ANALISIS PAKET MANFAAT PELAYANAN TRANSFUSI DARAH DI FASILITAS KESEHATAN TINGKAT PERTAMA (FKTP) PADA PERATURAN PRESIDEN NO. 12 TAHUN 2013 PASAL 22 (STUDI IMPLEMENTASI KEBIJAKAN DI KOTA SURABAYA) - Hidayad Heny Sholikhah; Wahyu Dwi Astuti (Buletin Penelitian Sistem Kesehatan, 2018)
Background: The need for blood services in Indonesia are still high. These were related to the high number of maternal deaths from hemorrhage during and after childbirth. The National Health Insurance (JKN) provide great opportunities for ensuring the needs of the community blood transfusion services. Presidential Decree No. 12 of 2013 article 22 paragraph 1a.6 mentioned that blood transfusions became one of the health care benefi ts package in the fi rst degree. The purpose of this study to analyze the benefi ts package in the regulation of blood transfusion services, especially in health centers. Methods: This study was conducted in Surabaya. The analysis was performed on the results of Focus Group Discussion with actor implementing policies (health center, Indonesian Cross Red/PMI, Hospitals, and BPJS), by content analysis. Results: The blood transfusion services benefi t package had not been able to do in Health Center (Puskesmas/FKTP), especially Puskesmas in Surabaya. Package benefi ts of blood transfusion services confl ict with other policies. Theauthority to give a blood transfusion was not a health center (puskesmas) but the hospital. The technical requirements of medical support blood transfusion services in health centers did not according to the standard. Referral service was the most likely carried out by the health center when encountered cases of maternal urgency requiring blood transfusions. Conclusion: Package benefi ts of blood transfusion services in Presidential Decree No. 12 of 2013 article 22 contradicted by other policies already set. Availability of medical requirements that support these services had not been fulfilled. Blood transfusion services could not currently be implemented in Puskesmas Surabaya. Recommendation: The content of Presidential Decree no. 12 of 2013 article 22 requires the revision, that the blood transfusion service could only be carried out in health facilities provided medical technical requirements, both human resources and supporting infrastructure. Abstrak Latar Belakang: Kebutuhan pelayanan darah di Indonesia masih tinggi. Ini terkait masih tingginya jumlah kematian ibu akibat perdarahan saat dan pascamelahirkan. Jaminan Kesehatan Nasional (JKN) memberikan peluang terjaminnya kebutuhan masyarakat terhadap pelayanan transfusi darah. Peraturan Presiden (Perpres) no. 12 tahun 2013 pasal 22 ayat 1a.6 menyebutkan bahwa transfusi darah menjadi salah satu paket manfaat di pelayanan kesehatan tingkat pertama. Tujuan kajian untuk menganalisis paket manfaat pelayanan transfusi darah di puskesmas dalam Perpres tersebut. Metode: Kajian ini merupakan studi implementasi kebijakan Perpres no. 12 tahun 2013 yang dilakukan di Surabaya. Analisis dilakukan terhadap hasil FGD dengan aktor pelaksana kebijakan (Puskesmas, PMI, Rumah sakit, dan BPJS), secara content analysis. Hasil: Paket manfaat pelayanan transfusi darah belum dapat dilakukan di FKTP, khususnya Puskesmas di Surabaya, karena bertentangan dengan perundang-undangan yang lebih tinggi dan ditetapkan sebelumnya. Pemberian transfusi merupakan kewenangan rumah sakit. Persyaratan teknis medis penunjang pelayanan transfusi darah di puskesmas belum memenuhi standar. Puskesmas hanya berwenang merujuk ketika menjumpai kasus kegawatan maternal yang memerlukan transfusi darah. Kesimpulan: Pelayanan transfusi darah dalam Perpres no. 12 tahun 2013 pasal 22 kontradiktif dengan kebijakan lain. Pelayanan transfusi darah belum dapat dilaksanakan di Puskesmas Kota Surabaya, karena belum memenuhi persyaratan tranfusi darah yang aman. Rekomendasi: Isi Perpres no. 12 tahun 2013 pasal 22 perlu direvisi, bahwa pelayanan transfusi darah hanya dapat dilakukan di fasilitas kesehatan yang memenuhi persyaratan teknis medisnya, SDM dan sarana prasarana penunjangnya.