Evaluasi pola tarif PT Askes terhadap unit cost pelayanan rawat jalan RSUD Abepura Jayapura Provinsi Papua :: Kajian di Poli Bedah, Poli Mata dan Poli Fisiotherapi

RUMBINO, Franky, drg. Julita Hendrartini, M.Kes

2005 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kebijakan

Latar Belakang : Pola Tarif Askes yang berlaku di RSUD Abepura saat ini adalah berdasarkan SKB Menkes dan Mendagri tahun 2004 yang besarannya lebih tinggi dibandingkan tarif Perda rumah sakit. Terhadap selisih biaya tersebut dapat memberikan keuntungan atau kerugian bagi RSUD Abepura sejak diberlakukan per 1 Januari 2005 sehingga perlu dilakukan perhitungan unit cost tiap jenis pemeriksaan dan tindakan rawat jalan. Metode Penelitian : Jenis penelitian ini adalah deskriptif dengan rancangan studi kasus dan menggunakan data kuantitatif. Variabel penelitian ini adalah biaya langsung, biaya tidak langsung, pola tarif PT.Askes dan persepsi manajemen rumah sakit. Setelah semua data yang dikumpulkan lengkap kemudian dianalisa dengan menggunakan metode pendekatan real cost. Sementara itu data hasil wawancara dengan manajemen rumah sakit diolah secara kualitatif kemudian disajikan secara deskriptif. Hasil Penelitian : Berdasarkan identifikasi biaya langsung untuk mengetahui total biaya yang selanjutnya dibagi dengan output untuk mendapatkan unit cost Terdapat selisih biaya setelah dilakukan perbandingan antara hasil perhitungan unit cost dan pola tarif negosiasi PT.Askes sehingga terdapat kerugian pada masing-masing poliklinik rawat jalan dari bulan januari-juni 2005 antara lain : poliklinik gigi Rp 52.864.422, poliklinik bedah Rp 36.488.950, poliklinik mata Rp 34.515.958, serta poliklinik fisiotherapi Rp 22.668.588, sehingga total kerugian RSUD Abepura dari penetapan tarif negosiasi PT.Askes per 1 januari 2005 adalah sebesar Rp 146.537.918, dan bila selisih biaya tersebut tanpa menghitung penyusutan investasi maka kerugian yang dialami adalah sebesar Rp 102.619.123. Kesimpulan : Tarif Negosiasi Pt Askes saat ini belum sesuai, sehingga pihak manajemen RSUD Abepura menginginkan adanya perubahan tarif

Background: PT. Askes tariff whis is currently implemented at RSUD Abepura is based on collaborative decree between the Ministry of Health and the Ministry of Home Affairs 2004 which is higher than hospital tariff based on the local government. Whether difference in cost can contribute profit or loss to RSUD Abepura after its implementation per January 2005 needs to be calculated from unit cost of each type of outpatient examination and action. Result of the calculation is then compared to tariff of PT. Askes. Method: The research was of descriptive type with case study design and used quantitative data. Variables consisted of direct cost, indirect cost, tariff pattern of PT. Askes and perception hospital management. After all data were completely collected, they were than analyzed using real cost approach method. Meanwhile data of interview with hospital management were qualitatively processed and presented descriptively. Result: Based on identification of direct cost and indirect cost to know the total cost which is divided by output to get the unit cost, there was difference in cost after comparison was made between result of unit cost calculation and negotiated tariff pattern of PT. Askes. There was loss in each outpatient polyclinic from January to June 2005, i.e. dental polyclinic as much as Rp 52,864,422; surgery polyclinic as much as Rp 36,488,950; ophthalmic polyclinic as much as Rp 34,515,958, and physiotherapy polyclinic as much as Rp 22,668,588. Thus total loss of RSUD Abepura based on negotiated tariff of PT. Askes per January 2005 was as much as Rp 146,537,918. and if the cost difference without counting the investation decrease, the loss would be Rp 102.619.123. Conclusion: Negotiated tariff of PT. Askes was irrelevant so that management of RSUD Abepura wanted tariff changes.

Kata Kunci : Kebijakan Pembiayaan Rumah Sakit,Rawat Jalan,Taris Askes,unit cost, real cost method, tariff pattern of PT. Askes