Lamk THE EFFECT OF ATTITUDE TOWARD BEHAVIOR, SUBJECTIVE NORM AND PERCEIVED BEHAVIOR CONTROL AT DM THERAPY ADHERENCE: STUDY THEORY OF PLANNED BEHAVIOR

Utilization of Outpatient Care Based on Health Facilities Individual Factors CHC Private Practitioner OR 95 CI p- value OR 95 CI p- value Predisposing Factor Age Elderly aged more than 75 years 0,75 0,25-2,28 0,61 1,69 0,52-5,43 0,38 Elderly aged 60-74 years Gender 1 1 Female 0,56 0,26-1,21 0,13 4,11 1,4-12,0 0,01 Male Education level 1 1 Basic 0,49 0,17-1,45 0,19 1,74 0,2-13,8 0,59 Secondary Enabling Factor Location of residence 1 1 Rural areas 0,53 0,23-1,21 0,12 1,28 0,36-4,61 0,70 Urban areas Illness levelneed Factor Purpose of outpatient care Treatment of illness 1 1 Yes 23,0 7,9-66,2 0,00 26,5 6,4-110,4 0,00 No 1 1 Discussion The most interesting result in this study is the comparison between the utilization of outpatient care in community health center and private practitioner by the elderly who live in rural areas. They rather choosing to utilize health services in private practitioner than in community health service. Trust, comfort, and safety are factors that predispose individuals to re-utilize the health services in the health facilities Conclusion Contrary to the expectations, the elderly especially those living in rural areas, used private centers. It shows that there are some specific practitioner rather than community health considerations for the selection of health centers. In the future, the government is expected facilities, for example regarding quality to be able to improve the quality of community considerations, the availability of health care which near with their elderly home, or the consideration of the level of trust among the elderly with certain health facilities. Quality considerations are supported by research in Uganda, which states that male elderly take advantage of health services in a high level, because ederly with aged more than 64 years had severe illness that requires medical care with complete and quality equpment in private health facilities. In addition to quality considerations, that study also states that the availability of health services near home, is one of the most factors that affect the elderly in choosing health facility. Besides quality consideration and the location of health facilities, the level of trust by the elderly for choosing their best health facilities based on Health Belief Model, states that people who have faith or trust in a particular health facilities, will feel comfortable and safe while getting a health health centers, and provide pro-elderly health services that can reach the elderly in rural areas, such as homecare services and “Posyandu” for elderly. BPJS of Health with the National Health Insurance program, together with the government and local governments, should not only cooperate with public health facilities, but also can reach the private health facilities, one of which is private practitioner in the village. The cooperation is expected to ensure the quality of health care, the elderly can expand access to quality health services, and health services as desired without having to consider the high price of health care. In addition, with not too many choices of outpatient health services in the village for the elderly, the presence of medical personnel in villages located in remote areas, particularly in eastern Indonesia, is an opportunity for the elderly to get close access for