Persepsi Kepala Puskesmas terhadap layanan PT Askes Indonesia di Kabupaten Bolaang Mongondow

RUMOPA, Lucky Lukas, dr. Andung Prihadi Santosa, MKes

2005 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kebijakan Pembiayaan

Latar Belakang : Kerjasama dalam pelayanan kesehatan antara pihak Puskesmas dan PT Askes Indonesia telah berlangsung lama. Literatur melaporkan banyak keberhasilan dan bukan tidak sedikit kegagalan dan ketidakpuasan yang timbul dalam bekerjasama oleh karena perbedaan prinsip mengenai sudut pandang organisasi. Cara pandang yang berbeda tersebut muncul akibat antara lain adanya perbedaan kepentingan, latar belakang profesi dan pengalaman. Oleh karena itu pemahaman terhadap persepsi dari pengambil kebijakan dalam organisasi pelayanan kesehatan perlu diketahui. Metode : Jenis penelitian ini adalah penelitian deskriptif dengan rancangan cross sectional study dengan menggunakan pendekatan kualitatif. Subjek dalam penelitian adalah kepala Puskesmas sebanyak 17 orang. Proses pengumpulan data dilakukan dengan menggunakan panduan wawancara mendalam (indepth Interview), studi dokumentasi dan observasi. Hasil : Ada perbedaan persepsi di antara informan kepala Puskesmas terhadap layanan PT Askes Indonesia dalam hal : a. Kontrak, dipersepsikan kurang baik oleh sebanyak 13 orang informan dan lainnya sebanyak 4 orang mempersepsikan baik. b. Mekanisme pembayaran, dipersepsikan baik oleh sebanyak 9 orang informan dan lainnya sebanyak 8 orang mempersepsikan kurang baik. c. Manajemen kepesertaan, dipersepsikan kurang baik oleh sebanyak 16 orang informan dan lainnya sebanyak 1 orang mempersepsikan baik. Hal-hal yang belum dipahami dalam kerjasama antara lain : kontrak, prosedur klaim, perhitungan jasa, dan distribusi obat. Masih ada perbedaan persepsi mengenai program dokter keluarga, sebanyak 9 orang informan kurang setuju dan lainnya 8 orang setuju. Kesimpulan : Layanan PT Askes Indonesia dipersepsikan baik oleh sebagian besar informan dalam hal mekanisme pembayaran sedangkan sebaliknya kontrak dan manajemen peserta dipersepikan kurang baik. Program dokter keluarga sebagian besar informan kurang setuju.

Background: Collaboration in the health service between Primary Health Care and PT Askes Indonesia has run for a long time. A literature reported that many successfulness and failure as well as disappointment in the collaboration occurred because of principle difference about organization’s perspective. The different perspective occurred as the consequence of difference need, professional and experience background. Therefore, understanding toward perception of decision maker in the health service organization need to be investigated. Method: This was a descriptive research with cross sectional study design by using qualitative approach. The subject in this research was 17 principals of Primary Health Care. Data collection process was done by using in-depth interview, documentation and observation study. Result: There was a different perception among the informants of Primary Health Care principals toward the service given by PT Askes Indonesia in the matter of: a. Contract, which was perceived as not very good by 13 informants and 4 informants perceived good. b. Payment mechanism, which was perceived good by 9 informants and 8 perceived not very good. c. Membership management, was perceived not very good by 16 informants and 1 informant perceived as good. There was some issues that were not understood in the collaboration such as: contract, claim procedure, service calculation, and drugs distribution. In addition, there was also a different perception regarding family doctor program; 9 informants were disagree and 8 informants were agree. Conclusion: The service given by PT Askes Indonesia was perceived good by most of the informants in the matter of payment mechanism while on the other hand, contract and membership management was perceived not very good. Indeed, most of the informants disagree with the family doctor program.

Kata Kunci : Asuransi Kesehatan,Layanan Puskesmas,Persepsi Kepala Puskesmas, contract, payment system, membership management and perception