ABSTRAK
Latar belakang dilakukannya penelitian ini adalah karena meningkatnya persalinan sejak dilaksanakannya Program Jaminan Persalinan (JAMPERSAL) di Rumah Sakit Umum Pusat (RSUP) Fatmawati tahun 2011.Metode penelitian deskriptif analitik melalui pendekatan kuantitatif dengan jumlah sampel 297 responden, diambil sebelum dan setelah dilaksanakan Program JAMPERSAL. Studi kualitatif dilakukan melalui wawancara dengan peserta JAMPERSAL dan karyawan RSUP Fatmawati serta audit klinik pada peserta dengan selisih biaya tertinggi setiap tahun.Ketidaktepatan rujukan ditunjukkan dengan rujukan yang dominan dari Puskesmas DKI Jakarta serta dari RSUD Depok, tingginya persalinan spontan (25,25%- 35,4%) dan ketidaksesuaian diagnosis antara perujuk dan Dokter Spesialis Kebidanan dan Kandungan (14,8%- 22,9%). Didapatkan rerata selisih biaya persalinan spontan sebesar Rp 1,286,079.82 - Rp 4,306,453.02 dan sectio caesarea Rp 4,076,727.07 - Rp 6,280,824.40. Diperlukan penyempurnaan pelaksanaan Program JAMPERSAL didukung kebijakan lain secara terintegrasi.

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ABSTRACT

This sudy is conducted due to uprising number of labor in Fatmawati General Hospital (RSUP Fatmawati) as a referral hospital in Jakarta ever since the Labor Insurance Programme (JAMPERSAL) initiated in the year 2011.

Descriptive analytic method was used with quantitative and qualitative approach. The total sample of 297 correspondents was taken from the labeor bofore and after the JAMPERSAL is launched. The qualitative study is achieved by interviewing the JAMPERSAL participant, the staff of RSUP Fatmawati, and also by conducting the clinical audit on patient with the highest cost difference annually.

Imprecision of the referral system is shown accordingly to the dominant referral from Puskesmas DKI Jakarta (21%-49,4%), RSUD Depokoverload quota as a reason (before JAMPERSAL 78,6% - after JAMPERSAL 90,5%), high number of spontaneous delivery (25,25%- 35,4%) and the dissimilarity between the diagnosis of the refers and the Obstetric Gynecologist (14,8%- 22,9%). It is drawn that the mean of cost difference in spontaneous delivery is 1,286,079.82 - 4,306,453.02 IDR while in caesarean section 4,076,727.07- 6,280,824.40 IDR. Improvement of the JAMPERSAL guidance is needed, supporting by other integrated policy.