Persepsi Stakeholder terhadap pembiayaan kesehatan keluarga miskin dengan konsep jaminan pemeliharaan kesehatan di Kabupaten Parigi Moutong Propinsi Sulawesi Tengah

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

2005 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang : Pembiayaan kesehatan keluarga miskin di Kabupaten Parigi Moutong berasal dari dana PKPS-BBM yang disalurkan langsung ke Puskesmas dan rumah sakit. Tujuan dari program ini sangat baik akan tetapi kelangsungan dari program ini masih perlu dipertanyakan karena dana yang ada hanya mampu membiayai pelayanan kesehatan keluarga miskin selama enam bulan. Dalam dua tahun terakhir, dikembangkan program pemeliharaan kesehatan Gakin (JPK Gakin) di beberapa daerah. Beberapa temuan awal menunjukkan dengan penunjukan pihak ketiga sebagai pengelola telah meningkatkan efisiensi dan efektifitas serta komitmen pemerintah daerah terhadap pelayanan dan pendanaan kesehatan Gakin. Penelitian ini bertujuan untuk mengetahui persepsi Stakeholder terhadap pembiayaan kesehatan Gakin dengan Konsep JPK. Metode : Penelitian ini adalah penelitian deskriptif dengan rancangan studi kasus. Subjek penelitian adalah stakeholder yang meliputi Bupati, Ketua Bapeda, Kepala Dinas Kesehatan, Direktur Rumah sakit, Kepala Puskesmas, serta Tokoh masyarakat. Pengumpulan data dilakukan melalui diskusi kelompok terarah dan wawancara mendalam. Data yang telah terkumpul kemudian dilakukan koding untuk memperoleh organisasi data. Data yang sudah diorganisasi akan dianalisis kemudian disajikan secara deskriptif. Hasil : Sebagian besar responden berpendapat bahwa pembiayaan kesehatan Gakin dengan sistem JPK adalah bermanfaat dan sangat dibutuhkan di Kabupaten Parigi Moutong. Adanya pemisahan antara pengelola dengan PPK, diharapkan lebih efektif dan efisien serta bisa memperbaiki kekurangan-kekurangan selama ini. Sumber dana pembiayaan JPK Gakin menurut responden berasal dari pemerintah pusat (APBN), Pemda (APBD) serta masyarakat mampu melalui subsidi silang dan swasta. Pemerintah daerah sangat mendukung JPK Gakin, dalam bentuk siap menetapkan suatu Perda atau minimal SK Bupati untuk mengaturnya. Sebagian besar responden berpendapat bahwa badan penyelenggara sebaiknya pemerintah daerah serta bersifat not for profit. Pada umumnya responden kurang setuju kalau badan penyelenggara dikelola oleh PT. Askes karena tidak sejalan dengan semangat otonomi daerah. Kesimpulan : Pembiayaan kesehatan Gakin dengan sistem JPK sangat bermanfaat dan dibutuhkan serta mendapat dukungan dari pemerintah Kabupaten Parigi Moutong. Badan penyelenggara sebaiknya dikelola oleh pemerintah daerah dan bersifat not for profit. Sebelum dilaksanakan sebaiknya diadakan sosialisasi terlebih dahulu.

Background: Health funding for poor families at Parigi Moutong District comes from oil compensation program priorities of health service fund which is directly given to community health centers and hospitals. The program is very beneficial but its sustainability is being questioned because the funding can be used to provide health service for poor families for six months only. During the last two years, a program of health maintenance for poor families has been developed in some territories. Some initial findings show that the assignment to third party as program organizer has increased efficiency, effectiveness and local government commitment to health service and funding for poor families. Objectives: The study was meant to know stakeholders' perception about health funding for poor families with health maintenance assurance. Methods: The study was of descriptive type which used case study design. The subject of the study were stakeholders consisting of District Head, Head of Local Planning Council, Hospital director, Head of Community Health Center and leaders of the community. Data were collected through focus group discussion and indepth interview. Coding was then made to organize and analyze data for descriptive presentation. Result: Most of respondents considered that health funding for poor families with health maintenance assurance system was beneficial and greatly needed at Parigi Moutong District. Differentation between program organizer and health service provider was expected to be more effective and efficient and could improve the farmer system. Source of funding according to respondents, should came from central government, local government and prosperous community through cross subsidy and private sector. Local government was very supportive to the program as seen from their readiness to issue an act or at least District Head's decree from the program to continue. Most of respondents suggested that local government should become program organizer which was non profit oriented. Most of respondents did not agree if PT. Askes functioned as program organizer because this did not go in line with the spirit of autonomy. Conclusion: Health funding for poor families with health maintenance assurance system was very beneficial and greatly needed as well as well supported by local government of Parigi Moutong District. Program organizer should be non profit oriented and managed by local government. Publicity should be made prior to program implementation

Kata Kunci : Asuransi Kesehatan, Kebijakan, Jaminan Kesehatan Keluarga Miskin, perception, stakeholder, poor families, health assurance