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Visi Indonesia sehat 2010 mengharapkan masyarakat Indonesia dimasa depan melalui pembangunan kesehatan adalah penduduknya hidup dalam lingkungan dan perilaku yang sehat, memiliki kemampuan untuk menjangkau pelayanan kesehatan yang bermutu secara adil dan merata serta memiliki derajat kesehatan yang setinggi-tingginya. Dengan adanya UU Nomor 22 tahun 1999 tentang Pemerintahan Daerah dan UU Nomor 25 tahun 1999 tentang Dana Perimbangan antara Pemerintah Pusat dan Pemerintahan Daerah, diharapkan Pemerintah Daerah Kabupaten lebih aktif melaksanakan pembangunan di bidang kesehatan mulai dari perencanaan, pelaksanaan maupun pengawasan. Puskesmas sebagai ujung tombak pelayanan kesehatan kepada masyarakat lebih meningkatkan perannya sebagai pusat pembangunan kesehatan, pusat pembinaan peran serta masyarakat serta pusat pelayanan kesehatan tingkat pertama dengan cara meningkatkan sistim manajemen sumberdaya, khususnya manajemen peralatan Puskesmas. Penelitian ini bertujuan untuk mendapatkan secara rinci proses manajemen peralatan di Puskesmas Inderalaya, Puskesmas Tanjung Raja dan Puskesmas Tanjung Lubuk Kabupaten Ogan Komering Ilir. Dalam mendeskripsikan proses manajemen peralatan Puskesmas yang digunakan dalam penelitian ini adalah pendekatan evaluasi dimensi kesesuaian (appropriateness) dan dimensi kecukupan (adequateness). Penelitian ini dirancang dengan pendekatan kualitatif dilakukan pada bulan April sampai Mei 2002 dengan subjek penelitian adalah Pimpinan Puskesmas, Bendaharawan barang dan koordinator program, masing-masing 1 (satu) orang untuk tiap Puskesmas. Dari hasil penelitian dapat disimpulkan bahwa kesesuaian dan kecukupan faktor dalam kajian manajemen peralatan di 3 (tiga) Puskesmas telah sesuai dan cukup. Sedangkan faktor pemanfaatan dan pemeliharaan hanya Puskesmas Inderalaya yang sesuai dan cukup. Demikian juga Pimpinan Puskesmas diharapkan membina stafnya terus menerus, meningkatkan keterampilan petugas pengelola peralatan Puskesmas dengan cara mengirim petugas tersebut untuk mengikuti pelatihan baik di kabupaten maupun propinsi, sehingga nantinya diharapkan manajemen peralatan Puskesmas sebagai bagian dari sistim manajemen sumberdaya Puskesmas tujuannya akan betul-betul tercapai.
Evaluation of Equipment Management System in Community Health Center of Indralaya, Tanjung Raja and Tanjung Lubuk, at the District of Ogan Komering Ilir Year 2001The vision of "Healthy Indonesia Year 2010" expects that the health development of the future Indonesia will construct healthy community and nation which are indicated by people living in healthy environment, applying healthy behavior, and able to access to health services equitably. The Law No. 22, 1999 about Local Government and the Law No. 25, 1999 about the Fiscal Balance of Central and Local Government outlined that Local Government at the district level to be more active on undertaking health development including planning, implementing, and controlling. Community Health Center (PUSKESMAS) as the main community health services should play more important role as the center of health development, the community participation and center of primary health services by improving its management system of resources especially the management of PUSKESMAS equipment. This research aims to get the detail information about management system of equipment in PUSKESMAS of Indralaya, Tanjung Raja, and Tanjung Lubuk at the District of Ogan Komering Ilir. To describe the process of PUSKESMAS equipment management, this research used the appropriateness and adequateness dimension evaluation approaches. This research was designed with qualitative approach that conducted during April and May 2002. Subject of this research were the head of PUSKESMAS, commodities treasurer, and program coordinator, and respectively one person in each PUSKESMAS. The result of the research concluded that the appropriateness and adequateness of input factors of equipment management in the three PUSKESMAS has been appropriate and adequate, while the process factor, especially the utilization and maintenance, only PUSKESMAS of Indralaya which is appropriate and adequate. It is gratefully hoped that the head of PUSKESMAS could guide his staff continuously and increase the skills of the worker who uses and maintains the PUSKESMAS equipment by sending him to get such training either in district or provincial level. Thus, the purpose of PUSKESMAS equipment management as the part of resources management system of PUSKESMAS will be reached.
Public health center as the &ont line in health development must increase management execution so that in conduct health service can in an optimal fashion. Not yet activity program achievement pickings the maximal at public health center exist in Tasikmalaya regency, show that utilization public health center as according to the fimction by society not yet optimal, mean that performance public health center in this case concem management execution public health center at Tasikmalaya regency still necessary increased again, because function and good management execution very influential towards success a program or well~being efforts that done public health center. Central figure in management execution that is head public health center, there education background medical scholar, society health scholar, and general scholar/nurse. This research aims to detect description management process execution at public health center and factors that connected management process public health center that lead by head public health center that background education differ at Tasikmalaya regency in year 2006, with system approaching consist of input variable (human resource : official total, leadership, erudition, motivation, double function, work load, repaymenthncentive, limd, and infrastnicnue tools), process (planning, activation and execution, monitoring, controlling, constmction, and evaluation) and output variable (perfomiance public health center). This research is done with qualitative approach with analytic plan passes in-depth interview, observation, and document study in six public health center that canvassed, and research time in April and May 2007. From result research inferential that in carry out management function at public health center, each public health center both for led by education medical scholar, society health scholar, and general scholar/nurse, in apply strategy, integrate and coordinating, motivating, overcome conflict, ascertain activity execution, and evaluate activity result, very various, but in principle that all can done in the effort subsidize management iiinction execution at public health center. As to lixctors that management execution public health center, with deficit existence or energy limitedness or human resource either through also quality, directly also not direct influence management function execution at public health center, also operational fund public health center that felled less, for infrastructure tool, physical building Karangjaya public health center improper wear, construction under communication from regcncy health senrice. also not yet optimal. in management function execution, begin from planning/PZKT, activation and execution that is workshop monthly at public health center, supervision, control, constmction, and evaluation, each public health center carry out, but in the case of the execution not yet optimal, especially in planning/P2l
Hasil penelitian menunjukan bahwa distribusi biaya yang dapat disediakan oleh masyarakat untuk setiap kali kunjungan di BP Umum minimum Rp.2.000, maksimum Rp.25.000, rata-rata Rp 9.200, Periksa kehamilan, bayi & anak minimum Rp.2.000, maksimum Rp.20.000, rata rata Rp 9.850, dan bila sakit gigi minimum Rp.3.000, maksimum Rp25.000; rata-rata Rp.10.050, dengan harapan adanya peningkatan kualitas layanan dan selalu diperiksa oleh dokter serta obat yang memadai. Hasil simulasi tarif dibandingkan biaya satuan normatif, tarif pesaing dan ATPI, maka tarif yang dapat direkomendasikan adalah untuk BP Rp 5.000, KIA, Rp 9.000, dan BP Gigi Rp. 12.500. Masyarakat yang tersingkir perlu diberikan subsidi silang, melalui upaya kartu sehat yang pengaturannya ditentukan bersama dengan pemerintah kecamatan dan desa. Puskesmas merupakan pilihan utama masyarakat Lubuk Alung Kabupaten Padang pariaman untuk mendapatkan pelayanan kesehatan. Masalah ini karena biaya puskesmas terjangkau, serta lokasi puskesmas dengan sarana transportasi relatif lancar.
In performing the price determination of public health center it is done in an arbitrary and political consideration, So that price of public health center services in is felt no Rational. The rational is price that try to consumer surplus. There are several factors to determine a rational price. One of them is determined based on public ability and willingness to pay for the health service, competitors price, and unit cost. With the ratification of Law No. 22 year 1999 regarding Regional Autonomy, the districts goverment is demanded to explore its own financial sources for its operations. The public health center is performing its 18 major programs needs a large amount of money, while the subsidy from the government is insufficient. While it must improve the quality of its services. So, one of the way to adjust the health community center according to the self-financing policy or pure self-financing is the recalculation of the actual rate of the health community services that must be paid by the customer. This research is a descriptive analysis by using Cross-Sectional method. It user interview to collect data interviview is conducted with visitors of public health center in the last month before the research is done.
The result of the research indicates that the cost distribution that can be covered by the people for each visit to General Health Clinic is at minimum of Rp. 2.000; and maximum Rp. 25.000; and average Rp. 9.200.- Mother and children care consultation at minimum of Rp 2.000.- and maximum Rp. 20.000.- and average Rp. 9.850.-, dental health care at minimum of Rp. 3.000.- and maximum Rp. 25.000.-and average Rp. 10.500.- , with the expectation that the quality of service will increase and always examine by doctors with sufficient medicines. The result of price simulation compared to normative unit - cost, the competitor's price ATP1 indicate that the price to be recommended for Health Clinic is Rp. 5.000.-, Mother and Children Health Clinic is Rp. 9.000: and Dental Clinic is Rp. 12.500. The disadvantaged people need to subsidized with cross-subsidy through health card, the arrangement of which can be done with the local government of sub-district and village. The public health center is the main choice of the people of Lubuk Alung, Padang Pariaman district to obtain health services, because the price of public health center reached and its location is accessible with relatively smooth transportation.
Penelitian ini merupakan penelitian deskriptif analisis dengan rancangan cross sectional. Data yang digunakan adalah data sekunder untuk pusat-pusat biaya dan untuk menentukan ATP (kemampauan membayar masyarakat) dipakai data Susenas 1999 dan data pengunjung Puskesmas. Data primer dilakukan dengan wawancara terpimpin dengan memakai kuesioner. Perhitungan biaya satuan pelayanan didapatkan dari analisis biaya dengan metode double distribution sedangkan analisis tarif dikembangkan melalui simulasi tarif.
Hasil penelitian menunjukkan bahwa biaya satuan aktual tanpa Annualized Fixed Cost (AFC) dan gaji di Unit BP adalah Rp. 2.617,34 untuk KIA Rp. 3.630,14 dan untuk poli gigi Rp. 5.074,55. Biaya satuan normatif untuk unit BP adalah Rp. 4.603,96 untuk KIA Rp. 7.850,65 dan poli gigi Rp. 12335,55. Biaya satuan yang didapatkan ini lebih besar dari tarif yang berlaku sekarang yang hanya Rp. 1.500.
Dari simulasi tarif di unit pelayanan BP, KIA dan Poli Gigi maka tarif yang rasional, untuk unit BP adalah Rp. 3.000,-dengan jumlah pengunjung Puskesmas yang mampu membayar adalah 97% dan Cost Recovery Rate (CRR) 108,18% untuk unit KIA adalah Rp. 4.000,- dengan jumlah pengunjung yang mampu membayar adalah 97% dan CRR 103,88% dan untuk poli gigi (pengobatan) adalah Rp. 6.000,- dengan jumlah pengunjung Puskesmas yang mampu membayar 94% dan CRR 105,14%. Hasil penelitian ini dapat dijadikan pertimbangan oleh Pemerintah daerah Kota Solok dalam menetapkan tarif rawat jalan di Puskesmas.
The Analysis of the Pricing Policy Outpatient Service Based on Unit Cost and the People Ability to Pay in Community Health Center, Tanjung Paku, Solok at the Year 1999/2000Determination of health care fee in Tanjung Paku Community Health center has not referred unit cost analysis of service and the people ability to pay. In order to know whether the current rate have approached unit cost of service and the people ability to pay and how rational rate in the Community Health Center in Tanjung Paku has done it, a research/analysis regarding this rate has been done in work area of Community Health Center in Solok.
This research is a descriptive analysis with cross-sectional design. The data used is secondary data for cost centers and to determine ATP (the people Ability To Pay) National Census 1999 data is used and data of the Community Health Center. The primary data is obtained by service unit cost is obtained from cost analysis by using double distribution method, while the rate analysis is developed by using rate simulation.
The result of research indicates that the actual unit cost without Annualized Fixed Cost (AFC) and the salary in General Policlinic unit is Rp. 2.617,34 Mother and Children Welfare section is Rp. 3.630,14,- and Dentist Policlinic is Rp. 5.074,55. The normative unit cost for General Policlinic unit is Rp. 4.603,96, Mother and Children Welfare section is Rp. 7.850,65,- and Dentist Policlinic is Rp. 12.735,55. The unit cost obtained is larger than the present rate is only Rp. 1,500,-.
From simulation of rate determination in General Policlinic is Rp. 3.000,- the patient that is able to pay 97% with Cost Recovery Rate (CRR) 147,47%, Mother and Children Welfare section is Rp. 4.000.- the patient that is able to pay 97% with CRR 103,88% and for Dentist Policlinic is Rp. 6.000,- the patient that are able to pay is 94% with CRR 105,14%. The Government of Solok Municipality in determining outpatient service rate in the Community Health Center can use the result of this research as consideration.