Asimetri Supply dan Demand dalam Pemenuhan serta Pemerataan Dokter di Puskesmas di Jawa Barat

Abstract

Pada implementasi Jaminan Kesehatan Nasional (JKN), masyarakat yang membutuhkan pelayanan kesehatan harus ditangani di pelayanan kesehatan primer terlebih dahulu. Puskesmas merupakan bentuk pelayanan kesehatan primer yang dituntut memberikan pelayanan kesehatan berkualitas dan prima. Sumber daya manusia (SDM)adalah faktor penting dalam pencapaian kinerja. Manajemen SDM membahas ketersediaan SDM sesuai dengan kualifikasi, kompetensi, dan motivasi. Tujuan penelitian ini menganalisis kesenjangan antara kebutuhan dan ketersediaan dokter di pelayanan kesehatan primer. Penelitian menggunakan metode deskriptif untuk menjelaskan kesenjangan kebutuhan dokter ditinjau dari standar dokter dengan jumlah penduduk, ketersediaan dokter dan puskesmas terhadap jumlah penduduk, serta minat dokter bekerja di puskesmas pada era implementasi JKN. Penelitian dilakukan di Kota Bandung pada April−Mei 2015. Hasil kajian menyatakan terdapat kesenjangan antara kebutuhan dokter di puskesmas dan dokter yang berminat bekerja di puskesmas. Penyebab minat dokter yang bekerja di layanan primer rendah disebabkan oleh ketidakjelasan pengembangan profesionalisme; ketidakpuasan pembayaran sistem kapitasi; lingkungan kerja kurang menyenangkan; beban kerja yang tinggi; pendapatan berdasar atas jasa medis yang diterima rendah; dan proses pendidikan yang kurang membangun minat untuk bekerja di layanan primer. Simpulan, terdapat kesenjangan kebutuhan dokter di puskesmas dengan dokter yang berminat bekerja di puskesmas. Disarankan memperbanyak program pada masa pendidikan kedokteran yang dapat membangun minat bekerja di layanan primer.

ASYMETRI OF SUPPLY AND DEMAND FOR DISTRIBUTION OF MEDICAL DOCTOR IN PRIMARY HEALTH CARE IN WEST JAVA

The implementation of the National Health Insurance required people who need health services to be treated first in primary health care (PHC). PHC required quality health services and one of the important factor was human resources. Human resources management was needed to ensure the adequacy of human resources both in quantity and quality, the availability of appropriate qualification, competence and motivation to work in an organizational unit. The objective of this study was to analyze the gap between supply and demand of the doctors working in PHC. This study was a case report using descriptive methods, to explain the gap between supply and demand of the doctors in term of the standard for population, availability the doctors and PHC. The study was conducted in Bandung City during April−May 2015. The study found that there was a gap between the supply and demand of doctors who were interested to work in PHC. The reason of low interest doctors working in PHC among others were, uncertain professional development; dissatisfaction on capitation payment system; less convenient work environment; the high workload and too many government programs; low income based on medical services cost; and the process of education in medical school were delivered to make less interest to work in PHC. In conclusion, there is gap between supply and demand of doctor to work in PHC. The recommendation is encouraging interaction between the medical students with the primary care services to build the medical student’s motivation.