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* Corresponding Author
Disparitas Peran Preventif dan Pola Rujukan Kasus Anak di Fasilitas Kesehatan Tingkat Pertama
https://doi.org/10.22146/jkki.116550 Bima Indra(1*), Dewi Purnamawati(2), Munaya Fauziah(3)
(1) Master of Public Health Study Program, Universitas Muhammadiyah Jakarta, Jakarta, Indonesia
(2) Faculty of Public Health, Universitas Muhammadiyah Jakarta, Jakarta, Indonesia
(3) Faculty of Public Health, Universitas Muhammadiyah Jakarta, Jakarta, Indonesia
(*) Corresponding Author
Abstract
Program Jaminan Kesehatan Nasional (JKN) menuntut Fasilitas Kesehatan Tingkat Pertama (FKTP) untuk memberikan pelayanan komprehensif, mencakup upaya promotif-preventif dan kuratif. Namun, belum ada evaluasi nasional mengenai profil kunjungan pasien anak (0-18 tahun) yang membandingkan performa fasilitas pemerintah dan swasta. Penelitian ini bertujuan memetakan profil kunjungan, beban penyakit, dan pola rujukan pasien anak di FKTP di Indonesia tahun 2023. Studi potong lintang dilakukan menggunakan Data Sampel BPJS Kesehatan tahun 2023 dengan total sampel 527.432 kunjungan anak. Analisis deskriptif dilakukan untuk membandingkan proporsi jenis kunjungan (sehat vs sakit) dan diagnosa rujukan antar jenis fasilitas kesehatan. Terdapat kesenjangan peran yang signifikan antara fasilitas pemerintah dan swasta. Puskesmas menunjukkan fungsi layanan berimbang dengan 41,69% proporsi Kunjungan Sehat (imunisasi/pemantauan tumbuh kembang). Sebaliknya, Klinik Pratama dan Dokter Praktik Perorangan didominasi oleh layanan kuratif, dengan proporsi Kunjungan Sakit mencapai >87% hingga 95%. Pola rujukan menunjukkan beban tinggi pada kasus non-spesialistik pediatri, dengan Poli THT-KL dan Kulit Kelamin menjadi tujuan rujukan terbanyak setelah Poli Anak, mengindikasikan adanya celah kompetensi di layanan primer. Fungsi gatekeeper dan paradigma sehat belum berjalan optimal di sektor swasta. Diperlukan reformasi sistem insentif kapitasi untuk mendorong FKTP swasta lebih aktif dalam upaya preventif kesehatan anak.
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DOI: https://doi.org/10.22146/jkki.116550
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