Evaluasi Distribusi Dokter dan Akses Masyarakat Terhadap Pelayanan Medis di Kabupaten Gunungkidul Tahun 2010

https://doi.org/10.22146/jkki.v1i4.35805

Abdul Azis(1*), Andreasta Meliala(2), Lutfan Lazuardi(3)

(1) Dinas Kesehatan Kabupaten Gunungkidul
(2) Bagian Ilmu Kesehatan Masyarakat, Fakultas Kedokteran UGM Yogyakarta
(3) Bagian Ilmu Kesehatan Masyarakat, Fakultas Kedokteran UGM Yogyakarta
(*) Corresponding Author

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.


Keywords


Distribution; accessibility; availability; doctor; Distribusi; Ketersediaan; Akses; Dokter

Full Text:

PDF


References

Trisnantoro, L, Ed, Desentralisasi Kesehatan di Indonesia dan Perubahan Fungsi Pemerintah: 2001-2003, Gadjah Mada University Press. Yogyakarta, 2005.

Oliver, M, and Angelbert, M, Distribution of Public Sector Health Warkers in Zimbabwe : A Challange for equity In Health , Journal equinet Discusion, Departement of Community Medicine, University of Zimbabwe, 2006;(34).

Black M, Ebener S, Aguilar PN, Vidaurre M, El Morjani Z, Using GIS to Measure Physical Accessibility to Health Care, World Health Organization, Pan American Health Organization Journal and RMIT University, 2004.

Dreesch, N, Doleace, Dal poz, ML, Goubarev, A, Adam, O, Oregawi, M, Bergstrom, K, Fogstad, H, Sheratt, D, Linkins, J, Scherpbier, R, Youssef, Fox, M, an Approach to Estimating Human Resource Requirements to Achieve the Millenium Development Goals, Journal of Health Policy and Planning, 2005;(20):267-76.

Baros, FF, Howard, AW, Martin, D, KM, Inequitable Distribution of Health Resources in Brasil: an Analysis of National Priority Setting, Journal of Tropical Pediatric, Acta Bioethica; 2009;15 (2):179-183.

Alkam, BB, Atakan, CA, and Sahin, A, (2011), Measuring Inequalities in the Distribution of Health Worker By Bi-plot approach : The Case Of Turkey, Journal of Economic and Behavioral Studies, Ankara and Gazi University, Ankara,Turkey, 2011;(2);57-66.

Theodorakis, PN, Mantz avinis, GD, Lionis, LR, Trell, E, Measuring Health Inequalities in Albania: a Focus on The Distribution of General Practitioners, Journal of Human Resource Health, 2006;4

CDC Atlanta, Framework For Program Evaluation in Public Health, Recommendations and Reports , 1999;48(11):1-40

Leger, AS, Schniedan, H, dan Walsworth Bel, JP, Evaluating Health Services’ Effectiveness, Milton Keynes–Philadelphia, Open University Press, 1992.

Douglah, M, Developing a Concept of Extension Program Evaluation, Program Development and Evaluation, Journal of Extention, University

of Wisconsin, 1998.

Husain, I, Kecukupan dan Kualitas Tenaga Kesehatan Puskesmas Studi Distribusi DesaKota dan Regional Analisa Data Sakerti 2000, Tesis, Universitas Gadjah Mada, Yogyakarta, 2004.

Agustino, L, Dasar-dasar Kebijakan Publik, Alfabeta, Bandung, 2006.

Siagian, SP, Manajemen Sumber Daya Manusia, Bumi Aksara, Jakarta, 2003.

Trisnantoro, L, Memahami Penggunaan Ilmu Ekonomi Dalam Manajemen Rumah Sakit, Gadjah Mada University Press, Yogyakarta, 2005.

Subarsono, AG, Analisis Kebijakan Publik Konsep Teori dan Aplikasi, Pustaka Pelajar, Yogyakarta, 2005.

Departemen Kesehatan Republik Indonesia. SK Menkes No. 81/Menkes/SK/1/2004 tentang Penyusunan Perencanaan Sumber Daya Manusia Kesehatan di Tingkat Propinsi, Kabupaten/Kota serta Rumah Sakit, Jakarta, 2004.

Departemen Kesehatan Republik Indonesia, Sistem Kesehatan Nasional, Jakarta, 2009. Dinas Kesehatan Kabupaten Gunungkidul, Profil Kesehatan Kabupaten Gunungkidul tahun 2009, Gunungkidul, 2009.

Wibulpolpraset, SMD, Inequitable distribution of doctors: can it be solved?, Human resources for health development journal, 1999;3(1). Salafsky, B, Glasser M, Dan Ha, J, Addressing Issues of Maldistribution of Health care Workers, Journal Ann Acad Med Singapore, 2005;34:520-6.

Andersen R, Revisting the Behavioral Model and Access to Medical Care : Does it Matter, Journal of Health and Social Behavior, 1995;36:1-



DOI: https://doi.org/10.22146/jkki.v1i4.35805

Article Metrics

Abstract views : 231 | views : 215

Refbacks

  • There are currently no refbacks.


Copyright (c) 2018 Jurnal Kebijakan Kesehatan Indonesia : JKKI

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

The 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.
 Web
Analytics View My Stats