Characteristics Sectio Caesaria under National Health Insurance Program at the Non Profit Referral Hospital in Jakarta

Abstract

Background: Sectio Caesaria (SC) at the hospital in 2014 to 2017 ranks in the 10th highest cases and costs

of claim under the Indonesia National Health Insurance (JKN) program. The World Health Organization

(WHO) sets the optimum SC rate of 15% by deliveries. This study aims to identify the socioeconomic and

clinical characteristic of women with SC and its relationship with JKN program at the Non-Profit Referral

Hospital.

Method: This research is a retrospective study with cross sectional design using a quantitative approach.

A total sample of 385 cases of SC were taken from the hospital medical records in the period January 1-31

December 2018. Using univariate and bivariate-Chi Square analysis

Result: The proportion of women with SC under JKN was 67.63% whose were 57.7% received contribution

assistance/PBI. Mostly in room class 3 (51.9%). Most referrals were from government primary public

clinic/ Puskesmas (53.8%). Women’s education mostly was high school (56.2%) with the age between 21-34

years (68.1%). Gestational ages between 37-40 weeks (72.3%) with a history of one childbirth/ primiparous

(55%). ANC outside the hospital more often underwent SC (53.5%).There was a significant

relationship between socioeconomic and clinical characteristics women SC under JKN at the Referral

Hospital (p <0.05; CI: 95%).

Conclusion: The proportion of SC deliveries at the Referral Non hospital exceeds the standards set by

WHO. There is a significant relationship between socioeconomic and clinical variations mothers with SC

under JKN. Quality control of SC delivery services needs to be done routinely and continuously through the

application of service standards and perinatal maternal audit activities.