Dampak Reformasi Manajemen Rumah Sakit (Unit Swadana) Terhadap Mutu Pelayanan
SUMINAR, Yunita Dyah, Dr. Muhadjir Darwin
2003 | Tesis | Magister Administrasi PublikReformasi manajemen diperkenalkan sebagai paradigma alternatif untuk meningkatkan kineija sektor publik yang menekankan pada elisiensi, ekonomi dan efektifitas. Salah satu bentuk rel'ormasi manajemen pemcrintah adalah dcsentralisasi yang olch Bank Dunia direkomendasikan menjadi strategi bagi negara-negara berkembang. Desentralisasi sebagai salah satu bentuk reformasi di bidang kesehatan menjadi menarik karena secara teoritis banyak memiliki kcuntungan. Otonomi/semi otonomi Rumah Sakit (Unit Swadana) adalah merupakan sa] ah satu bentuk desentralisasi di bidang kesehatan. Penelitian ini bertujuan untuk mengetahui dampak refonnasi manajemen (Unit Swadana) terhadap mutu pelayanan yang berdimensi standar dan kepuasan. Penelitian ini dilakukan di RSUD Prof. Dr. Margono Soekarjo Purwokerto dengan menggunakan data primer dan sekunder pada tahun sebelum dan sesudah penetapan Unit Swadana (1997- 2002). Pengambilan data primer dilakukan melalui kuesioner untuk pasien rawat jalan dan pasien rawat inapTeknik pengambilan sampel yaitu dengan quota sampling, dengan jumlah 320 sampel untuk pasien rawat jalan dan 100 sampel untuk pasien rawat inap. Data sekunder diambil dari laporan bulanan dan tahunan mulai tahun 1997-2002, mengenai tingkat pemanfaatan tempat tidur (BOR), rata-rata lama rawa (LOS), waktu kuang tempat tidur (To1), produktifitas tempat tidur (BTO), angka kematian net (NDR), angka kematian kasar (GDR), angka kunj ungan dan angka cakupan. Hasil penelitian menunjukkan bahwa adanya reformasi manajemen (Unit Swadana) mampu meningkatkan mutu pelayanan Rumah Sakit dalam dimensi standar dan dimensi kepuasan, namun demikian masih perlu inovasi-inovasi terutama pada sistem ruj ukan agar angka kematian net dan angka kematian kasar dapat diturunkan.
Management reform has been introduced as an alternative paradigm to improve public sector performance with emphasize on efficiency, economy and effectiveness. Decentralization has become generally recommended strategy for developing countries as form of public sector reform Health sector decentralization has become appealing to many because it has several theoretical advantages. One of the most common reforms advocated by WHO and World Bank to improve management performance and efficiency is the decentralization of Ministry of Health structure, usually at the district level, but also to large hospital through the establishment of hospital management boards which have considerable management autonomy. The reason is a decentralized bureaucracy makes hospital management efficient, increases flexibility and innovation, make management more responsive and able to improve service quality , by shifting the burden operational management away from the centre. This research has main goal to examine management reform policy in public hospital. Due to the theories, management reform has high impact on improving service quality. So that this research can be used as reference by central government to continue or nor management reform program in public hospital as consequence This research examined the exact impact of management reform on quality in public hospitals (Margono Soekarjo Hospital). To assess quality, a case approach has been used. Three methods of data collection: patient experiences data gained through questionnaire with quota sample technique; face to face indepth interviewed has been taken from inpatient and outpatient; secondary data will be analyzed with respect to quality standard based on time series such as Bed Occupancy Rate (BOR), Length of Stay (LOS), Turn Over Interval (TOI), Bed Turn Over (BTO), Net Death Rate (NDR), Gross Death Rate (GDR), a number of out patient and covered. Based on this research, management reform (hospital autonomy) is able to improve quality in public hospital in terms of standard and satisfaction dimension. However, it needs more innovation particularly for referral system to decrease Gross Death Rate and Net Death Rate.
Kata Kunci : Manajemen Rumah Sakit,Swadana,Mutu Layanan, Impact, Management Reform, Quality
