Penerimaan dokter dan perawat terhadap sistem pelayanan gratis di Puskesmas Kabupaten Kampar

ELFIAN, dr. Mubasysyir Hasanbasri, MA

2007 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kebij. dan Manaj. Pe

Latar Belakang: Sejak diberlakukan Undang-Undang No. 22 Tahun 1999 Tentang Pemerintahan Daerah dan Undang-Undang No. 25 Tahun 1999 Tentang Perimbangan Keuangan Pusat Daerah dinyatakan bahwa kewenangan daerah untuk menyelenggarakan pemerintahan yang mencakup kewenangan disemua bidang termasuk dibidang kesehatan. Dengan keputusan tersebut, Bupati Kampar membuat suatu kebijakan untuk membebaskan biaya pelayanan kesehatan di puskesmas kepada masyarakat tanpa membedakan status sosial ekonominya. Akan tetapi kebijakan tersebut tidak diiringi dengan penambahan insentif yang adil untuk para petugas yang bertugas memberikan pelayanan. Cara Penelitian: Penelitian ini dilakukan dengan menggunakan pendekatan deskriptif kualitatif, penelitian ini dilaksanakan diwilayah Kabupaten Kampar dan subjek penelitian ini adalah dokter, Kepala Puskesmas dan perawat puskesmas. Untuk menganalisa data digunakan teknik kualitatif yaitu interpretasi naratif, kesimpulan dan validasi data dengan teknik triangulasi Hasil Penelitian: Kebijakan puskesmas gratis memberikan pelayanan kesehatan di puskesmas secara gratis bagi semua masyarakat membuat kunjungan rawat jalan meningkat hampir dua kali lipat dari biasanya. Peningkatan ini menambah beban kerja. Kebijakan tidak disertai dengan penambahan insentif yang adil kepada petugas. Kebijakan ini tidak diterima oleh petugas. Kesimpulan: Penerapan pelayanan gratis di Kabupaten Kampar membuat peningkatan jumlah kunjungan puskesmas dan menambah beban kerja petugas. Karena kebijakan ini tidak didukung oleh dana yang cukup kebijakan ini tidak diterima oleh petugas.

Background. Since the regulations number 22 1999 about the the local government and the regulations number 25 1999 about the balance of local budget was established, it was stated that the authority of the local government to implement the government administration including the authority in all sectors included in health sector. By this decision, the head of local government of Kampar regency made a policy to exempt the cost of health services in the public health centre to the public regardless of their social economic status. Nevertheless, this policy was not accompanied by the increasing of fair incentive to the employee who gave the services to the public. Method. This research was implemented by the descriptive. This research was carried out in Kampar regency territory and the subjects of the research were the doctor, the head of public centre and the nurse of public health centre. To analyze the data it was used the qualitative technique those are narrative interpretation, conclusion and the validity data by triangular technique. Findings. The policy of local government of Kampar regency gave free helath services in the public health centre to the public made a mobile treatment increased almost twice as much as usual. By increasing the number of visiting to the public health centre would increase a burden of employee’s duties. The policy was not accompanied by the increasing of incentive to the employees. This policy was accepted by the employees because as a civil servant who must obey to the government and it was not caused by the income in this services for free. Conclusion. Free puskesmas services policy has increased patients visit. The lack of operational cost compensating for higher workload among health workers has created a hidden protest at the implementation level. There is a need to review the existing financial arrangement strategies and to modify to the one that addresses the higher health workers workload.

Kata Kunci : Kebijakan Kesehatan,Layanan Gratis,Kinerja Petugas, free puskesmas service, public health center, incentive