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ABSTRAK Rumah Sakit Pendidikan dalam pemberian pelayanan kesehatan kepada masyarakat melibatkan residen untuk berinteraksi dan melaksanakan tindakan-tindakan medis tertentu dibawah pengawasan dan pendelegasian wewenang dari dokter penanggung jawab pelayanan. Tujuan penelitian ini adalah untuk mengetahui kedudukan residen dalam pemberian pelayanan dan risiko tindakan medis residen yang didelegasikan padanya. Penelitian ini merupakan penelitian deskriptif kualitatif, dengan melakukan wawancara dan penelusuran dokumen. Analisis data dengan content analysis. Hasil penelitian menunjukkan bahwa risiko tindakan medis oleh residen adalah besar karena bukan staf medis. Kesimpulan dari penelitian ini adalah HBL RSUP Sanglah tidak mengatur tentang tindakan medis yang dilakukan oleh residen meskipun Undang-Undang Pendidikan Kedokteran mensyaratkan adanya perlindungan hukum bagi residen. Risiko pemberian tindakan medis yang dilakukan residen sangat berisiko mengingat hasil analisis yang dilakukan terhadap aturan perundang-undangan yang dilakukan adalah tidak adanya pengaturan secara tegas yang tertuang. Saran yang utama adalah adanya aturan pelaksana dari Undang-Undang Pendidikan Kedokteran dari Kementerian Kesehatan dan Kementerian Pendidikan yang jelas tentang perlindungan hukum kepada residen dalam pemberian pelayanan kesehatan.
ABSTRACTTeaching Hospital in the provision of health services to the community is to engage residents to interact and carry out certain medical acts under the supervision and delegation of authority from the physician in charge of the service. The purpose of this study was to determine the position of resident in service delivery and the risk of resident medical actions delegated to him. This research is a qualitative descriptive study, by conducting interviews and document searches. Data analysis is done by content analysis. The results showed that the risk of medical treatment by a resident is great because the resident is not a medical staff.
The conclusion of this study is Sanglah HBL does not regulate medical procedures performed by residents although Medical Education Law requires the existence legal protection for residents. The risk of giving medical treatment undertaken resident is very risky because of the results of the analysis conducted on the rules of law that have been done show no rule expressly set forth.The main suggestion was made rule of implementation of Medical Education Law issued by the Ministry of Health and Ministry of Education are clear about the legal protection to the residents in the delivery of health services.;Teaching Hospital in the provision of health services to the community is to engage residents to interact and carry out certain medical acts under the supervision and delegation of authority from the physician in charge of the service. The purpose of this study was to determine the position of resident in service delivery and the risk of resident medical actions delegated to him. This research is a qualitative descriptive study, by conducting interviews and document searches. Data analysis is done by content analysis. The results showed that the risk of medical treatment by a resident is great because the resident is not a medical staff. The conclusion of this study is Sanglah HBL does not regulate medical procedures performed by residents although Medical Education Law requires the existence legal protection for residents. The risk of giving medical treatment undertaken resident is very risky because of the results of the analysis conducted on the rules of law that have been done show no rule expressly set forth.The main suggestion was made rule of implementation of Medical Education Law issued by the Ministry of Health and Ministry of Education are clear about the legal protection to the residents in the delivery of health services. , Teaching Hospital in the provision of health services to the community is to engage residents to interact and carry out certain medical acts under the supervision and delegation of authority from the physician in charge of the service. The purpose of this study was to determine the position of resident in service delivery and the risk of resident medical actions delegated to him. This research is a qualitative descriptive study, by conducting interviews and document searches. Data analysis is done by content analysis. The results showed that the risk of medical treatment by a resident is great because the resident is not a medical staff.The conclusion of this study is Sanglah HBL does not regulate medical procedures performed by residents although Medical Education Law requires the existence legal protection for residents. The risk of giving medical treatment undertaken resident is very risky because of the results of the analysis conducted on the rules of law that have been done show no rule expressly set forth. The main suggestion was made rule of implementation of Medical Education Law issued by the Ministry of Health and Ministry of Education are clear about the legal protection to the residents in the delivery of health services.
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.