Peranan Organisasi dalam Implementasi BPJS dan Kinerja Perawat di Puskesmas Wirosari I Kabupaten Grobogan

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi Rumah Sakit 2015 ABSTRAK Sri Panuwun Rahayu Peranan Organisasi dalam Implementasi BPJS dan Kinerja Perawat di Puskesmas Wirosari I Kabupaten Grobogan xiv + 145 halaman + 6 tabel + 4 gambar + 7 lampiran Puskesmas menyelenggarakan pelayanan kesehatan terutama promotif preventif tanpa mengabaikan kuratif dan rehabilitatif dalam implementasi BPJS. Dalam sembilan bulan implementasi BPJS, capaian yang diharapkan belum optimal. Hal ini dibuktikan capaian upaya promotif sangat rendah yaitu kurang dari 40%, sehingga tenaga kesehatan yang bertanggungjawab berkontribusi dalam implementasi BPJS, salah satunya adalah tenaga perawat. Tujuan penelitian ini adalah menganalisis peranan organisasi Puskesmas Wirosari I dalam implementasi BPJS meliputi struktur, desain pekerjaan, kepemimpinan, imbalan, sumber daya di organisasi Puskesmas Wirosari I dalam implementasi BPJS; menganalisis kuantitas dan kualitas kinerja perawat di Puskesmas Wirosari I sejak implementasi BPJS. Metode penelitian ini menggunakan rancangan kualitatif yang disajikan secara deskriptif eksploratif dengan jenis penelitian studi kasus dengan teknik observasi dan wawancara mendalam dengan pendekatan cross sectional. Subyek penelitian meliputi lima informan utama di Puskesmas Wirosari I dan satu informan triangulasi Kepala Dinas Kesehatan Kabupaten Grobogan. Variabel penelitian yaitu peranan organisasi Puskesmas (struktur, desain pekerjaan, kepemimpinan, imbalan, sumber daya) dalam implementasi BPJS dan kinerja perawat (kuatitas dan kualitas) sejak implementasi BPJS. Hasil penelitian menunjukkan organisasi Puskesmas mempunyai struktur yang kurang optimal, desain pekerjaan untuk perawat kurang sesuai, kepemimpinan belum optimal, sistem imbalan belum mampu memotivasi perawat, sumber daya secara kuantitas memadai secara kualitas belum optimal untuk melaksanakan upaya promotif preventif dalam program BPJS. Kuantitas dan kualitas kinerja perawat dalam upaya promotif preventif di Puskesmas Wirosari I sejak pelaksanaan program BPJS belum ada peningkatan yang signifikan. Kesimpulannya adalah bahwa organisasi Puskesmas mempunyai peranan yang penting dalam implementasi BPJS. Peranan organisasi Puskesmas Wirosari I untuk melakukan upaya promotif preventif dalam implementasi BPJS belum optimal dalam waktu yang bersamaan kinerja perawat Puskesmas Wirosari I untuk upaya promotif preventif dalam implementasi BPJS juga belum ada peningkatan yang signifikan. Kata kunci : BPJS, organisasi Puskesmas, kinerja perawat Kepustakaan : 57 (1990-2014) Diponegoro University Faculty of Public Health Master Program in Public Health Majoring in Hospital Administration 2015 ABSTRACT Sri Panuwun Rahayu The Role of Organisation in Implementing BPJS and Performance of Nurse at Wirosari I Health Centre in Grobogan District xiv + 145 pages + 6 tables + 4 figures + 7 enclosures A health centre is an institution that provides health services particularly promotive and preventive services without ignoring curative and rehabilitative services in implementing BPJS. During nine months of BPJS implementation, a target had not been achieved. Coverage of promotive efforts was low, less than 40%. Nurse was one kind of the health workers that was responsible and contributed in implementing BPJS. The aim of this study was to analyse the role of organisation of Wirosari I Health Centre in implementing BPJS comprised structure, work design, leadership, reward, and resources and to analyse quantity and quality the performance of nurses at Wirosari I Health Centre since implementing BPJS. This was a qualitative study presented using descriptive-explorative methods and case study design. Data were collected by conducting observation and indepth interview using cross-sectional approach. Five main informants were selected at Wirosari I Health Centre and head of Grobogan District Health Office (DHO) was selected as an informant for triangulation purpose. Research variables consisted of the role of Health Centre organisation (structure, work design, leadership, reward, and resources) in implementing BPJS and the performance of nurses (quantity and quality) since implementing BPJS. The results of this research showed that structure of Health Centre organisation was not optimal; work design was unsuitable for nurses; leadership was not optimal; reward system was unable to motivate nurses; resources was quantitatively sufficient but insufficient qualitatively to make promotive and preventive efforts in the BPJS program. Quantity and quality of nurses working at Wirosari I Health Centre in making these efforts remained constant since the implementation of BPJS program. In conclusion, organisation of Health Centre played an important role in implementing BPJS. However, the role of organisation of Wirosari I Health Centre to make promotive and preventive efforts in implementing BPJS was not optimal. Similarly, the performance of nurses remained constant. Key Words: BPJS; Health Centre organisation; performance of nurse Bibliography: 57 (1990-2014)