Determinan Tempat Bersalin di Rumah Sakit Pada Kasus Persalinan Normal Peserta JKN Kota Semarang Tahun 2022

MUNGKI NOVITASARI, Dr. drg. Julita Hendrartini, M. Kes., AAK; Dr. Drs., Abdul Wahab, MPH

2023 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Kasus persalinan normal di rumah sakit (RS) peserta Jaminan Kesehatan Nasional (JKN) di Kota Semarang meningkat. Persalinan normal merupakan kompetensi fasilitas kesehatan tingkat pertama (FKTP). Tujuan penelitian ini mengidentifikasi determinan tempat bersalin di RS pada kasus persalinan normal.            

Metode: Penelitian ini menggunakan mix method sequential explanatory dengan variabel penelitian tempat bersalin, usia, jenis FKTP, segmen peserta, alasan bersalin di RS, pemeriksaan antenatal care (ANC), dan cara menggunakan jaminan JKN. Analisa data dengan Chi Square test dan logistic regression. Data kualitatif didapatkan dengan wawancara mendalam. 
Hasil: Terdapat 3.065 kasus klaim persalinan normal pada Januari - Juni 2022 dilayani di RS 63,59% (1.949), usia ibu risiko rendah 85,51% (2.621), jenis FKTP puskesmas 55,89% (1.713), dan peserta segmen PPU 45,81% (1.404). Secara signifikan (p value < 0 OR=1,3; p=0,028); OR=1,2; p=0,049); OR=2,1; p=0,001) OR=1,9; p=0,001).>

Kesimpulan: Tempat bersalin di rumah sakit pada kasus persalinan normal peserta JKN Kota Semarang tahun 2022 meningkat pada peserta usia risiko tinggi, jenis FKTP klinik pratama, dan pada segmne peserta PBPU atau PPU.

Background: The numbers of normal delivery at Universal Health Coverage (UHC) participating hospitals in Semarang City increased. However, normal delivery is supposed to be completed at primary health care facilities (PHC). The current study aims to identify the determinants for birthplace at hospitals among cases of normal delivery. 

Methods: This study employed an explanatory sequential mixed method design. The following variables were being studied: birthplace, age, PHC type, participant’s segment, reasons for hospital delivery, ANC examination, and type of UHC utilization. Data analysis was performed with Chi-Square test and logistic regression. Qualitative data obtained through in-depth interviews. 

Results: A total of 3,065 normal deliveries claimed between January - June 2022. The number represents delivery at hospitals 63.59% (1,949), low risk maternal age 85.51% (2,621), Primary Health Care Facility 55.89% (1,713), and PPU participants segment 45.81% (1,404). A significant finding (p value<0 OR=1.3; p=0.028); OR=1.2; p=0.049); OR=2.1; p=0.001) OR=1.9; p=0.001).>

Conclusion: Choice for birthplace at hospital of normal delivery among JKN participants in Semarang City year 2022 increased within high-risk age participants, PHC, and PBPU or PPU participant segments groups

Kata Kunci : tempat bersalin, fasilitas kesehatan, persalinan normal, rumah sakit