Analisis biaya operasional Puskesmas rawat jalan swadana kota Bandar Lampung

NOOR, Muhammad, drg. Julita Hendrartini, M.Kes

2005 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kebijakan Pembiayaan

Latar belakang: Keterbatasan biaya operasional puskesmas kini masih menjadi kendala untuk peningkatan mutu puskesmas. Penelitian ini bertujuan untuk menganalisis biaya operasional puskesmas rawat jalan Simpur dan mengetahui tanggapan stakeholders terhadap biaya operasional setelah penerapan puskesmas swadana. Metode Penelitian: Jenis penelitian adalah deskriptif, rancangan studi kasus, kasus penelitian adalah biaya operasional puskesmas, unit analisis puskesmas Simpur karena memiliki sarana yang lengkap, informan penelitian yaitu pengelola program promosi kesehatan, kesehatan lingkungan, kesehatan ibu dan anak serta keluarga berencana, perbaikan gizi masyarakat, pencegahan dan pemberantasan penyakit menular, pengobatan. Sumber data adalah data primer dan sekunder. Pengumpulan data primer dengan wawancara pada stakeholders. Analisis data sekunder dengan mengumpulkan data kuantitatif, kemudian direkapitulasi, lalu dikategorikan menjadi penerimaan, subsidi, biaya langsung dan biaya tidak langsung. analisis kualitatif, hasil wawancara dibuat transkrip, dicoding, dan diintepretasikan. Hasil penelitian : Jumlah biaya operasional Rp.87.827.840,-, biaya langsung Rp.61.879.990,- (70,5%), biaya tidak langsung Rp.25.947.850,- (29,5%). Subsidi Angggaran Pembangunan Belanja Daerah Rp.28.441.600 (32,4%), Subsidi Anggaran Pembangunan Belanja Negara Rp.11.964.785,- (13,6%). Jumlah subsidi Rp.40.406.385,- (46%). Penerimaan Retribusi Rp.20.093.000,- (23%), Penerimaan kapitasi Rp.26.502.866,- (30%). Cost Recovery Rate Rp. 46.595.866,.(53,1%). Stakeholders berpendapat bahwa masih diperlukan subsidi untuk biaya operasional puskesmas dan revisi terhadap perda tarif saat ini. Kesimpulan : Penerimaan fungsional puskesmas dengan tarif yang ada ditambah subsidi masih belum mencukupi kebutuhan biaya operasional puskesmas.

Background: Limited community health center's operational cost is still an obstacle for the improvement of the center's quality. Objectives: The study was meant to analyze operational cost of outpatient community health center and identify stakeholders' perception about operational cost after the implementation of Simpur self-funded community health center. Methods: This was a discriptive study with a case study design. Research case was operational cost of community health center. Simpur community health center was chosen as unit analysis because it had complete facilities. Research informen consisted of managers of health promotion program, environmental health, mother and child health and family planning, community nutrition improvement, prevention and eradication of contagious diseases, and medication. Data derived from both primary and secondary data. The first was obtained from interview with stakeholders. Secondary data were descriptively analyzed, recapitulated and categorized as revenue, subsidy, direct cost, and indirect cost. Interview (primary) data were made into transcript, decoded and interpreted. Results: Total operational cost was Rp 87,827,840, direct cost was Rp 61,879,990 (70.5%), indirect cost was Rp 25,947,850 (29.5%), subsidy of Local Expenditure Development Fund was Rp 28,441,600 (32.4%), subsidy of National Expenditure Development Fund was Rp 11,964,785 (13.6%), total subsidy was Rp 40,406,385 (46%), retribution revenue was Rp 20,093,000 (23%), capitation revenue was Rp 26,502,866 (30%), cost recovery rate was Rp 46,595,866 (53.1%). Stakeholders thought that subsidy was still needed for the center's operational cost and the current tariff based on local regulation needed revision. Conclusion: Functional revenue of community health center according to the current tariff plus subsidy had not yet sufficed need for the center's operationalcost.

Kata Kunci : Asuransi Kesehatan,Biaya Operasional,Rawat Jalan Puskesmas