Pengurangan subsidi Penerima Bantuan Iuran (PBI) APBD Provinsi Sulawesi Selatan terhadap capaian Universal Health Coverage (UHC) di Kabupaten/Kota
Studi kasus PBI APBD 2024 Kabupaten Takalar dan Kota Makassar
DOI:
https://doi.org/10.60036/5bfzzp48Keywords:
Universal Health Coverage, UHC, PBI APBD, Health Financing, Revenue Collection, Risk Pooling, Strategic Purchasing, Active MembershipAbstract
Penelitian ini menganalisis dampak pengurangan subsidi Penerima Bantuan Iuran (PBI) APBD terhadap keberlanjutan Universal Health Coverage (UHC) di Kabupaten Takalar dan Kota Makassar menggunakan kerangka Health Financing Kutzin. Menggunakan metode kualitatif studi kasus, data diperoleh melalui wawancara mendalam dengan pemangku kepentingan dan masyarakat, serta telaah dokumen BPJS Kesehatan. Hasil penelitian menunjukkan kebijakan ini memengaruhi revenue collection, risk pooling, dan strategic purchasing. Pengurangan dana sharing provinsi mengubah struktur pembiayaan. Di Makassar, peserta PBPU Pemda menurun 0,65% menjadi 259.978 jiwa. Di Takalar, terjadi penurunan 18,59% menjadi 74.351 jiwa. Namun, berkurangnya 16.980 jiwa peserta daerah di Takalar diimbangi lonjakan 21.181 jiwa peserta PBI-JK pusat, menunjukkan pergeseran beban dari APBD ke APBN. Data BPJS per Desember 2024 mencatat peserta nonaktif di Takalar mencapai 13,02% dan Makassar 4,62%. Kesimpulannya, meski capaian UHC administratif sangat tinggi (Takalar 99,76% dan Makassar 99,63%), tantangan utama saat ini adalah menjaga status keaktifan peserta serta memastikan akses layanan yang efektif.
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