Analisis biaya pengelolaan limbah RS Bethesda Yogyakarta

HIDAYAT, Drs. Manahati Zebua, M.Kes

2006 | Tesis | S2 Ilmu Kesehatan Kerja (Kesehatan Lingkungan)

Undang-Undang No 23/1997 tentang Lingkungan Hidup, mewajibkan setiap pengelola kegiatan termasuk rumah sakit untuk mengelola limbah yang dihasilkan dari proses pelayanan kesehatan. Hasil penelitian menyimpulkan 60,7% manajemen rumah sakit mengakui kendala terbesar dalam mengelola limbah medis adalah biaya. Penelitian lain menyebutkan stake holder RS Bethesda kurang memberikan perhatian terhadap sarana pengelolaan limbah yang ada karena beranggapan pengelolaan limbah tidak menghasilkan dana, tetapi membutuhkan biaya yang tidak sedikit. Kurangnya perhatian mungkin disebabkan belum adanya informasi biaya mengenai pengelolaan limbah tersebut, sehingga sukar untuk dimasukkan dalam anggaran biaya RS. Penelitian ini bertujuan untuk mengetahui besarnya volume limbah dan biaya pengelolaan, serta korelasi antara keduanya. Penelitian ini bersifat deskriptif korelasional dengan rancangan cross sectional. Penelitian dilakukan di RS Bethesda dengan unit analisis insinerator dan IPAL. Pengambilan data primer dan data sekunder dilakukan dengan metode observasi, wawancara dan metode dokumentasi. Analisis data menggunakan analisis korelasi dan regresi. Biaya pengelolaan akan dikelompokkan ke dalam biaya tetap dan biaya variabel dengan metode least square. Goodness of fit dinilai dari angka koefisien penentu (R2) dan nilai uji statistik t, serta kuatnya hubungan dinilai dari angka koefisien korelasi (r). BOR RS Bethesda Juli,Agustus,September adalah 57,87%, 53,87%, 59,99%. Angka kunjungan rawat inap 1.382, 1.377, 1.401. kunjungan rawat jalan 15.407, 16.085, 16.690. Volume sampah medis RS 0,39 kg/bed/hari dengan biaya pengelolaan diprediksi menurut persamaan garis regresi Y= 295.622+3.216X adalah Rp 298.838/kg/hari. Volume limbah cair sebesar 322 liter/bed/hari dengan biaya pengelolaan diprediksi menurut persamaan Y= 559.457 + 799 X adalah Rp 560.253/hari. Persamaan kedua garis sangat baik karena mempunyai nilai R2 dan t hitung yang lebih besar dari nilai t tabel pada tingkat kepercayaan 95%. Nilai 0,9911 dan 33,36 (sampah medis) serta 0,8276 dan 11,798 (limbah cair). Koefisien korelasi sampah medis 0,9955 dan 0,9697 pada limbah cair. Volume sampah medis RS Bethesda sebesar 0,39kg/bed/hari dengan biaya pengelolaannya Rp 298.838/kg/bed/hari. Volume limbah cair sebesar 322 liter/bed/hari dengan biaya pengelolaannya Rp 560.253/hari. Hubungan antara volume limbah dengan biaya pengelolaannya sangat kuat dan searah dilihat dari nilai koefisien korelasi kedua jenis limbah.

Government Act No. 23/1997 about Life Environment requires that every institution including a hospital has to manage waste that produces from medical service process. Result of study concludes that 60.7% of hospitals management state that cost of medical waste is the biggest problem. Whereas another study finds out that stakeholders of Bethesda Hospital does not give much attention to waste management facilities. They believe that waste management does not give revenue, however it costs a lot of money. Lack of attention may be due to unavailability of information about cost of waste management therefore it is excluded from calculation of hospital cost. The objective of this study is to identify waste volume and its management cost, and to find out correlation between them. The study was descriptive correlational with cross sectional design. It was conducted at Bethesda Hospital with incinerator and liquid waste processing installation as analysis unit. Primary and secondary data were obtained from observation, interview and documentation. Data analysis used correlation and regression analyses. Cost of waste management was grouped to fixed and variable cost with least square method. Goodness of fit was measured from determinant coefficient value (R2) and value of t statistical test, and strength of relationship was measured from correlation coeficient value (r). Bed Occupancy Rate of Bethesda Hospital in July - September was 57.87%, 53.87%, and 59.99%. Inpatient visits were 1,382, 1,377 and 1,401 whereas outpatient visits were 15,407, 16,08, and 16,690. Volume of medical waste was 0.39 kg/bed/day with estimated management cost based on regression line equivalent y = 295,622 +3,216 x was Rp 298,838/kg/day. Volume of liquid waste was 322/litre/bed/day with management cost based on equivalent y = 559,457 + 799 x as much as Rp 560,253/m3/day and being charged to inpatients as much as Rp 661(425 - 898)/bed/day. Equivalent of both lines was very good because it had R2 value and calculation t greater than t table value with significance level 95%. Values were 0.9911 and 33.36 for medical waste and 0.8276 and 11.798 for liquid waste. Correlation coefficient was 0.9955 for medical waste and 0.9697 for liquid waste. Volume of medical waste of Bethesda Hospital was as much as 0.39 kg/bed/day with management cost as much as Rp 298,838/kg/bed/day. Volume of liquid waste was 322 litre/bed/day with management cost as much as Rp 560,253 /day. Value of correlation coefficient of both equivalents showed in line and very strong relationship between waste volume and management cost

Kata Kunci : Kesehatan Lingkungan,Pengelolaan Limbah,Analisis Biaya