Jaminan kesehatan adalah salah satu cara untuk mengurangi beban pembiayaan kesehatan yang dikeluarkan masyarakat. Sebagian besar masyarakat perdesaan di Kabupaten Banyumas yang mempunyai tingkat kemampuan membayar pelayanan kesehatan rendah belum mempunyai jaminan kesehatan. Penelitian ini bertujuan untuk menganalisis kebutuhan jaminan dan faktor-faktor yang memengaruhi kesehatan masyarakat daerah. Penelitian ini merupakan penelitian observasional dengan desain studi cross sectional. Populasi penelitian adalah seluruh kepala keluarga diKabupaten Banyumas dengan jumlah sampel 130 orang. Metode analisis yang digunakan meliputi analisis univariat, bivariat, dan multivariat. Penelitian menemukan bahwa sebagian besar masyarakat Kabupaten Banyumas (72,3%) membutuhkan jaminan kesehatan daerah (Jamkesda).Terdapat hubungan antara pendidikan, pengetahuan, pendapatan, dan keyakinan terhadap mutu pelayanan kesehatan serta pola pembiayaan kesehatan dengan kebutuhan Jamkesda. Persepsi berpengaruh terhadap tarifpelayanan kesehatan dengan kebutuhan Jamkesda. Persepsi terhadap tarif pelayanan kesehatan merupakan variabel yang berpengaruh terhadap kebutuhan Jamkesda.Kata kunci: Kebutuhan, pembiayaan kesehatan daerah, jaminan kesehatanAbstractHealth insurance is one of the ways to reduce the burden of health financing issued by the society. Most communities in Banyumas district living in rural areas do not have health insurance. Rural communities in Banyumas district have low ability to pay health care services. The aim of this study isto analyze the health insurance needs of local communities and the factors that affect the public health insurance need of the area. This study is an observational study with survey research methods. This study used cross sectional approach. The study population was all households in Banyumas district.The research sample consisted of 130 people. Retrieval research data used a questionnaire instrument. Analysis of research data used univariate, bivariate, and multivariate. The research was conducted in Banyumas district. Most people in Banyumas district (72,3%) required regional health insurance. The result showed no relationship between education, knowledge, income, beliefs in health care quality and patterns of health financing in local communities needs of health insurance. The result showed the influence perceptions of health care rates with the health insurance needs of local communities. Perceptions of health care is a variable rate which affects the health insurance needs of local communities.Keywords: Needs, district health financing, health insurance

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Background: Expansion of coverage for informal workers is still one problem in achieving universal health coverage. Independent participants non-PBI scheme is intended for people in the informal sector in National Health Insurance (JKN) era. The existence of adverse selection and delay in contributions payment by Independent participants non-PBI need to be solve in order to find the most appropriate model of contribution collection in informal sector. Objective: To analyze policies in prevention of adverse selection in JKN and identify potential health funding by informal sector in rural and urban communitiesin Banyumas. Method: Cross sectional design with structured qualitative approach conducted in populationof Independent participants non PBIwho delay in contribution payment at least 6 months, with a sample of 197 respondents. Results: There was potential health funding in informal workers in Banyumas. Ability to Pay (ATP) was greater than the amount of the contribution Class III (3,49 USD-7,35 USD). Willingness ToPay (WTP) was greater than the amount of the contribution Class III (2.00 USD-USD $ 2,57). ATP was greater than the WTP. Conclusions: It is necessary to create a policy to provide incentives to informal sector who able and willing to pay the JKN contributions regularly.

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AbstrakPembiayaan kesehatan sekitar 146 (60%) penderita talasemia di Banyumas, tahun 2011 ditanggung rumah tangga dalam bentuk pembayaran langsung (out of pocket payment). Penelitian ini bertujuan untuk menganalisis ability to pay, willingness to pay, dan need assessment pembiayaan kesehatan penderita talasemia di Kabupaten Banyumas. Jenis penelitian ini adalah observasional analitik dengan rancangan studi kasus. Penelitian ini menggunakan desain studi cross sectional dengan teknik pengambilan sampel simple random sampling. Jumlah sampel penelitian 30 responden yang mempunyai anggota keluarga penderita talasemia di Kabupaten Banyumas. Hasil penelitian menunjukkan keluarga penderita talasemia mempunyai kemampuan membayar ability to pay rata-rata adalah Rp34.448,8/bulan dan rata-rata willingness to pay pengobatan talasemia adalah Rp133.833,3/ bulan. Pola pembiayaan kesehatan talasemia di Kabupaten Banyumas menggunakan 93,3% Jaminan Kesehatan Masyarakat (Jamkesmas), 3,3% biaya sendiri, dan 3,3% asuransi kesehatan. Sebelum mendapatkan Jamkesmas, 90,0% responden membayar dengan out of pocket, berhutang, berhemat pada kebutuhan nonkesehatan, dan menjual perhiasan/sawah. Kebutuhan pelayanan kesehatan yang diharapkan keluarga penderita talasemia adalah konsultasi talasemia dan desain khusus ruang perawatan anak. Kebutuhan pembiayaan kesehatan keluarga penderita talasemia adalah uang transportasi ke rumah sakit sebagai bentuk biaya tidak langsung.Kata kunci: Ability to pay, need assessment, pembiayaan kesehatan, talasemia, willingness to pay Abstract Health financing of majority thalassemia patients, around 146 people (60%) in Banyumas year 2011 is assured by Households in direct payments to health care providers (out-of-pocket payment). This study aimed to analyze the ability to pay, willingness to pay, and need assessment of health financing thalassemia in Banyumas. This research an analytic observation- Analisis Pembiayaan Kesehatan Keluarga Penderita Talasemia Health Financing Analysis of Thalassemia Patient FamilyArif Kurniawan, Arih Diyaning Intiasari al with case study design. This research used cross sectional approach. Sampling technique used simple random sampling. Total sample of 30 respondents who had had family members suffering from thalassemia in Banyumas. The results showed thalassemia families have an average ability to pay of Rp34,448.8/month and the average willingness to pay for the treatment on thalassemia Rp133,833.3/month. Health financing patterns of thalassemia in Banyumas district uses 93.3% health security, 3.3% personal costs, and 3.3% health insurance. Before getting health security, 90.0% of respondents performed out-of-pocket financing, get loan, skimped on nonmedical needs, and sold jewelry/rice fields to finance thalassemia's health services. Health care needs that expected by thalassemia patient's family is thalassemia consulting and special design of child-care room. Health financing needs of thalassemia's patient family is transportation money to hospital as indirect costs.