Analisis kecukupan biaya pelayanan kesehatan masyarakat di Puskesmas non perawatan Kabupaten Sleman
ORDIANI, Wardani Sri, dr. Sunartono, M.Kes
2005 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar Belakang: Pelayanan kesehatan masyarakat (Yankesmas) merupakan salah satu pelayanan yang diberikan oleh puskesmas. yang bersifat publik, sehingga pembiayaannya menjadi tanggung jawab pemerintah antara lain berupa subsidi operasional puskesmas (SOP).. SOP ini dialokasikan ke puskesmas berdasarkan beban kerja wilayah puskesmas. Diharapkan dana ini cukup untuk kegiatan yankesmas, akan tetapi masih terjadi keluhan dari beberapa kepala puskesmas bahwa dana SOP tidak cukup untuk membiayai Yankesmas.Tujuan penelitian ini untuk mengetahui seberapa besar kecukupan biaya Yankesmas, Persepsi stakeholder terhadap kecukupan biaya, potensi sumber dana, serta kemampuan advocacy stakeholder atas kecukupan biaya tersebut Metode : Penelitian ini merupakan penelitian analitik dengan rancangan studi kasus dengan data penelitian berupa data kuantitatif dan kualitatif. Analisa data kuantitatif menggunakan metode real cost dilakukan untuk menghitung kebutuhan biaya yankesmas dan kemudian dihitung kecukupan biaya dari SOP untuk membiayai Yankesmas. .Metode kualitatif digunakan untuk mengetahui persepsi stakeholder terhadap kecukupan biaya Yankesmas serta kemampuan advocacy stakeholder atas kecukupan biaya tersebut. Hasil: Biaya Yankesmas dari 4 puskesmas sampel penelitian ternyata berasal dari tiga sumber yaitu SOP, pendapatan Puskesmas dan Askes. Dana untuk biaya Yankesmas di puskesmas yang berasal dari SOP rata-rata sebesar 66%, dari pendapatan 22,8 % dan dari Askes 20,8% Persepsi stakeholder atas kecukupan biaya Yankesmas, yang berasal dari luar kesehatan menyatakan cukup sedang yang berasal dari kesehatan menyatakan kurang. Potensi sumber dana dengan menaikkan alokasi dana dari pemerintah, Kemampuan advokasi manajer kesehatan cukup baik dengan adanya hasil yang dicapai seperti keluarnya perda tarif, kenaikan dana SOP tahun 2004 . Kesimpulan:Tingkat kecukupan biaya Yankesmas di puskesmas berasal dari SOP merupakan yang tertinggi 66,4% dan yang terendah adalah dari Askes yakni 10,8% Untuk mencukupi biaya yankesmas ada potensi sumber dana dengan meningkatkan peran masyarakat dalam pembiayaan yankesmas dan mengajak peran swasta serta perbaikan manajemen puskesmas. Kemampuan advokasi manajer kesehatan cukup baik dilihat dari indikator keberhasilan yang sudah ada.
Background: Public health service (yankesmas) is one service that is provided by the Primary Health Care. It is oriented on public since the cost is government’s responsibility such as with the subsidy operational of primary health care (SOP). SOP is allocated to the Primary Health Care based on job burden of the Primary Health Care area. It is expected that the fund is sufficient for the activity of public heath services, however, complaints from various principals of the Primary Health Care that funding of SOP is not sufficient for the activity of public health service often occurred. The aim of this research was to find out that the cost of public heath service, stakeholder’s perception toward cost sufficiency, potential of funding source, as well as ability of advocacy stakeholder toward cost sufficiency. Method: This was a descriptive research with case study design. This research used quantitative and qualitative data. Analysis of quantitative data used real cost method and used to measure the need of public health sevice cost as well as to find out the cost sufficiency that is originated from SOP to give funding on public health service. Qualitative method was used to find out stakeholders perception toward cost sufficiency of public health service as well as ability of advocacy stakeholder for the cost sufficiency. Result: Level of cost sufficiency of public health service for three primary health care as the sample of the research. 3 Primary Health Care with funding deficiency and one primary health care was over funding. Perception of the stakeholders outside the health field stated that the funding was sufficient and those from the health field stated that the funding was lack. Potential of funding source was by increasing the funding allocation from government. The advocacy ability of health manager was quite fine with the achieved result such as with the tariff regulation and increasing of SOP funding in the yearof2004. Conclusion: Funding for the cost of public heath service for three Primary Health Cares was lack with 9,6%-35% and one primary health care was over funding with 16%. Potential of funding source was by increasing budget from government and asking private role as well as management improvement of the primary health care. The ability of health manager advocacy was quite fine if it is seen from the existing successful indicator.
Kata Kunci : Layanan Kesehatan,Biaya Layanan Kesehatan,Puskesmas Non Perawatan
