HALAMAN JUDUL EVALUASI PEMANFAATAN DANA KAPITASI JAMINAN KESEHATAN NASIONAL DI PUSKESMAS KABUPATEN SELUMA PROPINSI BENGKULU

HERIAWAN, dr. Lutfan Lazuardi, M.Kes, Ph.D.; Dra, Retnasiwi Padmawati, MA.

2016 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang : Puskesmas di Kabupaten Seluma secara umum tidak didukung dengan tenaga kesehatan yang memadai, penerima bantuan iuran (PBI) belum mendapatkan kartu Jaminan Kesehatan Nasional dari BPJS, puskesmas belum didukung dengan fasilitas kesehatan dan alat kesehatan yang memadai dan terdapat penggunaan dana kapitasi di puskesmas yang tidak sesuai dengan ketentuan Permenkes Nomor 19/2014 pasal 5 ayat 1 dan 3, (BPK RI Perwakilan Bengkulu, 2015). Masih ada keluhan petugas puskesmas terutama bidan dan perawat terhadap ketidakadilan pembagian insentif jasa pelayanan kesehatan dana kapitasi JKN dan ketidaktransparanan pemanfaatan dan pertanggungjawaban dana kapitasi untuk dukungan operasional layanan kesehatan puskesmas (40%). Metode: Jenis penelitian yang digunakan adalah penelitian deskriptif kualitatif, adalah penelitian yang observasinya dilakukan terhadap sejumlah ciri subyek menurut keadaan seadanya (innature) tanpa ada manipulasi atau intervensi peneliti (Pratiknya, 2010). Penelitian ini menggunakan rancangan studi kasus, peneliti menyelidiki secara cermat suatu program, peristiwa, aktivitas, proses, atau sekelompok individu. (Cresswel, 2008). Hasil: Dana kapitasi Jaminan Kesehatan Nasional di puskesmas Kabupaten Seluma tahun anggaran 2015, dimanfaatkan untuk jasa pelayanan kesehatan 75%, dukungan opearasional pelayanan kesehatan 20%, untuk belanja obat 5%. Proses pemanfaatan dana kapitasi JKN di kedua puskesmas sudah sesuai dengan aturan, akan tetapi proses perencanaan belum dilakukan dengan baik dan belum berdasarkan prioritas masalah. Realisasi dana kapitasi Puskesmas Kota Tais 96,4% dan Puskesmas Seluma Timur 95,8%. Kesimpulan: Pemanfaatan dana kapitasi JKN di Puskesmas Kota Tais dan Seluma Timur secara umum sudah cukup baik dan sesuai dengan aturan, akan tetapi masih ada pegawai yang belum dapat menerima aturan teknis pembagian jasa pelayanan kesehatan dan masih ada pegawai yang mengeluhkan pemanfaatan dana kapitasi belum adil dan belum transparan.

Background of Knowledge: Primary health care of Seluma Regency is generally not supported by adequate health workers. Tuition Assistance Recipients (PBI) has not received National Health Insurance from BPJS (Social Security Administrative Body). Primary health care has not been supported by adequate health facilities and medical devices dan there are capitation fund use in Primary Health Care which is not in accordance with Regulation of the Minister of Health Number 19/2014 Article 5 paragraph 1 and 3, (BPK RI Perwakilan Propinsi Bengkulu, 2015). There are still some complaints from community health care workers, especially from midwives and nurses on the inequitable distribution of health services incentive of National Health Insurance (JKN) capitation funds and lack of accountability in the use and responsibility of capitation funds for operational support of primary health care health services (40%). Method: The design used was descriptive qualitative. It was a study of which the observation was performed toward a number of subject characteristics based on innature status without manipulation or intervention from the researcher (Pratiknya, 2010). This study used case study, in which the researcher investigated particular program, incident, activity, process, or a group of individuals carefully (John W. Creswel, 2010). Results: Capitation Fund of National Health Insurance at primary health care of Seluma Regency in the Fiscal Year 2015, is used for health service by 75%, operational support for health service by 20%, for drug expenditure by 5%. National Health Insurance capitation fund accountability in both Primary Health Cares has been in accordance with the regulation, but the planning process is not done properly and not based on priority issues. Realizational the use of capitation funds in Kota Tais 96.4% and Seluma Timur 95.8%. Conclusions: The use of National Health Insurance capitation fund in PrimaryHealth Cares Kota Tais and Seluma Timur has generally been in accordance withthe regulation, but there are still employees who have not been able to acceptregulation of the division of health services and there are still employees who complained about the use of capitation funds have not been fair and transparent.

Kata Kunci : national health service capitation fund, primary health care, health funding system