Evaluasi sistem pengadaan obat dari dana APBD Pemerintah Propinsi DIY Tahun 2001-2003 terhadap ketersediaan dan efisiensi obat di Rumah Sakit Grhasia

ISTINGANAH, dr. Sulanto S. Danu, SpFK

2005 | Tesis | S2 Ilmu Kesehatan Masyarakat (Manajemen dan Kebija

Latar belakang : Sistem pengadaan obat menggunakan dana APBD Pemerintah Propinsi DIY di Rumah Sakit Grhasia kurun waktu tahun 2001- 2003 berdasarkan Keputusan Presiden Nomor 18 tahun 2000 dan Keputusan Gubernur Nomor 172 tahun 2001. Pembelian obat dalam jumlah besar, waktu pengadaan obat cukup lama, frekwensi pembelian 1- 2 kali setahun. Dari pemeriksaan Bawasda Pemerintah Propinsi DIY bulan Juni 2004 ditemukan obat rusak dan kadaluwarsa senilai 82.210.626 rupiah. Adanya penumpukan sejumlah obat, obat tidak diresepkan tinggi dan stock out tinggi. Hal ini dapat diduga bahwa ketersediaan dan efisiensi obat di Rumah Sakit Grhasia kurang baik. Tujuan Penelitian : Melakukan evaluasi sistem pengadaan obat dari dana APBD Pemerintah Propinsi DIY kurun waktu 2001-2003 terhadap ketersediaan dan efisiensi obat di Rumah Sakit Grhasia. Metode penelitian : Penelitian ini merupakan penelitian deskriptif yang dilaksanakan secara kualitatif didukung analisis data sekunder dan observasi gudang penyimpanan obat dan IFRS. Subyek penelitian terdiri dari dua kelompok yaitu kelompok pengadaan dan kelompok pengguna (user). Obyek penelitian ini adalah proses perencanaan dan sistem pengadaan obat di Rumah Sakit Grhasia serta status ketersediaan obat. Wawancara mendalam dilakukan terhadap subyek penelitian tentang proses perencanaan dan pengadaan obat di Rumah Sakit Grhasia, serta penghitungan ketersediaan obat yang meliputi : obat rusak/kadaluarsa, penumpukan obat, obat tidak diresepkan, stock out dan nilai TOR obat. Hasil Penelitian: Hasil penelitian menunjukkan bahwa proses pengadaan obat menggunakan dana APBD Pemerintah Propinsi DIY di Rumah Sakit Grhasia kurun waktu tahun 2001-2003 sudah berdasarkan Keppres 18 tahun 2000 dan Kepgub 172 tahun 2001 dengan pelelangan dan penunjukan langsung dengan SPK. Terdapat beberapa hal dari hasil evaluasi, antara lain : Waktu pengadaan obat cukup lama(1-3 bulan), frekwesi pengadaan obat kecil(1-2) kali setahun, prosedur pengadaan melalui beberapa tahapan yang baku. Hal tersebut mengakibatkan penumpukan obat tinggi (tahun 2001; 2002; 2003 nilainya 54%; 46%; 30%), obat tidak diresepkan tinggi (tahun 2001; 2002; 2003 nilainya 29,01%; 26,02%; 16,59%), stock out obat lama(15-276 hari), obat rusak/kadaluarsa tinggi, dan nilai TOR setiap tahun rendah( tahun 2001; 2002; 2003 nilainya 0,44; 0,71; 0,88). Kesimpulan : Tingkat ketersediaan dan efisiensi obat di Rumah Sakit Grhasia dari sistem pengadaan obat menggunakan dana APBD Pemerintah Propinsi DIY pada tahun 2001-2003 di Rumah Sakit Grhasia kurang baik. Saran : Mengganti pola Pelelangan dan penunjukan langsung menjadi Swakelola anggaran pengadaan obat.

Background : Drug procurement system using Local Expenditure and Revenue Fund of Yogyakarta Special Territory Province is based on the President Decree No. 18, 2000 and the Governor Decree No 172, 2001. Drug procurement is done in basis of large quantity, and long period procurement (1-2 time/year). According to the evaluation of Local Monitoring Council in June 2004 there were many damaged and expired drugs which costing as much as Rp 82,210,626. Over stock of number of drugs have been existed every year since 2001, highly non prescribed drugs and highly out of stock drugs. This may cause poor availability and inefficiency of drugs at Grhasia Hospital. Objective : To evaluate drug procurement system financed by local expenditure and revenue fund of Yogyakarta Special Territory Province from 2001 – 2003 concerning drug availability and efficiency at Grhasia Hospital. Method : This was a qualitative descriptive study, which support used secondary data and observation of drug storage warehouse as well as depot of hospital pharmacy. Subject of the study consisted of two groups : procurement group and user group. Object of the study would be planning process and drug procurement system at Grhasia Hospital as well as drug availability status. Indepth interview was also conducted to subject who took responsibility of planning process and drug procurement at Grhasia Hospital, and calculation was done to drug availability consisting of : damaged/expired drugs, drug overstock, non prescribed and out of stock drugs as well as value of drug turnover ratio. Result : Result of the study showed that the process of drug procurement using local expenditure and revenue fund of Yogyakarta Special Territory Province at Grhasia Hospital from 2001 to 2003 had been based on the President Decree No. 18, 2000 and Governor Decree No. 172, 2001 through selective tender and negotiated purchase. Result of the evaluation showed that: 1) period of drug procurement was 1-3 month; 2) frequency of drug procurement was 1-2 time/year; 3) procurement procedure was based on some standardized phases. The procurement system caused drug overstock (30-54%), highly non prescribed drugs (16,59-29,01%), drugs were out of stock (15-276day), highly damaged/expired drugs and low annual turn over ratio (TOR). TOR value in 2001 was 0.44; in 2002 was 0.71, in 2003 was 0.88, which meant that drug circulation in warehouse was relatively low. Conclusion : Level of drug availability and efficiency at Grhasia Hospital using procurement system of local expenditure and revenue fund of Yogyakarta Special Territory Province in 2001 – 2003 was not good enough. Suggestion : There was a need to change from selective tender a

Kata Kunci : Sistem pengadaan obat, Dana APBD, Ketersediaan obat, drug procurement system, local expenditure and revenue fund, drug availability.