Harapan pasien terhadap mutu pelayanan berkaitan dengan kenaikan tarif pelayanan Puskesmas di Kabupaten Sleman Daerah Istimewa Yogyakarta

HARYATI, Sri, dr. Kristiani, SU

2005 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Tarif puskesmas yang berlaku sampai bulan Juni 2003 adalah berdasarkan Perda nomor 17/Tahun 1996 dengan retribusi rawat jalan sebesar Rp.600,- dan mulai bulan Juli 2003 berlaku tarif baru berdasarkan Perda nomor 10/Tahun 2002 sebesar Rp.3500,-. Kunjungan rawat jalan puskesmas sebelum kenaikan tarif rata-rata 127-178 pasien perhari, sedangkan setelah kenaikan tarif rata-rata 74-120 pasien perhari. Dalam memberikan pelayanan diperlukan standar kualitas untuk memenuhi kebutuhan pasien, sehingga perlu diteliti bagaimana harapan pasien terhadap mutu pelayanan sesudah kenaikan tarif pelayanan puskesmas. Tujuan penelitian ini untuk mengetahui harapan pasien terhadap mutu pelayanan rawat jalan sesudah kenaikan tarif pelayanan puskesmas. Metode penelitian: Penelitian ini merupakan penelitian analitik, dengan rancangan cross sectional. Unit analisisnya pasien rawat jalan puskesmas, dan lokasi penelitian di 3 puskesmas Kabupaten Sleman. Subyek penelitian adalah 300 responden yang termasuk dalam kriteria inklusi. Analisis statistik menggunakan diskriptif, oneway anova dan T-test. Wawancara mendalam kepada pasien 15 orang sesuai kriteria inklusi, diambil secara acak dan petugas puskesmas 12 orang. Hasil: Persepsi dan harapan pasien terhadap mutu pelayanan puskesmas sesudah kenaikan tarif, dari ke-5 dimensi yang tertinggi dimensi keandalan dan terendah dimensi daya tanggap. Hal-hal yang masih perlu ditingkatkan adalah kenyamanan ruang tunggu, penambahan petugas pendaftaran dan dokter/dokter ahli. Tidak terdapat hubungan yang bermakna antara yang bermakna dengan jenis kelamin. Terdapat perbedaan persepsi dengan harapan terhadap mutu pelayanan, dan harapan lebih tinggi dari persepsi dengan nilai rerata gap 5,51. Kesimpulan dan saran: Harapan pasien terhadap mutu pelyanan masih lebih tinggi daripada yang dipresepsikan, sehingga perlu ditingkatkan pelayanan yang menjadi harapan pasien dan dievaluasi secara berkesinambungan.

Background: Fee for outpatient visit in health community center which had been enacted until June 2003 was based on Local Regulation No. 17/1996 with outpatient retribution as much as Rp 600,- and starting from July 2003 new tariff based on Local Regulation No. 10/2002 as much as Rp 3,500,- was imposed. Outpatient visits to community health center before tariff increase are at average 127 – 178 patients per day, whereas after the increase visits are at average 70 – 120 patients per day. Standard of quality is necessary in service provision to fulfill patients' needs, therefore patients' expectation about quality of service after tariff increase of community health center service needs to be identified. Objectives: The study was meant to identify patients' expectation about quality of outpatient service after tariff increase of community health center service. Methods: This was an analytic research with cross sectional design. Unit of analysis were outpatients of three community health centers at Sleman District. The subject were 300 respondents who belonged to inclusion criteria. Statistical analysis used descriptive method, one way anova and t- test. Indepth interview was conducted to 15 patients randomly chosen according to inclusion criteria and 12 staff of the center. Results: Patients' perception and expectation about service quality of the center after tariff increase indicated that out of 5 dimensions of service, reliability had the highest average gap whereas responsiveness had the lowest. Aspects which needed improvement were convenience of waiting room, increase of registration staff and doctors/specialists. There was no significant relationship between expectation and age, education and job, but there were significant relationship between expectation and gender. There was difference in perception and expectation about quality of service, whereby expectation was higher than perception with average gap value 5.51. Conclusion and suggestion: Patients' expectation about quality of service was higher than their perception so that services needed to be improved as expected by the patients and evaluated continuously

Kata Kunci : Puskesmas,Tarif Layanan,Mutu Layanan