Analisis usulan tarif Puskesmas rawat inap berbasis Unit Cost di Puskesmas Lintau Buo II Kabupaten Tanah Datar

HARTONO, Suwanto, drg. Julita Hendrartini, M.Kes

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

Latar Belakang Penetapan tarif Puskesmas rawatan di Kabupaten Tanah Datar belum berdasarkan analisis biaya dan belum mempertimbangkan kemampuan bayar masyarakat serta tidak mempertimbangkan tarif pesaing. Penelitian ini bertujuan menganalisis tarif pelayanan kesehatan di Puskesmas rawatan Lintau Buo II Kabupaten Tanah Datar. Metode Penelitian: Penelitian ini merupakan penelitian studi kasus, dengan pendekatan kuantitatif dan kualitatif, dengan unit analisis layanan di puskesmas. Subjek penelitian meliputi pimpinan puskesmas dan staf serta stakeholders. Variabel meliputi usulan tarif, unit cost, ATP, tarif pesaing dan persepsi stakeholder. Data dikumpulkan melalui penelusuran biaya di puskesmas dengan instrumen penelitian mengacu pada P2KT, ATP masyarakat dengan menggunakan data sekunder dan tarif pesaing metanyakan langsung kepada dokter dan bidan praktek, sedangkan persepsi stakeholders dengan wawancara. Analisis biaya dilakukan secara deskriptif dengan metode double distribution dengan bantuan program spreadsheet, sedangkan hasil wawancara dianalisis dalam bentuk transkrip, matrik dan koding. Hasil Penelitian : Hasil penelitian menunjukkan bahwa besarnya biaya total Puskesmas Lintau Buo II sebesar Rp 304.856.269,-.Biaya satuan pelayanan rawat inap Rp 18.214,- dan rawat jalan BP Rp 4.066,- sementara tarif perda rawat inap sebesar Rp 15.000,- dan untuk rawat jalan BP Rp 3000,-. Persepsi stakeholders tentang tarif sekarang murah. Semua stakeholders terlibat dalam penetapan tarif dan setuju tarif mengacu pada unit cost dengan persyaratan bila ekonomi masyarakat sudah baik dan diikuti peningkatan kualitas pelayanan insentif dicarikan sumber lain dan tarif baru yang diusulkan berkisar antara Rp 3.000,- s/d Rp 10.000,- Kesimpulan : Tarif yang berlaku di Puskesmas Lintau Buo II tahun 2004 lebih rendah dari biaya satuan. Stakeholders setuju tarif berdasarkan biaya satuan dengan syarat kualitas pelayanan ditingkatkan dan insentif dicarikan sumber lain.

Background: The determination of inpatient commuity health center tariff at Tanah Datar District has not been based on cost analysis and has not yet considered the ability of the community to pay as well as competitors’ tariff. Objective: The objective of the study was to analyze proposed inpatient community health center tariff at Lintau Buo II Community Health Center of Tanah Datar District, Province of Sumatera Barat. Method: This was a case study with quantitative and qualitative approaches. Analysis unit was service at community health center. Subject of the study consisted of heads and staff of community healt center and stakeholders. Variables comprised proposed tariff, unit cost, ability to pay, competitors’ tariff and stakeholders’ perception. Data were obtained from observation of cost at community health center usung research instruments based on integrated health funding and planning, ability to pay of the community based on secondery data, competitors’ tariff obtained from practising doctors and midwives, whereas stakeholders’ perception method with gathered from interview. Cost analysis was done descriptively using double distribution method with spreadssheet program, meanwhile the result of interview was analyzed in transcript, matrix and coding. Result: The result of the study showed that the amount of total coast of Lintau Buo II Community Health Center was as much as Rp304,856,269. Unit cost of inpatient service was Rp 18,214 and outpatient was Rp 4,066, whereas tariff according to local regulation for inpatient service was Rp 15,000 and outpatient was Rp 3,000. Stakeholders perseaved the tariff was low. All stakeholders were involved in tariff determination and agreed on tariff based on unit cost on condition that the ability to pay of the community was getting better and quality of service was improved. Incentives should be supported from other resources and the new tariff proposed was between Rp 3000 to Rp 10,000. Conclusion: The tariff determined at Lintau Buo II Community Health Center in 2004 was lower than the unit cost. Stakeholders agreed on tariff based upon unit cost on condition that quality of sevice was improved and incentives were supported from other resources.

Kata Kunci : Pembiayaan Kesehatan,Puskesmas,Tarif Rawat Inap, tariff, unit cost, stakeholders, perception.