ANALISIS FAKTOR�¢ï¿½ï¿½FAKTOR YANG BERPENGARUH TERHADAP UTILISASI LAYANAN PROTESA GIGI PESERTA JAMINAN KESEHATAN NASIONAL (JKN) DI FASILITAS KESEHATAN GIGI PRIMER
GUSTI AYU YOHANNA L, Prof. Dr. Drg. Widowati Siswomihardjo, M.S.; Dr. drg. Julita Hendrartini, M.Kes.; Prof. Dr. drg. Haryo Mustiko Dipoyono, M.S.,Sp.Pros (K); Dr. drg. Dewa Made Wedagama, Sp.KG., FICD.
2021 | Disertasi | DOKTOR ILMU KEDOKTERAN GIGIUtilisasi layanan prostesa gigi di Indonesia masih jarang dibandingkan dengan pelayanan kesehatan gigi dan mulut lainnya. Berdasarkan data BPJS Kesehatan Kantor Cabang Denpasar, permintaan pelayanan protesa gigi oleh peserta di tiga wilayah kerja BPJS Kesehatan Kantor Cabang Denpasar masih rendah. Penelitian ini bertujuan menguji pengaruh faktor predisposing, faktor enabling, faktor needs peserta Jaminan Kesehatan Nasional (JKN) terhadap utilisasi protesa gigi JKN, dan mengeksplorasi pengalaman persepsi provider dan pemegang kebijakan tentang utilisasi pelayanan protesa gigi JKN di Kabupaten Badung. Hasilnya dapat menjadi bahan pertimbangan untuk memperbaiki sistem pelayanan protesa gigi JKN. Penelitian ini dilakukan dengan mengaplikasikan pendekatan campuran divergen (divergent mixed methods), yaitu penelitian kuantitatif jenis survei dilengkapi penelitian kualitatif. Populasi penelitian ini adalah seluruh peserta provider FKTP BPJS Kesehatan Kabupaten Badung, diambil sampel melalui purposive sampling. Data kuantitatif dianalisis dengan teknik analisis regresi binary logistik atau regresi logistik untuk membuktikan hipotesis-hipotesis penelitian, sedangkan data kualitatif menggunakan analisis dokumen dan tematik saling berhubungan (interconecting themes). Hasil analisis menunjukkan bahwa faktor predisposing peserta program JKN: penghasilan, pengetahuan protesa gigi, pengetahuan layanan protesa gigi JKN, persepsi kualitas pelayanan, dan persepsi terhadap iur biaya berpengaruh positif signifikan terhadap tingkat utilisasi protesa gigi JKN. Jenis kelamin berpengaruh negatif signifikan terhadap tingkat utilisasi protesa gigi JKN. Usia dan pendidikan tidak berpengaruh signifikan terhadap tingkat utilisasi protesa gigi JKN. Faktor enabling peserta JKN (akses) berpengaruh positif signifikan terhadap tingkat utilisasi protesa gigi JKN. Faktor enabling dukungan sosial peserta JKN tidak berpengaruh signifikan terhadap tingkat utilisasi protesa gigi JKN. Faktor need yaitu persepsi sakit saat kehilangan gigi berpengaruh positif signifikan terhadap tingkat utilisasi protesa gigi JKN. Persepsi provider dan pemegang kebijakan menyatakan bahwa pasien tidak memanfaatkan pelayanan protesa gigi ke BPJS JKN, antara lain karena masyarakat kurang percaya kualitas pelayanan protesa gigi di Puskesmas, dan proses pengurusan klaim yang rumit. Solusi yang diprogramkan antara lain mengusulkan standarisasi biaya protesa gigi yang ditanggung JKN BPJS, serta mempermudah dan menyederhanakan administrasi klaim melalui e-claim.
Compared to other dental and oral health services, dental prosthesis services in Indonesia are rarely utilized. Based on data of BPJS Kesehatan Denpasar, the demand for dental prostheses services by participants in its three working areas is still low. This study aims to examine the influence of predisposing factors, enabling factors, and needs factors of National Health Insurance (JKN) participants on the utilization of JKN dental prostheses, and to explore the perceptions of providers and policy holders regarding the utilization of JKN dental prostheses in Badung Regency. The results can be taken into consideration for improving the JKN dental prosthesis service system. This research was conducted by applying a divergent mixed methods approach, which is a survey type quantitative research complemented by qualitative research. The population of this study were all participants of the BPJS Health FKTP provider in Badung Regency, sampled through purposive sampling. Quantitative data were analyzed using binary logistic regression analysis or logistic regression to prove the research hypotheses, while interconnecting themes and document analysis were used for the qualitative data. The results of the research show that the predisposing factors for JKN program participants are income, knowledge of dental prostheses, knowledge of JKN dental prostheses services, perceptions of service quality, and perceptions of cost contributions that have a significant positive effect on the level of utilization of JKN dental prostheses. Several factors influence the level of use of JKN dental prostheses, one of which is gender that is shown to have significant negative effects. On the contrary, the enabling factor for JKN participants (access) and the need factor, namely the perception of pain when losing teeth have a significant positive effect on the level of utilization of JKN dental prostheses. The services are not significantly affected by the enabling factor for social support for JKN participants.The perception of providers and policy holders states that patients do not use dental prostheses services to BPJS JKN, partly due to their low confidence in the quality of dental prostheses service performances at the public health center, and the complicated claim processing process. The programmed solutions include proposing standardization of the cost of dental prostheses borne by BPJS JKN, as well as simplifying claims administration through e-claims.
Kata Kunci : JKN, protesa gigi, predisposing, enabling, need
