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Abstract
Latar Belakang: Efisiensi pembiayaan layanan kesehatan primer merupakan aspek penting dalam memperkuat sistem Jaminan Kesehatan Nasional (JKN), karena Puskesmas sebagai fasilitas kesehatan tingkat pertama dituntut mengelola dana kapitasi secara rasional untuk mendukung program promotif, preventif, dan kuratif. Tujuan: Penelitian ini bertujuan menganalisis efisiensi biaya program Kesehatan Keluarga (Kesga) serta Pencegahan dan Pengendalian Penyakit (P2P) di Puskesmas Umbulharjo II berdasarkan pemanfaatan dana kapitasi JKN. Metode: Penelitian menggunakan desain evaluasi ekonomi deskriptif dengan pendekatan Cost-Effectiveness Ratio (CER) dan memanfaatkan data sekunder dari laporan keuangan serta capaian program tahun 2024. Nilai CER dihitung dengan membandingkan total biaya terhadap output program sebagai indikator efisiensi operasional berbasis produktivitas. Hasil: Total biaya pelaksanaan program mencapai Rp337.017.000 atau 72,4% dari dana operasional kapitasi. Program skrining HIV dan skrining PTM menunjukkan nilai CER terendah dan berada di bawah rata-rata kapitasi per peserta per bulan (Rp3.765), sedangkan program pengendalian vektor dan pemberian makanan tambahan (PMT) memiliki nilai CER tertinggi dan berada di atas Rp3.765, yang menunjukkan biaya per unit luaran relatif lebih besar. Secara fiskal, sebagian besar program tetap berada dalam batas pagu operasional kapitasi, terutama kegiatan promotif dan preventif yang proporsional terhadap kapasitas anggaran. Kesimpulan: Pemanfaatan dana kapitasi di Puskesmas Umbulharjo II relatif efisien secara fiskal dan operasional berdasarkan benchmark kapitasi lokal. Diperlukan penguatan manajemen pembiayaan, terutama untuk program dengan kebutuhan logistik tinggi agar tetap berada dalam batas efisiensi yang rasional.
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References
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- Parulian AP, et al. Utilization of National Health Insurance capitation funds at Puskesmas. Jurnal Pengabdian Masyarakat Sains. 2024; 6(1). https://doi.org/10.34012/jpms.v6i1.4972
- Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. 4th ed. Oxford University Press; 2015.
- Gold MR, Siegel JE, Russell LB, Weinstein MC. Cost-effectiveness in health and medicine. Oxford University Press; 1996.
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- Friska M, Syaharani L, Rahayu S, Gurning FP. Analisis pemanfaatan dana kapitasi di Puskesmas Kutalimbaru Medan Tuntungan. Jurnal Dinamika Kesehatan Terpadu. 2025; 6(2). https://doi.org/10.54957/ijhs.v4i4.939
- Dewanto I, et al. Adequacy of dental capitation payment at community health centers. Journal of Internaional Oral Health. 2021; 13(5):311–317. https://doi.org/10.4103/jioh.jioh_311_20
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- Suwantika AA, Kautsar AP, Zakiyah N, Abdulah R, Boersma C, Postma MJ. Cost-Effectiveness Analysis of Spending on Research and Development to Address the Needs for Innovative Therapeutic Products in Indonesia. Therapeutics and Clinical Risk Management 2020; 16:969-977. https://doi.org/10.2147/TCRM.S260377
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References
Kementrian Kesehatan RI. Profil Kesehatan. Jakarta: Kemenkes RI; 2023. https://kemkes.go.id/id/profil-kesehatan-indonesia-2023
Putri, N. K., et al. Theory-practice gap of capitation payment in the Indonesian national health insurance. International Journal of Health Governance. 2024; 29(1), 27–41. https://doi.org/10.1108/IJHG-08-2023-0081
Parulian AP, et al. Utilization of National Health Insurance capitation funds at Puskesmas. Jurnal Pengabdian Masyarakat Sains. 2024; 6(1). https://doi.org/10.34012/jpms.v6i1.4972
Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. 4th ed. Oxford University Press; 2015.
Gold MR, Siegel JE, Russell LB, Weinstein MC. Cost-effectiveness in health and medicine. Oxford University Press; 1996.
Sambodo NP, Bonfrer I, Sparrow R, Pradhan M, van Doorslaer E. Effects of performance-based capitation payment on the use of public primary health care services in Indonesia. Social Science & Medicine. 2023; 327:115921. https://doi.org/10.1016/j.socscimed.2023.115921
Mindarti M, et al. The relationship between National Health Insurance capitation funds and the quality of health services. Jurnal Kesehatan. 2024;2(2). https://doi.org/10.62185/issn.3023-5448.2.2.4
Hasan AG, Adisasmito WB. Analisis kebijakan pemanfaatan dana kapitasi JKN pada FKTP Puskesmas di Kabupaten Bogor tahun 2016. Jurnal Kebijakan Kesehatan Indonesia. 2017; 6(3):127–37. https://doi.org/10.22146/jkki.v6i3.29658
Anindita R, et al. Evaluating primary care providers' compliance with special capitation in Indonesia's national health insurance. Jurnal Jaminan Kesehatan Nasional. 2024; 4(2). https://doi.org/10.53756/jjkn.v4i2.206
Maryam L. Analisis implementasi pemanfaatan dana kapitasi JKN di Puskesmas Namrole Kabupaten Buru Selatan [Tesis]. Makassar: Universitas Hasanuddin; 2023.
Friska M, Syaharani L, Rahayu S, Gurning FP. Analisis pemanfaatan dana kapitasi di Puskesmas Kutalimbaru Medan Tuntungan. Jurnal Dinamika Kesehatan Terpadu. 2025; 6(2). https://doi.org/10.54957/ijhs.v4i4.939
Dewanto I, et al. Adequacy of dental capitation payment at community health centers. Journal of Internaional Oral Health. 2021; 13(5):311–317. https://doi.org/10.4103/jioh.jioh_311_20
Noviyani R, Duong KNC, Ngo NTN, et al. Empirical antibiotics versus definitive antibiotics for sepsis patients in Indonesia: A cost-effectiveness analysis. Journal of Applied Pharmaceutical Science. 2024; 14(10):053–059. https://doi.org/10.7324/JAPS.2024.195834
Novyandina J, Noerjoedianto D, Sari RE. Analisis pengelolaan dana kapitasi JKN di Puskesmas Muara Bungo I Kabupaten Bungo. Jurnal Manajemen Kesehatan Indonesia. 2025; 13(1):99–109. https://doi.org/10.14710/jmki.13.1.2025.99-109
Nguyen TPL, Rokhman MR, Stiensma I, et al. Cost-effectiveness of non-communicable disease prevention in Southeast Asia: A scoping review. Front Public Health. 2023; 11:1206213. https://doi.org/10.3389/fpubh.2023.1206213
Purba FD, Siahaan RM, Nurmala I. Participation in community-based healthcare interventions and early detection of non-communicable diseases in Indonesia. SSM Population Health. 2022; 19:101236. https://doi.org/10.1016/j.ssmph.2022.101236
Stenberg K, Watts R, Bertram M, et al. Cost-effectiveness of interventions to improve maternal, newborn and child health outcomes. International Journal of Health Policy and Management. 2021; 10:706–23. https://doi.org/10.34172/ijhpm.2021.07
Suwantika AA, Kautsar AP, Zakiyah N, Abdulah R, Boersma C, Postma MJ. Cost-Effectiveness Analysis of Spending on Research and Development to Address the Needs for Innovative Therapeutic Products in Indonesia. Therapeutics and Clinical Risk Management 2020; 16:969-977. https://doi.org/10.2147/TCRM.S260377
Edejer TT, Baltussen R, Adam T, et al. Making choices in health: WHO guide to cost-effectiveness analysis. Geneva: World Health Organization; 2003. https://iris.who.int/handle/10665/42699
Sabillah EF. Evaluasi pengelolaan dan pemanfaatan dana kapitasi JKN di Puskesmas. Journal of Comprehensive Science. 2022;1(5):1378–86. https://doi.org/10.59188/jcs.v1i5.156