PERFORMANCE BASED PAYMENT (PBP)DAN KEPUASAN KOMPENSASI DALAM PEMBERIAN JASA PELAYANAN KAPITASI JAMINAN KESEHATAN NASIONAL BAGI TENAGA KESEHATAN PUSKESMAS DI KABUPATEN ENDE

MARIANE ERIKA PAY, Dr. dr. Andreasta Meliala, DPH, M.Kes, MAS.; Dr. dr. Dwi Handono Sulistyo, M.Kes.

2018 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar Belakang: Performanced Based Payment (PBP) adalah solusi intervensi untuk mengatasi krisis kinerja pada kesehatan di negara-negara yang berpendapatan rendah, dimana merupakan pembayaran berupa uang atau barang sesuai dengan pekerjaan yang dilakukan atau setelah mencapai target kinerja yang telah ditetapkan. Pelaksanaan PBP dalam bidang kesehatan di Indonesia dapat digambarkan dalam pelaksanaan pemberian jasa pelayanan bagi tenaga kesehatan. Penerapan pembayaran jasa pelayanan yang bersumber dari dana kapitasi di Kabupaten Ende telah berjalan sejak tahun 2014 sampai saat ini. Permasalahan terjadi ketika adanya ketidakpuasan dalam pemberian jasa pelayanan yang bersumber dari dana kapitasi JKN, walaupun pembagian tersebut sudah dijalankan sesuai dengan peraturan yang berlaku. Metode: Penelitian ini bersifat kualitatif menggunakan rancangan studi kasus. Subjek penelitian 23 orang dipilih dengan teknik purposive sampling.Lokasi penelitian di Dinas Kesehatan dan 2 puskesmas. Pengumpulan data menggunakan panduan wawancara dan telaah dokumen.Data kualitatif disajikan dalam bentuk narasi, gambar, dan tabel. Jawaban responden akan ditampilkan dalam bentuk kutipan. Hasil: Pemberian kompensasi jasa pelayanan masih menimbulkan ketidakpuasan. Kesimpulan: Perlu adanya pengawasan, supervisi, monitoring dan evaluasi dari Dinas Kesehatan Kabupaten Ende terhadap pelaskanaan pembagian jasa pelayanan kapitasi. Pimpinan dan staf puskesmas harus bisa bekerjasama dan berkoordinasi dengan baik dalam membuat kebijakan puskesmas dan melaksanakan kebijakan tersebut.

Background: The implementation of PBP in the health sector in Indonesia can be described in the implementation of the provision of services for health workers, including at Puskesmas. The provision of services in Puskesmas can be said to be performance-based payments. The implementation of payment for services originating from capitation funds in Ende District has been running since 2014. Problems occur because of dissatisfaction in the provision of service services sourced from National Health Insurance (NHI) capitation funds, even though the distribution has been carried out in accordance with applicable regulations. Objective: The aim of the study was to explore the implementation of PBP in the form of providing NHI capitation services to health workers at the Puskesmas, as well as the compensation received and satisfaction with the compensation. Method: This research is a qualitative research using case study design. Research was carried out at the DHO and 2 Puskesmas in Ende District. The criteria for selecting Puskesmas were based on the amount of NHI capitation funds received by each Puskesmas. The research subjects were 23 people selected by purposive sampling technique. Result: There is still dissatisfaction with the services at both Puskesmas, although some respondents expressed satisfaction with the compensation received. Puskesmas Nangapanda already has a performance assessment team in charge of calculating services based on existing rules, while Puskesmas Saga assesses performance without involving staff. The DHO acknowledges that there is a lack of compliance with the supervision function of the Puskesmas. Conclusion: Regulations concerning the provision of service services are perceived to be different between puskesmas so that there are variations in implementation and dissatisfaction with the services. The District Health Organization (DHO) of Ende has not functioned optimally in the supervision and evaluation of the implementation of capitation services.

Kata Kunci : Performance based payment, jasa pelayanan, kapitasi, kepuasan kompensasi, Performance Based Payment (PBP), service fee, capitation, compensation satisfaction