Analisis biaya satuan sebagai dasar pengajuan usuan tarif rawat jalan di Puskesmas Yosomulyo Kota Metro

LUKMAN, Prof.dr. Ali Ghufron Mukti, MSc.,PhD

2006 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kebij. Pembiayaan da

Pendahuluan: Puskesmas merupakan unit pelayanan kesehatan terdepan yang diharapkan mampu memberikan pelayanan kesehatan yang bermutu dan terjangkau oleh masyarakat, namun kenyataannya dana yang dimiliki puskesmas sangat terbatas dan di sisi lain biaya pelayanan kesehatan terus meningkat, sehingga dikhawatirkan hal tersebut dapat mempengaruhi kualitas/mutu pelayanan kesehatan. Untuk mengantisipasi hal tersebut puskesmas dituntut harus mampu menggali sumber pembiayaan yang berasal dari masyarakat, salah satunya adalah melalui penyesuaian tarif yang disusun berdasarkan hasil analisis biaya satuan. Tujuan penelitian ini untuk mendapatkan gambaran biaya pelayanan rawat jalan di Puskesmas Yosomulyo Kota Metro. Metode Penelitian: Penelitian ini adalah penelitian studi kasus dengan metode analisis deskripsi menggunakan data kuantitatif dan kualitatif. Variabel terikat usulan tarif, variabel bebas: unit cost, ability to pay (ATP)/wilingnes to pay (WTP), pesaing dan stakeholders. Analisis biaya dengan metode double distribution Hasil Penelitian: 1. Unit cost di BP Rp. 6.347,-, BPG rata-rata Rp. 8.151,- dan KIA/KB rata-rata Rp. 6.056,-. 2. Hasil rata-rata besarnya kemampuan masyarakat membayar biaya pelayanan kesehatan (ATP) tiap keluarga sebesar Rp. 43.900,- dan kemauan membayar (WTP) antara Rp. 5.000,- sampai dengan Rp. 10.000,-. 3. Besar tarif pesaing semuanya berada di bawah unit cost. 4. Pendapat stakeholders berlainan antara stakeholders internal dan eksternal, yaitu stakeholders internal berpendapat bahwa tarif puskesmas tidak relevan lagi dan terlalu murah sehingga perlu direvisi, sedangkan stakeholders eksternal menginginkan tarif puskesmas digratiskan. Kesimpulan: Bisa diajukan tarif pelayanan kesehatan rawat jalan baru, yang relevan dengan keadaan sekarang dengan mempertimbangkan ATP/WTP, pesaing dan pandangan stakeholders adalah sebesar hasil perhitungan unit cost tanpa investasi dan gaji ditambah margin.

Background: Community Health Center is a milestone of health service unit which is expected to provide quality and affordable health service. However, community health center has limited fund, while the cost of health service is increasing. People worry that such condition may affect the quality of health service. To anticipate the increasi health service cost, so that the community health center be able to generate income from the community, an adjustment of fee based on unit cost analysis is needed. Objective: The objective of the study was to identify cost of outpatient service at Yosomulyo Community Health Center, Metro Municipality Method: This was a case study which used a descriptive design. Data was analysed by qualitative and quantitative method. Dependent variable was proposed fee and independent variables were unit cost, ability to pay (ATP)/willingness to pay, competitors and stakeholders. Cost analysis used double distribution method. Result: 1) Unit cost at the health clinic was Rp. 6.347,- dental clinic was at average Rp. 8.151,- and mother and child health/family planning clinic was Rp. 6.056,-, 2). Average amount of ATP for health service of every family was Rp. 43,900,- and WTP was between Rp. 5,000,- and Rp. 10,000,-, 3) The amount of fee of competitors was all below the unit cost, 4) There was different opinion between internal and external stakeholders. Internal stakeholders considered that the fee was no longer relevant and too low so that it needed revision, meanwhile external stakeholders wanted free community health service. Conclusion: New outpatient health service fee might be proposed as long as it was relevant with the current condition and considered ATP/WTP, and competitors. According to the stakeholders the amount of tariff, was as much as the result of unit cost calculation without investment and salaries were added to margin.

Kata Kunci : Pembiayaan Kesehatan,Puskesmas,Tarif Rawat Jalan, unit cost, fee, ability to pay, willingness to pay, competitors and stakeholders