Faktor-faktor yang mempengaruhi persepsi Stakeholder terhadap pelaksanaan pembiayaan pelayanan kesehatan keluarga miskin di Kabupaten Aceh Tamiang

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

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

Latar Belakang : Salah satu program pemerintah yaitu pembiayaan pelayanan kesehatan keluarga miskin. Kabupaten Aceh Tamiang sejak adanya konflik banyak sumber dana untuk pelayanan kesehatan keluarga miskin. Temuan awal menunjukkan bahwa perubahan demi perubahan pembiayaan pelayanan kesehatan keluarga miskin terjadi penurunan kunjungan pasien keluarga miskin yang berobat baik di Puskesmas dan Rumah Sakit, kemudian adanya pasien rujukan yang tidak terlayani. Stakeholder internal yaitu petugas kesehatan tidak memberikan pelayanan yang baik terhadap pasien keluarga miskin dan stakeholder eksternal sebagai penentu kebijakan tidak mempunyai tanggapan dan pendapat mengenai pelaksanaan pembiayaan pelayanan kesehatan keluarga miskin. Penelitian ini bertujuan untuk mengetahui faktor-faktor apa saja yang mempengaruhi persepsi stakeholder terhadap pelaksanaan pembiayaan pelayanan kesehatan keluarga miskin. Metode : Penelitian ini bersifat analitik dengan rancangan cross sectional dengan pendekatan kuantitatif dan kualitatif. Data kuantitatif diperoleh dari kuesioner dan dianalisis dengan analisis Univariat, Bivariat, sedangkan untuk data kualitatif diperoleh dengan wawancara mendalam kepada 5 orang stakeholder yaitu : Sekda, Ketua komisi C DPRD, Kepala Bappeda, Kepala Dinas dan Direktur Rumah Sakit. Pengambilan sampel secara pusposive sampling, dengan jumlah sampel 60 orang. Pengumpulan data dilakukan dengan kuesioner dan panduan wawancara. Variabel yang diteliti yaitu: variabel bebas meliputi pengetahuan, sikap, pengalaman, motivasi dan variabel terikat yaitu persepsi stakeholder tentang pelaksanaan pembiayaan pelayanan kesehatan keluarga miskin. Hasil Penelitian : Dari hasil analisis kuantitatif memperlihatkan bahwa variabel sikap berhubungan siqnifikan (p<0,05). Hasil wawancara mendalam stakeholder eksternal memiliki persepsi negatif terhadap program jaminan kesehatan masyarakat miskin karena belum adanya sosialisasi dari dinas kesehatan. Stakeholders internal memiliki persepsi positif terhadap program jaminan kesehatan masyarakat miskin karena terlibat langsung dengan pelayanan kesehatan keluarga miskin.

Background: One of government’s programs is health service financing for poor family. Since the occurrence of conflict, the district of Aceh Tamiang has a lot of funding source for poor family health service. Preliminary research finding showed that there were changes on health service financing of poor family such as decreasing visit of poor family patients who seek for treatment in Primary Health Care and hospital, and there were referral patients who were not being serviced. Internal stakeholders that is the health care provider did not give a good service for poor family patients and external stakeholders as policy maker did not respond and had opinion regarding the implementation of health service for poor family. This research was aimed to find out factors that could influence stakeholders perception toward the implementation of health service financing of poor family. Method: This was an analytic research that used cross sectional design with quantitative and qualitative descriptive approaches. Quantitative data was obtained from questioner and analyzed with univariat, bivariat, while qualitative data was obtained with in depth interview toward 5 stakeholders such as: Sekda (regional secretary), DPRD ketua komisi C (head of legislative board of komisi C), head of Bappeda, head of health office and hospital director. The sample was taken with purposive sampling method that used quantitative sample size of 60 people. Data was collected by using questioner and indepth interview guidance. The examined variable was independent variable that consists of knowledge, attitude, experience, and dependent variable that consists of stakeholders perception regarding the implementation of health service of poor family. Result: The result of quantitative analysis showed that the attitude variable was significantly related (p<0,05). The result of in depth interview showed that external stakeholders had negative perception toward the Managed Care program for poor family because there was no socialization from the health office. Internal stakeholders had positive perception because they were directly involved in the health service for poor family. Conclusion: Factor that influence stakeholders perception regarding the implementation of health service financing of poor family was only attitude variable.

Kata Kunci : Pembiayaan Kesehatan,Keluarga Miskin,Persepsi Stakeholder