Analisis Pengaruh Persepsi Keadilan Dan Transparansi Remunerasi Terhadap Kepuasan Insentif Jasa Pelayanan Dokter Dalam Penerapan Sistem JKN Di RSUD Kota Madiun Dan RSI Siti Aisyah Madiun

Yessi Kumalasari, Dr. dr. Andreasta Meliala, M.Kes., MAS;

2016 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Pemberlakuan system pembayaran oleh BPJS Kesehatan membawa konsekuensi pada perubahan besarnya imbalan jasa pelayanan yang diterima oleh para dokter. Banyak dokter yang menganggap bahwa remunerasi yang diterima oleh para dokter yang melayanani peserta BPJS Kesehatan terlalu kecil dan tidak jelas hitungannya. Pembayaran imbalan jasa pelayanan dengan system kapitasi maupun INA CBGs dinilai terlalu rendah. Imbalan jasa pelayanan yang rendah ini dinilai tidak adil karena beban dokter dalam melayani pasien bertambah. Adanya JKN membuat masyarakat yang berobat meningkat jumlahnya. Tujuan: Tujuan penelitian adalah untuk mengukur pengaruh persepsi keadilan internal dan eksternal serta pengaruh transparansi remunerasi terhadap kepuasan insentif jasa pelayanan dokter di RSUD Kota Madiun dan RSI Siti Aisyah. Metode: Jenis penelitian ini adalah analitik dengan menggunakan rancangan cross sectional. Studi analitik umumnya menggunakan metoda kuantitatif dan dituntun oleh hipotesis yang diajukan oleh peneliti. Studi analitik biasanya menggunakan metoda yang telah baku. Penelitian ini murni menggunakan metoda kuantitatif. Melalui pendekatan kuantitatif, penelitian ini akan melakukan analisis terhadap hubungan antar variable dalam model penelitian yang dibangun dari hasil-hasil studi sebelumnya atau prinsip-prinsip teori. Hasil dan pembahasan: Hasil penelitian mengidentifikasi factor-faktor yang berkontribusi terhadap variable kepuasan jasa pelayanan di rumah sakit yaitu keadilan internal, keadilan eksternal, dan transparansi remunerasi. Hasil analisis data terhadap RSUD Kota Madiu dan RSI Siti Aisyah menunjukkan bahwa tingkat kepuasan, tingkat keadilan dan transparansi dipersepsikan rendah. Tingkat kepuasan insentif jasa pelayanan dokter umum lebih rendah daripada tingkat kepuasan insentif jasa pelayanan dokter spesialis. Rata-rata tingkat kepuasan insentif jasa pelayanan dokter pada RSUD Kota Madiuan relatif lebih rendah daripada tingkat kepuasan insentif jasa pelayanan dokter pada RSI Siti Aisyah. Kesimpulan dan saran: Hasil analisis bivariat menunjukkan bahwa dari 3 variabel independen yang masing-masing diuji pengaruhnya terhadap variable independen, terbukti berpengaruh signifikan secara statistic terhadap variavel dependen kepuasan jasa pelayanan dokter. Signifikansi ini terbukti pada sampel RSUD Kota Madiun dan RSI Siti Aisyah.

Background: The implementation of payment system by Indonesian National Health Insurance brought consequences in the changes of service fee amount which was received by doctors. Many doctors thought that remuneration they were received when they served Indonesian National Health Insurance patients was too low and wasn’t clearly counted. The service fee payment with capitation system and INA-CBGs was thought too low for them. This low service fee for doctors was percieved as inequity for them in the situation that their patients were increased. The presence of National Health Insurance made people tended to seek healthcare more than before. Objective: The aim of this research was to assess the influence of internal and external equity perception, and the influence of remuneration transparency towards the service fee satisfaction of doctors in Madiun City General Hospital and Siti Aisyah Madiun Islamic Hospital. Method: This research was an analytic research with using cross-sectional design. Analytic study generally used quantitative method and was guided by hypothesis that was submitted by researcher. Analytic study usually used standard method. This research genuinely used quantitative method. By using quantitative approach, this research would implement an analysis towards the relation between variables in reseach model which was developed from previous study results or theory principles. Result and Discussion: Research result identified factors that were contributed on service fee satisfaction variable in hospital were internal equity, external equity, and remuneration transparency. Data analysis result towards Madiun City General Hospital and Siti Aisyah Madiun Islamic Hospital showed that the satisfaction level, equity level, and transparency were perceived as low. The satisfaction level of general practice doctors towards service fee was lower than the satisfaction level of specialized doctors. The average of service fee satisfaction level of doctors in Madiun City General Hospital was relatively lower than the service fee satisfaction level of doctors in Siti Aisyah Madiun Islamic Hospital. Conclusion and Suggestion: Bivariate analysis result explained that from three independent variables which each of them was tested its influence on independent variable, proved influenced statistically significant towards the dependent variable of doctor’s service fee satisfaction. This significance was proved in sample of Madiun City General Hospital and Siti Aisyah Madiun Islamic Hospital.

Kata Kunci : remuneration, satisfaction, perception, transparency