Article Sidebar

Submitted
August 8, 2025
Accepted
August 29, 2025
Published
August 31, 2025
Download
PDF
Statistic
Read Counter : 122 Download : 22

Downloads

Download data is not yet available.

Main Article Content

Abstract

Introduction: Equitable access to primary health services is a critical element in achieving Universal Health Coverage (UHC). Aims: This study aims to analyze the influence of educational level and BPJS ownership on access to primary healthcare services within the working area of Sidotopo Public Health Center (Puskesmas), Surabaya. Method: This research applied a quantitative approach with an analytical observational design utilizing a cross-sectional framework. A total of 84 respondents residing in RW 6, Sidotopo Subdistrict, were selected using a purposive sampling technique. Data were obtained from structured interviews and health center records. Results: The analysis showed that among respondents with middle-level education (junior and senior high school), 61.7% had used Puskesmas services, while only 45.2% of those with higher education had done so. In contrast, respondents with BPJS were more likely to use Puskesmas services (59.2%) than those without BPJS (25.0%), with a p-value of 0.064, approaching statistical significance. Conclusion: Although the relationship between education level and access to Puskesmas services was not statistically significant, there was a tendency for individuals with middle-level education to utilize primary services more frequently. These findings indicate the need to strengthen health literacy and expand the reach and effectiveness of the BPJS program, especially among underserved population groups.


 


Pendahuluan: Akses yang merata terhadap layanan kesehatan primer merupakan elemen penting dalam pencapaian Universal Health Coverage (UHC). Tujuan penelitian: Penelitian ini bertujuan untuk menganalisis pengaruh tingkat pendidikan dan kepemilikan BPJS terhadap akses layanan kesehatan primer di wilayah kerja Puskesmas Sidotopo, Surabaya. Metode: Studi ini menggunakan metode penelitian kuantitatif dengan desain observasional analitik serta pendekatan cross-sectional. Sebanyak 84 responden yang berdomisili di RW 6 Kelurahan Sidotopo dipilih dengan metode purposive sampling. Data diperoleh dari wawancara terstruktur dan catatan Puskesmas. Hasil: Analisis menunjukkan bahwa dalam kelompok responden dengan pendidikan menengah (SMP–SMA), 61,7% tercatat pernah memanfaatkan layanan Puskesmas, sementara hanya 45,2% pada kelompok berpendidikan tinggi. Sebaliknya, responden yang memiliki BPJS lebih banyak memanfaatkan layanan Puskesmas (59,2%) dibandingkan mereka yang tidak memiliki BPJS (25,0%), dengan nilai p = 0,064, yang mendekati signifikansi statistik. Kesimpulan: Meskipun hubungan antara tingkat pendidikan dan akses layanan Puskesmas tidak signifikan secara statistik, terdapat kecenderungan bahwa individu dengan pendidikan menengah lebih sering memanfaatkan layanan primer dibandingkan kelompok lainnya. Temuan ini menunjukkan perlunya penguatan literasi kesehatan dan perluasan cakupan serta efektivitas program BPJS, terutama pada kelompok masyarakat yang belum terjangkau secara optimal.

Keywords

Pelayanan Puskesmas, pemanfaatan fasilitas kesehatan primer, pendidikan, regulasi sistem kesehatan, status kepesertaan JKN.

Article Details

License
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite
Seliana, I. (2025). Pengaruh Pendidikan dan Kepemilikan BPJS terhadap Akses Layanan Primer di Puskesmas Sidotopo. Sanus Medical Journal, 7(1), 41–59. https://doi.org/10.22236/sanus.v7i1.20415
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. [ Q. Cheng et al., "Determinants of healthcare utilization under the Indonesian national health insurance system - a cross-sectional study," BMC Health Serv. Res., vol. 25, no. 1, 2025, doi: 10.1186/s12913-024-11951-8.
  2. https://doi.org/10.1186/s12913-024-11951-8
  3. A. Alkhawaldeh et al., "Application and Use of Andersen's Behavioral Model as Theoretical Framework: A Systematic Literature Review from 2012-2021," Iran. J. Public Health, vol. 52, no. 7, pp. 1346-1354, 2023, doi: 10.18502/ijph.v52i7.13236.
  4. https://doi.org/10.18502/ijph.v52i7.13236
  5. A. D. Laksono, R. D. Wulandari, and O. Soedirham, "Urban and rural disparities in hospital utilization among Indonesian adults," Iran. J. Public Health, vol. 48, no. 2, pp. 247-255, 2019, doi: 10.18502/ijph.v48i2.819.
  6. https://doi.org/10.18502/ijph.v48i2.819
  7. A. N. Fauziyyah, A. Shibanuma, K. I. C. Ong, and M. Jimba, "What are the factors affecting primary care choice when the access under health insurance scheme is limited?: a cross-sectional study in Bandung, Indonesia," BMC Prim. Care, vol. 25, no. 1, pp. 1-13, 2024, doi: 10.1186/s12875-024-02296-6.
  8. https://doi.org/10.1186/s12875-024-02296-6
  9. A. D. Laksono, R. D. Wulandari, Z. Zuardin, H. Ashar, M. Ipa, and A. P. Kesuma, "Factors Related to Hospital Inpatients among the Poor in Indonesia," Iran. J. Public Health, vol. 53, no. 6, pp. 1372-1380, 2024, doi: 10.18502/ijph.v53i6.15911.
  10. https://doi.org/10.18502/ijph.v53i6.15911
  11. Dinas Kesehatan Kota Surabaya, Profil Dinas Kesehatan Kota Surabaya 2023. 2023.
  12. Dinkes Surabaya, Profil Dinas Kesehatan Kota Surabaya 2022. 2022.
  13. Dinkes Surabaya, Profil Dinas Kesehatan Kota Surabaya 2021, no. November 2022. 2021.
  14. R. D. Wulandari, A. D. Laksono, N. Rohmah, and H. Ashar, "Regional differences in primary healthcare utilization in Java Region-Indonesia," PLoS One, vol. 18, no. 3 March, pp. 1-12, 2023, doi: 10.1371/journal.pone.0283709.
  15. https://doi.org/10.1371/journal.pone.0283709
  16. A. D. Laksono, R. D. Wulandari, Z. Zuardin, and N. Rohmah, "Education's Role In Primary Healthcare Utilization Among Older People In Indonesia | Peran Pendidikan dalam Pemanfaatan Puskesmas pada Lansia di Indonesia," Indones. J. Heal. Adm., vol. 12, no. 1, pp. 11-24, 2024, doi: 10.13140/RG.2.2.32847.05287.
  17. https://doi.org/10.20473/jaki.v12i1.2024.11-24
  18. M. Khairunnisa, A. D. Laksono, S. Purwoko, S. Sulasmi, and A. Nursafingi, "Factors Associated With the Utilization of Public Health Center in Central Java," Indones. J. Heal. Adm., vol. 11, no. 2, pp. 221-230, 2023, doi: 10.20473/jaki.v11i2.2023.221-230.
  19. https://doi.org/10.20473/jaki.v11i2.2023.221-230
  20. D. Astuti, S. Kongsin, S. Jiamton, P. Prakongsai, and S. R. Hearnden, "Utilization of Primary Health Care Under National Health Insurance in Samarinda Municipality, East Kalimantan Province, Indonesia," J. Multidiscip. Healthc., vol. 17, no. February 2024, pp. 1025-1039, 2024, doi: 10.2147/JMDH.S447332.
  21. https://doi.org/10.2147/JMDH.S447332
  22. M. Haemmerli, T. Powell-Jackson, C. Goodman, H. Thabrany, and V. Wiseman, "Poor quality for the poor? A study of inequalities in service readiness and provider knowledge in Indonesian primary health care facilities," Int. J. Equity Health, vol. 20, no. 1, pp. 1-12, 2021, doi: 10.1186/s12939-021-01577-1.
  23. https://doi.org/10.1186/s12939-021-01577-1
  24. D. A. Solikha, D. C. Butler, E. Setiawan, R. J. Korda, and M. Kelly, "Primary health care performance measurement at the service delivery level in Indonesia: a scoping review," BMC Health Serv. Res., vol. 25, no. 1, 2025, doi: 10.1186/s12913-025-12955-8.
  25. https://doi.org/10.1186/s12913-025-12955-8
  26. D. S. Arsyad et al., "The readiness of public primary health care (PUSKESMAS) for cardiovascular services in Makasar city, Indonesia," BMC Health Serv. Res., vol. 22, no. 1, pp. 1-12, 2022, doi: 10.1186/s12913-022-08499-w.
  27. https://doi.org/10.1186/s12913-022-08499-w
  28. R. V. Ramadani, M. Svensson, S. Hassler, B. Hidayat, and N. Ng, "Effects of the COVID-19 pandemic on healthcare utilization among older adults with cardiovascular diseases and multimorbidity in Indonesia: an interrupted time-series analysis," BMC Public Health, vol. 24, no. 1, pp. 1-10, 2024, doi: 10.1186/s12889-023-17568-6.
  29. https://doi.org/10.1186/s12889-023-17568-6
  30. E. Zairina, I. Dhamanti, I. Nurhaida, D. S. Mutia, and A. Natesan, "Analysing of drug patterns in primary healthcare centers in Indonesia based on WHO's prescribing indicators," Clin. Epidemiol. Glob. Heal., vol. 30, no. October, p. 101815, 2024, doi: 10.1016/j.cegh.2024.101815.
  31. https://doi.org/10.1016/j.cegh.2024.101815
  32. R. D. Wulandari, A. D. Laksono, Z. Zuardin, N. Rohmah, and M. Dahlui, "Socioeconomic disparities in primary healthcare utilization in Eastern Indonesia," Clin. Epidemiol. Glob. Heal., vol. 35, no. March, p. 102154, 2025, doi: 10.1016/j.cegh.2025.102154.
  33. https://doi.org/10.1016/j.cegh.2025.102154
  34. A. B. Pratiwi, R. S. Padmawati, J. Mulyanto, and D. L. Willems, "Patients values regarding primary health care: a systematic review of qualitative and quantitative evidence," BMC Health Serv. Res., vol. 23, no. 1, pp. 1-15, 2023, doi: 10.1186/s12913-023-09394-8.
  35. https://doi.org/10.1186/s12913-023-09394-8
  36. T. Rahmawati and H. M. Hsieh, "Appraisal of universal health insurance and maternal health services utilization: pre- and post-context of the Jaminan Kesehatan Nasional implementation in Indonesia," Front. Public Heal., vol. 12, no. March, pp. 1-9, 2024, doi: 10.3389/fpubh.2024.1301421.
  37. https://doi.org/10.3389/fpubh.2024.1301421