Abstrak

Dalam Undang Undang Nomor 29 Tahun 2004 pasal 29 menyatakan bahwa setiap dokter dan dokter gigi yang melakukan praktik kedokteran di Indonesia wajib memiliki STR sesuai sertifikat kompetensi yang dimiliki. STR berlaku lima (5) tahun. Jika sampai masa berlaku STR habis dokter atau dokter gigi tidak melakukan registrasi ulang, akan kehilangan kewenangan untuk melakukan praktik kedokteran. Sanksi bagi yang menjalankan praktik dengan sengaja tanpa STR dan surat ijin adalah denda maksimal Rp 100 juta ( pasal 75). Hasil pencapaian registrasi ulang belum 100%.

Penelitian ini ditujukan untuk melakukan analisis terhadap kebijakan dan analisis untuk menyusun rekomendasi (analysis of policy dan analysis for policy) registrasi ulang dokter dan dokter gigi di Indonesia. Penelitian ini menggunakan pendekatan kualitatif dan untuk analisis data digunakan model content analisis diolah dengan pendekatan model Patton Savicky dengan kriteria boulton disajikan berdasarkan analysis of policy dan analisis for policy sebagai rekomendasi.

Hasil penelitian menemukan bahwa dokter dan dokter gigi kurang bersedia melakukan registrasi ulang karena : alur sertifikasi kompetensi untuk persyaratan registrasi ulang terlalu panjang, pemenuhan persyaratan terlalu sulit, pengisian borang borang terlalu banyak, pengumpulan SKP untuk memperoleh sertifikat kompetensi bagi registrasi ulang kurang menilai kompetensi (skill) lebih untuk menilai administrasi, pendidikan dan pelatihan yang diselenggarakan oleh organisasi profesi membutuhkan biaya dan hanya untuk peningkatan pengetahuan (knowledge) bukan untuk meningkatkan keterampilan (skill), proses penerbitan sertifikat kompetensi dan STR ulang menjadi terlalu lama.Kesimpulannya, implementasi kebijakan registrasi ulang dokter dan dokter gigi kurang efektif pelaksanaannya karena dipengaruhi oleh peraturan itu sendiri, upaya dokter atau dokter gigi, institusi yang melaksanakan kebijakan serta kondisi lingkungan.

Peneliti menyarankan agar mengembangkan sistem registrasi, meningkatkan komitmen, meningkatkan otoritas KKI, meningkatkan resources, meningkatkan pemahaman dan kesepakatan terhadap tujuan dan stakeholder agar meningkatkan pembinaan dan pengawasan.

According to the Law Number 29 in 2004 article 29 States that every doctors and dentists who conduct medical practices in Indonesia must have a certificate of competence in accordance STR owned .STR is expired after five (5) years. If until the expiration date of STR, doctor and dentist do not apply for the re-registration, so doctors or dentists will loss their authority to conduct medical practices. The consequence for doctors and dentists who running practice without STR and licence intentionally is a fine of up to Rp 100 million (article 75). The achievements of re-registration have not been 100% yet.

This study aimed to analysis the policy and analysis to make recomendations for reregistration policy of doctors and dentists in Indonesia. This study used qualitative approach and for data analysis using the content analysis model, prepared by "Patton Savicky model approach with Boulton criteria based on the analysis of policy and analysis for policy as a recommendation.

The study has found that doctors and dentists are less willingness to be registered as the competencies certification flow for the reregistration are too long, too difficult STR making requirements, too many forms must be fulfilled, the SKP activity colllecting to have competence certificate for the reregistration is not to assess the competencies (skills) but to assess the administration, education and training organized by professional organizations to expensive and only for knowledge increase, not for the skills the,and the waiting time for STR publishing is too long. To sum up, the implementation of the re-registration policies of doctors and dentists have not performed well because it was influenced by the re-registration policy and efforts of the doctors and dentists and institutions in implementing the policy and environmental circumstance.

Researchers suggests to develop a registration system, to increase the commitment, to improve KKI authority, increase resources, to increase the understanding and agreement on goals and stakeholders in order to improve the guidance and supervision

Penelitian ini bertujuan untuk melakukan analisis kebijakan rekrutmen Tim Kesehatan Haji Indonesia (TKHI). Kebijakan rekrutmen TKHI dapat dipandang sebagai suatu sistem, dengan input berupa permintaan, sumber daya dan dukungan, proses mencakup tiga dimensi kebijakan publik yang meliputi dimensi politik, dimensi hukum dan dimensi manajemen, untuk menghasilkan kebijakan rekrutmen TKHI sebagai output. Dari penelitian yang dilakukan, diketahui bahwa kebijakan yang ada sekarang cukup memadai untuk mencapai tujuannya, namun masih memerlukan perbaikan dalam aspek manajemen yang meliputi perencanaan, penilaian kinerja dan pemberian kompensasi serta diperlukan suatu prosedur operasional standar sebagai pedoman pelaksanaan kegiatan. Kata kunci : Analisis kebijakan, rekrutmen, TKHI, professional

 This thesis is focused on the analysis of Indonesian Hajj Health Team (TKHI) Recruitment Policy. TKHI recruitment policy can be seen as a system consisting of demand, resources and support as the input, three dimensions of public policy as the process which aimed at the policy for recruiting TKHI itself as the output. In this research, the writer found that the policy is effective in gaining its objective. However, there are still several aspects needs to be strengthened i.e. planning, performance appraisal and compensation as part of management functions and the need for a standard operating procedure as guidelines for implementation to be fulfilled. Key words : Policy analysis, recruitment, TKHI, professional

Implementasi Program Jaminan Kesehatan Nasional mendapatkan berbagai tantangan salah satunya adalah peningkatan utilisasi pelayanan kesehatan yang berakibat tingginya beban biaya pelayanan kesehatan. Tren persalinan dengan metode bedah caesar mengalami peningkatan setiap tahunnya.  Disertasi ini bertujuan untuk menganalisis kebijakan dan menyusun suatu usulan kebijakan untuk pengendalian utilisasi tindakan bedah caesar dalam penyelenggaraan program Jaminan Kesehatan Nasional. Jenis penelitian adalah analitik dengan mixed method melalui analisis data kuantitatif dan data kualitatif, analisis kebijakan menggunakan Eugene Bardach’s eightfold framework yang dimodifikasi oleh Collins. Penelitian kuantitif melalui analisis data rekam medis tahun 2019 pada pasien bedah caesar di tiga rumah sakit dengan aspek bisnis yang berbeda di Provinsi Jakarta. Penelitian kualitatif dilakukan dengan wawancara mendalam dengan para pemangku kepentingan. Hasil penelitian menunjukkan bahwa Proporsi persalinan caesar dibanding normal di RSSP Y 99,3% di RSSK Z 63,66%, dan di RSUD X 13,42%. Tidak terdapat perbedaan karakteristik sosial dan karakteristik medis pasien bedah caesar di ketiga rumah sakit. Tidak terdapat perbedaan upaya pengendalian utilisasi operasi bedah caesar di ketiga rumah sakit. Bekas SC 1x memiliki persentase tertinggi sebagai indikasi SC dengan persentase 41,67% di RSUD X, di RSSK Z 39,48% dan di RSSP Y 24,11%. Terdapat hubungan antara usia, adanya komplikasi dalam kehamilan, malposisi janin, hipertensi, diabetes mellitus, penyakit jantung, dengan metode persalinan ibu secara caesar. Hasil penelitian kualitatif menunjukkan belum terdapat metode/tools khusus untuk pengendalian utilisasi caesar. Berdasarkan analisis kebijakan menggunakan Bardach’s eightfold framework yang dimodifikasi oleh Collins terdapat skenario/alternatif kebijakan pengendalian utilisasi bedah caesar diantaranya penyusunan program promotive preventif yang melibatkan organisasi-organisasi profesi terkait (seperti: Kebidanan Kandungan, Penyakit Dalam, Gizi, Penyakit Jantung) dengan sasaran wanita usia subur yang merencanakan kehamilan dan ibu hamil, yang khususnya berfokus untuk meminimalisir adanya penyulit kehamilan seperti: Hipertensi, Diabetes mellitus, obesitas, penyakit jantung. Hal ini penting dalam upaya menekan penyulit kehamilan yang dapat berpotensi meningkatkan angka utiliasi bedah caesar.

The implementation of the National Health Insurance Program faces various challenges, one of which is the increase in the utilization of health services which results in high health service costs. The trend of childbirth by Caesarean section method has increased every year. This dissertation aims to analyze the policy and prepare a policy proposal for controlling the utilization of Caesarean section procedures in the implementation of the National Health Insurance program. The type of research is analytical with a mixed method through quantitative and qualitative data analysis, policy analysis using Eugene Bardach's eightfold framework modified by Collins. Quantitative research through analysis of medical record data in 2019 on caesarean section patients in three hospitals with different business aspects in Jakarta Province. Qualitative research was conducted through in-depth interviews with stakeholders. The results showed that the proportion of caesarean deliveries compared to normal in RSSP Y was 99.3% in RSSK Z 63.66%, and in RSUD X 13.42%. There were no differences in the social characteristics and medical characteristics of caesarean section patients in the three hospitals. There were no differences in efforts to control the utilization of caesarean section operations in the three hospitals. Former 1x CS has the highest percentage as an indication for CS with a percentage of 41.67% in RSUD X, in RSSK Z 39.48% and in RSSP Y 24.11%. There is a significant influence between age, complications in pregnancy, fetal malposition, hypertension, diabetes mellitus, heart disease, and the method of maternal delivery by caesarean section. The results of qualitative research indicate that there are no specific methods/tools for controlling caesarean section utilization. Based on policy analysis using Bardach's eightfold framework modified by Collins, there are scenarios/alternative policies for controlling caesarean section utilization including the preparation of promotive preventive programs involving related professional organizations (such as: Obstetrics and Gynecology, Internal Medicine, Nutrition, Heart Disease) targeting women of childbearing age who are planning pregnancy and pregnant women, which specifically focus on minimizing pregnancy complications such as: Hypertension, Diabetes mellitus, obesity, heart disease. This is important in an effort to reduce pregnancy complications that can potentially increase the rate of caesarean section utilization.