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This study aims to describe the physician availability, drugs availability, healthfacilities, physician understanding as a gatekeeper, physician understanding ofcapitation, and medical diagnosis in referral case from primary health care ofAskes Sosial participants at Puskesmas Sumbersari Bantul in 2012. This studyuses descriptive qualitative research design. The result indicates that the limiteddrugs and health facilities, physician lack of understanding about gatekeeper andcapitation, and number of patients with chronic disease, causing high referralcases. The researcher suggests improving the physician decision to reduce referralcase that is not based on medical indication and also improving the coordinationbetween PT Askes, Dinas Kesehatan, and primary health care to provide thedemand of drugs and health facilities in primary health care.Key words:Referral case, referral from primary health care, primary health care as agatekeeper, capitation
Laporan Pelaksanaan Program JPKMM Puskesmas Warung Jambu Tahun 2007 tentang kunjungan peserta Jamkesmas ke pelayanan kesehatan mencatat hanya sebanyak 7,7 %. Sedangkan pada tingkat Puskesmas, diharapkan peserta yang dapat dilayani sebanyak 15 % - 20 % dari total penduduk miskin di suatu wilayah kerja. Tidak tercapainya target utilisasi pelayanan kesehatan dapat berdampak pada rendahnya status kesehatan penduduk. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang mempengaruhi utilisasi pelayanan kesehatan Puskesmas Warung Jambu di Kecamatan Bogor Utara Tahun 2008. Penelitian ini menggunakan disain Cross Sectional, yang dilakukan pada Bulan November 2008 pada 118 responden yang memiliki kartu Jamkesmas dan dalam tiga bulan terakhir pernah ke Puskesmas. Variabel dependen adalah utilisasi pelayanan kesehatan, variabel independen adalah faktor predisposisi (pendidikan, pengetabuan, sikap dan persepsi), faktor enabling (ketersediaan pelayanan, jarak, waktu, sarana dan biaya transportasi serta waktu tunggu layanan) dan faktor reinforcing (dukungan petugas dan dukungan keluarga). Hasil penelitian diperoleh sebanyak 56,8 % responden menggunakan pelayanan kesehatan di Puskesmas dalam 3 bulan terakhir. Hasil uji statistik menunjukkan ada hubungan yang bermakna antara waktu tunggu layanan dengan utilisasi pelayanan kesehatan Puskesmas setelah dikontrol pengetahuan dan dukungan petugas, dimana responden yang menilai waktu tunggu layanan singkat berpeluang 2,3 kali untuk menggunakan pelayanan kesehatan Puskesmas dibandingkan dengan responden yang menilai waktu tunggu layanan lama. Berdasarkan hasil tersebut maka untuk meningkatkan utilisasi pelayanan kesehatan Puskesmas perlunya mempersingkat waktu tunggu layanan dengan cara mempercepat proses pendaftaran, menerapkan pelaksanaan SOP pada pemeriksaan pasien tanpa mengorbankan waktu tunggu pasien lain dan membuat sebuah sistem pelayanan yang terpadu pada alur pelayanan.
JPKMM program at Warung Jambu health center reported that in 2007 there were only 7,7% of Jamkesmas participants who used public health center. Meanwhile, at the level of health centers, it is expected that participants can be as much as 15% - 20% of the total population in a poor area. The non optimum utilization of health services can impact on the low health status of the popUlation. This study objective is to know the ractors that affect the utilization of health services at Warung Jambu health centers in the sub-district of North Bogor in 2008. This research is using cross sectional design, conducted in November 2008 following by 118 respondents who have Jamkesmas card and in the last three months have been to health center. The dependent variable is the utilization of health services, the independent variables are predisposing factors (education, knowledge, attitudes and perceptions), enabling factors (the availability of services, distance, time, cost and facilities of transporiation and waitting time services) and reinforcing factors (health worker and family support). Research revealed 56.8% of respondents use health services at health centers. Statistic test showed thst there is significant relationship of the waitting time of service to utilization of health services at the health center controlled by the knowledge and health worker support, where respondents who rate the waitting time services are good likely to use health services at health centers 2,3 times higher compared by respondents who rate the waitting time service less. Based On these results. in order to improve health services utilization at public health center by improving the performance of waitting time service. By speed up the registration desk, use strandard operational procedure on patient checking whitout neglecting other patient waitting time service and make the better system in service low.