Analisis Utilisasi Layanan Kesehatan Ibu dan Anak Sebelum dan Setelah Kebijakan UHC Open Member di Kabupaten Takalar

Fausiah, dr. Firdaus Hafidz as Shidieq, MPH., AAK., PhD; Bayu Satria Wiratama, S.Ked., MPH., Ph.D

2023 | Tesis | MAGISTER KEBIJAKAN DAN MANAJEMEN KESEHATAN

Penelitian ini mengindentifikasi dampak kebijakan open member terhadap pemanfaatan layanan KIA (ANC, persalinan, dan PNC) pada peserta JKN Kabupaten Takalar. Penelitian menggunakan data sekunder peserta JKN-KIS Kabupaten Takalar tahun 2015-2022 yang mengakses pelayanan KIA baik di FKTP maupun di FKTRL. Analisis yang digunakan merupakan unadjusted odds ratio dan adjusted odds ratio serta penelitian ini adalah observasional dengan pendekatan cross-sectional. Didapatkan hasil sebagai berikut skema program UHC open member menurunkan peluang besar kemungkinan memanfaatkan pelayanan ANC secara lengkap sebesar 97,3% dibandingkan skema close member, skema program UHC open member 1,9 kali lebih besar memiliki kemungkinan utilisasi layanan persalinan normal dibandingkan skema close member, dan skema program UHC open member menurunkan kemungkinan memanfaatkan pelayanan PNC secara lengkap sebesar 92,6% dibandingkan skema close member. Penerapan skema program UHC open member memberikan pengaruh yang signifikan secara positif terhadap pemanfaatan layanan persalinan normal namun berpengaruh signifikan secara negatif terhadap layanan ANC dan PNC secara lengkap di Kabupaten Takalar. Keberadaaan program UHC open member perlu untuk tetap diterapkan. Peningkatan kualitas layanan maternal tidak lepas dari keterlibatan dan peran seluruh stakeholder mulai dari kepala lingkungan hingga kepala daerah serta keluarga. Elaborasi perlu dilakukan oleh BPJS Kesehatan, pihak keluarga ibu, dan pemerintah daerah untuk memastikan layanan maternal di Kabupaten Takalar telah berjalan dengan baik.

This study identifies the impact of the open member policy on the utilization of MCH services (ANC, childbirth, and PNC) in JKN participants in Takalar Regency. The study used secondary data of JKN-KIS participants in Takalar Regency in 2015-2022 who accessed MCH services both at primary health care facilities and at FKTRL. The analysis used is the unadjusted odds ratio and adjusted odds ratio and this research is observational with a cross-sectional approach. The following results were obtained: the open member UHC program scheme decreased the chances of utilizing complete ANC services by 97.3% compared to the close member scheme, UHC open member schemes were 1.9 times more likely to have normal delivery service utilization than close member schemes, and UHC open member schemes decreased the likelihood of utilizing complete PNC services by 92.6% compared to close member schemes. The implementation of the UHC open member scheme had a significant positive effect on the utilization of normal delivery services but a significant negative effect on the utilization of complete ANC and PNC services in Takalar Regency. The UHC open member program should continue to be implemented. Improving the quality of maternal services cannot be separated from the involvement and role of all stakeholders ranging from neighborhood heads to regional heads and families. Elaboration needs to be carried out by BPJS Kesehatan, the mother's family, and local government to ensure maternal services in Takalar Regency are running well.

Kata Kunci : ANC, Persalinan Normal, PNC, UHC, open member