HOSPITAL’S LIFE CYCLE STRATEGIES: STUDI MULTIKASUS RUMAH SAKIT SWASTA DI DAERAH ISTIMEWA YOGYAKARTA

Eko Rahmadi, Prof. dr. Laksono Trisnantoro, M.Sc., Ph.D.; Prof. dr. Adi Utarini, M.Sc., MPH., Ph.D.

2010 | Tesis | S2 Kesehatan Masyarakat

Latar belakang: Organisasi RS memasuki lingkungan dengan perubahan bersifat radikal, konstan, pesat, serentak, pervasif dan semakin sering terjadi. Perkembangan RS sangat dinamis, fenomena menarik di Amerika Serikat, 30 RS ditutup pada tahun 2003. Di Indonesia terjadi pertumbuhan dan migrasi serta kemunduran RS milik dokter di DIY. Kemampuan RS dalam mengidentifikasi dan mengelola life cycle akan membantu dalam menjaga kelangsungan hidupnya. Tujuan: Penelitian ini bertujuan: 1) mengidentifikasi hospital life cycle berbagai RS swasta di DIY, 2)mengidentifikasi strategi yang berhasil untuk menjaga organisasi tersebut berada di comfort zone dan pada level performa yang lebih baik untuk menjaga kelangsungan hidupnya. Metode: Penelitian ini terdiri dari dua sub penelitian, yakni cross sectional survey dengan subyek seluruh RS di DIY menggunakan data sekunder indikator kinerja RS periode 1997-2008 dan studi kasus eksplanatori rancangan multikasus holistik dengan subyek jajaran direksi RS swasta terpilih di DIY. Instrumen penelitian berupa panduan wawancara mendalam. Unit analisis adalah rumah sakit. Pada tahap akhir data diolah dan dianalisis isinya. Hasil: Hospitals’ Life Cycle berbagai RS di DIY adalah 17,7% fase start up, 13,3% fase growth,17,7% fase maturity, 26,6% fase decline leading to renewal, 0,04% prolong start up leading to decline, 0,02% start up decline leading to revitalization, 0,08% growth leading to decline, dan 0,06% anomali comfort zone. 75% rumah sakit khusus milik dokter mengalami decline. Strategi yang mempunyai peran penting untuk kelangsungan hidup RS adalah adaptif strategy dengan enterpreneurship pada fase start up, adaptif strategy pada fase growth, transformation strategy pada fase maturity leading to second wave, turn around strategy pada fase maturity leading to renewal, sedangkan crisis management pada fase decline. Kesimpulan: Hospitals’ life cycle, strategic management dan change management sebagai bentuk organization learning mempunyai peran penting dalam kelangsungan hidup RS.

Background: Hospital organization is entering an environment with radical, sharp, simultaneous, pervasive and frequent changes. Hospital development is very dynamic. United States of America has indicated surprising phenomenon whereby 30 hospitals were closed in 2003. In Indonesia there are growth, migration and decline of hospitals owned by doctors in Yogyakarta Special Territory. Capability of a hospital to identify and manage life cycle will help in sustaining survival. Objective: The study aimed to 1) identify life cycle of some private hospitals at Yogyakarta Special Territory, 2) identify strategies that succeed in keeping the organization at comfort zone and at better performance to sustain survival. Method: The study consisted of two sub studies, i.e. cross sectional survey with the subject of all hospitals at Yogyakarta Special Territory that used secondary data of hospital performance indicators in 1997-2008 and explanatory case study with holistic multicase design that used directors of selected private hospitals at Yogyakarta Special Territory as subject. Research instruments were indepth interview guides and analysis unit were hospitals. At the final phase data were processed and the contents were analyzed. Result: Life cycle of private hospitals at Yogyakarta Special Territory was 17.7% in start up phase, 13.3% in growth phase, 17.7% in maturity phase, 26.6% in decline leading to renewal phase., 0.04% in prolonged start up leading to decline phase, 0.02% in start up decline leading to revitalization phase, 0.08% in growth leading to decline phase, and 0.06% in anomali comfort zone phase. 75% hospitals which owned by doctors are declining. Strategies that had essential role in hospital survival were adaptive strategy with enterpreneurship at start up phase, adaptive strategy at growth phase, transformation strategy at maturity leading to second move phase, turn around strategy at maturity leading to renewal phase. Crisis management belonged to decline phase. Conclusion: Hospitals' life cycle, strategic management and change management as a form of organizational learning had essential role in hospital survival.

Kata Kunci : Hospitals’ life cycle, strategy, strategic management, change management, dan organization learning.