Analisis Efisiensi Teknis Dana Kapitasi Puskesmas di Kabupaten Sleman Menggunakan Data Envelopment Analysis
Mas’ud Mas’ud(1*), Laksono Trisnantoro(2), Julita Hendrartini(3)
(1) Dinas Kesehatan Kabupaten Sigi, Sulawesi Tengah
(2) Program Studi Ilmu Kesehatan Masyarakat Fakultas Kedokteran Universitas Gadjah Mada, Yogyakarta
(3) Program Studi Ilmu Kesehatan Masyarakat Fakultas Kedokteran Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author
Abstract
ABSTRACT
Background. Presidential Decree No. 12/2013 states that BPJS Health in carrying out health insurance, using a capitation financing system in health care first level (primary). According to Minister Regulation No.19 / 2014, that the allocation of capitation funds used for the payment of health care services for health workers and non-health workers who perform services on health care first level. While the operational services allocated for drugs, medical devices, and medical consumable material and other health care operations. Necessary to study the use of the funds in question so that the operational and health services can run effectively, efficiently in order to determine the appropriate policies by local government and center.
Methods. This type of study is a mixed analytic methods. In the quantitative data analysis method Data Envelopment Analysis (DEA) and qualitative data to explain the quantitative data. The study population includes all government-owned health centers in Sleman (25 health centers. This study will look at the efficiency of technical management puskesmas capitation funds for the implementation of individual health efforts in Sleman district PHC in 2014.
Results. Based on the analysis with DEA method, only 3 of the 25 health centers health centers (12%) which has been technically cost efficiency and 13 health centers (52%) were technically efficient system. Tobit regression analysis shows that there are four variables that significantly, variable utilization figure (positive direction), reference number (positive direction), the ratio of non-medical personnel (negative direction), and capitation funds (negative direction).
Conclusion and Suggestions. In general, health centers in Sleman yet technically efficient in the management of capitation funds. Policy-oriented technical efficiency costs will affect the value of the technical efficiency of the system. Expected DHO monitoring, evaluation and improvement of the efficiency of the management of Puskesmas capitation funds intensively and comprehensively on the quality of the performance of health centers as an indicator.
Keywords. Capitation Funding, Primary Health Care, Technical Efficiency, Data Envelopment Analysis (DEA).
ABSTRAK
Latar Belakang. Perpres No. 12/2013 menyebutkan bahwa BPJS Kesehatan dalam menyelenggarakan jaminan kesehatan, menggunakan sistem pembiayaan kapitasi di faskes tingkat pertama (primer). Menurut Permenkes No.19/2014, bahwa alokasi dana kapitasi dipergunakan untuk pembayaran jasa pelayanan kesehatan bagi tenaga kesehatan dan tenaga non kesehatan yang melakukan pelayanan pada FKTP (60%). Sedangkan layanan operasional dialokasikan untuk obat, alat kesehatan, dan bahan medis habis pakai dan kegiatan operasional pelayanan kesehatan lainnya. Diperlukan kajian penggunaan dana yang dimaksud sehingga operasional dan layanan kesehatan dapat berjalan efektif, efisien guna menentukan kebijakan yang tepat oleh pemdah dan pusat.
Metode. Jenis Penelitian ini merupakan analitik dengan pendekatan mixed methods. Pada data kuantitatif menggunakan metode analisis Data Envelopment Analysis (DEA) dan data kualitatif menjelaskan data kuantitatif. Populasi penelitian meliputi seluruh puskesmas milik pemerintah di Kabupaten Sleman (25 puskesmas). Penelitian ini akan melihat efisiensi secara teknis pengelolaan dana kapitasi puskesmas terhadap penyelenggaraan upaya kesehatan perorangan di puskesmas Kabupaten Sleman tahun 2014.
Hasil. Berdasarkan hasil analisis dengan metode DEA, dari 25 puskesmas hanya 3 puskesmas (12%) yang telah efisiensi secara teknis biaya dan 13 puskesmas (52%) yang efisien secara teknis sistem. Hasil analisis regresi tobit menunjukkan terdapat 4 variabel yang berpengaruh secara signifikan, yaitu variabel angka utilisasi (arah positif), angka rujukan (arah positif), rasio tenaga non kesehatan(arah negatif), dan dana kapitasi (arah negatif).
Kesimpulan dan Saran. Secara umum puskesmas di Kabupaten Sleman belum efisien secara teknis dalam pengelolaan dana kapitasi. Kebijakan yang berorientasi kepada efisiensi teknis biaya akan berpengaruh terhadap nilai efisiensi teknis sistem. Diharapkan Dinkes melakukan monitoring, evaluasi serta peningkatan efisiensi pengelolaan dana kapitasi puskesmas secara intensif dan komprehensif terhadap mutu kinerja puskesmas sebagai indikatornya.
Kata Kunci. Dana Kapitasi, Puskesmas, Efisiensi Teknis, Data Envelopment Analysis (DEA).
Keywords
Full Text:
PDFReferences
Peraturan Presiden No. 12/2013 tentang Jaminan Kesehatan Nasional, Republik Indonesia
Peraturan Presiden No. 32/2014 tentang Pemanfaatan Dana Kapitasi Jaminan Kesehatan Nasional pada Fasilitas Kesehatan Tingkat Pertama Milik Pemerinta Daerah, Republik Indonesia.
Trisnantoro, L. 2014. Skenario Pelaksanaan Kebijakan Jaminan Kesehatan Nasional di DI Yogyakarta (Hasil Sementara Penelitian, Juli 2014., p. 22). Yogyakarta: Pusat Kebijakan dan Manajemen Kesehatan FK UGM. http:// www.slidesearch.org/slide/hasil-monev-jkn- 21092014
Nur Yatiman dan Arif Pujiyono. 2013. “Analisis Efisiensi Teknis Anggaran Belanja Sektor Kesehatan Pemerintah Daerah Kabupaten/Kota Di Provinsi Daerah Istimewa Yogyakarta.” Diponegoro Journal Of Economics Vol. 2 No.1, hal : 1-13. http://ejournal-s1.undip.ac.id/ index.php/jme
Mackenbach, JP. 1991. Healthcare Expenditure and Mortality from amenable Condition in the European Community. Health Policy, vol 19.
Babazono A dan Hillman AL. 1994. A comparison of International Health outcomes and health care Spending. International Journal of Technology Assess healthcare, Vol 10. No.3.
W HO, 2005. Achieving universal health coverage: Developing the health financing system. Technical brief for policy-makers. Number 1, 2005. World Health Organization, Department of Health Systems Financing, Health Financing Policy.
Makmun, 2002 A multi-criteria data envelopment analysis model for measuring the productive efficiency of hospitals. University of Bahrain, Bahrain. http://u.math.biu.ac.il/~mschaps/ f i n a n c e / r e a d i n g s / c o m p _ f i n / d e a / dea%20hospitals.Pdf
Forrest , C.B., Shi. I., Von Schrader, S., 2002a, Managed Care, Primary care and the Patien- Practioner Relationship, J Gen Interm Med, 17(4):270 – 277.
Primudyasiwi, A.N. dan Rochmah, T.N, 2013. Perhitungan Anggaran Jaminan Kesehatan Berdasarkankan Nilai Kapitasi di Pg Krebet Baru Malang. Jurnal Administrasi Kesehatan Indonesia Volume 1 Nomor 2, hal : 7
Riley, 2010. Rekayasa Beriotensi Objek.Yogyakarta:Penerbit CV Andi.
Nur, A.A., 2005. Satisfaction of Compulsory and Voluntary Health Insurance Participants with First Level Health Service Quality A Comparative Study. JMPK Vol. 08/No.04. Hal. 183 –190.
Retzlaff-Roberts, Donna, Cyril F. Chang, and Rose M. Robin. (2004) “Technical Efficiency in the Use of Health Care Resources: A Comparison of OECD Countries,” Health Policy, 69, 55–72 Goroll, A.H., Berenson, R.A., Schoenbaum, S.C., Gardner, L.B., 2007, Fundamental Reform of Payment f or Adult Primary Care:Comprehensive Payment for Comprehensive Care, J Gen Intern Med., 22(3): 410 – 415
Marschall, P. & Flessa, S., 2011. Efficiency of primary care in rural Burkina Faso. A two-stage DEA analysis. Health Economics Review, 1(1), p.5. http://www.pubmedcentral.nih.gov / articlerender. [Accessed Juli 11, 2015].
Schuler, R.S., Jackson, Susan, E., Manajemen Sumber Daya Manusia Menghadapi Abad 21, Penerbit Erlangga, Jakarta.1999;6.
Ilyas, 2011. Perencanaan Sumber Daya Manusia Rumah Sakit: Teori, Metoda, dan For- mula. Depok: Fakultas Kesehatan Masyarakat, Universitas Indonesia.
Inda, S.W, 2011. Hubungan Determinan Individu Terhadap Utilisasi Pelayanan Kesehatan Jam- kesda Puskesmas Tumbang Talaken, Kabupaten Gunung Mas. Tesis Program Pasca Sarjana Ilmu Kesehatan Masyarakat, Universitas Indonesia
Hendrartini, Y. 2010, Model Kinerja Dokter dengan Pembayaran Kapitasi dalam Program Asuransi Kesehatan. Disertasi, Program Doktor Ilmu Kedokteran dan Kesehatan FK UGM.
Donabedian, Avendis, 1988. Exploration in Quality Assesment and Monitoring. Health Adminis- tration Press, Ann Asbor, Michigan.
Peraturan Presiden No. 32/2014 tentang Pemanfaatan Dana Kapitasi Jaminan Kesehatan Nasio- nal pada Fasilitas Kesehatan Tingkat Pertama Milik Pemerinta Daerah, Republik Indonesia
Peraturan Presiden No. 72/2012 tentang Sistem Kesehatan Nasional, Republik Indonesia
Peraturan Menteri Kesehatan No. 19/2014 tentang Penggunaan Dana Kapitasi JKN Untuk Jasa Pelayanan Kesehatan dan Dukungan Biaya Operasional Pada Fasilitas Kesehatan Tingkat Pertama Milik Pemerintah Daerah, Republik Indonesia
DOI: https://doi.org/10.22146/jkki.v5i3.30667
Article Metrics
Abstract views : 2954 | views : 5265Refbacks
- There are currently no refbacks.
Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Jurnal Kebijakan Kesehatan Indonesia : JKKI [ISSN 2089 2624 (print); ISSN 2620 4703 (online)] is published by Center for Health Policy and Management (CHPM). This website is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. Built on the Public Knowledge Project's OJS 2.4.8.1.
View My Stats