash health expenditure in DKI Jakarta Province. This study uses secondary data from Susenas Kor in 2021. The quantitative analysis conducted in this study includes two stages, the first stage using individual-level data to determine the determinants of individual health behavior on health service utilization. The second stage was carried out using household-level data to determine the tendency of health insurance utilization with out-of-pocket health expenditure in DKI Jakarta Province. This study found that the economic status of the population in quintile one (Q1) and quintile two (Q2) is the largest group of people who do not have health insurance. The results of the first stage of analysis show that DKI Jakarta residents prefer privately-run health facilities for outpatient utilization, while government-operated health facilities are slightly superior for inpatient utilization. Residents who have JKN will use it for outpatient and inpatient utilization. The results of the second stage showed that the out-of-pocket cash health expenditure of people with national health insurance (JKN) was lower than that of people without health insurance. Residents who have dual/combination health insurance (JKN and private) when utilizing health services are using private health insurance. The higher the economic status of the population, the higher their health expenditure. This study suggests that the government should pay close attention to the coverage of health insurance among people with low economic status. It also needs to encourage people to make more use of JKN when utilizing outpatient and inpatient care in order to further reduce financial risk, especially for people with vulnerable household members.
