Sources of funding for caesarean section in two hospitals in Jakarta

Abstract

AbstrakLatar belakang: Prevalensi seksio sesarea meningkat setiap tahunnya. Penelitian ini bertujuan untuk mengetahui sumber pembiayaan seksio sesarea di beberapa rumah sakit di Jakarta. Metode: Penelitian dilakukan dengan desain potong lintang yang dilakukan di satu rumah sakit pemerintah daerah DKI Jakarta dan satu rumah sakit bersalin di Jakarta. Pengumpulan data dilakukan dengan mengekstrak data rekam medis pasien yang melahirkan dan dirawat pada periode 1 Januari sampai 31 Desember 2011. Analisis dilakukan dengan menggunakan regresi Cox dengan waktu konstant. Hasil: Proporsi seksio sesaria di rumah sakit (RS) pemerintah Jakarta (922/1351 = 68,2%) relatif lebih tinggi dari rumah sakit swasta (1036/1645 = 63,0%). Insiden tertinggi seksio sesaria pada kelompok umur 21-35 tahun (76,9%). Subjek paling banyak berpendidikan menengah (74,5%). Kebanyakan sumber pendanaan merupakan biaya pribadi (51,2%), sedangkan sumber pendanaan terendah dari perusahaan (0,3%). Dibandingkan dengan yang harus membayar sendiri, subjek yang memiliki Jamkesda, Jamsostek, dan Jampersal lebih memilih seksio scesaria. Subjek yang memiliki Jampersal 35% lebih banyak melakukan seksio sesarea [risiko relatif suaian (RRa) = 1,35; P = 0,000]. Kesimpulan: Seksio sesarea paling banyak atas biaya pribadi, dan di samping itu banyak yang memanfaatkan Jamsostek dan Jampersal sebagai sumber pembiayaannya. (Health Science Indones 2013;2:93-7)Kata kunci: seksio sesarea, sumber pembiayaanAbstractBackground: The prevalence of Caesarean section (c-section) has increased each year. This study aimed to identify the major source of funding related to c-section in government and private hospitals in Jakarta. Methods: The cross sectional study was conducted in a provincial general hospital in Jakarta and a private maternity hospital in Jakarta. The data were collected from all medical records of patients giving birth in those hospitals in the period of January 1st through December 31st, 2011. Analysis was performed using Cox regression with a time constant.Results: The proportion of c-section deliveries in the government hospital (922/1351 = 68.2%) was relatively higher than the private hospital (1036/1645 = 63.0%). The highest incidence of c-section was in the age group 21-35 years (76.9%). Most subjects had middle level education (74.5%). Most c-section funding source was derived from out of pocket or personal expenses (51.2%), while the lowest funding source came from the company (0.3%). Compared with those who paid out of pocket, those who had Jamkesda, Jamsostek, and Jampersal schemes had more c-section deliveries. Subjects with Jampersal had the highest incidence of c-section (35%) [adjusted relative risk (RRa) = 1.35; P = 0.000]. Conclusion: In addition to out of pocket, most of subjects who had c-section used Jamsostek and Jampersal as funding sources. (Health Science Indones 2013;2:93-7)Key words: caesarean section, funding sources

Keywords

• caesarean section, funding sources