Analisis Investasi Pengembangan Pelayanan Umum di Rumah Sakit Jiwa Madani Daerah Propinsi Sulawesi Tengah

HIDAYAT, Teguh, dr. Andung Prihadi S., M.Kes

2008 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang : Desentralisasi tahun 2001 diikuti penyerahan pengelolaan 25 rumah sakit jiwa ke pemerintah daerah beserta pengelolaan anggarannya, anggaran rutin turun sebesar 58 % dan anggaran pembangunan turun sebesar 65 %, beberapa rumah sakit jiwa daerah mencoba untuk mengembangkan usaha yang berorientasi bisnis utama atau membuka pelayanan umum. Rumah Sakit Jiwa Madani mengembangkan pelayanan umum pada 4 bidang keahlian dasar. Kebijakan ini berdampak pada pengeluaran biaya dan tenaga yang besar tanpa didukung oleh studi kelayakan sehingga investasi yang telah dilakukan ini perlu dinilai. Tujuan : Menilai kelayakan investasi pembukaan pelayanan umum di RSJ Madani ditinjau dari aspek keuangan dan aspek regulasi. Metode Penelitian : Penelitian ini merupakan penelitian deskriptif kuantitatif dengan rancangan studi kasus pada kasus tunggal terpancang. Data yang dikumpulkan bersifat kualitatif dan kuantitatif. Pengumpulan data kualitatif menggunakan teknik purposive sampling. Subyeknya pengelola keuangan, pengelola barang dan pengelola data rekam medik di rumah sakit jiwa Madani serta pemangku kepentingan sedangkan yang menjadi obyek biaya investasi gedung, biaya investasi peralatan, data – data arus kas, daftar inventarisasi barang dan jumlah pasien. Variabel penelitian ini adalah kelayakan investasi, PP 23/2005 tentang BLU, Perda 5/2006 tentang RPJM propinsi Sulawesi Tengah , arus kas, payback periode, net present value,return of investment, analisis sensitifitas. Data sekunder berupa laporan hasil kinerja unit pelayanan umum, biaya pengadaan alat dan gedung, biaya pemeliharaan alat dan gedung, tarif pelayanan dan laporan penerimaan keuangan, data dari tahun 2003 sampai dengan 2006, data primer berupa tanggapan pemangku kepentingan. Investasi dikatakan tidak layak jika NPV negatif dan jika NPV positif maka investasi yang telah dilakukan adalah layak. dan dilakukan analisis sensitifitas serta menilai dukungan pemangku kepentingan. Hasil dan Pembahasan : Outlays Investment sebesar Rp. 5.305.517.556,-di tahun pertama (2003) dengan payback period selama 11 tahun 1 bulan, net present value positif dengan discount rate 8 % dan return of investment 11,8 % pada estimasi investasi selama 20 tahun, analisis sensitifitas pada keadaan penerimaan dan pengeluaran naik dan turun pada kisaran 5 – 10 % menghasilkan NPV positif dan negatif, analisis kualititatif menunjukkan dukungan pemangku kepentingan terhadap 2 peraturan yang diminta tanggapannya. Kesimpulan : Investasi pengembangan pelayanan umum di rumah sakit jiwa Madani layak dari aspek keuangan dan mendapat dukungan dari pemangku kepentingan dari aspek regulasi.

Background : Decentralization in the year of 2001 was followed with hand over of 25 mental hospitals management as well as financial management to the regional government, the routine budget was decreased up to 58 % and the development budget was decreased up to 65 %, some mental hospitals in the area was trying to develop the main business oriented effort or public service. The mental hospital of Madani developed the public service in 4 basic fields. This policy was affected on cost expenditure and great authority without supported by feasibility study, so that the conducted investment needs to be examined. Objective : This research was examined the feasibility of public service opportunity investment in mental hospital of Madani that was observed from financial and regulation aspects. Method : This was a quantitative descriptive research that used case study design in single case study. The collected data was qualitative and quantitative. The collection of qualitative data was using purposive sampling technique. The subject was manager of finance, procurement and medical record data in mental hospital of Madani as well as decision maker while the project was investment cost for building, equipment investment cost, data of cash flow, list of goods inventarisation and the number of patient. The variabel of this research was investment feasibility, PP 23/2005 on BLU, regional regulation 5/2006 on RPJM province of central Sulawesi, cash flow, payback period, net present value, return of investment and sensitivity analysis. The secondary data was report result of performance of public service unit, procurement cost, maintenance cost, tariff for service and report of financial acceptance, data from year 2003 up to 2006, and the primary data that was responded by policy maker. The investment was know as insufficient when NPV negative when NPV positive, the conducted investment was sufficient. Sensitivity analysis was conducted as well as examined the support from policy maker. Result and Discussion : Outlay investment was Rp. 5.305.517.556,- in the first year (2003) with payback period during 11 years 1 month, net present value was positive with discount rate 8 % and return of investment was 11.8 % in the investment estimation during 20 years, sensitivity analysis on condition of income and expenditure was in the range of 5 – 10 % and created NPV positive and negative. Qualitative analysis showed support of policy maker toward 2 regulation that asked for response. Conclusion : Investment on the development of public service in mental hospital of Madani from the financial aspect was sufficient and obtained support from policy maker from the aspect of regulation.

Kata Kunci : Investasi, kelayakan, regulasi payback period, analisis sensitifitas, Investment, feasibility, payback period, regulation, net present value, return of investment, sensitivity analysis