Tantangan Pengembangan Pelayanan Kesehatan Primer di Indonesia

ali 6sept

Pelayanan kesehatan primer yang menitikberatkan pada promosi dan prevensi dipertanyakan kalangan dokter muda. Bagaimana upaya tersebut dibebankan pada dokter, yang selama ini berkutat pada bidang kuratif atau pengobatan.

Hal itu mengemuka dalam seminar bertajuk "Tantangan Pelaksanaan dan Kebijakan Pelayanan Kesehatan Primer dan BPJS" yang diselenggarakan JEN, PDKMI dan Lembaga Penelitian Universitas Trisakti, di Jakarta, Sabtu (6/9).

Tampil sebagai pembicara Wakil Menteri Kesehatan (Wamenkes) Prof Ali Ghufron Mukti itu dan anggota Komisi IX dari PDI-P, dr Surya Chandra Suropaty.

Prof Ali Ghufron mengakui, pendidikan kedokteran selama ini memang masih fokus pada bidang kuratif. Sementara pelayanan kesehatan, sejak diterapkannya program Jaminan Kesehatan Nasional (JKN) akan bergeser ke layanan kesehatan primer yang menekankan pada promosi dan prevensi.

"Ini pertanyaan paling jujur dari dokter, yang baru pertama saya dengar selama sosialisasi program JKN dan layanan primer. Siapakah yang bertanggungjawab atas promosi dan prevensi, karena dokternya sudah sibuk dengan kuratif," ucap Wamenkes kembali mempertanyakan.

Dijelaskan, pelayanan kesehatan primer merupakan kata kunci untuk melihat keberhasilan program JKN. Karena jika hal itu berkembang dengan baik, maka jumlah orang yang akan dirujuk ke rumah sakit semakin sedikit. Dengan demikian biaya kesehatan nasional semakin kecil.

"Dibanyak negara, layanan kesehatan primernya mencapai 80 persen, sementara biaya kuratifnya 20 persen. Jadi anggaran kesehatannya kecil. Kondisi sebaliknya terjadi di Indonesia, dimana anggaran kesehatannya 80 persen habis untuk kuratif," ujarnya.

Karena itu, lanjut Prof Ali Ghufron, sejak awal program JKN diterapkan pada 1 Januari 2014, pemerintah akan meningkatkan kompetensi dokter umum menjadi dokter layanan primer (LDP). Seorang LDP sedikitnya memiliki kompetensi terhadap 155 jenis penyakit yang banyak diderita masyarakat.

"Untuk itu, dokter umum yang akan menjadi LDP harus ikut pendidikan setara spesialis, sekitar 2 tahun lamanya agar memiliki kompetensi terhadap 155 jenis penyakit. LDP akan berperan sebagai mitra, pembina, koordinator dan komunikator segala kebutuhan pelayanan kesehatan dari komunitas yang dibinanya," tutur Prof Ali Ghufron.

Jika kompetensi LDP tersebut sudah diraih, menurut Prof Ali Ghufron, tak akan ada lagi pertanyaan siapakah yang menjalankan upaya promosi dan prevensi. Karena hal itu merupakan tanggungjawab LDP.

Karena selain menjadi gatekeeper, lanjut Prof Ali Ghufron, LDP diharapkan mampu berperan dalam upaya kesehatan masyarakat (UKM), seperti melakukan analisa masalah kesehatan di wilayahnya mulai dari pengumpulan data hingga melakukan surveillance.

Selain juga mampu melakukan manajemen Puskesmas, menggerakan masyarakat dan melakukan koordinasi lintas sektor. "Ini tantangan bagi Fakultas Kedokteran, terutama soal UKM ini," ucap Prof Ali Ghufron menandaskan.

cndra 6septHal senada dikemukakan dr Surya Chandra Suropaty. Ia sempat menyayangkan minimnya peran pemda dalam mendukung keberhasilan program JKN. Dengan demikian, seluruh masyarakat Indonesia merasa terlindungi kesehatan karena pemda-nya peduli.

"Pemda seharusnya bisa menyajikan data akurat peserta JKN by name by address sehingga tak ada lagi sasaran. Karena merekalah yang sesungguhnya memiliki data warga. Selain itu, pemda bisa melakukan pendataan daerah sehingga kebutuhan layanan primer bisa dipenuhi," ujarnya.

Jika nantinya program JKN berubah nama menjadi Kartu Indonesia Sehat diharapkan Presiden Terpilih Joko Widodo bisa melakukan koordinasi dengan kepala daerah untuk serius menangani masalah kesehatan masyarakat. Termasuk upaya promosi dan prevensinya. Sehingga anggaran kesehatan pemerintah bisa ditekan seminimal mungkin. (TW)

 

Materi Presentasi

Tantangan Pengembangan Pelayanan Kesehatan Primer dalam Menunjang Pelaksanaan SJSN dan SKN - Prof. dr. Ali Ghufron Mukti
    Dr. Surya Chandra Surapati, MPH
    Prof Charles Sujardi FK Unika Atmajaya Jakarta
Upaya Promotif & Preventif yang (masih) terabaikan di Faskes Primer dalam era BPJS
    Pengembangan Pelayanan Kesehatan Primer

 

Comments  

# kuning tiadi 2014-09-15 01:45
Saya kira syah-syah saja pakar yang
pejabat juga mengambil kebijakan yang
Beliau bukan tidak tahu teori ataupun
Prakteknya dan beliau juga tahu
konskuensinya..... Antara lain akan
mengorbankan sistem yang sudah ada
dengan sebuah konsep baru. Yang jelas
Indonesia tidak seluas kampus
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# Abdul Kadar 2014-09-16 06:40
Apa lupa bahwa sekarang sudah banyak sarjana kesehatan masyarakat ? kan sudah ada pembagian kerjanya ?
Reply
# Hanny 2014-09-16 14:01
Strategi ubah paradigma hagemoni profesi adalah dengan perbanyak Sarjana2 kesnasy mengisi DPR
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# Agus Samsudajat S 2014-09-21 16:35
alangkah lebih baik jika Prof Ali menghormati dan memberikan ruang dan peran kepada setiap tenaga kesehatan untuk bersinergi sesuai porsinya, bukan untuk saling menguasai satu sama lain...
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