PROGRAM JAMINAN KESEHATAN NASIONAL DARI ASPEK SUMBER DAYA MANUSIA PELAKSANA PELAYANAN KESEHATAN

Abstract

Jaminan kesehatan nasional (JKN) mulai beroperasi sejak 1 Januari 2014. Pelaksanaan jaminan kesehatan di Kabupaten Tabalong, masih mengalami beberapa permasalahan seperti SDM pelaksana pelayanan kesehatan yang masih belum mencukupi baik dari segi kuantitas, distribusi dan kualitas. Penelitian ini bertujuan untuk melakukan evaluasi program JKN dari aspek SDM pelaksana pelayanan kesehatan di Kabupaten Tabalong periode Januari-Juni 2014. Penelitian ini menggunakan mix method dengan desain urutan pembuktian sequential explanatory. Subjek penelitian berasal dari Dinas Kesehatan Kabupaten Tabalong, RSUD H. Badaruddin, Puskesmas Kelua dan BPJS Kesehatan. Hasil evaluasi konteks, informan memahami mengenai batasan JKN, roadmap dan hambatan program. Hasil evaluasi input SDM pelaksana pelayanan kesehatan, kuantitas masih mengalami kekurangan 136 orang. Distribusi di Puskesmas Kelua sudah sesuai dengan standar ketenagaan di puskesmas tetapi kuantitasnya masih belum sesuai standar rasio per 100.000 jumlah penduduk. Distribusi di RSUD H. Badaruddin berdasarkan standar ketenagaan kesehatan di rumah sakit sudah sesuai, kecuali untuk dokter spesialis. Penilaian kualitas SDM di Puskesmas Kelua belum menggunakan standar Kepmenkes Nomor 857 Tahun 2009. Sedangkan di RSUD H. Badaruddin masih menggunakan penilaian Daftar Penilaian Pelaksanaan Pekerjaan (DP3). Hasil evaluasi proses, kuantitas sudah meningkat tetapi masih mengalami kekurangan 82 orang. Distribusi di Puskesmas Kelua tidak ada perubahan. Distribusi di RSUD H. Badaruddin mengalami penambahan tenaga keperawatan. Penilaian kualitas SDM di Puskesmas Kelua tidak ada perubahan. Penilaian SDM di RSUD H. Badaruddin menggunakan Penilaian Prestasi Kerja Pegawai (PKP). Evaluasi output menunjukkan belum ada perubahan kuantitas, distribusi dan kualitas dari hasil evaluasi proses. Pelaksanaan JKN di Kabupaten Tabalong sudah berjalan, baik dari aspek peraturan perundangan, kepesertaan, pelayanan kesehatan, keuangan dan tata kelola organisasi. Ada beberapa hambatan seperti peraturan daerah masih kurang dan kurangnya jumlah SDM pelaksana pelayanan kesehatan. Oleh karena itu, perlu adanya upaya penambahan kuantitas dan pemerataan distribusi SDM pelaksana pelayanan kesehatan oleh Pemerintah Daerah dan upaya memaksimalkan jumlah dan kualitas SDM pelaksana pelayanan kesehatan yang tersedia.

National health insurance (JKN) started operating on January 1, 2014. The implementation of health insurance in Tabalong, still have some problems such as health services workforce are still not enough in terms of quantity, distribution and quality. This study aims to evaluate the JKN program of health services workforce aspects in Tabalong period January to June 2014. This study used a mixed method design with sequential explanatory. Study subjects were from the Department of Health Tabalong, H. Badaruddin Hospital, Kelua Health Center and BPJS Health. The results of the evaluation context, informants understand the JKN restrictions, roadmap and program obstacles. The results of the evaluation of health services workforce inputs, the quantity is still deficient 136 people. Distribution in Kelua Health Center is appropriate with the standard for personnel in health centers but the quantity is still not appropriate with the ratio per 100,000 of population standard. Distribution in H. Badaruddin hospital based health workforce standards in hospitals is appropriate, except to specialists. Assessment of the quality of human resources in Kelua Health Center not using Kepmenkes No. 857 of 2009 standard. While in H. Badaruddin hospital still use assessment Implementation Assessment Work List (DP3). The results of the evaluation process, the quantity has increased but is still deficient 82 people. Distribution in Kelua Health Center no change. Distribution in H. Badaruddin hospital have additional for nursing staff. Assessment of the quality of human resources in the Kelua Health Center no change. Assessment of human resources in H. Badaruddin hospital using Employee Job Performance Assessment (PKP). Evaluation of the output shows no change in the quantity, distribution and quality of the results of the evaluation process. Implementation JKN in Tabalong already running, both from the aspect of legislation, participation, health care, financial and organizational governance. There are several obstacles such as local regulation are still lacking and the lack of workforce for the services of health. Therefore, efforts are needed to increase the quantity and distribution of health workforce by local government and maximizing the amount and quality of available health workforce.