Evaluasi pelaksanaan perjanjian antara PT Askes Cabang Utama Yogyakarta dan RSD Panembahan Senopati Bantul dalam pemberian pelayanan kesehatan keluarga miskin

PALALUNAN, Melkias, Prof.dr. Ali Ghufron Mukti, MSc.,PhD

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

Latar belakang : PT. Askes (Persero) dan RSD Panembahan Senopati Bantul mengadakan perjanjian dengan Nomor ; 62/PKS/1201/0105 dan Nomor 188.445/307 tanggal 3 Januari 2005, sebagai perwujudan SK Menkes Nomor 1241/Menkes/SK/XI/2004. Dalam pelaksanaan perjanjian ditemukan pelanggaran perjanjian yaitu penarikan iur biaya kepada peserta PJKMM. Tujuan : Tujuan penelitian ini untuk mengetahui pelaksanaan perjanjian kerja sama antara PT. Askes (Persero) dengan RSD Panembahan Senopati terhadap pelayanan kesehatan Gakin yang berkaitan dengan pelanggaran iur biaya dan penyelesaian hukumnya. Metodologi : Penelitian ini merupakan penelitian diskriptif dengan pendekatan kuantitatif dan kualitatif. Obyek penelitian adalah peserta yang memanfaatkan pelayanan kesehatan rawat inap PJKMM bulan Nopember tahun 2005 sebanyak 45 0rang. Kepada Direktur PT. Askes (Persero) dan Direktur RSD. Panembahan Senopati Bantul. Instrumen penelitaian kuesioner dan panduan wawancara mendalam. Hasil : Ditemukan 45 kasus iur biaya yang terdiri dari 58.5 persen peserta dan 41,5 persen kartu sehat dan SKTM. Rata-rata iur biaya sebesar 12,87 persen dengan nilai tertinggi 94,2 persen dan terendah 0,33 persen dari jumlah tagihan. Pehak RSD Penembahan Senopati Bantul menarik iur biaya karena identitas peserta yang tidak jelas, obat yang tidak terdaftar dalam DPHO. Biaya paket dalam perjanjian belum mencukupi biaya operasional serta keterlambatan pembayaran klaim. Waktu pembayaran tidak dicantumkan dalam perjanjian. Pelanggaran yang dilakukan oleh RSD Panembahan Senopati Bantul diselasaikan dengan jalan musyawarah tanpa dikenai sanksi sesuai dengan perjanjian. Kesimpulan : Telah terjadi pelanggaran perjanjian yang dilakukan oleh pihak RSD Panembahan Senopati Bantul berupa penarikan iur biaya terhadap peserta PJKMM namun pelanggaran tersebut tidak dikenai sanksi oleh PT.Askes (Persero) sesuai perjanjian.

Background: PT. Askes and Panembahan Senopati Hospital made an agreement No. 62/PKS/1201/O105 and No. 188.445/307 in 3rd January 2005 as a realization of the Decree of the Ministry of Health No. 1241/Menkes/SK/Xl/2004. At the implementation stage there is infringement to the agreement, i.e. certain charge is imposed to participants of health insurance program for poor community. Objective: To observe the implementation of agreement between PT. Askes and Panembahan Senopati Hospital in the provision of health service for poor community and identify legal action that might be taken when the agreement was infringed. Method: This was a descriptive study with both quantitative and qualitative approaches. Subject of the study were participants utilizing inpatients health service of health insurance program for poor community in November 2005 (42 people). Research instruments were questionnaires and indepth interview guide. Result: Panembahan Senopati Hospital had infringed the agreement section 6 article 4 by imposing for poor community identihcation card (59.5%). PT. Askes was delayed in paying claims from Panembahan Senopati. Both sides had not been ready in implementing the agreement and such an agreement was made only to carry out the decree of the Ministry of Health No. 1241/Menkes/Xll/2004 on the determination of PT. Askes as insurer of health service for poor community. The implementation of the agreement was disrupted by ever changing regulation, thus there was no law assurance. Legal settlement on the infringement of agreement about cost contribution was made through discussion. This was made possible by civil code which could help solve the problem quickly and did not involve third parties but it did not have strength to enforce through the court. Conclusion: The implementation of agreement between PT. Askes and Panembahan Senopati Hospital had not been well implemented

Kata Kunci : Pembiayaan Kesehatan,Keluarga Miskin,Perjanjian Askes dan RSD Panembahan Senopati