Evaluasi kinerja Badan Rumah Sakit Umum Daerah Wonosobo sebagai rumah sakit daerah unit swadana
PRAMAAN, Dibyo Astu Sigit, Agastya, SE., MBA., MPM
2009 | Tesis | S2 IKM/MMRLatar belakang : Kebijakan RS Daerah menjadi unit swadana merupakan upaya dalam menyikapi kebijakan otonomi daerah yang cenderung berdampak pada berkurangnya subsidi pemerintah untuk RS. Kebijakan swadana memacu manajemen RS untuk lebih inovatif dan kreatif dalam mengelola dan mengembangkan potensi dan sumber daya RS secara efisien untuk meningkatkan kinerja RS (kinerja keuangan, kinerja pemberdayaan SDM dan kinerja produktifitas). Sejak kebijakan swadana diterapkan Tahun 2001, evaluasi implementasi kebijakan swadana terhadap kinerja BRSD Wonosobo belum pernah dilakukan. Maka perlu ada evaluasi terhadap kinerja RS. Tujuan penelitian untuk mengetahui kinerja RS sebelum dan sesudah kebijakan swadana diterapkan serta untuk mengetahui apakah implementasi kebijakan swadana erpengaruh terhadap kinerja BRSD Wonosobo. Metode Penelitian : Penelitian ini adalah penelitian non eksperimental dengan rancangan penelitian ex post facto yaitu mengidentifikasi akibat-akibat dari penerapan kebijakan swadana yang menjadi obyek penelitian dan melakukan wawancara mendalam dengan Bupati, Direktur RS, Ketua Komite Medik, Kabag Keuangan, Kabid Keperawatan serta rekanan RS. Kinerja produktifitas yang diteliti; jumlah pasien rawat jalan dan rawat inap, BOR,LOS,TOI,NDR dan GDR. Kinerja Finansial yang diteliti ; pendapatan RS dan pendapatan instalasi penunjang (revenue centre). Kinerja pemberdayaan SDM yang diteliti yaitu jumlah dana, jumlah peserta Diklat tiap tahun dan proses rekruitmen SDM RS. Data kualitatif dianalisa dengan membandingkan kesesuaian pola (patern matching),antara data yang ada dengan pola standard/ yang diperkirakan sedangkan data kuantitatif dilakukan analisa rangkaian waktu. Hasil : Hasil penelitian menunjukkan perubahan jumlah pasien rawat jalan (21,1%),rawat inap (23,4%),BOR (4,8%),LOS (1,6%),TOI (-13,0%),NDR (-5,1%) dan GDR (-2,3%). Hasil penelitian kinerja finansial yaitu ; perubahan rata-rata dari instalasi farmasi (200,3%), laboratorium (148,4%), radiologi (159,3%) dan cost recovery (1,7%). Peningkatan Kinerja pemberdayaan SDM ; anggaran naik 23,3% dan jumlah peserta Diklat naik rata-rata 28,3% per tahun. Tingkat implementasi kebijakan swadana di BRSD Wonosobo tergolong rendah sehingga tingkat otonomi RS juga rendah. Kesimpulan : Kinerja BRSD Wonosobo 2001-2007 meningkat karena kinerja pengelola/ managemen RS yang baik, bukan karena dampak implementasi kebijakan swadana. Hal ini karena tingkat implementasi kebijakan swadana di BRSD Wonosobo tergolong rendah/ sangat terbatas.
Background : The policy of regional hospital to become a self funding unit is an effort in facing the policy of regional autonomy that could affected on the decreasing of subsidy from government for hospital. The self funding policy triggered the hospital management to be more inovative and creative in managing and developing the potency and resources of hospital in improving hospital’s work performance efficiently (work performance of finance, human resources empowerment and productivity). Since the self funding policy was applied in the year of 2001, evaluation on it’s implementation toward the board of government owned hospital (BRSD) Wonosobo was never been implemented. Therefore, evaluation toward the work performance of hospital need to be done. The research objective was to find out hospital’s work performance before and after the self funding policy that was applied as well as to find out whether the implementation of self funding policy was influenced the work performance of BRSD Wonosobo. Method : This was a non experimental research that used ex post facto design that was identifying the impacts of self funding policy application that becomes research object and it was conducted with indepth interview toward regent (bupati), hospital director, head of medical committee, head of financial division, head of nursing division and hospital colleagues. The productivity work performance that was examined was the number of out patient and in patient treatment, BOR,LOS,TOI,NDR and GDR. The financial work performance that was examined was hospital income and revenue centre. The work performance of human resources empowerment that was examined was the amount of funding, the number of education and training participant every year as well as recruitment process of human resources in hospital. The qualitative data was analysed with pattern matching between the existing data and the estimated standard method and quantitative data was analysed with time frame. Result : The research result showed that the changes on the number of out patient treatment patient was 21,1%, in patient treatment was 23,4%,BOR was 4,8%,LOS was 1,6%,TOI was -13,0%, NDR was -5,1% and GDR was -2,3%. The research result of financial performance was the average changes from pharmaceutical installation (200,3%), laboratory (148,4%), radiology (159,3%) and cost recovery (1,7%). The improvement of human resources empowerment performance was that the budget was increased up to 23,3% and the number of education and training participant was increased in average of 28,3% annually. The implementation level of self funding policy in BRSD Wonosobo was considered as low so that the level of hospital autonomy was also low. Conclusion : The work performance of BRSD Wonosobo in the year of 2001- 2007 was improved because of the better work performance of hospital management instead of the impact of self funding policy implementation. This was because of the implementation level of self funding policy in BRSD Wonosobo was considered as low/very limited.
Kata Kunci : Implementasi kebiajkan swadana,Evaluasi kinerja,Kinerja finansial,Kinerja produktifitas
