IMPLEMENTASI PROGRAM JAMINAN PEMELIHARAAN KESEHATAN BAGI MASYARAKAT MISKIN YANG MENJALANI RAWAT INAP DI RSUD JAYAPURA

Guy Yana Emma Come, Prof. dr. Laksono Trisnantoro, M.Sc., Ph.D.

2011 | Tesis | S2 Kesehatan Masyarakat/MMPK

Latar belakang Masalah: Menurut data BPS provinsi Papua tahun 2006 di Papua terdapat kurang lebih 80% rumah tangga miskin. Salah satu program penanggulangan kemiskinan dari pemerintah pusat adalah program JAMKESMAS. Rumah Sakit Umum Daerah (RSUD) Jayapura sebagai rumah sakit pemerintah menggunakan program JAMKESMAS sebagai salah satu program dalam memberikan pelayanan kesehatan bagi masyarakat miskin yang menjalani rawat inap. Tujuan Penelitian: Untuk mengetahui bagaimana efektivitas implementasi program JAMKESMAS (jaminan pemeliharaan kesehatan bagi masyarakat miskin) bagi masyarakat miskin yang menjalani rawat inap di RSUD Jayapura. Metodologi: Penelitiaan deskriptif, dengan pendekatan kualitatif, menggunakan rancangan studi kasus. Adapun yang menjadi kasus dalam penelitian ini mengenai bagaimana implementasi kebijakan pemeliharaan kesehatan bagi masyarakat miskin yang menjalani rawat inap. Pengumpulan data melalui observasi dan wawancara mendalam (interview), dengan melalui pengkajian terhadap sistem yang sedang berjalan. Hasil Penelitian: Implementasi program JAMKESMAS di RSUD Jayapura diupayakan untuk memenuhi semua ketentuan dalam pedoman pelaksanaan JAMKESMAS. Organisasi pelaksana dibentuk mengikuti desain pusat, dan menjalankannya sebatas mematuhi instruksi . Sumber daya manusia pengelola program kurang siap karena sosialisasi dari pemerintah pusat dirasa kurang serta aplikasi JAMKESMAS yang digunakan sering diubah-ubah tanpa disertai sosialisasi yang cukup. Pemerintah daerah kurang mendukung program ini, terutama dari penetapan kepesertaan dan pendanaan. Tim verifikator independen sangat minim sarana sehingga mendapat kendala teknis dalam bekerja. Verifikasi administrasi yang sangat ketat berdampak pada terjadinya efisiensi dana dan rumah sakit “dipaksa” lebih tertib administrasi tetapi disisi lain menjadi halangan bagi sekelompok masyarakat miskin untuk memdapat pelayanan yang lebih optimal bila menjalani rawat inap di RSUD Jayapura. Kesimpulan: Implementasi program JAMKESMAS di RSUD Jayapura sudah mengikuti pedoman pelaksana JAMKESMAS tahun 2009 terutama terhadap standar kepesertaan dan standar pelayanan namun dalam pelaksanaannya masih banyak kendala teknis seperti kurangnya pengetahuan dan ketrampilan SDM pelaksana, sosialisasi program dari Tim Pusat yang belum akurat, sistem penunjang lainya di rumah sakit belum mendukung, serta belum ada dukungan pendanaan dari pemerintah daerah.

Background: Government owned hospital Jayapura was established by the Dutch government in the year of 1956. It was established base on humanitarian value and therefore non-profit oriented organization. Communities participation was still very low and even they did not have enough buying power to access a qualified health service. This was supported by statistic data that was issued by BPS (statictic bureau) of Papua province in the year of 2006 which mentioned that there were more or less 80% of poor households. One of the programs that were use to give health service for the poor who had in patient treatment was health insurance for the poor program, called JAMKESMAS. Objective: to invertigate effectiveness of the JAMKESMAS program for the poor who had in-patient in RSUD Jayapura. Methodology: This is a case study, descriptive research with qualitative approach. Data was gathered through in-depth interview that focused on how the system is working. Result: The implementation of JAMKESMAS program supposed to be in line with the guidance that was already issued. The organizational arrangement was determined by the central government, and it was like a bureaucratic machine. The human resources were not well prepared due too lack of proper disseminasion from the central government. The software was frequently changed without prior information. Local government was not supportive for the program, easpecially in terms of membership selection and financing. The verification team was short of infrastructure, and experienced technical difficulties while working. Administrative verification was very strict and the impact was financial efficiency. The hospital was “forced” to be administratively correct, while on the other hand the poor had obstacles in accessing optimum services when they are admitted to in-patien care in the hospital (RSUD Jayapura) Conclusion: The implementation of JAMKESMAS program in RSUD Jayapura was following guidelines of JAMKESMAS program in 2009, although there are still any problems that similar with knowledge and skill of human resources, the others supporting system have not supported and the program was not supported by the provincial government”s budget of Papua.

Kata Kunci : Masyarakat Miskin, Program JAMKESMAS, RSUD Jayapura