Risiko Kardiovaskular Berdasarkan Faktor Jaminan Kesehatan pada Masyarakat Pedesaan di Kabupaten Sleman Yogyakarta
DOI:
https://doi.org/10.21776/ub.jkb.2017.029.04.10Keywords:
Jaminan kesehatan, risiko kardiovaskular, skor FraminghamAbstract
Penyakit kardiovaskular merupakan risiko kesehatan terbesar di Indonesia. Penelitian survei cluster random sampling tahun 2015, program jaminan kesehatan berhasil meningkatkan kesadaran dan terapi pada subjek dengan tekanan darah ≥140/90mmHg di Kabupaten Sleman Yogyakarta. Penelitian ini bertujuan untuk mengevaluasi risiko kardiovaskular terkait program jaminan kesehatan. Penelitian ini merupakan survei potong lintang analitik dan subanalisis pada subjek yang dapat dihitung risiko kardiovaskular 10 tahun ke depan menggunakan skor Framingham. Penelitian dilakukan pada subjek berumur 30-74 tahun dan menandatangani informed-consent. Subjek dikelompokkan berdasarkan dengan atau tanpa jaminan kesehatan. Data rerata umur, body mass index (BMI), tekanan darah, dan skor Framingham dianalisis dengan uji-t (p<0,05), sedangkan tingkatan risiko kardiovaskular 10 tahun ke depan dianalisis menggunakan statistik chi-square. Dari penelitian ini ditemukan sebanyak 64,6% dari 429 subjek memiliki jaminan kesehatan dalam beberapa sistem jaminan. Parameter observasi kelompok dengan dan tanpa jaminan kesehatan tidak berbeda bermakna (p>0,05) untuk variabel umur, gender, merokok, pendidikan, tekanan darah, hiperglikemia, dan BMI. Subjek dengan dan tanpa jaminan kesehatan berturut-turut memiliki tekanan darah sistolik 156,5 (22,2) mmHg berbanding 156,4 (20,0) mmHg dan skor Framingham 18,4 (9,3)% berbanding 19,2 (9,3)% (p>0,05) yang termasuk kategori risiko kardiovaskular sedang. Pada subkelompok subjek dengan tekanan darah ≥140/90 mmHg (n=347, 80,9%) subjek dengan jaminan kesehatan (n=277, 53,2%) dan tanpa jaminan kesehatan memiliki skor Framingham yang tidak berbeda bermakna, namun berbeda kategori risikonya yaitu 19,8 (8,9)% kategori risiko sedang berbanding 21,1 (8,3)% kategori risiko tinggi. Kesimpulan, jaminan kesehatan belum terbukti menurunkan secara bermakna risiko kardiovaskular subjek di pedesaan di Sleman-Yogyakarta.Downloads
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