EFEKTIVITAS PELAYANAN KESEHATAN BAGI LANJUT USIA DI DALAM PANTI

FERIAWAN AGUNG N, Dr. Subando Agus Margono, M.Si.

2018 | Tesis | MAGISTER MANAJEMEN DAN KEBIJAKAN PUBLIK

Penelitian ini bertujuan untuk menelaah efektivitas pelayanan kesehatan pada lanjut usia yang ada di Balai Pelayanan Sosial Tresna Werdha Yogyakarta Unit Abiyoso yang merupakan panti werdha milik pemerintah, dengan kualitas sumber daya kesehatan, dan kualitas fasilitas penunjang pelayanan kesehatan. Metode penelitian ini adalah kualitatif dengan pendekatan studi kasus berdasarkan data primer dan data sekunder. Narasumber penelitian ini adalah klien lanjut usia, dokter, perawat dan pramubakti (caregiver) yang ada di Balai, dan pihak-pihak yang dinilai terlibat dalam pelayanan kesehatan lanjut usia di Balai ini. Dipilihnya Balai PSTW Yogyakarta unit Abiyoso sebagai lokasi penelitian dikarenakan Balai ini merupakan model pelayanan sosial lanjut usia berbasis institusi milik pemerintah yang pertama di Indonesia dengan menggunakan ketentuan standar pelayanan yang sama yang berlaku bagi seluruh panti werdha milik pemerintah. Temuan dalam penelitian ini adalah pertama, adanya pelayanan kesehatan yang tidak efektif karena regulasi yang tidak mampu menyesuaikan diri dengan kebutuhan lanjut usia di dalam panti. Persoalan tersebut diantaranya adalah ijin praktek dokter, ijin praktek perawat, status perawat honorer dan ketidakmampuan memenuhi permintaan obat bagi klien penderita penyakit kronis, meskipun sudah diupayakan dengan melibatkan Puskesmas. Pelayanan kesehatan di Balai ini menjadi terbatas hanya dalam memberikan pertolongan darurat dan rujukan ke sarana kesehatan di luar Balai. Kedua, potensi sumber daya manusia kesehatan profesional yang dimiliki oleh Balai ini tidak mampu digunakan secara maksimal dikarenakan persoalan ijin praktek tersebut. Karena ketiadaan ijin praktek, sumber daya manusia kesehatan yang dimiliki Balai ini mampu responsif, tidak bisa memberikan jaminan terhadap adanya pelayanan kesehatan yang profesional, khususnya jaminan kesembuhan penyakit lanjut usia. Ketiga, fasilitas penunjang pelayanan kesehatan yang dimiliki oleh Balai ini belum memenuhi standar minimal pelayanan kesehatan. Penelitian ini memberikan rekomendasi bagi pemerintah pusat dan daerah untuk menjadikan pelayanan kesehatan di dalam panti sebagai upaya kolaboratif sehingga pelayanan kesehatan bagi lanjut usia di dalam panti dapat efektif dan tidak terhambat oleh sekat kelembagaan.

This study aims to examine the effectiveness of health services for the elderly at the Center for Social Service Tresna Werdha Yogyakarta Abiyoso's Unit, which is a government-owned old people's home, by seeing the quality of health resources, and the quality of supporting facilities for health services. This research method is a qualitative case study approach based on the obtained primary and secondary data. The resource persons of this study were elderly clients, doctors, nurses, and caregivers in the old people's home, and those who were assessed as being involved in health services for the elderly at the old people's home. Center for Social Service Tresna Werdha Yogyakarta Abiyoso Unit was chosen as the location of the study because this old people's home was the first institution-based social service model for the elderly owned by the government in Indonesia using the same provision of service standards that apply to all government-owned old people's homes. There were three findings in this study. First, the health services were not effective because the regulations were not able to adjust to the needs of the elderly at the old people's home. These issues include license for doctor's practice, license for nurse's practice, status of non-permanent nurses and inability to fulfill drug requests for clients with chronic diseases, even though efforts have been made to involve the local health center (Puskesmas). Health services at this old people's home are limited only in providing emergency assistance and referral to health facilities outside the old people's home. Second, the potential of professional health human resources possessed by the old people's home is not able to be used optimally due to the issue of the practice permits. Due to the absence of practice permits, the health human resources owned by the old people's home are capable of being responsive, unable to provide guarantees for the existence of professional health services, especially the guarantee of recovery of elderly diseases. Third, the supporting facilities for health services owned by the old people's home do not meet the minimum standards of health services. This study provides recommendations for the central and regional governments to make health services at old people's homes function as collaborative efforts so that health services for elderly people there can be effective and not hampered by institutional barriers.

Kata Kunci : effectiveness of health services, elderly, old people's home, efektivitas pelayanan kesehatan, lanjut usia, panti werdha