Implementasi Permenkes Nomor 812 Tahun 2010 tentang Tata Laksana Penyelenggaraan Pelayanan Hemodialisis di Indonesia

Abstract

Abstrak
 Implementasi Peraturan Menteri Kesehatan (Permenkes) RI No. 812 tahun 2010 tentang penyelenggaraan pelayanan dialisis pada fasilitas pelayanan kesehatan (yankes) di Indonesia menimbulkan masalah bagi penderita gagal ginjal kronis. Kajian ini menggunakan metode deskriptif kualitatif, teknik pengumpulan data melalui tinjauan pustaka pada sejumlah artikel, laporan penelitian, dan jurnal serta diskusi/konsultasi melalui daring. Data yang diperoleh dianalisis dengan teori Miles & Hubermans. Kajian dilakukan dari bulan Desember 2020 s.d. Maret 2021. Hasil menunjukkan bahwa implementasi Permenkes No. 812/2010 tentang penyelenggaraan pelayanan dialisis pada fasilitas yankes (fasyankes) belum optimal. Ketersediaan sarana dan prasarana, sumber daya manusia (SDM), alat, mesin, cairan dialisat, dan obat belum terbagi merata di seluruh Indonesia. Banyak pasien belum mendapatkan pelayanan hemodialisis (HD) 2 kali seminggu. Jumlah pasien dialisis terus meningkat, sekitar 20 ribu pasien belum mendapatkan akses pengobatan, pemilihan jenis terapi HD dan continuous ambulatory peritoneal dialysis (CAPD) yang dilaksanakan sesuai rekomendasi dokter. Pasien belum mendapat dosis obat dan waktu HD yang cukup karena berbagai kendala. RS/Klinik belum melakukan kunjungan rumah dalam rangka edukasi dan pemantauan, pasien dialisis berpotensi mengalami komplikasi/infeksi/kematian (drop out). Monev belum berjalan optimal, pembiayaan HD lebih mahal dari CAPD membebani keuangan negara, pelatihan dialisis masih minim di RS/Klinik. Kebijakan pelayanan dialisis saat ini belum terpadu. Belum ada pencerahan rohani dan kewajiban pencabutan/pemotongan alat dialisis bagi pasien muslim ketika sudah meninggal di rumah. Kajian ini merekomendasikan perlu melakukan perubahan Permenkes No. 812 tahun 2010 pasal 15 ayat 1 dan 2, seiring dengan upaya yang bisa dilakukan oleh Kementerian Kesehatan, Dinas Kesehatan dan Rumah Sakit dalam memperkuat sistem kesehatan dan mutu pelayanan bagi pasien dialisis.
 Kata kunci: Kebijakan Kesehatan, Pelayanan Dialisis, Penyakit Gagal Ginjal
 Abstract
 Implementation of Permenkes No. 812 of 2010 concerning the implementation of dialysis services in health facilities in Indonesia causing problems for people with cordic kidney failure. This study uses qualitative descriptive methods, data collection techniques through literature reviews in a number of articles, research reports, and journals and discussions / consultations through online. The data was obtained in the analysis with miles hubermans theory. Conducted from December 2020 to March 2021. The results concluded that the implementation of Permenkes No. 812/2010 on The Implementation of Dialysis Services in Health Care Facilities has not been optimal. The availability of facilities and infrastructure, human resources, tools, machinery, dialysis fluids, and drugs has not been evenly divided throughout Indonesia. Many patients do not get hemodialysis therapy (HD) services twice a week. Dialysis patients continue to increase, about 20 thousand patients have not received access to treatment, the selection of types of hemodialysis therapy HD and continuous ambulatory peritoneal dialysis (CAPD) implemented according to the recommendations of doctors. Patients have not received enough HD doses drugs and time due to various obstacles. Hospitals /Clinics have not made home visits in the framework of education and monitoring, dialysis patients have the potential to experience complications / infections / deaths (droup out). Monev has not run optimally, HD financing is more expensive than CAPD burdening the country’s finances, dialysis training is still minimal in hospitals / clinics. The current dialysis service policy is not yet integrated. There has been no spiritual revocation and obligation to revocation/cut dialysis equipment for Muslim patients when they have died at home. This study of authors recommends policy solutions that need changes to Permenkes No. 812 of 2010 article 15 paragraphs 1 and 2. And concrete efforts that can be done by the Ministry of Health, Hospitals, and Health Services.
 Keywords: Health Policy, Dialysis Services, Kidney Failure.