FAKTOR-FAKTOR YANG MEMPENGARUHI PERSEPSI MASYARAKAT TERHADAP PERUBAHAN TARIF RETRIBUSI DI PUSKESMAS SEMANU 1 KABUPATEN GUNUNGKIDUL

Bintang Berlian, Sked., dr. Kristiani, SU

2013 | Tesis | S2 Kesehatan Masyarakat/MAK

Latar belakang: Peraturan Daerah Kabupaten Gunung Kidul No. 7 Tahun 2007 tentang Retribusi pelayanan kesehatan di pusat kesehatan masyarakat ditetapkan sebesar Rp. 5.000,-. Pergantian Kepada Daerah (Bupati) pada tahun 2007 telah merubah ketentuan UU tentang retribusi pelayanan kesehatan dengan surat edaran dari Bupati terpilih bahwa tarif retribusi pelayanan di Puskesmas ditiadakan atau gratis. Pada tahun 2011 melalui Peraturan Daerah Kabupaten Gunungkidul Nomor 16 tahun 2011, tarif retribusi Puskesmas sebesar Rp. 9.500,- diberlakukan kembali. Kenaikan tarif Puskesmas pada satu sisi dapat dipandang sebagai sebuah kewajaran untuk menyesuaikan dengan kondisi yang ada, namun di sisi lain kenaikan tarif retribusi akan menimbulkan persepsi yang berlainan pada masyarakat pengguna jasa puskesmas. Berpijak pada permasalahan ini, menarik untuk dikaji tentang faktor-faktor yang mempengaruhi persepsi masyarakat terhadap perubahan tarif di Puskesmas Semanu 1 Kabupaten Gunungkidul. Tujuan penelitian: untuk mengetahui persepsi masyarakat terhadap perubahan tarif di Puskesmas Semanu 1 Kabupaten Gunungkidul. Metode penelitian: jenis penelitian analitik dengan metode kuantitatif didukung kualitatif. Rancangan penelitian cross-sectional, subyek penelitian adalah responden umum yang tidak terjamin asuransi kesehatan yang berada di 3 desa yaitu Desa Semanu, Desa Ngeposari, dan Desa Dadapayu dengan jumlah sampel 95 responden. Instrumen penelitian menggunakan kuesioner dan panduan wawancara. Data kuantitatif dianalisis menggunakan univariat dan bivariat . Hasil penelitian. Responden lebih banyak yang mempersepsikan butuh akan layanan kesehatan (78,9%) dibandingkan yang tidak butuh akan layanan kesehatan (21,1%). Tidak ada perbedaan signifikan antara responden yang setuju dan yang tidak setuju mengenai persepsi tentang kebutuhan layanan kesehatan (p > 0,05). Responden lebih banyak mempersepsikan bahwa responden mampu untuk membayar (81,1%), sedangkan yang tidak mampu untuk membayar (18,9%). Ada perbedaan signifikan antara responden yang setuju dan yang tidak setuju mengenai persepsi tentang kemampuan membayar (p < 0,05). Responden lebih banyak mempersepsikan mutu layanan yang diberikan Puskesmas tidak baik (53,7%) dibandingkan menyatakan baik (46,3%). Tidak ada perbedaan persepsi tentang mutu layanan yang diberikan oleh puskesmas antara responden yang setuju perubahan tarif dan yang tidak setuju perubahan tarif (p > 0,05). Kesimpulan. Persepsi tentang kebutuhan layanan puskemas, persepsi tentang kemampuan membayar dan persepsi tentang mutu layanan yang diberikan Puskesmas terhadap perubahan tarif dapat diindikasikan bahwa responden rata-rata setuju dengan perubahan tarif.

Background: The local regulation of Gunung Kidul district No. 7 of 2007 on the retribution of healthcare in public healthcare centers establishes the healthcare rate of Rp. 5,000. The change in the local head (regent) in 2007 caused the change in the stipulation of the regulation on the retribution of the healthcare service based on the circular of the new regent that the retribution of the healthcare in the primary health is abolished or free. In 2011 a local regulation of Gunungkidul Number 16 of 2011 has been reenacted by applying Rp. 9.500,- as Puskesmas retribution. The increase in the healthcare service rate was in one hand considered as normal to adjust to the existing condition, while in other hand the increase in the retribution would cause different perception of the people using the healthcare service of the clinics. Concerning with the problem, it was interesting to study the perception of the people using the primary health on the change in the healthcare service rate in the primary health Semanu 1 of Gunung Kidul district. Objective: It aimed at examining the perception of the people on the change in the healthcare service rate in the primary health Semanu 1 of Gunung Kidul district. Methode: It was an analytic study with quantitative method supported by qualitative method. It used cross-sectional design. Its subjects were the general patients without health insurance in 3 villages, which were Semanu, Ngeposari and Dadapayu, while there were 95 respondents. The instruments of the study were questionnaire and guided interview. The quantitative data was analyzed using univariat and bivariate methods. Results: There were more respondents with the perception of the need for the healthcare service (78.9%) compare to the need for the healthcare service (21.1%). There was not any significant difference between the respondents who agreed and did not agree with the perception of the need for the healthcare service (p > 0.05). There were more respondents with the perception that they were able to pay the rate (81.1%) and not able to pay it (18.1%). There was a significant difference between the respondents who agreed and did not agree with the perception of being able to pay the rate (p < 0.05). There were more respondents with the perception that the quality of the healthcare service in the primary health was not good (53.7%) compare to good (46.3%). There was not any significant difference of the quality of the healthcare service delivered by the primary health between the respondents who agreed the change in the healthcare service rate and those who did not agree it (p > 0.05). Conclusion: The perception of the need for the healthcare service in the l primary health, the perception of the ability to pay and the perception of the quality of the healthcare service delivered by the clinic on the change of the healthcare service rate could indicate that in general they agreed the change in the rate.

Kata Kunci : Pengguna jasa puskesmas, perubahan tarif