Distribusi Insentif COVID-19 dan Kepuasan Kompensasi Tenaga Kesehatan RSUD Alimuddin Umar di Masa Pandemi COVID-19

WIDYAN PUTRA A, Dr. dr. Andreasta Meliala, DPH, M.Kes., MARS

2022 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Pandemi COVID-19 meningkatkan risiko dan beban pekerjaan tenaga kesehatan (nakes), yang diapresiasi oleh pemerintah dengan pemberian insentif COVID-19 oleh Kementerian Kesehatan yang realisasinya mencapai hampir 5 persen dari APBN Kesehatan 2021. Dalam penerapan sistem insentif, penelitian sebelumnya menetapkan bahwa evaluasi sistem insentif adalah bagian krusial dari membangun sistem insentif yang efektif. Evaluasi distribusi insentif di RSUD Alimuddin Umar (RSAU) sebagai satu-satunya RS tipe C pemerintah di Kabupaten Lampung Barat dapat memberi gambaran sistem insentif di tingkat kabupaten dan memberi masukan pada stakeholder kesehatan untuk perbaikan sistem insentif kedepannya. Tujuan dari penelitian ini adalah untuk mendeskripsikan proses distribusi insentif COVID-19, mengukur kepuasan kompensasi nakes di masa pandemi COVID-19, dan mengidentifikasi faktor yang mempengaruhi kepuasan kompensasi nakes terhadap insentif COVID-19. Penelitian ini menggunakan pendekatan studi kasus dengan unit analisis terjalin, yang dilakukan di RSUD Alimuddin Umar pada Maret-April 2022. Kepuasan kompensasi diukur pada 100 subjek dengan modifikasi Comprehensive Compensation Satisfaction Questionnaire yang dideskripsikan secara kuantitatif. Proses distribusi insentif dan faktor yang mempengaruhi kepuasan kompensasi terhadap insentif dideskripsikan dengan semi-structured interview dan diinterpretasikan secara kualitatif. Prosedur distribusi insentif di RSUD Alimuddin Umar sudah sesuai dengan regulasi dari Kementerian Kesehatan walaupun dalam pelaksanaan pemberian insentif terdapat beberapa kendala seperti perubahan yang berubah-ubah secara mendadak, sehingga sempat terkendala dalam pembiayaan dan kekecewaan nakes akibat dibatasinya jumlah nakes yang diberi insentif. Sebagian besar nakes RSAU puas terhadap kompensasi finansial, insentif COVID-19, non-finansial. Aspek kepuasan kompensasi yang mendapat rerata nilai tertinggi adalah kepuasan mengenai besaran insentif COVID-19, take home pay kompensasi finansial dan prosedur kompensasi non-finansial. Kepuasan mengenai perbedaan kompensasi antar profesi dan kemanfaatan kompensasi non-finansial menjadi aspek dengan nilai rerata terendah diantar aspek lain. Dari hasil wawancara juga didapatkan faktor yang mempengaruhi kepuasan tenaga kesehatan Tantangan yang dihadapi dalam insentif COVID-19 meliputi adanya sistem pagu insentif yang mempengaruhi keadilan distributif dan peraturan yang sentralistik dan berubah dengan cepat sehingga membatasi adaptasi RS terhadap konteks masing-masing RS. Transparansi, komunikasi persuasif, dan manajemen struktur kompensasi dapat menjadi cara manajemen menyelesaikan masalah terkait insentif COVID-19.

COVID-19 pandemic increases the risk and workload of healthcare workers, appreciated by Government of Indonesia via Ministry of Health appreciates the sacrifices done by healthcare worker by handing out incentive for healthcare workers dealing with COVID-19 cases. In applying incentive mechanism, evaluation of incentive system is a crucial step in constructing an effective incentive system. Evaluation of incentive distribution in RSUD Alimuddin Umar (RSAU) as the only government type C General Hospital may represent incentive distribution in a regency government hospital, and become an insight for the healthcare stakeholders to improve incentive system. This reseach was conducted describe the mechanism of healthcare workers COVID-19 incentive distribution and the compliance to regulation, measure healthcare workers compensation satisfaction in COVID-19 pandemic, and identify factors determining the compensation satisfaction of healthcare workers toward incentive system. This research were using case study approach with multiple embedded unit of analysis. This study was conducted in Alimuddin Umar General Hospital in March-April 2022. Quantitative description of compentation satisfaction score were measured using Modified Comprehensive Compensation Satisfaction Questionnaire from 100 healthcare workers and interpreted as mean and standard deviation. Qualitative description of incentive distribution process and factors influencing compensation satisfaction from semi-structured interview from 6 healthcare worker selected including structural doctor, structural nurse, functional nurse, functional doctor, pharmacist, and lab analyst and were analysed using qualitative analysis. The incentive distribution process in RSUD Alimuddin Umar is in accordance to regulation from Ministry of Health. Regardless, rapidly changing regulation and limitation of number of healthcare workers eligible bring challenges on managerial and functional healthcare workers to adapt to the regulation. Most of the healthcare worker of RSAU satisfied to the financial, non-financial, and COVID-19 incentive compensation. The highest satisfaction score were gotten by amount of COVID-19 incentive, take home pay of financial compensation, and non-financial compensation procedure. Interprofessional difference in financial compensation and COVID incentive, also benefit of the non-financial compensation were the lowest scored item in compensation satisfaction questionnaire. Challenges faced in COVID-19 incentive distribution were quota limitation system that may affect distributive justice accompanied with centralistic and rapidly changing regulation that limit the ability of individual hospital to adapt to each contaxt within the hospital. In resolving compensation dissatisfaction on COVID-19 incentive, there were several solution taken by management such as: compensatory transparency, persuasive communication by professional colleagues, and managing other controllable compensatory structure.

Kata Kunci : Distribusi, insentif, Covid-19, kepuasan, konpensasi, tenaga kesehatan, Distribution, Incentive, Covid-19, Compensatory, Satisfaction, Healthcare Workers