Analisis biaya pelayanan kesehatan di Puskesmas Cahaya Negeri Kabupaten Seluma Propinsi Bengkulu

HARTONO, Prof.dr. Ali Ghufron Mukti, MSc.,PhD

2005 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Penetapan tarif pelayanan kesehatan di Puskesmas yang berlaku di Kabupaten Seluma saat ini, belum berdasarkan hasil analisis biaya dan belum mempertimbangkan kemampuan dan kemauan membayar masyarakat. Tujuan: Penelitian ini bertujuan untuk menganalisis biaya pelayanan kesehatan di Puskesmas Cahaya Negeri Kabupaten Seluma Propinsi Bengkulu. Metode Penelitian: Penelitian ini merupakan penelitian studi kasus dengan pendekatan kuantitatif dan kualitatif. Penelitian dilakukan di Puskesmas Cahaya Negeri Kabupaten Seluma Propinsi Bengkulu. Subjek penelitian adalah petugas Puskesmas dan pasien, dengan unit analisisnya adalah unit layanan di Puskesmas. Variabel yang diteliti meliputi variabel usulan tarif, unit cost, total cost, ouput pelayanan, kemampuan dan kemauan membayar biaya pelayanan kesehatan. Data dikumpulkan melalui penelusuran dan identifikasi biaya pada unit-unit layanan di Puskesmas. Instrumen penelitian yang digunakan pada penelitian ini merupakan modifikasi dari instrumen penelitian Perencanaan dan Penganggaran Kesehatan Terpadu (P2KT) yang dikembangkan oleh Biro Perencanaan Depkes. Analisis biaya dilakukan secara deskriptif menggunakan program spreadsheet. Hasil Penelitian: Hasil penelitian menunjukkan bahwa: besarnya total cost untuk pelayanan kesehatan di Puskesmas Cahaya Negeri adalah sebesar Rp. 443.350.220. dengan unit cost untuk pelayanan rawat jalan di BP sebesar Rp. 14.609,- sementara tarif perda yang berlaku saat ini Rp.2.500. Rata-rata tingkat kemauan membayar masyarakat untuk biaya pelayananan kesehatan di BP sebesar Rp. 6.155,- , BPG Rp. 6.360,- dan di poliklinik KIA/KB Rp. 6.185,-, dengan rata-rata tingkat kemampuan membayar sebesar Rp. 4.012,-. Tarif baru yang diusulkan untuk pelayanan rawat jalan di BP sebesar Rp. 3.500,- Saran: Perlunya dikaji ulang tarif perda untuk pelayanan kesehatan di puskesmas dan kemampuan pemerintah daerah untuk membiayai pelayanan kesehatan dalam rangka pengembangan JPKM bagi masyarakat miskin di Kabupaten Seluma.

Background: The implementation of tariff for health service at Community Heath Center at Seluma District has not been based on cost analysis as well as community’s ability and willingness to pay. Objective: The study was meant to analyze the cost of health service at Cahaya Negeri Community Health Center of Seluma District, Province of Bengkulu. Methods: This was a case study type of research which used both quantitative and qualitative approaches. The study was conducted at Cahaya Negeri Community Health Center of Seluma District, Province of Bengkulu. The subject of the study were staff and patients at the Center with service unit as analysis unit. Variables observed consisted of recommended tariff, unit cost, total cost, service output, ability and willingness to pay for health service cost. Data were collected through cost identification of service unit in the Center. Research instruments used were Integrated Health Fund and Planning research instruments developed by the Ministry of Health Planning Bureau which had been modified. Cost analysis was descriptively done using spreadsheet program. Result: The result of the study showed that the total cost for health service at the Center was Rp 443.350.220 with unit cost for outpatients service at clinic as much as Rp 14,609 whereas the current tariff according to local government act was Rp 2,500,-. Average community’s willingness to pay for health service cost was Rp 6,155 at clinic, Rp 6,380 at dental clinic and Rp 6,185 at Mother and Child/Family Planning Polyclinics with average ability to pay was as much as Rp 4,012. The tariff recommended for outpatient service at clinic was Rp 3,500,- Suggestion: There was a need to review 1) the current tariff adopted by the local government for health service at the Center and 2) local government capacity to provide fund for health service for the development of Community Health Service Assurance to the poor at Seluma District.

Kata Kunci : Kebijakan Pelayanan Kesehatan, Biaya Layanan Kesehatan, Tarif Layanan