Sistem kupon pelayanan kesehatan ibu peserta jamkesmas dan kepuasan kerja bidan desa di Kabupaten Bireuan, Propinsi Aceh

NURHIDAYATI, Prof. dr. M. Hakimi, SpOG(K)

2010 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Untuk menjamin akses penduduk miskin terhadap pelayanan kesehatan sebagaimana diamanatkan dalam Undang-Undang Dasar 1945, saat ini pemerintah telah menerapkan program Jaminan Kesehatan Masyarakat (Jamkesmas). Kebijakan pelayanan Jamkesmas yang diterapkan Pemerintah Kabupaten Bireuen dengan sistem kupon pelayanan kesehatan ibu peserta Jamkesmas ini masih belum merata ke semua puskesmas, sehingga berakibat pada perbedaan kepuasan kerja bidan desa. Tujuan: Untuk mengetahui perbedaan tingkat kepuasan kerja bidan desa dalam memberikan pelayanan kesehatan ibu keluarga miskin peserta Jamkesmas di Kabupaten Bireuen, Propinsi Aceh. Metode: Penelitian ini menggunakan metode kuantitatif, yang merupakan penelitian analitik dengan menggunakan rancangan cross sectional. Untuk mengetahui hubungan antara variabel independen yaitu implementasi sistem kupon dengan variabel dependen yaitu kepuasan kerja bidan desa serta pemanfaatan bidan desa oleh masyarakat, insentif yang diterima oleh bidan desa dan hubungan kerja. Metode analisis data pada penelitian ini akan dilakukan antara lain: analisis univariabel, bivariabel dan multivariabel. Hasil: Kepuasan kerja bidan desa di Kabupaten Bireuen terhadap palayanan kesehatan ibu peserta Jamkesmas 61%. Implementasi sistem kupon memiliki hubungan yang bermakna secara statistik dan praktis terhadap kepuasan kerja bidan desa dengan nilai p value <0,001 dan nilai RP sebesar 2,6 (95% CI: 1,73–3,86). Pemanfaatan bidan, insentif dan hubungan kerja juga mempunyai hubungan yang signifikan dengan kepuasan kerja bidan desa. Kesimpulan: Kepuasan kerja bidan desa yang mengimplementasikan sistem kupon pelayanan kesehatan ibu lebih tinggi. Pelayanan kesehatan ibu peserta Jamkesmas dengan menggunakan sistem kupon lebih efektif dan memuaskan bagi bidan desa dalam bekerja, akan tetapi sistem kupon pelayanan kesehatan ibu peserta Jamkesmas belum efektif dan memuaskan bagi masyarakat

Background: To ensure access of poor community to health service as decreed in Fundamental Act 1945, the government has recently implemented Community Health Insurance (Jamkesmas) program in order to improve health service, especially for poor community. However the policy of Jamkesmas service adopted by Bireuen District government using the coupon system has not covered all health centers so that this affects job satisfaction of village midwives. Job satisfaction of village midwives that use coupon system may differ from those that do not use coupon system. Objective: To identify difference in job satisfaction of village midwives in providing health service for mothers from poor community participants of Jamkesmas at District of Bireuen, Aceh Province. Method: The study was analytical that used quantitative method and cross sectional design to identify association between independent variable (coupon system implementation) and dependent variables (job satisfaction of village midwives, utilization of village midwives by the community, incentives received by village midwives and work relationship). Data analysis used univariate to identify proportion of each variable associated with job satisfaction of village midwives, bivariate with chi square and multivariate with logistic regression test. Result: Job satisfaction of village midwives at District of Bireuen with health service for mothers participants of Jamkesmas was 61%. Out of all satisfied village midwives 72.13% of them used coupon system and 27.87% had not used coupon system. Implementation of coupon system statistically and practically had significant association with job satisfaction of village midwives (p=0.000; RP=2.6; 95% CI=1.73-3.86). Utilization of midwives, incentives and work relationship also had significant association with job satisfaction of village midwives. Conclusion: Job satisfaction of village midwives implementing coupon system in health service for mothers was higher. Health service for mothers participants of Jamkesmas using coupon system was more effective and satisfactory for village midwives but not for the community.

Kata Kunci : Kepuasan kerja,Sistem kupon,Jamkesmas