PEMANFAATAN PELAYANAN KESEHATAN PADA KELUARGA NELAYAN DI KABUPATEN JEPARA

Abstract

Telah dilakukan penelitian untuk melihat pemanfaatan pelayanan kesehatan oleh keluarga nelayan di Kabupaten Jepara. Penelitian ini untuk menjawab masalah jangkauan pelayanan kesehatan kepada keluarga nelayan yang sebagian besar miskin dan berpendidikan rendah. Survei dilakukan terhadap 200 sampel keluarga nelayan di Kecamatan Kedung dan Kecamatan Jepara. Kerangka konsep penelitian dikembangkan dari model pemanfaatan pelayanan kesehatan oleh Andersen (1975), Sorkin (1976), Feldstein (1963) dan Kroeger (1983) dan Akin et al (1985). Variabel terikat adalah pemanfaatan Pelayanan kesehatan, sedangkan variabe) bebas yaitu : kebutuhan, pendidikan, jumlah dan struktur keluarga, persepsi, pengeluaran keluarga, biaya pengobatan, biaya transpor, waktu menunggu pelayanan, waktu perjalanan serta jarak tempat pelayanan. Basil penelitian menyebutkan bahwa 79,5% keluarga nelayan berada dibawah garis kemiskinan, 96% hanya berpendidikan Sekolah Dasar beban tanggungan keluarga rata-rata 5 orang disertai dengan beban anggota kelarga yang rentan terhadap panyakit.Penyakit yang banyak diderita yaitu: batuk, batuk pilek, rematik, pegal linu lelah, hipertensi, diare, penyakit kulit, typhus, TBC serta radang/infeksi tenggorokan. Upaya berobat terbanyak yaitu: beli obat di warung/toko, berobat ke doktar praktek, paranedis/ bidan/ bidan desa -serta Puskesmas. Persepsi keluarga membeli obat adalah karena merasa cocok dan biaya terjangkau. Persepsi berobat ke dokter karena merasa coeok, pelayanannya balk serta karena kegawatan penyakit. Berobat ke paramedis karena alasan merasa cocok dan biaya terjangkau, sedargkan berobat ke Puskesmas karena alasan biaya terjangkau dan sudah merasa cocok. Rata-rata lama hari sakit upaya beli obat dan berobat ke paramedis adalah 4 hari, sedangkan untuk dokter praktek dan Eiuskesmas rata-rata 7 hari. Waktu tunggu, waktu menompub perjalanan dan jarak tempat pelayanan paling lama/jaull adalah berohat ke dokter. Biaya pengobatan dan biaya transportasi paling mahal juga apabila berobat ke dokter. Basil analisis multivariat menunjukkan hasil bahwa variabel kebutuhan, jumlah dan struktur keluarga bermakna untuk semua upaya/ pelayanan (p = 0.05). Pada upaya berobat ke dokter prektek dan Puskesmas biaya pengobatan bermakna. Variabel lain yang bermakna yaltu pendidikan, pengeluaran keluarga, biaya transpor, waktu menempuh perjalunan serta jarak tempat pelayanan Untuk selanjutnya masih diperlukan kajian tentang kemampuan dan kemanan membayar pelaysnan kesehatan serta kajian yang lebih luas tentang masalah transisi epidemiologis pada masyarakat nelayan pedesaaan yang miskin tersehut. Masih perlu peningkatan kuantitas dan kualitas pelayanan dokter, puskesmas dan paramedis. Begitu juga diperlukan rumusan kebijakan dan program yang segera dapat diterapkan untuk meningkatkan kemampuan membeli pelayanan pengobatan keluarga nelayan dalam rangka mensukseskan program pengentasan kemiskinan di Indonesia. This research have objective to acelize how's the fisiormen' families use the health servives in the condition of they poverty 8Pd low education. With the sample 200 fishermen families in Kecamatan Jepara and Kecamatan Kedung Kabupaton Jcpara, the conceptual framework is developed from the health services use models from: Andersen (1975), Sorkin (1976), Feldstein (1383), Kroeger (1983) and Akin et al (1985). Dependent, variable is the utilization of health services and the independent variable are: needs, education, the size and families' structure, fanilies perJ.otion about health services, household expenditure, health services price/cost, transportation cosh, waiting time, transportation time and the health services distance. The result of this researh mentions that 79,5% fishermen/s families are under poverty line, 96% respondent with the elementary school education. Dependency burden are 5 person with the high risk of illness. The major illness are: a•ute respiratory disease, reumathic, hipertension, diarrhea, skin illness, typhus abdominalis, TBC. Self treatment with buy specific drug, doctor, paramedic and Puskesmas (Health Cormunity Centre) are the major health servives used by the families. The families have certain perception about health services. They bought drug because they believes that the effect cf those drugs could cured them and the price of the drugs are low_ They went to the doctor bccause they believe that the doctor could cure them with the good services and because of the condition of the illmove. They went to paramedic/widwifes and Fuskesmas because they believe that they could cure them and the families could reach Lhe medical cost_ The result of the mulvivariiai size and structure and families' services' use (buy drug, doctor. Medical cost are significant in t significant variables are educa-cost, transportation time and the analysis mentioned that needs, the families erception were significant with the health naramedic and Puuskeemae with P 9,05). doctor's services and Puskesmas. The other. Jon, household expenditure, transportation iealth services distance. For the further research, it ,ry important to make the research that will analize the willingness and the .lity to pay health services for those poor fishermen' families and the Aphrehensive research about. epidemiology transition in this cammity o- under poverty line community. The specific policy/ program to rise thei ability to purchase health services. are important to applied for the t r community, especially : kartu sehat, dana sehat and the subsidy for the pr families. The health services quantity and quality are For the further research, it ,ry important to make the research that will analize the willingness and the .lity to pay health services for those poor fishermen' families and the Aphrehensive research about. epidemiology transition in this cammity o- under poverty line community. The specific policy/ program to rise thei ability to purchase health services. are important to applied for the t r community, especially : kartu sehat, dana sehat and the subsidy for the pr families. The health services quantity and quality are For the further research, it ,ry important to make the research that will analize the willingness and the .lity to pay health services for those poor fishermen' families and the Aphrehensive research about. epidemiology transition in this cammity o- under poverty line community. The specific policy/ program to rise thei ability to purchase health services. are important to applied for the t r community, especially : kartu sehat, dana sehat and the subsidy for the pr families. The health services quantity and quality are are to de important vel L 7 because the health are the basic right of human being