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Berdasarkan SK Gub DKI Jakarta No. 2086 tahun 2006, 44 Puskesmas di Provinsi DK] Jakarta ditetapkan menjadi unit yang menerapkan Pola Pengelolaan Keuangan Badan Layanan Umum Daelah ( PPK BLUD ) secara bertahap. Penelitian ini bertujuan untuk mengetahui gamharan realisasi anggaran kesehatan bersumber pemerintah provinsi di 42 puskesmas DKI Jakarta untuk periode tahun 2007-2009 paska menerapkan PPK BLUD. Desain penelitian adalah deskriptif. Data yang dikumpulkan adalah data sekunder yang berasal dari laporan keuangan puskesmas tahun 2007- 2009. Hasil penelitian menunjukkan bahwa realisasi anggaran di Puskesmas DKI Jakarta dari tahun 2007 sampai dengan 2009 cenderung meningkat yaitu Rp l7b.l66.506.28l (2007) , Rp 242.295.485.|2l (2008) dan Rp 247.076.8l0.111 (2009). Biaya perkapita berkisar dari USS 2 ( Jakarta Barat ) - USS 4,6 ( Jakarta Pusat ). Total pendapatan BLUD Puskesmasjuga menunjukkan peningkatan yaitu Rp 57.24l.949.0l7,- (2007), Rp 59.779.032.965 ,- (2008) dan Rp 65.745.497.256,- (2009). Realisasi anggaran rata-rata pertahun pada periode 2007-2009 untuk : upaya wajib 80%, program pzioritas 8l,08%. Berdasarkan sifat plogram : Kuratif 58%, preventif 2l%, promotif 0.98%. Berdasarkan jenis kegiatan : UK? 58%, UKM sebesar 22 %, Manajemen 13% dan investasi 6%. Berdasarkan kelompok belanja : BOP 85%. adum 8,56% , modal 5,76%. CRR 46,97%.
Under Decree of the Governor of DKI Jakarta Province No. 2086 ln 2006, 44 health centers in Jakarta Province enacted into units that implement the Financial Management Pattems Regional Public Service Board gradually. This research aims to reveal the health budget comcs in 42 health centers of the provincial govemment of DKI Jakarta for the period 2007-2009 afler applying Financial Management Panems Regional Public Service Board. The study design is descriptive. Data collected is secondary data derived from the consolidated financial health centers in 2007-2009. The results showed that the realization of budget in Jakarta Health Center from 2007 to 2009 tended to increase the l76,l66,506,28l IDR (2007), 242,295,481 121 IDR (2008) and 247,076,8l0,l ll IDR (2009). Per capita costs ranged fiom U.S. S 2 (West Jakarta) - U.S. S 4.6 (Central Jakarta). Total revenues Regional Public Service Board PHC also showed an increase of 57,24I,949,0l7 IDR (2007), 59,779,032,965 IDR (2008) and 6S,745,497,256 IDR (2009). Total expenditure per year on average for the period 2007-2009: the effort required 80% 8l.08% priority programs. Based on the nature of the program : Curative 58%, 21% preventive, promotive 0.98%. Based on the types of activities: UKP 58%, 22% SME, investment Management l3% and 6%. Based on expenditure groups: BOP 85%, ADUM 8.56%, 5.76% of capital. CRR 46.97% .
In the Performance Based Capitation (KBK) payment system, the performance achievement of First Level Health Facilities (FKTP) will be calculated based on the indicators of Contact Rate, Non-Specialist Referral Ratio, and Controlled Prolanis Participant Ratio as the basis for capitation payments. This research is a non-experimental research using a quantitative approach, which aims to determine the relationship between the status of implementation of KBK consequences, the ratio of doctors to participants, fulfillment of infrastructure, scope of services and financial management patterns of Community Health Centers with the value of KBK achievements at Puskesmas in the North Sumatra Province region in 2023. From the results of this research, the KBK achievement value for Puskesmas in North Sumatra Province in December 2023 is 2.8 or has not yet reached the target maximum. The ratio of doctors to participants and fulfillment of infrastructure have a significant relationship to the KBK achievement score. Fulfillment of doctors based on the number of registered participants, fulfillment of infrastructure and arrangements for the distribution of registered participants need to be paid attention to in order to improve performance in accordance with the provisions of Performance Based Capitation.
Pembangunan kesehatan adalah proses yang terus menerus dan progresif untuk meningkatkan derajat kesehatan masyarakat. Dengan di berlakukannya Amandemen I - IV UU Dasar Negara Republik Indonesia tahun 1945, tujuan negara sudah semakin jelas di mana secara eksplisit menempatkan kesehatan sebagai bagian dari kesejahteraan rakyat yang. harus tersedia merata. Konsekwensinya daerah-daerah harus mengalokasikan pendanaan.. yang lebih besar terhadap sektor kesehatan. Pendanaan kesehatan merupakan kunci utama dalam suatu sistem kesehatan di berbagai negara. Penelitian Oleh WHO di Indonesia yang selama bertahun-tahun prihatin bahwa masalah kesehatan di Indonesia mengalami kemandegan akibat pendanaan, sebagai salah satu masukan (input) yang penting kurang mendapat perhatian. Dinas Kesehatan Kabupaten Muaro Jambi dengan jumlah anggaran kesehatan yang masih rendah di tambah lagi dengan belum teratasinya beberapa masalah kesehatan, penting dilakukan analisis pembiayaan kesehatan. Tujuan penelitian ini adalah untuk mengetahui gambaran tentang peta pembiayaan kesehatan bersumber pemerintah di Dinas kesehatan Kabupaten Muaro Jambi tahun 2006. Jenis penelitian ini adalah penelitian dengan desain deskriptif operasional di bidang analisis pembiayaan kesehatan Masyarakat yang bersumber dari pemerintah di Dinas Kesehatan, Puskesmas dan Gudang Farmasi dalam wilayah Kabupaten Muaro Jambi, Penelitian ini adalah telaah dokumen Dalam DASK yang di kelompokan menurut, sumber, provider, Fungsi biaya, program Prioritas dan realiasasi angearan. Hasil penelitian ini menunjukan bahwa total anggaran untuk pembiayaan kesehatan masyarakat bersumber pemerintah sebesar Rp 21,052,017,064,- dan nilai per kapita adalah Rp 71,104,11,- per tahun, yang bersumber dari APBD Kabupaten Rp 13,448,602,038 (65 %), Pinjaman Luar Negeri/Bantuan Luar Negeri PLN/BLN adalah sebesar Rp 4,300,000,000,- (21%) dan APBN sebesar Rp 3,015,000,000,(15 %). Dari 7 Provider, Bagian Tata Usaha mendapat porst terbesar Rp 7,013,652,601,- (34%) sedangkan terkecil alokasi biaya Bidang Pelayanan Kesehatan dasar Rp 919,380,000,- (4%). Pengelompokan menurut biaya pelayanan kesehatan yang terbesar adalah suporting Rp 12,770,145,438,- (62%). Fungs) pembiayaan Line Htem dengan alokasi dana terbesar adalah biaya Operasional yaitu Rp 16.121,935,838,(78%). Pembiayaan program kesehatan alokasi terbesar adalah program kesehatan kuratif Rp, 6,543,320,200,- (32%). Pembiayan 9 program kesehatan prioritas sesuai Standar Pelayanan Minimal (SPM) alokasi terbesar untuk program pelayanan kesehatan dasar sejumlah Rp 4,695,774,960,- (23%). Realisasi dana yang sudah di alokasikan adalah sejumlah 92% terdiri dari: Dana yang bersumber APBN 99%, realisasi anggaran bersumber APBD adalah 98%, dana yang besumber dari BLN/PLN mempunyai realisasi dana terrendah hanya 68% dani total alokasi anggaran. Di sarankan bagi pemerintah Kabupaten Muaro Jambi dalam menyusun kebijakan pembiayaan sektor kesehatan kiranya lebih memperhatikan distribusi per Provider, Program prioritas dan standar pelayanan minimal bidang kesehatan maupun distribusi sesuai fungsi pembiayaan pelayanan kesehatan. Hal ini harus di ikuti dengan peningkatan pembiayan sektor kesehatan terutama untuk pelayanan publik untuk menunjang visi dan misi kesehatan serta visi Pemerintah daerah Kabupaten Muaro Jambi tercapai. Dinas Kesehatan perlu memaksimalkan penyusunan Disirict Health Account (DHA) sehingga diperoleh bahan evaluasi dan penentuan alokasi pembiayaan program yang lebih memudahkan dalam pengelompokan pembiayaan kesehatan Masyarakat. Dinas Kesehatan dan Rumah Sakit Daerah lebih meningkatkan advokasi kepada Pemerintah Daerah, DPRD dan sektor swasta serta masyarakat dalam memobilisasi sumber pembiayaan kesehatan.
Development of health is progressive and continuous process to increase degree of health of public. With in the doing of Amendment I - [VY UU Dasar Negara Republic Indonesia year 1945, purpose of state have been progressively clear where explicitly place health as part of prosperity of people to be be available flatten. The consequence of allocation areas have to financing of larger oneses to health sectors. Financing of health is main key in health system in various states. According To Thabrani H" Research By WHO in Indonesia which during through years concerned that problem of health in Indonesia experience stag as result of financing, as one of input ( input) important less getting attention " The purpose of this research is to know about defrayal of health from duty of health government of Sub-Province Muaro Jambi year 2006. This research type is descriptive operational research design in deftayal analysis of Public health which stemming from government in health of duty, Puskesmas (public health centre) and Pharmacy warehouse in Sub-Province of Muaro Jambi, this research is DASK document study which grouped according, source, provider, cost function, Priority program and budget realization. This research result show that total budget for defrayal of public health from government equal to Rp 21,052,017,064,,- and assess per capita is Rp 71,104,11,- per year, from Sub-Province District Revenue Plan (APBD) Rp 13,448,602,038 (65%), Foreign Loan /Foreign Aid (PLN/BLN) is equal to Rp 4.300,000,000,- (21%) and State Revenue Plan (APBN) equal to Rp 3,015,000,000,- (15%). From 7 Provider, Arranging Effort get the biggest portion Rp 7,013,652,601,- (- 34%), smallest cost allocation is Base Health Service Rp 919,380,000,- (- 4%). Subdividing according to the service health budget the biggest is supporting Rp 12,770,145,438,- (- 62%). Line Item defrayal function with the biggest fund allocation is Operational expense that is Rp 16,121,935,838,- (78%). The biggest allocation health program defrayal is curative Medicare Rp 6,543,320,200, (32%). Defrayal of 9 priorities Medicare according to Minimum Standard Service (SPM) the biggest allocation for base health service program is Rp 4.695.774.960, (23%). Fund Realization which allocated was 92% consisted: Fund from APBN 99%, budget realization from APBD 98%, fund from BLN/PLN have low fund realization which is only 68% from total budget allocation. In suggesting for government of Sub-Province of Muaro Jambi in compiling policy of health defrayal sector presumably more pay attention to distribution per Provider, Priority program and Minimum Standard Service and also distribution according health service defrayal function. This thing must follow with increasing of health defrayal sector especially public service for supporting health mission and vision and also to reach the vision of Sub-Province Muaro Jambi Government. Duty of Health enquires to maximize compilation of District Health Account (DHA) so that can obtained a material for evaluation and determination of defrayal allocation of program which more facilitate in subdividing of health public defrayal. Duty of Health and district hospital needs more advocating to local government, private sector and Local Parliament and also public in mobilization source of health defrayal.
Dinas Kesehatan Provinsi Sulawesi Tengah memiliki berbagai masalah dart keterbatasan antara. lain menyangkut SDM perencana, S1K, dan dana. Belum adanya dana yang khusus dialokasikan untuk membiayai proses perencanaan dan penganggaran merupakan salah satu masalah yang penting diperhatikan. oleh sebab itu, penelitian ini bertujuan melakukan analisis biaya menggunakan konsep Activity Based Costing (ABC) terhadap proses perencanaan dan penganggaran program kesehatan tahunan Dimas Kesehatan Provinsi Sulawesi Tengah serta menganalisis berbagai faktor yang mempengaruhinya dan hambatan masalah yang dihadapinya. Penelitian ini adalah penelitian studi kasus, dengan pendekatan deskriptif menggunakan metode kualitatif. Melalui vvawancara. mendalam, Focus Group Discussion (FGD), telaah dokurnen danobservasi langsung. Seluruh tahapan aktivitas pereneanaan, mulai dari analisis situasi, identifikasi masalah, penetapan prioritas masalah, penetapan tujuan„ penentuan altematif pemeeahan masalah, penyusunan Reneana Operasional Proyek/Program (ROP), pengerjaan RICA—KL dan RKA—SKPD, asistensi, Koreksi dan revisi serta finalisa.si dokumen perencanaan dan penganggaran sarnpai penyu.sunan draft DIPA dan DPA Dinas Kesehatan Tahun 2007. walaupun implementasinya, tidak selalu dilakukan seeara berumtan atau terpisah tahap demi tahapnya. Beberapa aspek yang mempengaruhi perencanaan dan penganggaran adalah ketersediaan, kecukupan dan kesesu.aian serta kelengkapan berbagai sumber daya, seperti SDM perencana, saran; waktu, dana, jadwal, juklak, Kebijakan OTDA yang mendukung, Sistem Informasi Kesehatan (SIK) dan standar harga satuan barangijasa. Kegiatan perencanaan dan penganggaran selanria ini, merupakan bagian dari Prograrn Kebijakan dan Manajemen Pembangunan Kesehatan (PICMPK). Alokasi dana tahun anggaran 2007 sebesar Rp. 6.706.789.494,- terdiri dari Rp. 5.166.347.000,- APBN dan Rp. 1.540.442.494,-. APBD. Hasil perhitungan dan analisis biaya yang dilakukan temyata diperoleh biaya total proses perencanaan dan penganggaran Dinas Kesehatan Provinsi Sulawesi Tengah sebesar Rp. 259.794.844,- yang keseluruhannya merupakan biaya operasional kegiatan per tahapan aktivitas tersebut. Permasalahan dan hambatan yang dihadapi dalam proses perencanaan dan penganggaran adalah 1)sektor kesehatan belurn menjadi prioritas 2)Belum optimalnya S1K, 3)belum adanya SK Kadis tentang SDM perencanaitim penyusun dokumen perencanaan dan penganggaran dinas. 4)Da.ftar harga satuan barangijasa belum sepenuhnya dimanfaatkan sebagai acuan.5) Belum adanya Juklak perencanaan clan penganggaran, 6)belum semua personil yang terlibat proses perencanaan dan penganggaran belum teriatih secara tehnis maupun. manajerial. 7)Koordinasi Lintas Program (LP) belum optimal. 8) Perencanaan & penganggaran yang dilakukan selama ini belum terpadu, terpisah antara perencanaan APBN dengan APBD. Begitu pula dengan tenaga perencananya. APBN oleh Seksi Penyusunan Program sedangkan APBD oleg Subag Keuangan. 9)Belum adanya dana yan khusus dialokasikan untuk aktivitas perencanaan clan penganggaran. 10)Belum adanya risetistudi sejenisnya mengenai analisis biaya programikegiatan untuk acuaniperbandingan kearah perbaikan. 11)Masalah yang sifatnya spesifik lokal yakni seringkali terjadi pemadarnan lampu oleh PLN. Penelitian ini menyimpulkan perlu dilakukan berbagai upaya dan penataan sena pembenahan baik secara temis maupun manajerial dala.m proses perencanaan dan penganggaran. Upaya sosialisasi dan advokasi yang lebih intensif kepada stakeholder/decision maker setempat juga masih perlu ditingkatkan.
Central Sulawesi Provincial Health Office, have many problems and scarcity of many aspect like planning officer, SIK and budget. Have not budget allocaction for the planning and budgeting process. This study aim to conduct a special cost analysis for the process of health planning and budget by using Activity Based Costing (ABC) concept. This study is a qualitative design, researcher used a framework system which covered input, process and output to analyze various aspect which related to planning and budget process. Public Health Service in the Central Sulawesi Province has conducted all planning activities steps, starting from situation analysis, identify problem, decision of problem priority, decision of aim, determination of trouble-shooting alternative, arrangement of Project Operational Planning. (ROP), Making of RICA - ICL and RICA - SKPD, assistance, correction and revision, final document of planning and budget until draft arrangement of DIPA and DPA at Public Health Service in 2007. Although their implementation are not always conducted alternately or separated step by step. Some aspects which affected to planning and budget at Public Health Service in the province of Sulawesi Tengah is availability, sufficiency, compatible and also the equipment of various resources, such as Human Resources Development planner, medium, timing, fund, schedule, implementation guide (Juklak), supported decentralisation policy, Health Information System (5I1C) and standard price of service unit. Available planning and budget activity is part of Policy Program and Health Development Management at Public Health Service. Available fund allocation in this program is destined for some Subdin, department, section and sub section at Public Health Service in the province of Sulawesi Tengah. Fund allocation of this prograrne in 2007 are 6.706.789.494,- rupiahs which consist of 5.166.347.000,- rupiahs from APBN and 1.540.442.494,- rupiahs from province APB1). From calculation result and cost analysis which has conducted was obtained total cost of planning and budget process at Public Health Service in the province of Sulawesi Tengah are 259.794.844,- rupiahs which all of them are operational cost in every activities steps. Problems and resistances which are faced on planning and budget process such as: 1) Health sector does not become a priority yet concerning a local OTDA policy, because Kamtibrnas is more important aspect. 2) SIK is not optimal yet, 3) There is no SK ICadis concerning Human Resources Development of planner or compiler team of planning and budget document at Health Service. 4) Price list of material or service unit is not fully exploited as reference yet 5) There is no Juklak of planning and budget, 6) All personals who concerned on planning and budget process are not trained yet both technically and managerial. 7) Program pass coordination (LP) is not optimal yet. 8) Planning and budget which conducted are not solid yet, separated between APBN and APBD planning and also their planner. APBN is arranged by section of program arrangement while APBD is arranged by sub department of financial. 9) There are no funds which are allocated especially for planning and budget activity. 10) There is no study which concerns on cost analysis program or activity for reference on repair. 11) Local problems specifically are often happen extinction of electric by PLN. This study concluded that it was important to be conducted various effort and administration and also correction both technique and managerial on planning and budget process at Public Health Service in the province of Sulawesi Tengah. Socialization effort and more intensive advocation to stakeholder or decision maker is also improved.
Kata Kunci: Kesenjangan biaya, Program Gizi, Perencanaan & Penganggaran
Increasing nutrition and overcoming the issues surrounding it is essential in increasing the quality of human resources in Indonesia. One of the important input aspects to achieve minimum standard services (SPM) is sufficient budget allocation. This study aims to uncover the discrepancy between budget realization and budget estimations of minimum standard services (SPM) for the nutrition program in 2016 and 2017; as well as to understand the planning and budgeting process. This was a qualitative study with a cross sectional design, utilizing resources of financial data and program implementation. Results of the study revealed that budget realization of nutrition program at Bekasi Municipal Health Office in 2016 and 2017 were Rp 3,931,449,461 and Rp. 9,146,251,165 respectively. The majority of the budget was directed to preventive programs where in 2016 comprised of 66.55% and in 2017 was 59.35% of the total nutrition budget. Total spending realized was higher than the yearly total budget estimations based on minimum standard services (SPM). There was excess in budget in 2016 of Rp. 2,152,354,011 and Rp. 6,798,429,672 in 2017. In-depth interviews revealed the planning process already includes extensive problem analysis, objective determination and activities identification. The budgeting process is already based on work performance due to it priority scale budgets and established. Bekasi Municipal Health Office should continue to pursue its commitment in improving health budget planning and budget efficiency.
Key words: Budget Gap, Nutrition Program,Health Planning and Budgeting
ABSTRAK
Latar Belakang. Bencana sebagai peristiwa yang mengancam dan mengganggukehidupan dan penghidupan masyarakat dapat mengakibatkan timbulnya korban jiwamanusia, kerusakan lingkungan, kerugian harta benda, dan dampak psikologis.Pembiayaan bencana mengakibatkan pengeluaran negara yang tidak sedikit dan diluarperkiraan. Besarnya kerusakan dan kerugian akibat dampak bencana di Indonesiasangat besar, sementara itu kemampuan pemerintah mengalokasikan dana cadanganpenanggulangan bencana setiap tahun hanya sekitar Rp 4 trilyun. Sistem pembiayaankesehatan di saat bencana menjadi salah satu faktor yang berperan mengurangidampak bencana, khususnya untuk membantu institusi pelayanan kesehatan dalammenyelenggarakan pelayanan yang baik dan efektif. Oleh karena itu masalahpembiayaan kesehatan menjadi sangat crusialMetode. Jenis penelitian ini adalah desain kuantitatif. Arah penelitian ini pembuatanmodel pembiayaan tanggap darurat di PPKK. Metode analisa yang digunakan adalahunivariat, bivariat dan multivariat melalui berbagai uji non parametrik danparametrik.Hasil. Adanya hubungan yang signifikan antara cakupan bencana, kegiatan tanggapdarurat, jumlah korban meninggal, jumlah korban luka, jumlah pengungsi dan lamafase tanggap darurat dengan pembiayaan tanggap darurat serta terbentuknya modelpembiayaan tanggap darurat dengan persamaan Pembiayaan tanggap darurat =e(14,296–0,870Cakupan bencana+0,533Jumlah korban meninggal+0,396Jumlah pengungsi+0,54Lama fase tanggapdarurat)
ABSTRACT
Background. Disasters as events that threaten and disrupt the lives and livelihoodscould result in human casualties, environmental damage, loss of property, andpsychological impact. State funding have led to disaster and not a little unexpected.The magnitude of the damage and losses caused by the disaster in Indonesia is verylarge, while the government's ability to allocate disaster relief reserve fund each yearis only about Rp 4 trillion. Health financing system in times of disaster to be one ofthe factors that contribute to reduction of disaster impacts, particularly to assisthealthcare institutions in carrying out good service and effective. Therefore the issueof health financing became very crusialMethod. This research is quantitative design. This direction of research fundingemergency response modeling in PPKK. The analytical methods used are univariate,bivariate and multivariate through a variety of non-parametric and parametric tests.Results. A significant relationship between the extent of the disaster, emergencyresponse activities, the number of fatalities, number of injuries, the number ofrefugees and the long phase of emergency response to the financing emergencyresponse as well as the establishment of emergency response funding model withEmergency response funding = e(14,296–0,870 Disaster coverage + 0,533 Death + 0,396 IDP’s + 0,54Emergencyphase)
