EFISIENSI RUMAH SAKIT JIWA PEMERINTAH DI PROVINSI JAWA TENGAH DAN DIY SEBELUM DAN SESUDAH JKN DENGAN MENGGUNAKAN TWO-STAGE DATA ENVELOPMENT ANALYSIS (DEA):

Rina Indrayanti; Lutfan Lazuardi; Mubasysyir Hasanbasri

doi:10.22146/jmpk.v19i2.1932

Rina Indrayanti Program Pascasarjana MMR, Fakultas Kedokteran UGM Yogyakarta
Lutfan Lazuardi Bagian Ilmu Kesehatan Masyarakat, Fakultas Kedokteran UGM Yogyakarta
Mubasysyir Hasanbasri Bagian Ilmu Kesehatan Masyarakat, Fakultas Kedokteran UGM Yogyakarta

DOI: https://doi.org/10.22146/jmpk.v19i2.1932

Abstract

Background: During a national health insurance
implementation, efficiency improvement becomes an important
issue as a result of the change of a payment method from free
for service to fixed pricing mechanism of INA CBG's by
containing cost and improving quality. Inefficiency occurs when
a psychiatric hospital uses an excessive input resource to
produce a given level output.
Objective: This study aimed to measure the level of efficiency
of government psychiatric hospitals in the provinces of Central
Java and Yogyakarta before and after the implementation of
JKN.

Methods: A descriptive quantitative study was conducted
using two-stage data envelopment analysis (DEA). The first
stage was to measure hospital efficiency. Second stage used
paired samples t-test to analyze different mean of BOR, LOS,
BTO, TOI and cost efficiency score. This study used secondary
data from financial report, human resources report, hospital
patient visit report of 5 psychiatric hospitals in central java and
DIY province, period 2010 until 2014.
Results: Efficiency measurement using DEA CRS inputoriented
model obtained the mean of cost efficiency score was
0,896. Mean of efficiency score decreased during a transition
period of national health insurance implementation from 0,947
in 2013 became 0,866 in 2014. Soedjarwadi hospital was the
only one of a psychiatric hospital that achieved cost efficiency in
2014. Paired samples t test analysis showed that there was no
difference of mean of BOR, LOS, BTO, TOI and score cost
efficiency before and after efficiency improvement in 2013 from
2010. There was no difference of mean of BOR, LOS, BTO and
score efficiency before and after implementation of national
health insurance. The only one variable had difference of mean
before and after implementation of national health insurance
was TOI.
Conclusion: Most psychiatric hospital in this study are still
inefficient. National health insurance has not been able to
improve efficiency in the early implementation period.
Decreasing of efficiency score happened because of the
decreasing of hospital output.

EFISIENSI RUMAH SAKIT JIWA PEMERINTAH DI PROVINSI JAWA TENGAH DAN DIY SEBELUM DAN SESUDAH JKN DENGAN MENGGUNAKAN TWO-STAGE DATA ENVELOPMENT ANALYSIS (DEA)

THE EFFICIENCY OF GOVERNMENT PSYCHIATRIC HOSPITAL IN THE CENTRAL JAVA AND DIY PROVINCE BEFORE AND AFTER JKN BY TWO-STAGE DATA ENVELOPMENT ANALYSIS (DEA)

Abstract