Lutfan Lazuardi
Bagian Ilmu Kesehatan Masyarakat, Fakultas Kedokteran UGM Yogyakarta

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Evaluasi Distribusi Dokter dan Akses Masyarakat Terhadap Pelayanan Medis di Kabupaten Gunungkidul Tahun 2010 Abdul Azis; Andreasta Meliala; Lutfan Lazuardi
Jurnal Kebijakan Kesehatan Indonesia Vol 1, No 4 (2012)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2283.904 KB) | DOI: 10.22146/jkki.v1i4.35805

Abstract

Background. The lack number of medical provider and imbalanced distribution are the most relevant issues in human resource planning and manning which effected on the decreasing of health service indicator as the impact of lack of skillful and experienced manpower when the health service demand keeps increasing. Hence, evaluation on availability and distribution of medical service as a basic to create a policy on medical service arrangement in Gunungkidul district is necessary. Objective. This research was aimed to identify the availability and distribution on medical service as well community access in Gunungkidul district. Method. This was a case study research that was conducted in Gunungkidul district in February – April 2010 in Healh Office, Regional Employee Board, 3 government hospitals, 30 Primary Health Care and 111 branch Primary Health Care, 46 clinics and 51 private doctors. The data was collected from secondary data in 2008-2010 and in depth interview toward government authority who managed medical providers; 6 in health office, 3 in Regional Employee Board, 30 doctors and 30 medical service users. In addition, the data was analysed descriptively. Result. There was a lack of the availability of medical officer in Gunungkidul district which was caused that there were many employees who resigned from the job than those who was signed in the past 3 years including private medical officers who were depends on the role of government health officer who had double practice. The arranged policy was not yet maximum because of the limited funding. The distribution of medical service was more in the area with high Product Domestic Regional Bruto and in municipalities. The distance to get medical service is in medium category. There was medical service unavailability from 9 PM up to 5 AM in urban areas except in the sub district which had inpatient treatment in Primary Health Care and in municipality. Conclusion. There was a lack of availability of medical provider in Gunungkidul district. The arranged policy was not yet optimum because of the limited funding. Distribution of medical service was more in the area with high Product Domestic Regional Bruto and municipality with medium category community access and there was still medical service unavailability at night.Latar Belakang. Jumlah tenaga medis yang kurang dan distribusi yang belum merata merupakan isu-isu paling relevan dalam human resource planning dan suplai tenaga yang berdampak pada indikator pelayanan kesehatan yang menurun akibat kekurangan tenaga terampil dan berpengalaman pada saat permintaan pelayanan terus meningkat. Sehingga perlu dilakukan kajian sebagai dasar menetapkan kebijakan di Kabupaten Gunungkidul. Tujuan Penelitian. Mengidentifikasi ketersediaan dan distribusi pelayanan medis serta akses masyarakat di kabupaten Gunungkidul. Metode Penelitian. Penelitian studi kasus ini dilakukan di Kabupaten Gunungkidul pada bulan Februari -April 2010 di Dinas Kesehatan, Badan Kepegawaian Daerah, 3 rumah sakit, 30 Puskesmas dan 111 Pustu, 46 Klinik/ BP/ RB dan 51 Dokter praktek swasta. Data dikumpulkan dari data skunder tahun 2008 - 2010 dan wawancara mendalam kepada pejabat pengelola tenaga medis. 6 pejabat dinas kesehatan, 3 di Badan Kepegawaian Daerah, 30 dokter dan 30 masyarakat. Analisis data secara deskriptif. Hasil Penelitian : Ketersediaan tenaga medis Kabupaten Gunungkidul masih kurang di sebabkan dalam 3 tahun terakhir jumlah yang keluar lebih banyak di bandingkan dengan yang masuk, termasuk tenaga medis swasta yang ketersediaannya tergantung dari tenaga medis pemerintah yang praktek ganda. Kebijakan yang di susun belum optimal karena terbatasnya pembiayaan.Pola distribusi pelayanan medis menumpuk di wilayah dengan PDRB tinggi, perkotaan dan mudah transportasinya. Jarak pelayanan untuk di akses masyarakat dengan kategori mudah. Tetapi terjadi kekosongan pelayanan medis pada malam hari di pedesaan Kesimpulan. Ketersediaan tenaga medis Kabupaten Gunungkidul masih kurang. Pola distribusi pelayanan medis lebih banyak di wilayah perkotaan, PDRB tinggi dan transportasi yang mudah. Sedangkan akses masyarakat terhadap pelayanan mudah tetapi terjadi kekosongan pelayanan medis pada malam hari di pedesaan. Kebijakan yang ada belum optimal karena terbatasnya biaya, daerah miskin, pedesaan, sulit transportasi/ komunikasi.
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
Journal of Health Service Management Vol 19 No 2 (2016)
Publisher : Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (476.432 KB) | DOI: 10.22146/jmpk.v19i2.1932

Abstract

Background: During a national health insuranceimplementation, efficiency improvement becomes an importantissue as a result of the change of a payment method from freefor service to fixed pricing mechanism of INA CBG's bycontaining cost and improving quality. Inefficiency occurs whena psychiatric hospital uses an excessive input resource toproduce a given level output.Objective: This study aimed to measure the level of efficiencyof government psychiatric hospitals in the provinces of CentralJava and Yogyakarta before and after the implementation ofJKN. Methods: A descriptive quantitative study was conductedusing two-stage data envelopment analysis (DEA). The firststage was to measure hospital efficiency. Second stage usedpaired samples t-test to analyze different mean of BOR, LOS,BTO, TOI and cost efficiency score. This study used secondarydata from financial report, human resources report, hospitalpatient visit report of 5 psychiatric hospitals in central java andDIY province, period 2010 until 2014.Results: Efficiency measurement using DEA CRS inputorientedmodel obtained the mean of cost efficiency score was0,896. Mean of efficiency score decreased during a transitionperiod of national health insurance implementation from 0,947in 2013 became 0,866 in 2014. Soedjarwadi hospital was theonly one of a psychiatric hospital that achieved cost efficiency in2014. Paired samples t test analysis showed that there was nodifference of mean of BOR, LOS, BTO, TOI and score costefficiency before and after efficiency improvement in 2013 from2010. There was no difference of mean of BOR, LOS, BTO andscore efficiency before and after implementation of nationalhealth insurance. The only one variable had difference of meanbefore and after implementation of national health insurancewas TOI.Conclusion: Most psychiatric hospital in this study are stillinefficient. National health insurance has not been able toimprove efficiency in the early implementation period.Decreasing of efficiency score happened because of thedecreasing of hospital output.