Analisis Hubungan Pemanfaatan Layanan Telemedis di Fasilitas Kesehatan Terhadap Indikator Kinerja Layanan Kesehatan di Indonesia

Abstract

Hak atas kesehatan merupakan hak fundamental yang menuntut akses layanan bermutu secara setara. Indonesia masih menghadapi ketimpangan akses antarwilayah akibat disparitas fasilitas, keterbatasan konektivitas, dan distribusi tenaga kesehatan yang belum merata, terutama di daerah terpencil dan kepulauan. Pemanfaatan teknologi digital melalui telemedis diharapkan dapat memperkuat layanan primer, mempercepat rujukan, dan memperluas jangkauan pelayanan. Penelitian ini menganalisis hubungan pemanfaatan layanan telemedis Konsultasi Medis Online (KOMEN) terhadap indikator kinerja kesehatan di Indonesia, yaitu persalinan di fasilitas kesehatan, kunjungan rawat jalan, dan Usia Harapan Hidup (UHH) pada tingkat kabupaten/kota. Analisis menggunakan regresi data panel model Fixed Effect (FE) pada 514 kabupaten/kota periode 2022–2023. Hasil estimasi menunjukkan bahwa rasio pemanfaatan KOMEN berkorelasi positif dan signifikan terhadap persalinan di fasilitas kesehatan (β = 0,00922; β = 0,00832) serta terhadap UHH (β = 0,000871; β = 0,000751). Sebaliknya, rasio KOMEN berkorelasi negatif dan signifikan terhadap kunjungan rawat jalan (β = −0,1003; β = −0,106), mengindikasikan adanya mekanisme substitusi layanan dan penguatan fungsi gatekeeping melalui telekonsultasi antar-fasilitas. Temuan ini menegaskan bahwa transformasi digital kesehatan perlu disertai penguatan kapasitas layanan dasar, tata kelola rujukan, serta pembangunan infrastruktur dan konektivitas digital khususnya di Kawasan Indonesia Timur agar manfaat telemedis lebih inklusif dan mampu mengurangi kesenjangan layanan kesehatan antarwilayah.

The right to health is a fundamental right that requires equitable access to quality health services. Indonesia continues to face regional disparities in access due to unequal distribution of health facilities, limited connectivity, and an uneven distribution of health workers, particularly in remote and archipelagic areas. The use of digital health technology through telemedicine is expected to strengthen primary care, accelerate referrals, and expand service coverage. This study analyzes the relationship between the utilization of the Online Medical Consultation (KOMEN) telemedicine service and health performance indicators in Indonesia, namely facility-based deliveries, outpatient visits, and life expectancy at the district/city level. The analysis employs a panel data regression using a Fixed Effects (FE) model across 514 districts/cities during the 2022–2023 period. The estimation results show that the utilization ratio of KOMEN is positively and significantly associated with facility-based deliveries (β = 0.00922; β = 0.00832) and life expectancy (β = 0.000871; β = 0.000751). Conversely, the KOMEN ratio is negatively and significantly associated with outpatient visits (β = −0.1003; β = −0.106), indicating a service substitution mechanism and strengthened gatekeeping functions through inter-facility teleconsultation.s These findings underscore that digital health transformation must be accompanied by strengthened primary care capacity, improved referral governance, and expanded digital infrastructure and connectivity particularly in Eastern Indonesia to ensure that telemedicine benefits are inclusive and reduce regional health service disparities.