Kajian sistem remunerasi staf medik rumah sakit pendidikan studi kasus distribusi beban kerja pelayanan bagi staf medik dan peserta didik pendidikan dokter spesialis dan sub spesialis di RSUPN Dr. Ciptomangunkusumo

SUMARIYONO, Prof. dr. Laksono Trisnantoro, MSc., PhD; DR. dr. Andreasta Meliala, DPH.,M.Kes.,MAS

2017 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang : Remunerasi telah diberlakukan di rumah sakit badan layanan umum (BLU) di bawah Kementerian Kesehatan. Pelayanan pasien di rumah sakit pendidikan dilakukan oleh staf medik dokter penanggunjawab pelayanan (DPJP) dan peserta program pendidikan dokter spesialis (PPDS). Undang-Undang Pendidikan Kedokteran dan Peraturan Pemerintah tentang Rumah Sakit Pendidikan mengamanatkan pemberian insentif bagi PPDS di rumah sakit pendidikan. Perlu data beban pelayanan staf medik dan PPDS di rumah sakit pendidikan yang dapat digunakan sebagai pertimbangan dalam pemberian reward bagi staf medik dan PPDS. Tujuan:. Mendapatkan gambaran distribusi beban kerja DPJP dan PPDS pada pelayanan pasien yang diberikan pelayanan bersama oleh DPJP dan PPDS. . Metode: Rancangan penelitian ini adalah studi kasus yang dilakukan melalui observasi langsung dilanjutkan dengan focus group discussion. Hasil dan pembahasan: Didapatkan rerata persentase lama waktu pelayanan DPJP pada kasus otitis media supuratif kronik (OMSK), sindrom koroner akut (SKA) dan stroke iskemi (SI) di RSCM masing-masing adalah 32%, 30% dan 26%, dengan rerata 30%. Rerata pelayanan PPDS 1 pada pelayanan pasien OMSK, SKA dan SI masing-masing adalah 68%, 64% dan 74%, dengan rerata 69%. Pelayanan mandiri PPDS didaptatkan meningkat dengan makin tingginya tahap pendidikan PPDS. Simpulan dan saran: Rerata persentase lama waktu pelayanan staf medik DPJP dan pelayanan mandiri PPDS pada pasien OMSK, SKA dan SI masing-masing adalah 30% dan 70. Semakin tinggi tahap pendidikan PPDS semakin tinggi rerata lama waktu pelayanan mandirinya. Pelayanan mandiri PPDS merupakan porsi waktu terbesar pada pelayanan bersama oleh DPJP dan PPDS di RSCM, sehingga sangat wajar bila PPDS diberikan insentif.

Background: Teaching hospitals under the Ministry of Health has implemented remuneration system. Medical services in teaching hospitals are given by the medical staffs as well as the residents. The Medical Education Law and Presidential Decree on The Teaching Hospitals stated that residents in teaching hospitals are to be incentivized.. There is a need for data on the medical staffs and residents workload at teaching hospitals that could be used as consideration in determining the reward or incentives for medical staffs and residents at teaching hospitals. Objective:. To understand the pattern of time spent distribution between the medical staffs (physicians in-charge) workload and the residents workload on shared medical services. Methods:. This case study used direct observation and focus group discussion as the research methodology. Result and discussion: Out of the total time spent for patient care on the shared medical services on cases chronic suppurative otitis media (CSOM), acute coronary syndrome (ACS) and ischemic stroke (IS) at RSCM the percentage of the time that served by the medical staffs and the residents were 30% and 70%. Moreover, if the results were grouped based on the level of the residency program, it was found that the more senior the residents, the higher the average proportion of the patient care with low supervision. Conclusion and recommendation. The percentage of time spent on patient care on CSOM, ACS, and IS patients by the medical staff and the residents were at 30% and 70%. The more senior the residents, the higher the average time they spent on the patient care with low supervision. As the results showed that residents took up the bigger time portion of the patient care service in RSCM, it is highly reasonable for the residents to be incentivized.

Kata Kunci : distribusi beban kerja, PPDS, DPJP, remunerasi