ANALISIS EFISIENSI SUMBER DAYA MANUSIA PUSKESMAS BERSERTIFIKAT ISO 9001:2008 MENGGUNAKAN METODE DATA ENVELOPMENT ANALYSIS (DEA) DI KABUPATEN PACITAN

DODIK KRISTIAWAN, dr. Lutfan Lazuardi, M.Kes., PhD

2017 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang : Pengukuran efisiensi penggunaan Sumber Daya Manusia Kesehatan (SDMK) di fasilitas pelayanan kesehatan dasar terutama Puskesmas sangat penting untuk dilaksanakan karena diharapkan kualitas layanan kesehatan yang dihasilkan dapat optimal dan maksimal sehingga kepuasan masyarakat yang menjadi pelanggan dapat terpenuhi. Kemampuan dan keterampilan Sumber Daya Manusia Kesehatan di Puskesmas dituntut lebih baik sesuai yang diharapkan oleh masyarakat, karena sejak 1 januari 2014 Pemerintah Republik Indonesia memberlakukan program jaminan kesehatan nasional (JKN) yang dilaksanakan oleh Badan Penyelenggara Jaminan Sosial (BPJS) ditargetkan tahun 2019 Indonesia sudah Universal Health Coverage (UHC) yang artinya seluruh warga negara sudah mendapatkan jaminan kesehatan melalui program JKN/BPJS. Permenkes Nomor 75 tahun 2014 tentang Puskesmas yang menetapkan standar ketenagaan Puskemas sehingga kualitas puskesmas baik Puskemas kawasan perkotaan, Puskesmas kawasan perdesaan dan Puskesmas kawasan terpencil/sangat terpencil menjadi lebih baik. Kabupaten Pacitan mempunyai 24 puskesmas yang terdiri 13 puskesmas rawat inap dan 11 puskesmas rawat jalan, puskesmas perkotaan maupun perdesaan dan untuk semakin meningkatkan layanan kesehatan 8 puskesmas telah mempunyai sertifikat ISO 9001 : 2008 tentang Sistem Manajemen Mutu (SMM). Tujuan : Penelitian ini bertujuan untuk mengukur efisiensi baik Overall Technical Efficiency (OTE), Pure Technical Efficial Effiency (PTE) dan Scale Efficiency (SE) melalui model Constant Return to Scale (CRS) dan model Variabel Return to Scale (VRS), kondisi puskesmas yang Increasing Return to Scale (IRS) dan Decreasing Return to Scale (DRS) serta faktor-faktor lingkungan/kontekstual yang mempengaruhi penggunaan sumber daya manusia Puskesmas yang belum bersertifikat ISO 9001 : 2008 maupun yang sudah bersertifikat ISO 9001 : 2008. Metode : Tahap pertama mengukur efisiensi penggunaan sumber daya manusia di seluruh Puskesmas apakah sudah efisien atau masih inefisien menggunakan metode nonparametrik linier programming Data Envelopment Analysis (DEA) model Variabel Return to Scale (VRS) asumsi output oriented. Sedangkan tahap kedua adalah untuk mengetahui pengaruh faktor-faktor lingkungan/kontekstual terhadap efisiensi di puskesmas menggunakan metode statistik regresi tobit.

Background: Measuring the efficient use of human resources health in primary health care facilities especially public health center is very important to be implemented because it is expected that the quality of health services produced can be optimal and maximal so that the satisfaction of the community that become customers can be fulfilled. The capability and skills of Health Human Resources at Public health center are demanded better as expected by the community, since since 1 January 2014 the Government of Indonesia enacted a national health insurance program implemented by the Social Security Board (BPJS) targeted in 2019 Indonesia is already universal health coverage which means that all citizens have health insurance through universal health coverage. Law of Ministry of Health 75/2014 about public health center that set the standard of public health center so that the quality of public health center in urban, rural and remote areas to be better. Pacitan regency has 24 public health center consist of 13 in-patient and 11 outpatient, urban and rural health centers and to further improve health services 8 public health center have certified ISO 9001:2008 on quality management system. Objective: This study aims to measure the efficiency of the Overall Technical Efficiency (OTE), Pure Technical Efficiency Efficiency (PTE) and Scale Efficiency (SE) through the Constant Return to Scale (CRS) model and the Return to Scale (VRS) model, the condition of public health center the Increasing Return to Scale (IRS) and Decreasing Return to Scale (DRS) as well as environmental/contextual factors affecting the use of human resources of Public health center that have not been ISO 9001:2008 certified or ISO 9001:2008 certified. Method: The first stage measures the efficiency of human resource use in all Public health center whether it is efficient or inefficient using nonparametric linear programming method Data Envelopment Analysis (DEA) model of Return to Scale Variables (VRS) assumptions of oriented output. While the second step is to know the influence of environmental factors/contextual to efficiency in public health center use tobit regression statistic method.

Kata Kunci : efisiensi teknis, efisiensi skala, SDM Kesehatan, ISO 9001:2008 Data Envelopment Analysis (DEA)