Pelayanan Gratis di Puskesmas Sikijang Kabupaten Pelalawan Propinsi Riau
AZNAR, dr. Kristiani, SU
2008 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar Belakang: Program Puskesmas Gratis menyebabkan peningkatan jumlah kunjungan pasien dan menambah beban kerja pada petugas kesehatan di Puskesmas Sikijang. Ada penambahan beban kerja tetapi insentif yang diterima petugas masih kurang memuaskan sehingga kemungkinan akan menurunkan kualitas pelayanan kesehatan bagi masyarakat. Tujuan: Untuk mengetahui persepsi pasien terhadap mutu pelayanan gratis di Puskesmas Sikijang. Metode: Penelitian ini menggunakan studi kasus serta menggunakan metode pengumpulan data kuantitatif dan kualitatif. Instrumen penelitian yang digunakan adalah kuesioner dan pedoman wawancara dan FGD. Subjek penelitian adalah petugas dan pasien yang memanfaatkan puskesmas. Hasil: Pelaksanaan program puskesmas gratis mengakibatkan terjadi peningkatan jumlah pasien dan akhirnya meningkatkan beban kerja pada petugas di puskesmas yang pada akhirnya menurunkan mutu pelayanan pada pasien di Puskesmas Sikijang. Persepsi pasien terhadap mutu pelayanan rendah. Ini dapat dilihat dari 5 item penilaian persepsi pasien. Petugas di Puskesmas Sikijang kurang puas bekerja setelah dikeluarkannya kebijakan program puskesmas gratis karena peningkatan jumlah pasien yang tinggi namun tidak diikuti dengan pemberian insentif yang memadai.Pola penyakit di Puskesmas Sikijang setelah dikeluarkannya kebijakan program puskesmas gratis dengan sebelum dikeluarkannya Program Puskesmas gratis tidak terdapat perubahan yang signifikan, tetapi ada muncul penyakit berbasis lingkungan yaitu scabies , sedangkan pola kunjungan pasien baru pada awal pengobatan gratis meningkat tetapi pada tahun selanjutnya menurun dan terjadi peningkatan pada pasien lama. Peningkatan pasien tidak memberikan kontribusi kepada PAD karena pasien tidak ditarik retribusi. Kesimpulan: Pelaksanaan kebijakan Program Puskesmas Gratis justru menyebabkan hilangnya kontribusi puskesmas terhadap PAD dan menurunkan kualitas pelayanan kesehatan akibat beban kerja petugas semakin berat sehingga menyebabkan ketidakpuasan petugas dan pasien memiliki persepsi kurang baik terhadap pelayanan Program Puskesmas Gratis.
Background: Free of charge Primary Health Care (Puskesmas) program has increased service utility and improved the workload of health care provider in the Primary Health Care of Sikijang.There is an improvement on work load and yet the incentive still not satisfying the health care provider, so that there is a possibility in decreasing the given health service quality for the community. Objective: This research was aimed to find out perception toward free of charge health service quality in the Primary Health Care of Sikijang. Method: This was a case study that used quantitative and qualitative data. The instrument being used was questioner, indepth interview guidance and FGD. The research subject was health care provider and patients who were utilized the Primary Health Care. Result: The implementation of free of charge Primary Health Care caused improvement in the number of patient which at the end could improve the work load of health care provider in Primary Health Care and could decreased service quality for patient in the Primary Health Care of Sikijang. Patient’s perception toward service quality was low. This can be seen from 5 evaluation of patient’s perception. Health care provider in the Primary Health Care of Sikijang was not satisfied when they had to work after the policy of free of charge Primary Health Care program was launched as the impact of the increasing number of patient and yet it was not followed with sufficient incentive. There was no significant changes of disease pattern in the Primary Health Care of Sikijang before and after the policy was launched and yet there was an environmental based disease that was ocurred such as scabies, however the visit pattern of new patient in the beginning of the treatment was improved and decreased in the year after, and there was an improvement number of old patient. The improvement of patient did not give any contribution toward regional income as the patients were not asked for retribution. Conclusion: The implementation of free of charge Puskesmas program caused the loose of Puskesmas contribution to district’s income and decreased the quality of health service as the impact of health care provider’s work load that was getting heavier that caused unsatisfaction and patients did not have good perception toward the free of charge Puskesmas programs.
Kata Kunci : Pengobatan Gratis,Mutu Pelayanan,Persepsi Pasien, perception to quality service, free medical treatment, and experience being patient
