Analisis tarif pelayanan persalinan oleh bidan di Puskesmas Kabupaten Barito Kuala

HUSIN, Amir, Prof. dr. Ali Ghufron Mukti, MSc, PhD

2009 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang : Penetapan tarif pelayanan persalinan oleh bidan di Puskesmas Kabupaten Barito Kuala yang berlaku saat ini masih dirasakan rendah, dengan mengingat harga kebutuhan di sarana kesehatan terutama obat-obatan yang selalu mengalami kenaikan, sehingga dianggap perlu diadakan perubahan tarif pelayanan persalinan oleh bidan di Puskesmas. Rancangan Perubahan tarif nanti berdasarkan Analisis biaya satuan aktivitas dan mempertimbangkan kemampuan dan kemauan masyarakat untuk membayar. Tujuan : Mengetahui besaran biaya pelayanan persalinan normal oleh bidan di Puskesmas dengan menggunakan metode Activity-Based Costing (ABC), dengan memperhatian ATP/WTP masyarakat Metode : Penelitian deskriptif, dengan rancangan studi kasus data dalam bentuk kuantitatif dan kualitatif. Subjek penelitian adalah ibu hamil yang pernah melahirkan dan bukan menjadi peserta anggota Program Jamkesmas, dan pernah melahirkan di tolong oleh bidan. Unit analisis adalah aktivitas bidan dalam melakukan perlayanan persalinan, variabel penelitian meliputi biaya satuan pelayanan persalinan,ATP/WTP dan usulan tarif. Perolehan data ATP/WTP melalui data sekunder dan pengisian kuesioner oleh ibu hamil (responden). Hasil : Dari hasil perhitungan analisis biaya satuan dengan menggunakan metode ABC, diperoleh biaya satuan untuk melahirkan di Puskesmas yang ditolong oleh bidan sebesar Rp. 317.708, sedangkan hasil dari ATP masyarakat sebesar Rp.255.000-300.000, untuk WTP masyarakat Rp.250.000 – 350.000, usulan tarif tahun 2009 Rp.325.000. Kesimpulan : Penetapan tarif No.03 tahun 2006 tentang pelayanan persalinan oleh bidan di Kabupaten Barito Kuala saat ini sebesar Rp. 150.000 perlu segera di revisi, sehingga pemerintah Daerah tidak mensubsidi orang yang mampu.

Background: The determination of maternity service tariff by midwives at health center of District of Barito Kuala presently is relatively low, considering that prices of health facilities particularly drugs are increasing so that it is necessary to adjust tariff of maternity service by midwives of the health center. The draft of tariff changes will be based on analysis of unit cost of activities and take into account community's ability and willingness to pay. Objective: To identify the amount of normal maternity service cost by midwives at the health center using Activity-Based Costing (ABC) method by taking into account ability and willingness to pay of the community. Method: This was a descriptive study with case study design in quantitative and qualitative data. Subject of the study were pregnant mothers that had given birth and did not belong to participants of community health insurance program and were assisted by midwives during childbirth. Analysis unit were activities of midwives in providing maternity service; variables of the study were unit cost of childbirth service, ability to pay/willingness to pay and tariff proposition. Data of ability to pay/willingness to pay were obtained from secondary data and the filling out of questionnaires by pregnant mothers (respondents). Result: The result of calculation on unit cost analysis using ABC method showed that unit cost for childbirth at the health center provided by midwives was as much as Rp 317.708, whereas the result of ability to pay of the community was Rp 225,000 – 300,00 and willingness to pay was Rp 250.000 – 350,000 and proposition of tariff in 2009 was Rp 325.000. Conclusion: The determination of tariff according to Local Government Act No.03 on maternity service by midwives at District of Barito Kuala presently was Rp 150,000. This needed immediate revision so that local government did not give subsidy to people who were able to pay.

Kata Kunci : Analisis biaya,Biaya satuan,Tarif,Activity,based costing,Ability to pay, Keywords: cost analysis, unit cost, tariff, Activity-Based costing, Ability to Pay, Willingness to Pay