Latar belakang: Pentingnya penanganan berlanjut terhadap penduduk miskin sebagai upaya memenuhi UUD 1945 pasal 34 ayat 1 dan 2, pemerintah memberikan jaminan kesehatan kepada masyarakat miskin melalui program jaminan kesehatan kepada masyarakat miskin dengan dikeluarkannya SK Menkes No. 1241/MENKES/SK/XI/2004 menunjuk PT Askes sebagai pihak ketiga dalam penyelenggaraan program JPKMM periode Januari sampai dengan Juli 2005 (semester pertama) dengan sistem kapitasi. Berdasarkan kebijakan baru menetapkan pembiayaan pelayanan kesehatan masyarakat miskin periode Juli sampai dengan Desember 2005 (semester kedua) secara Block Grant yang dananya langsung ke rekening puskesmas. Metode: Jenis penelitian ini adalah penelitian diskriptif dengan maksud mendiskripsikan dan menjelaskan penggunaan dana pelayanan kesehatan masyarakat miskin di puskesmas melalui mekanisme kapitasi dan Block Grant di Kabupaten Sleman. Unit analisis adalah pembiayaan kesehatan bagi masyarakat miskin di Kabupaten Sleman. Metode pengambilan sampel secara purposive dengan pertimbangan satu kecamatan diambil satu puskesmas dengan berdasarkan jumlah kunjungan sehingga jumlah sampel adalah 17 puskesmas di 17 kecamatan. Subjek penelitian adalah unit pelayanan rawat jalan dan rawat inap tingkat pertama. Data yang terkumpul dilakukan tabulasi dan diolah kemudian disajikan secara diskriptif. Hasil: Pembiayaan kesehatan masyarakat miskin bersumber dari subsidi pemerintah pusat melalui kapitasi dan Block Grant, subsidi pemerintah daerah melalui subsidi operasional puskesmas (SOP), pendapatan puskesmas dari klaim rawat jalan dan rawat inap, kapitasi dari PT Askes dan rawat inap maupun sumber dana lainnya (bila ada) yang merupakan biaya operasional (Rp. 4.578.212.354) yang dikelola sepenuhnya oleh puskesmas dan digunakan untuk kegiatan pelayanan kesehatan masyarakat miskin berdasarkan jenis pelayanan. Pemanfaatan pelayanan kesehatan masyarakat miskin pada pelayanan rawat jalan semester I sebesar 39.320 jiwa (utilisasi 4,85% per bulan) dan semester II sebesar 37.885 jiwa (utilisasi 4,68%), sedangkan pelayanan rawat inap semester pertama sebesar 416 jiwa (utilisasi 0,05% per bulan) dan semester kedua sebesar 552 jiwa (utilisasi 0,07% per bulan). Penyerapan dana pada pelayanan rawat jalan sebesar Rp. 183.287.750 (15,73%) dan semester II sebesar Rp. 170.833.150 (15,73%), sedangkan pada pelayanan rawat inap semester I sebesar Rp. 61.762.700 (24,46%), dan semester II sebesar Rp. 83.245.500 (33,55%). Kesimpulan: Pembiayaan kesehatan menjamin kesinambungan pemeliharaan kesehatan bagi masyarakat miskin di Kabupaten Sleman bersumber dari pemerintah pusat (dana PKPS-BBM 2005), subsidi pemerintah daerah, pendapatan puskesmas dan kapitasi PT Askes

Background: Considering the importance of continuous management for poor people as an effort to obey UUD 1945 section 34 verse 1 and 2, the government has issued health assurance program for poor community through Health Assurance Program for Poor People (PJKMM) along with the issued of SK Menkes No.1241/Menkes/XI/2004 which pointed PT.Askes (health insurance company) as the third party in implementing the JPKMM in the period of January to July 2005 (first semester) with capitation system. The new policy stated that the health service financing for poor people in the period of July to December 2005 used Block Grant which the funding is directly given to Primary Health Care. Method: This was a descriptive research that is aimed to describe and explain the utilization of health service funding for poor people in the Primary Health Care through capitation and block grant mechanism in Sleman district. The analysis unit was health financing for poor people in the district of Sleman. The sample was taken purposively with consideration of one Primary Health Care taken from each sub district based on the number of visit so that the number of sample was 17 Primary Health Care in 17 sub districts. The research subject was the first level of outpatient and inpatient treatment. The collected data was analyzed with tabulation and processed descriptively. Result: The health financing for poor people is originated from central government’s subsidize through capitation and block grant, regional government subsidy through inpatient and outpatient treatment, capitation from PT.ASKES and inpatient treatment or other funding sources (when available) which considered as operational funding (Rp 4.578.212.354) which is fully organized by Primary Health Care and used for the health service activity for poor people based on the type of service. The utilization of health service for poor people in the outpatient treatment in semester I was 39.320 people (utilization of 4,85% per month) and semester II was 37.885 people (utilization of 4,68%), while the inpatient treatment of first semester was 416 people (utilization of 0,05% per month) and second semester was 552 people (utilization of 0,07% per month). Funding incorporation in the outpatient treatment was Rp 183.287.750 (15,73%) and second semester was Rp 170.883.150 (15,73%), while in the inpatient treatment of semester I was Rp 61.762.700 (24,46%) and semester II was Rp 83.245.500 (33,55%). Conclusion: The health financing which guaranteed the continuation of health management for poor people in the district of Sleman is originated from central government (funding of PKPS-BBM 2005), regional government’s subsidy, Primary Health Care’s income and PT. ASKES capitation.

Kata Kunci : Pebiayaan Kesehatan,Masyarakat Miskin,Puskesmas,Kapitasi dan Block Grant