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The concept of Green Hospital is currently developing a new approach in themanagement of the Hospital. Green hospital is part of a global movement whichis generally known as the Green Building. Utilization of water resources, energy,material nature is a continuous need for the operational needs of the hospital, theyshould based on the principles of eco-efficiency. There is no guidelines in Indonesiaorganized by the government in implementing the concept of Green Hospital.Achievement of Embung Fatimah Batam Hospital in applying the concept of GreenHospital, influenced by the culture that developed, top management policies,human resources, costs and standard operating procedures.The method used is a qualitative and quantitative approaches, methods ofassessment by measuring the assessment of the Green Building criteria are basedon national standards system Greenship GBCI with Indonesia (GBCI). Steps beingtaken is the exploration, namely data collection focused, through interviews to theDirector of Regional General Hospital Embung Fatimah Batam, as well as do alsothe observation of the implementation of the Green Hospital.Regional General Hospital Embung Fatimah Batam total point value of 48 or 41%of the maximum 117 points from the total value of the required criteria inGreenship. Based on the value of the acquisition in accordance with the rankingGREENSHIP GBCI, Regional Hospital Embung Fatimah Batam building getBronze rank. Some of the advantages possessed by Regional Hospital EmbungFatimah Batam include already has Guidelines on Impact renovation orconstruction, Complaint Handling / Maintenance / Repair Facility andInfrastructure, standard operating procedure of clean water management andstandard operating procedure of waste management. To be able to improve theGreenship GBCI ranking, Regional Hospital Embung Fatimah Batam need to dothem to provide public transportation, area of an open green space, replace thebulbs with energy-saving lamps as well as trying to use the technology of solarpanels (solar cell).Key words: Green Building, Green Hospital, Assessment, Sustainability,Performance Management, environmental management, environmental friendly.
ABSTRAK Nama : Tita Rsoita Program Studi : Ilmu Kesehatan Masyarakat Peminatan : Ekonomi Kesehatan Judul : “Implikasi Pelaksanaan Jaminan Kesehatan Nasional Terhadap Kinerja Keuangan : Analisis Laporan Keuangan dan Hospital Base Rate 2 RSUD Tipe C di Jawa Barat “ Pelaksanaan program Jaminan Kesehatan Nasional di Indonesia sejak tahun 2014 telah mengubah sebagian besar pola pembayaran pelayanan kesehatan di rumah sakit dari sistem fee for service menjadi prospective payment system berdasarkan paket INA CBGs. Hal ini memberikan dampak terhadap rumah sakit, terutama rumah sakit milik pemerintah dan pemerintah daerah sebagai provider utama pelayanan kesehatan tingkat lanjut. Diperlukan strategi yang fokus pada peningkatkan kinerja secara terintegrasi untuk meminimalkan cost, merasionalisasi waste, serta meningkatkan efisiensi business process tanpa mengabaikan clinical pathway yang mengacu pada standar pelayanan profesi. Tujuan dari penelitian ini adalah mengetahui pengaruh pemberlakuan JKN terhadap kinerja rumah sakit umum daerah yang meliputi aspek kinerja keuangan dan hospital base rate. Penelitian dilakukan menggunakan data laporan keuangan periode 2012 – 2015 dan data klaim BPJS untuk menghitung hospital base rate di dua RSUD tipe C di kabupaten Sukabumi. Selama periode 2012 – 2015 terjadi kenaikan dari total aset dan aset lancar, terutama kas dan setara kas sangat meningkat setelah pemberlakuan Jaminan Kesehatan Nasional pada tahun 2014 dibandingkan tahun 2013. Peningkatan Aset disertai juga dengan peningkatan liabilitas. Peningkatan pendapatan layanan lebih tinggi setelah pemberlakuan JKN jika dibanding periode sebelumnya dan pendapatan dari APBD berkurang setelah pemberlakuan JKN di RSUD A. Sedangkan untuk komponen biaya justru peningkatannya lebih rendah setelah pemberlakuan Jaminan Kesehatan Nasional. Secara umum dilihat dari ratio keuangan, kinerja RSUD mengalami peningkatan, terutama RSUD A. Case mix indeks meningkat baik pada rawat jalan dan rawat inap di RSUD A, sedangkan di RSUD B case mix indek rawat inap meningkat sedangkan rawat jalan menurun. Hospital Base Rate untuk rawat inap dan rawat inap di kedua RSUD meningkat pada periode 2014 – 2015. Kata Kunci : Jaminan Kesehatan Nasional, kinerja keuangan, hospital base rate, RSUD.
ABSTRACT Name : Tita Rosita Study Programe : Public Health Majority : Health Economic : “The Implications of National Health Insurance on District Public Hospital Perfomance: Financial Analysis and Hospital Base Rate 2 District Hospital Type C in West Java” Title National Health Insurance (NHI) implementation in Indonesia since 2014 has transformed most of the payment system in the hospital from fee for service into a prospective payment system based on INA CBGs. Necessary strategies for management hospital that focus on enhancing performance in an integrated to minimize cost, rationalize waste, and improve business process efficiency without neglecting clinical pathways refers to the standard of professional services. The purpose of this study was to determine the effect of the implementation of NHI on the performance of district public hospitals were covering aspects of financial performance and hospital base rate (HBR). In order to conduct a financial analysis this study uses financial statement period 2012 – 2015 and BPJS claims period 20142015 to calculate the HBR in two type C public hospitals in Sukabumi. During 2012 - 2015 there was an increase of total assets and current, primarily cash and cash equivalents greatly increased after NHI period in 2014. The increase in assets is accompanied also by an increase in liabilities. Improved medical revenue after NHI period higher if compared to the previous period and revenues from the local goverment budget (APBD) was reduced after NHI period. As for the expenses precisely the increase is lower after NHI period. In general, if viewed from the financial ratios, the performance of hospitals has increased. Case mix index increased on both outpatient visit and inpatient admission at District Hospital A, while in District Hospital B case mix index increased on inpatient admission and decreased on outpatient visit. Hospital Base Rate on inpatient admission and outpatient visit in both hospital increased during 2014-2015. Keywords : NHI, financial performance, HBR, district public hospital.
Belum terdapatnya bentuk dokumen peraturan sesuai dengan Kepmenkes nomor 772 Tahun 2002 tentang Pedoman Peraturan Internal Rumah Sakit (Hospital By Laws) dan Permenkes nomor 755 tahun 2011 tentang Penyelenggaraan Komite Medik di Rumah Sakit di RSUD Prof.dr.M.Ali Hanafiah SM Batusangkar, menunjukkan bahwa implementasi kebijakan belum dilaksanakan secara optimal. Penelitian bertujuan untuk mengkaji hal yang menyebabkan belum dilaksanakannya pembuatan dokumen HBL ditinjau dari faktor Komunikasi, Sumber Daya, Disposisi, dan Struktur Birokrasi dikaitkan dengan aspek yuridis normatif. Penelitian menggunakan metode kualitatif retrospektif pada 11 informan. Hasil penelitian menyebutkan bahwa komunikasi kebijakan HBL masih belum konsisten dan tersosialisasikan secara optimal, sumberdaya belum memadai dan komitmen implementasi kebijakan yang masih rendah serta struktur birokrasi yang belum jelas dalam koordinasi pelaksanaan HBL menjadi faktor berpengaruh dalam pembuatan HBL. Kesimpulan bahwa implementasi kebijakan HBL di RSUD Prof.dr.M.Ali Hanafiah SM Batusangkar Provinsi Sumatera Barat tahun 2013 belum optimal sehingga membutuhkan advokasi kebijakan lebih lanjut.
ABSTRACT
Unavailable documentation of regulation due to policy Kepmenkes number 772 of 2002 on The Guidelines for Internal Hospital Regulation (Hospital By Laws) and Permenkes number 755 of 2011 on the Implementation Medical Committee in General District Hospitals Prof. dr. M. Ali Hanafiah SM Batusangkar, showed that the implementation of the policy has not been implemented optimally. Aims of this study is to assess documentation of regulation has not been done according to HBL Guidelines based on factors that influenced policy implementation, such as Communication, Resources, Disposition, and Bureaucratic Structure associated with normative legal aspects. This study uses Retrospective Qualitative methode using 11 informants and document review. Result shows that the communication policy of HBL is still not consistant and optimal socialized, fully-unsupported resources and low commitment of policy implementation and unclear bureaucratic structures in the coordination of the implementation of the HBL as influencing factors to make HBL. As the conclusion is that policy implementation in General Hospitals District Prof.dr.M.Ali Hanafiah SM Batusangkar West Sumatra Province in year 2013 has not been implemented optimally and need further advocacy as well.