Pengaruh persepsi pola pembayaran persalinan masyarakat miskin terhadap kepuasan kerja bidan di Kabupaten Kotawaringin Timur

WIJAYANTO, Ari, Prof.dr. Hari Kusnanto J., DrPH

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

Latar belakang : Salah satu pelayanan dalam program asuransi kesehatan masyarakat miskin di Kabupaten Kotawaringin Timur pada tahun 2005 adalah pelayanan persalinan. Bidan mempunyai perbedaan persepsi terhadap pola pembayaran persalinan pada waktu dikelola PT. Askes dan Puskesmas. Tujuan : 1) untuk mengetahui pengaruh persepsi pola pembayaran persalinan terhadap kepuasan kerja bidan di Kabupaten Kotawaringin Timur dan 2) untuk mengeksplorasi pelaksanaan pola pembayaran persalinan di Kabupaten Kotawaringin Timur. Metode : Penelitian menggunakan rancangan cross-sectional kuantitatif dan juga pendekatan kualitatif. Pengumpulan data dari responden menggunakan kuesioner tertutup terhadap 107 orang bidan yang bertugas di Kabupaten Kotawaringin Timur. Pendekatan kualitatif menggunakan diskusi kelompok terfokus dengan bidan dan wawancara dengan kepala Puskesmas, kasubdin kesga, kepala dinas kesehatan dan kepala PT. Askes. Penentuan peserta diskusi kelompok terfokus dengan cara purposive sampling. Sebanyak 38 orang bidan di Puskesmas dan bidan di Polindes yang bertugas di daerah perkotaan, terpencil dan sangat terpencil dengan cakupan pelayanan persalinan terendah dan tertinggi. Alat ukur penelitian berupa kuesioner, pedoman diskusi kelompok terfokus dan pedoman wawancara. Data kuantitatif dianalisa dengan uji statistik one sample t-test, korelasi product moment, anova satu jalur dan general linier model-univariate. Hasil penelitian : Bidan di perkotaan mempunyai persepsi yang baik terhadap keadilan dan prosedur pembayaran pola pembayaran persalinan pada waktu dikelola PT. Askes. Bidan di pedesaan mempunyai persepsi yang baik terhadap besaran pola pembayaran persalinan pada waktu dikelola PT. Askes. Pola pembayaran persalinan pada waktu dikelola PT. Askes maupun Puskesmas belum memberikan kepuasan kerja pada bidan. Tidak ada hubungan yang signifikan antara persepsi pola pembayaran persalinan dengan kepuasan kerja bidan. Tidak ada hubungan yang signifikan antara karakteristik bidan dengan kepuasan kerja bidan. Ada hubungan yang signifikan antara persepsi keadilan pola pembayaran persalinan dengan kepuasan kerja bidan.

Background: One of the sevices covered by health insurance programs for poor communities at District of Kotawaringin Timur in 2005 was childbirth service. Midwives had different perceptions about the payment for childbirth assistance, under payment scheme by PT. Askes or through Community Health Centers. Objective: 1) To find out the influence of perception about childbirth payment scheme to job satisfaction of midwives at District of Kotawaringin Timur and; 2) To explore the implementation of childbirth payment scheme at District of Kotawaringin Timur. Method: The study used cross-sectional quantitative design and also qualitative approaches. The respondents of closed questionnaires were all 107 midwives working in Kotawaringin Timur District. The qualitative approaches used focus group discussions with midwives and interviews with head of Community Health Centers, head of family health sub-office, head of health office and head of PT. Askes. Participants of focus group discussion were purposively chosen. There were as many as 38 midwives of Community Health Centers and those working at the city, remote and isolated areas with lowest and highest coverage of childbirth services. Research instruments consisted of questionnaires, focus group discussion and interview guides. Quantitative data were analyzed using one sample ttest, product moment correlation, one way anova and general linear univariate model statistical tests. Result: Midwives working in urban areas had good perception about fairness and procedures in childbirth payment scheme under management of PT. Askes. Midwives working in rural areas had good perception about the amounth of childbirth payment scheme under management of PT. Askes. Childbirth payment scheme both under management of PT. Askes and Community Health Centers had not provided job satisfaction to midwives. There was no relationship between perseptions on payment scheme and job satisfaction. There was no relationship between characteristics of midwives and job satisfaction. Perceived fairness of compensation for childbirth assistance was the only significant factors related for job satisfaction. Conclusion: Perceived fairness of compensation for childbirth assistance was the dominant factor which influenced job satisfaction of midwives.

Kata Kunci : Kepuasan Kerja,Bidan,Persalinan Masyarakat Miskin,Pola Pembayaran