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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.
Cakupan Peran Serta Masyarakat di Kabupaten Subang masih rendah, salah satu penyebab dari permasalahan tersebut berhubungan dengan kemampuan manajerial kepala Puskesmas. Berkaitan dengan hal tersebut maka dilakukan penelitian yang bertujuan untuk mendapatkan gambaran mengenai faktor-faktor yang berhubungan dengan kemampuan manajerial kepala Puskesmas dalam penggerakan masyarakat di Kabupaten Subang pada Tahun 2006. Dengan mempelajari hubungan antara kemampuan manajerial kepala Puskesmas tersebut dengan faktor internal yang terdiri dari Umur, Pendidikan dan Lama kerja serta faktor eksternal yang terdiri dari Supervisi, Pelatihan, Umpan balik dan Sarana kerja. Dalarn penelitian ini pendekatan yang digunakan adalah pendekatan kualitatif, dimana data yang dikumpulkan berupa data primer yang didapat melalui kegiatan wawancara mend alam dan Focus Group Discussion dengan informan dari Dinas Kesehatan, Kepala Puskesmas dan Tokoh Masyarakat, sedangkan data sekunder diperoleh melalui kegiatan penelusuran dokumen baik di tingkat Dinas Kesehatan maupun Puskesmas yang menjadi lokasi penelitian. Dari wawancara mendalam dapat diketahui bahwa rendahnya cakupan peran serta masyarakat dipicu oleh beberapa permasalahan mendasar, selain karena kualitas dan kuantitas tenaga kesehatan yang ada masih sangat terbatas, kemampuan manajerial kepala Puskesmas sebagai pimpinan tertinggi di wilayah kerjanya juga rata-rata masih kurang, mereka belum mampu memaksimalkan potensi yang ada untuk membantu pelaksanaan program Puskesmas. Hasil penelitian menunjukan bahwa dari ketiga faktor internal yang diteliti ternyata faktor yang tampak cenderung berhubungan dengan kemampuan manajerial kepala Puskesmas dalam penggerakan masyarakat adalah faktor lama kerja. Sedangkan dari keempat faktor eksternal temyata tidak ada satupun yang mempengaruhi kemampuan manajerial kepala Puskesmas dalam penggerakan masyarakat. Saran yang dapat disampaikan berdasarkan hasil penelitian ini ditujukan kepada pihak Dinas Kesehatan sebaiknya mempertimbangkan faktor-faktor tersebut diatas terutama lama kerja pegawai dalam pengangkatan Kepala Puskesmas di wilayah kerjanya. Disamping itu sebaiknya pihak Dinas lebih menyeimbangkan porsi pelatihan antara pelatihan teknis medis dengan pelatihan manajemen, khususnya mengenai manajemen dalam peningkatan peran serta masyarakat.
Public Cooperation in health sector in Subang distric still far from adequate, one of the causes from those problems related with Puskesmas chief managerial ability. Related with those cases then done research that aim to get the view about related factors related with Puskesmas chief managerial ability in moving society Subang distric in year 2006. By learn the relation between Puskesmas chief managerial ability along with internal factor that consist of Age, Education, and Working Length and also external factor that consist of Supervision, Training, Feedback and Working tools. In this research, approach that used is qualitative approach, where collected data is primary data that got from deep interview activity and Focus Group Discussion with informant from Health Agency, Puskesmas Chief and Public Figure, while secondary data got from document study activity whether in Health Agency or Puskesmas that become research location. From deep interview also known that public cooperation in health sector still far from adequate those cases triggered by some basic problems, besides quality and quantity of health source that still limited, Puskesmas chief managerial ability as highest leader in his working area even still low, they not yet can maximize available potency to help in conduct Puskesmas program. Research result be known that from three researched internal factor obviously factor that affect Puskesmas chief managerial ability in moving society is working length. While from four external factors obviously no one that affect Puskesmas chief managerial ability in moving society. Suggestion that can be submitted based on this research result showed to Public Health office is better considering those factors especially employee working length in giving position of Puskesmas Chief in his working area. Besides, Agency should balance training portion between medical techniques with management training, especially about management in improving public role.