Panduan Penulisan
Analisis Perbedaan Karakteristik Pasien terhadap Preferensi Pasien Rawat Jalan BPJS-Kesehatan di Rumah Sakit Kelas B Milik Swasta dan Pemerintah
Sari
ABSTRACT
In an effort to achieve universal health coverage in Indonesia, the government introduced the National Health Insurance program administered by BPJS Kesehatan as the single payer for healthcare services. This social insurance supports the utilization of healthcare services by the public, both in government-owned and private healthcare facilities. This study aims to identify factors influencing patient preferences in choosing between government-owned or private hospitals. This analytic survey research with a cross-sectional approach was conducted at Grandmed General Hospital (RSU Grandmed) and Drs. H. Amri Tambunan Regional General Hospital (RSUD Drs. H. Amri Tambunan). The study involved 393 patients, comprising 198 patients from RSU Grandmed and 195 patients from RSUD Drs. H. Amri Tambunan. Samples were selected using incidental sampling techniques. Data were collected using a questionnaire based on the valid and reliable Andersen healthcare utilization model. The statistical tests used in this study were the Chi square test and multiple logistic regression. The data showed no significant differences in predisposition and health behavior characteristics among patients choosing RSU Grandmed and RSUD Drs. H. Amri Tambunan (p>0.05). Additionally, differences between patients who choosing RSU Grandmed and RSUD Drs. H. Amri Tambunan were only observed in waiting times (p<0.001) and type of visits (p<0.05), while other aspects showed no significant differences (p>0.05). Logistic regression indicated that hospital choice was influenced by the availability of hospitals near the residence (OR: 3.047, p<0.01), the number of hospitals in the vicinity (OR: 1.554, p<0.05), type of visits (OR;0,618, p<0,05) and waiting time (OR: 2.138. p<0.001). It can be concluded that waiting time and type of visits are the only factors distinguishing patient who choose RSU Grandmed and RSUD Drs. H. Amri Tambunan. Since waiting time is a modifiable aspect by hospitals, it is highly recommended that both hospitals reduce waiting times by increasing service efficiency.
Keywords: BPJS Kesehatan, Utilization, Government Hospital, Private Hospital
ABSTRAK
Dalam rangka mewujudkan cakupan kesehatan semesta di Indonesia, pemerintah memperkenalkan program Jaminan Kesehatan Nasional yang dijalankan oleh BPJS Kesehatan sebagai pembayar tunggal pelayanan kesehatan. Jaminan sosial ini mendorong pemanfaatan layanan kesehatan oleh masyarakat baik di fasilitas kesehatan milik pemerintah maupun swasta. Penelitian ini bertujuan untuk mengetahui faktor yang berhubungan dengan preferensi pasien antara rumah sakit milik pemerintah atau swasta. Penelitian ini merupakan penelitian survei analitik dengan desain potong lintang yang dilaksanakan di Rumah Sakit Umum (RSU) Grandmed dan Rumah Sakit Umum Daerah (RSUD) Drs. H. Amri Tambunan. Populasi pada penelitian ini adalah seluruh pasien rawat jalan RSU Grandmed dan RSUD Drs. H. Amri Tambunan yang menggunakan BPJS Kesehatan dan sampel sebanyak 393 pasien yang terdiri dari 198 pasien RSU Grandmed dan 195 pasien RSUD Drs. H. Amri Tambunan digunakan sebagai sampel. Sampel dipilih dengan menggunakan teknik pemilihan insidental. Data pada penelitian ini dikumpulkan dengan teknik survei dengan menggunakan kuesioner yang valid dan reliabel yang disusun berdasarkan model pemanfaatan layanan kesehatan Andersen. Uji statistik yang digunakan pada penelitian ini adalah uji kai kuadrat dan regresi logistik binomial. Hasil penelitian ini menemukan bahwa tidak terdapat perbedaan karakteristik jenis kelamin, umur, status perkawinan, suku, pendidikan, pekerjaan, pendapatan, jenis pembiayaan, moda transportasi, jarak tempuh ke rumah sakit, ketersediaan tenaga kesehatan, ketersediaan pemeriksaan penunjang, ketersediaan dan jumlah rumah sakit di sekitar tempat tinggal, klinik tujuan, proses administrasi, maupun alasan memilih rumah sakit di antara pasien yang memilih RSU Grandmed dan RSUD Drs. H. Amri Tambunan (p>0,05). Perbedaan antara pasien yang memilih RSU Grandmed dan RSUD Drs. H. Amri Tambunan hanya terlihat pada waktu tunggu (p<0,001) dan jenis kunjungan (p<0,05). Regresi logistik menunjukkan bahwa pilihan rumah sakit memiliki hubungan dengan ketersediaan rumah sakit di sekitar tempat tinggal (OR:3,047, p<0,01), jumlah rumah sakit di sekitar tempat tinggal (OR:1,554, p<0,05), jenis kunjungan (OR:0,618, p<0,05) dan waktu tunggu (OR:2,138, p<0,001). Dapat disimpulkan bahwa waktu tunggu dan jenis kunjungan merupakan faktor yang membedakan pasien yang memilih antara RSU Grandmed dan RSUD Drs. H. Amri Tambunan. Dikarenakan waktu tunggu merupakan aspek yang dapat dimodifikasi oleh rumah sakit, sangat disarankan pada kedua rumah sakit untuk menekan waktu tunggu dengan peningkatan efisiensi pelayanan.
Kata Kunci: BPJS Kesehatan, Pemanfaatan, Rumah Sakit Pemerintah, Rumah Sakit Swasta
Teks Lengkap:
Download ArtikelReferensi
Alkhawaldeh, A., Albashtawy, M., Rayan, A., Abdalrahim, A., Musa, A., Eshah, N., Khait, A. A., Qaddumi, J., Khraisat, O., & Albashtawy, S. (2023). Application and Use of Andersen’s Behavioral Model as Theoretical Framework: A Systematic Literature Review from 2012–2021. Iranian Journal of Public Health, 52(7), 1346–1354. https://doi.org/10.18502/ijph.v52i7.13236
Andersen, R. M. (2008). National health surveys and the behavioral model of health services use. Medical Care, 46(7), 647–653. https://doi.org/10.1097/MLR.0b013e31817a835d
Andersen, R. M., Rice, T. H., & Kominski, G. F. (2001). Changing the U.S.Health Care System - Key Issues in Health Serv ices, Policy, and Management. Jossey-Bass.
Balia, S., Brau, R., & Moro, D. (2020). Regional Science and Urban Economics Choice of hospital and long-distances : Evidence from Italy. Regional Science and Urban Economics, 81(November 2019), 103502. https://doi.org/10.1016/j.regsciurbeco.2019.103502
BPJS Kesehatan. (2022). Panduan Layanan Bagi Peserta Jaminan Kesehatan Nasional Kartu Indonesia Sehat (JKN-KIS). BPJS Kesehatan.
Cao, N., Wang, C., Li, X., Jiang, J., & Xu, W. (2022). The effect of basic medical insurance on the changes of primary care seeking behavior: An application of hierarchical age-period-cohort analysis. Frontiers in Public Health, 10(929896).
David, N. K., Mwaura-Tenambergen, W., & Mapesa, J. (2020). Effects of Health Insurance Schemes on Utilization of Healthcare Services and Financial Risk Protection: A Systematic Review. Public Health Research, 10(4).
Dorland, W. A. N., Neumann, P. E., Gest, T. R., & Mejino, J. L. V. (2020). Dorland’s Illustrated Medical Dictionary (33rd ed.). Elsevier Saunders.
Gil, M., & Choi, C. G. (2019). Factors Affecting the Choice of National and Public Hospitals Among Outpatient Service Users in South Korea. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 56. https://doi.org/10.1177/0046958019833256
Gliedt, J. A., Spector, A. L., Schneider, M. J., Williams, J., & Young, S. (2023). A Description of Theoretical Models for Health Service Utilization: A Scoping Review of the Literature. Inquiry (United States), 60. https://doi.org/10.1177/00469580231176855
Kim, A. M., & Lee, J. (2024). Factors Affecting the Preference for Hospitals Over Clinics in Primary Care in Korea. Journal of Korean Medical Science, 39(2), 1–11.
Lendado, T. A., Bitew, S., Elias, F., Samuel, S., Assele, D. D., & Asefa, M. (2022). Effect of hospital attributes on patient preference among outpatient attendants in Wolaita Zone , Southern Ethiopia : discrete choice experiment study. BMC Health Services Research, 22(661), 1–11. https://doi.org/10.1186/s12913-022-07874-x
Mason, D., Ingham, B., Urbanowicz, A., Michael, C., Birtles, H., Woodbury, M., Brown, T., James, I., Scarlett, C., Nicolaidis, C., Parr, J. R., & Mason, D. (2019). A Systematic Review of What Barriers and Facilitators Prevent and Enable Physical Healthcare Services Access for Autistic Adults. Journal of Autism and Developmental Disorders, 49(8), 3387–3400. https://doi.org/10.1007/s10803-019-04049-2
Meleddu, M., Pulina, M., & Scuderi, R. (2020). Public and private healthcare services: What drives the choice? Socio-Economic Planning Sciences, 70, 100739. https://doi.org/https://doi.org/10.1016/j.seps.2019.100739
Miao, C., Fang, X., Sun, H., Yin, Y., Li, B., Shen, W., Chen, J., & Huang, X. (2024). The relationship between individual-level socioeconomic status and preference for medical service in primary health institutions: a cross-sectional study in Jiangsu, China. Frontiers in Public Health, 11(1302523).
Moscone, F., Siciliani, L., Tosetti, E., & Vittadini, G. (2020). Do public and private hospitals differ in quality? Evidence from Italy. Regional Science and Urban Economics, 83, 103523. https://doi.org/https://doi.org/10.1016/j.regsciurbeco.2020.103523
Murphy, A., Bourke, J., & Turner, B. (2020). A two-tiered public-private health system : Who stays in (private) hospitals in Ireland ? Health policy, 124(7), 765–771. https://doi.org/10.1016/j.healthpol.2020.04.003
National Academies of Sciences and Medicine, E. (2018). Health-Care Utilization as a Proxy in Disability Determination. The National Academies Press. https://doi.org/10.17226/24969
Nguyen, C. M., Nguyen, M. P., & Luc, L. D. P. (2023). How public health insurance expansion affects healthcare utilizations in middle and low-income households: an observational study from national cross-section surveys in Vietnam. BMC Public Health, 23(1), 624. https://doi.org/10.1186/s12889-023-15500-6
Peraturan Pemerintah Nomor 47 Tahun 2016 tentang Fasilitas Pelayanan Kesehatan (2016).
Ranjbar, M., Bazyar, M., Pahlevanshamsi, F., Angell, B., & Assefa, Y. (2023). What do Iranians value most when choosing a hospital? Evidence from a discrete choice experiment. medRxiv.
Sanogo, N. A., & Yaya, S. (2020). Wealth Status, Health Insurance, and Maternal Health Care Utilization in Africa: Evidence from Gabon. Biomed Research International, 1.
Singh, S., Lakshmi, V., Somu, G., & Kamath, R. (2022). Determinants of Hospital Choice among Patients and Perceptions of the Same among Hospital Employees in a Tertiary Care Corporate Hospital in Mumbai , Abstract : The Open Public Health Journal, 15, 1–17. https://doi.org/10.2174/18749445-v15-e221205-2022-126
Soleimanvandiazar, N., Kamal, S. H. M., Sajjadi, H., Harouni, G. G., Karimi, S. E., Djalalinia, S., & Forouzan, A. S. (2020). Determinants of Outpatient Health Service Utilization according to Andersen’s Behavioral Model : A Systematic Scoping Review. Iran Journal Medical Science, 45(6). https://doi.org/10.30476/ijms.2020.85028.1481.Abstract
Soraya, S., Syamanta, T., Saidi, H., Bakkol, R., & Greg, M. (2023). Impact of the National Health Insurance Program (JKN) on Access to Public Health Services: A Comprehensive Analysis. Jurnal Ilmu Pendidikan dan Humaniora, 12(3), 133–151.
Toraman, A., Kocbas, D., & Erdem, R. (2019). Examining Factors That Have an Impact on Hospital Preferences of University Staff. Journal of International Health Sciences and Management, 5(9), 16–25.
Undang-Undang Nomor 17 Tahun 2023 tentang Kesehatan (2023).
Undang-Undang Nomor 24 Tahun 2011 tentang Badan Penyelenggara Jaminan Sosial (2011).
United Nations Development Program. (2015). Sustainable Development Goals - Good Health. 17 SDGs. https://www.undp.org/sustainable-development-goals/good-health
Weiss, D. J., Nelson, A., Gligorić, K., Bavadekar, S., Gabrilovich, E., Rozier, J., Gibson, H. S., Shekel, T., Kamath, C., Lieber, A., Schulman, K., Shao, Y., Qarkaxhija, V., Nandi, A. K., Keddie, S. H., Rumisha, S., Amratia, P., & Arambepola, R. (2020). Global maps of travel time to healthcare facilities. Nature Medicine, 26(December). https://doi.org/10.1038/s41591-020-1059-1
Wenang, S., Schaefers, J., Afdal, A., & Gufron, A. (2021). Availability and Accessibility of Primary Care for the Remote , Rural , and Poor Population of Indonesia. Frontiers in Public Health, 9(September), 1–11. https://doi.org/10.3389/fpubh.2021.721886
Yu, W., Li, M., Ye, F., Xue, C., & Zhang, L. (2017). Patient preference and choice of healthcare providers in Shanghai, China: a cross-sectional study. BMJ Open, 7(e016418), 1–16. https://doi.org/10.1136/bmjopen-2017-016418
Zhang, H., Ma, W., Zhou, S., Zhu, J., Wang, L., & Gong, K. (2023). Effect of waiting time on patient satisfaction in outpatient: An empirical investigation. Medicine, 102(40).
Zhang, S., Chen, Q., & Zhang, B. (2019). Understanding Healthcare Utilization In China Through The Andersen Behavioral Model : Review Of Evidence From The China Health And Nutrition Survey. Risk Management and Healthcare Policy, 12. https://doi.org/10.2147/RMHP.S218661
Zhao, P., Li, S., & Liu, D. (2020). Unequable spatial accessibility to hospitals in developing megacities: New evidence from Beijing. Health & Place, 65, 102406. https://doi.org/https://doi.org/10.1016/j.healthplace.2020.102406
DOI: https://doi.org/10.33024/mahesa.v4i11.16111
Refbacks
- Saat ini tidak ada refbacks.
Publisher: Universitas Malahayati Lampung
Semua artikel dapat digunakan dibawah lisensi Creative Commons Attribution-ShareAlike 4.0 International License
kostenlose besucherzähler