Implementasi Program Jaminan Kesehatan Masyarakat Miskin di Kabupaten Sintang tahun 2006

JANGKAN, dr. Kristiani, SU

2007 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kebij. Pembiayaan da

Latar Belakang : Program Jaminan Kesehatan Masyarakat Miskin (PJKMM) merupakan kelanjutan komitment Pemerintah untuk menyantuni pembiayaan kesehatan keluarga miskin sejak tahun 1989/ 1999 dan dilanjutkan dengan PKPS BBM yang sekarang dilanjutkan dengan PJKMM/Askeskin Keputusan Menteri Kesehatan RI.No.332/Menkes/SK/ V/2006 dan ditahun 2007 No. 417/ Menkes/ SK/IV/ 2007, tanggal 10 April 2007. Penelitian ini bertujuan untuk menegtahui bagimana Implementasi pelayanan kesehatan masyarakat miskin yang menyangkut Kebijakan pemerintah daerah untuk mendukung kebijaksanaan pusat, ketepatan kepesertaan, utilisasi, prosedur pelayanan dan hambatanhambatannya. Metode Penelitian : Peneltian ini merupakan penelitian deskriptif kuantitatif, data diambil secar Coss Sectional. Unit analisis dalam penelitian penelitian adalah Puskesmas. Subyek penelitian adalah masyarakat miskin yang mendapatkan pelayanan RJTP puskesmas. Penelitian dilakukan dua tahap yakni tahap pendahuluan untuk memperoleh data sekunder guan melihat pelaksanaan pelayanan kesehatan serta jumlah kunjungan Januari 2005 sampai Desember 2006. Tahap lanjutan untuk memperoleh data primer tentang penggunaan kartu Askeskin Nopember 2006 sampai Mei 2007 dengan cara wawancara mendalam dan penyebaran kuesioner. Hasil penelitian : Kebijakan Pemda yang mendukung pelaksanaan pelayanan kesehatan bagi maskin baru sebatas penetapan jumlah maskin dan pembentukan tim safe guarding PJKMM, belum ada dukungan dan (pembiayaan) untuk pelayanan kesehatan bagi maskin.Dari hasil penelitian ini diperoleh data bahwa semua pasien yang datang ke pelayanan puskesmas sudah memenuhi kriteria miskin.Prosedur pelayanan maskin oleh puskesmas sudah cukup baik, dengan tidak membedakan pelayanan antara yang menggunakan kartu Askeskin dan yang membayar.Pemanfaatan pelayanan di puskesmas Emparu sudah cukup baik, mendekati target yang ditetukan, sedangkan di puskesmas Sepauk pemanfaatannya masih rendah, jauh dari target.Hambatan-hambatan yang dijumpai adalah masih belum meratanya pemberian kartu Askeskin, masih banyak penderita yang betul-betul miskin tapi tidak punya kartu Askeskin, dan juga masih belum menggunakan SKTM.

Background. The health insurance program for the poor was a follow up of the commitment of the government to subsidize health funding for poor families since 1999, using the fund of PKPS BBM. This program was then continued by distributing health insursnce card for the poor (Askeskin), based on the Decision Latter of the Minister of health No.332?MENKES/SK/V/2006 and No.417/MENKES/SK/IV/2007. 1In the District of Sintang, the implemntation of health insurance program for the poor has never been evaluated. Thus, it is very important to know how far the program is implemented in the Distric of Sintang. Objective. The objective of this research was to evaluate the implementation of health insurance program for the poor in the District of Sintang. Method. This research was a descriptive research, with cross sectional design. The unit of analysis was health center. The research subjects were poor patiens visiting health centers, the district coordination team, head of Sintang District Health Office,and head center with the highest visitation (Sepauk Health Center) and health center with the lowest visitatio (Emparu Health Center). Data were obtained through questionnaires and indepth intrview guide. Result. The local governance policies concerning the implementation of health service for the poor were still limited in counting the numbers of poor people and forming the safe guarding team of health insurance program for the poor.There was no financial support from the government for health service programs for the poor. All poor patients visiting health centers have gualified the criteria of poor people. Health service procedures for poor patients by health centers were considered good without discriminating patients using health insurance card and patihieved the patients who paid for health service. The utilization of health service by poor patients in Emparu Health Center was considered good and achieved the percentage of 14,3 % (close to the target of 15%). Meanwhile in Sepauk Health Center, the utilization of service by poor patients was still considered poor, which only achieved the percentage of 7,5%.The obstacle found in the program was concerning the uneven distribution of health insurance card for the poor. Many of the poor patients didn’t have both health insurance card and SKTM. Conclusion. The health service for the poor given by the health centers were considered good. Nevertheless, there were still obstracles found in the implementation. Many of the poor people didn’t have health insucance card and there was no financial support from the local government for health service program for the poor.

Kata Kunci : Program Jaminan Pemeliharaan Kesehatan, Masyarakat Miskin, Implementation of health insurance program for the poor (PJKMM), policy, accuracy of membership, health service procedure