Analisis kesiapan Puskesmas sebagai pemberi pelayanan kesehatan (PPK) dalam Program "Managed Care" (JPKM) di Kabupaten Karanganyar

KUSUMO, Cucuk Heru, dr. Kristiani, SU

2006 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kebijakan dan Manaj.

Latar Belakang: Kesehatan merupakan hak setiap individu. Dalam melaksanakan pembangunan kesehatan ditetapkan visi, misi dan strategi pembangunan kesehatan, yang mendasarkan kepada 4 pilar pembangunan kesehatan, yaitu pembangunan berwawasan kesehatan, profesionalisme, jaminan pemeliharaan kesehatan masyarakat (JPKM) dan desentralisasi. ”Managed care” (JPKM) merupakan konsep strategis yang tepat, kunci keberhasilannya terletak pada kualitas pemberi pelayanan pemeliharaan kesehatan (PPK) yang dimilikinya. Namun demikian konsep JPKM belum banyak dipahami.Di kabupaten Karanganyar, konsep JPKM telah dilaksanakan, sebagai badan penyelenggara Pra-Bapel Mitra Husada, memiliki 8.875 peserta, Puskesmas sebagai pemberi pelayanan kesehatan dasar yang dikontrak, tetapi penetapan Puskesmas sebagai PPK tidak melalui proses seleksi terstruktur. Tujuan: Untuk mengetahui kesiapan Puskesmas sebagai salah satu alternative Pemberi Pelayanan Kesehatan (PPK), dalam program “managed care” (JPKM). Metoda: Jenis penelitian ini adalah penelitian diskriptif dengan pendekatan “cross sectional”. Penelitian dilakukan dengan cara mengumpulkan data sekunder dan data primer melalui penyebaran kuesioner pada subyek penelitian dan observasi lapangan. Lokasi penelitian di 21 Puskesmas kabupaten Karanganyar dengan obyek penelitian adalah elemen struktur Puskesmas, dan subyek penelitian Kepala Puskesmas. Variabel penelitian ini, variabel bebas syarat PPK pogram ”managed care” (JPKM) dan variabel terikat Puskesmas. Hasil: Penelitian menunjukkan bahwa kesiapan Puskesmas sebagai PPK dalam program “managed care” (JPKM) dicapai 19% Puskesmas. Kekurangan terbesar adalah pada elemen jaminan mutu, kecukupan tenaga medis dan kesediaan kontrak dengan cara pembayaran pra-upaya. Kesimpulan: belum semua Puskesmas di kabupaten Karanganyar siap sebagai PPK dalam program ”managed care” (JPKM)

Background: Being healthy is a right of every body. In the implementation of health development, vision, mission and strategies of health development have been determined, based on 4 pillars of heallth development, i.e. health oriented development, professionalism, community health care insurance and decentralisation. Community health care insurance is a suitable strategic concept of which its success depends on the quality of health care service provider. However, concept of community health care insurance has not been well understood. At Karanganyar District such concept has been implemented. As an organizing office Mitra Husada Health Service Council has 8,875 participants and Community Health Center service as primary health health service providers has been contracted, but the decision or which community health center will function as health service providers is not made through structured selection process. Objective: The study was intended to identify Community Health Center preparedness as one of alternatives of health service provider in “managed care” program. Method: The study was descriptive with cross sectional approach. It was conducted through secondary and primary data collection through distribution of questionnaire to subject of the study and field observation. Location of the study was as many as 21 community health centers at Karanganyar District with object of the study was element of community health center and subject was heads of community health center. Independent variable was requirement of health service provider of “managed care” program and dependent variable was community heath center. Result: The result of the study showed that community health center preparedness as health service provider in “managed care” program was as much as 19%. Greatest limitations were in element of quality assurance, medical staff sufficiency and willingness of contract with pre-payment system. Conclusion: Not all community health centers at Karanganyar District were prepared to be health service provider to “managed care” program.

Kata Kunci : Layanan Kesehatan,Puskesmas,JPKM, managed care, health service provider, community health center