Factors Affecting Community Treatment in Bandar Masilam Health Center, Bandar Masilam District, Simalungun Regency

ABSTRACT


INTRODUCTION
Indonesia has a lot of diversity, such as the level of social, economic and cultural development of people in various regions. Indonesia is also an agricultural country, most of the population lives in rural areas with the majority of elementary school education levels and do not yet have a healthy life. The culture of checking the health of family members early is not yet visible, this can be seen from the large number of clients who come to health services to have their health checked as a curative measure that has not been fully supported by promotive and preventive efforts. In addition, not all people easily get access to Health Center services due to geographical conditions, area size, connecting facilities and population density. These things can affect the needs, awareness and interest of the community to come for treatment and visit health services [7].
Health services can be carried out in hospitals and health centers. Health Center is the technical implementation unit of the Regency/Municipal Health Service which is responsible for implementing health development in a work area. Nationally, the standard working area for a Health Center is one sub-district. If in one sub-district there is more than one Health Center, then the responsibility for the work area is divided between the Health Center by taking into account the integrity of the concept of the village or hamlet area. Health Center has a vision and mission. The vision of the Health Center is the realization of a healthy sub-district which must be adapted to the situation and conditions of the community and the local sub-district area. The mission of the Health Center in general is to support the achievement of the national health development mission [12]. Based on data from the Indonesian Health Service (2005) the number of people seeking treatment at the Health Center began to increase, from 853,460 people in 1999 to 1,093,778 in 2005. The increase in the number of people visiting the Health Center reached 3.8% over 6 years.
The government continues to strive to improve health services at the Health Center. However, these efforts have not been carried out in a comprehensive, integrated and sustainable manner. Until now, the implementation of health efforts at the Health Center that are aimed at improving health and preventing disease has not been optimal even though the Health Center as a basic health facility is available in the District. The community has not fully utilized health services. It is estimated that only 30% of the people use health services, and even then they are sick [13].
According to [1] human behavior in seeking treatment varies, there are attempts to treat the disease through their own efforts, seeking treatment at medical treatment facilities and at traditional treatment facilities. [6] states that people do not use health services because the attitude of health workers is unfriendly and does not explain the treatment and process of the disease.
According to [8] a person's actions to carry out a behavior are based on motivation so that a person utilizes health services or not based on motivation. [10] states that the factor that influences a person in utilizing health services is how his views are formed from his knowledge of health services so that if a person has good knowledge of health services it allows him to utilize health services, and vice versa if a person does not have good knowledge to health services, it is likely that he will not take advantage of these health services. [22] suggests that the factors that influence people to use the Health Center are the affordability of health services, the availability of health services, and the factor of service convenience.
Based on the description above, it can be concluded that community visits to the Bandar Masilam Health Center are influenced by several factors, but it is not yet known with certainty what factors influence people's desire to seek treatment at the Bandar Masilam Health Center so that this research is important to identify factors that influence people's desire to seek treatment at the Bandar Masilam Health Center, Bandar Masilam District, Simalungun Regency.

Formulation of the problem
Based on this background, the formulation of the problem in this study is what factors influence the community to seek treatment at the Bandar Masilam Health Center, Bandar Masilam District, Simalungun Regency.

METHOD Types and Research Design
The research design that will be used in this study is descriptive exploratory which aims to identify in depth the factors that influence people to seek treatment at the Bandar Masilam Health Center, Bandar Masilam District, Simalungun Regency.

Location and Time of Research
This research was conducted at the health center located in Bandar Masilam District. This area was chosen by the researcher because there were sufficient respondents, the location was not far from the researcher's residence and the community health center had never conducted research on the factors that influenced people to go to the health center for treatment. This health center is located in Bandar Masilam District, Simalungun Regency. When conducting research from April to May 2021.

Population
The population in the study is all subjects or objects that have predetermined criteria [1]. The population in this study were fathers/mothers who live in the village of Bandar Masilam. From the results of the 2013 population census, the total population in Nagori Bandar Masilam I was 2686 people (men: 1295 people and women: 1391 people). The community criteria that form the basis for research are people who are adults, physically and mentally healthy, people who can speak Indonesian well, and people who want to be research respondents.

Sample
The sample is part of the population to be studied or part of the total characteristics possessed by the population. In this study, researchers took samples using a convenience sampling technique , namely a sampling technique that was carried out by taking respondents who were available at the time and had met predetermined criteria [1]. So the sample from this study was taken from the community who came to visit the Bandar Masilam Health Center, Bandar Masilam District, Simalungun Regency.

Data Processing and Analysis
Data analysis was carried out through several stages starting with the first editing, namely checking the completeness of the identity and data of the respondents and ensuring that all answers had been filled in according to the instructions, the second stage of coding, namely giving a specific code or number on the questionnaire sheet to make it easier to tabulate and analyze data (aiming to grouping data based on the criteria of each sample), the third stage of processing is entering data from questionnaire sheets into a computer program, the fourth stage is cleaning, namely re-checking the data that has been entered to find out if there are errors or not, the fifth stage is tabulating , namely analyzing data descriptively.
The results of data processing are presented in the form of frequency distributions and percentages using computerized techniques to display the results of the data that has been collected regarding the factors that influence people to seek treatment at the Health Center. After the results of data processing are obtained, it can be known the factors that influence the community to seek treatment at the Bandar Masilam Health Center, Bandar Masilam District, Simalungun Regency.

RESULTS AND DISCUSSION Health Worker Factor
The behavior of health workers in providing health services is the behavior of health workers starting from patient registration, ticket collection, medical services, laboratory services, pharmacy services and cashier services [18]. Based on the results of the study, it was found that health workers had an influence on community visits for treatment at the Health Center (94%). This is because health workers are the closest people to patients so that health workers are things that greatly affect people's satisfaction when seeking treatment. Most of the people at the Bandar Masilam Health Center felt that the health workers on duty at the Health Center were quite good at providing services to them when they were seeking treatment. Only a small number of people are dissatisfied with the services of health workers at the Bandar Masilam Health Center.
The same results were also reported from Abidinsyah's research (2008) which stated that the level of dedication, discipline, skill and friendliness of health workers in providing health services greatly determines the number of people visiting health services. The hospitality of the Health Center staff supports the service convenience factor which is one of the factors that influence people to seek treatment at the Health Center. The better the service of health workers, the better the public's perception of the health services provided so that the number of people visiting the Health Center [2].

Motivational Factors
Motivation is a person's attitude and behavior in viewing a goal or task specifically. Motivation can be used as a term to describe the process of human behavior which implies a movement, joy, hope, directs or explores behavior, maintains or supports behavior [16].
Based on the results of the study, motivation influences people's visits to the Health Center for treatment (90%). This is in line with the opinion of Nawawi (2008) which states that motivation is a condition that causes a person to do a job consciously, including the behavior of respondents who express their decision to seek treatment at the Health Center.
The people who seek treatment at the Bandar Masilam Health Center are profitable for them because when they seek treatment at the Bandar Masilam Health Center they feel that their disease heals more quickly and also at the Bandar Masilam Health Center the community gets good health services so that in the end they continue to be motivated to seek treatment at the Bandar Masilam Health Center.

Health Facility Factor
Health facilities are facilities used in health services. From the results of the study, it was found that health facilities greatly influenced community visits for treatment at the Health Center (82%). The community seeking treatment at the Bandar Masilam Health Center stated that health facilities really support treatment, so that good and complete equipment determines the success or failure of treatment. According to the people of Bandar Masilam, for the size of the Health Center, the health facilities at the Bandar Masilam Health Center can be said to be complete and good.
Factors that influence the use of health services where one of the factors is the factor of the health service system concerned including the existence of medical facilities [6]. Hartono research [9] also states that the community pays attention to health facilities, so that facilities are things that influence community visits.

The cost factor for treatment
The cost of treatment is the amount of money spent by the community for treatment. From the results of the study it was found that the cost of treatment greatly influenced the visit of the community for treatment to the Health Center (80%). The people of Bandar Masilam said that the cost of treatment at the Health Center was cheap enough that they could afford it. This made them want to take advantage of the Bandar Masilam Health Center.
From this study, 36 people (36%) had an income of <500,000. The majority of respondents stated (75%) that free medical treatment helped the community to pay for treatment, (66%) that the Health Center always provided satisfying services at a low cost, (19%) that the community always took advantage of the free treatment that was provided by the Health Center. Research results by Mehida (2013) state that there is a relationship between socioeconomic factors and people's perceptions of health services, with the conclusion that there is a relationship between the costs incurred for treatment and the presence of the community at the Health Center. This is in accordance with