IMPLEMENTASI KEBIJAKAN SUBSIDI PELAYANAN KESEHATAN DASAR TERHADAP KUALITAS PELAYANAN PUSKESMAS DI KOTA SINGKAWANG

Abstract

Background: Health sector is inseparable from the
decentralized system of local autonomy. Health sector is a
responsibility of the local government, even though it is
frequently included in the political policies of a leader. The
direction of healthcare service development, particularly at
the level of Health Center, has been maintained in the Mayor's
Decree of Singkawang No. 82/2009 on the subsidiary of
healthcare in Kota Singkawang.
Objective: To find out the quality of healthcare at the Health
Centers in relation to the primary healthcare subsidy based on
the perception of society, control/supervision of Local Health
Office, management, service time, service capacity/type, and
attitude of the health center staffs.
Method: A descriptive research with case study design was
conducted in three Health Centers: Singkawang Tengah, Singkawang
Timur, and Singkawang Utara Health Centers. Subjects
of the research were 15 health staffs and 111 patients.
The data were collected using questionnaire, observation, and
interviews.
Results: The research found a score of 3.3 for the healthcare
in Singkawang Tengah, Singkawang Timur, and Singkawang
Utara Health Centers. It means that the Health Center provided
relatively high quality healthcare. From the Reliability dimension,
a score of 2.92 was found for Point 2 quick examination
service with reference to the standard procedure and a score
of 2.97 for Point 5, the timeliness of healthcare. From the Responsiveness
dimension, a score of 2.77 was found for Point 3
– the patients did not wait long to get the healthcare service –
and a score of 2.94 for Point 4 – the working hour of the Health
Center. Qualitative analysis showed that the Local Health Office
controlled/supervised the Health Centers by means of utilization/
visit reports and management. It was found that service
time was frequently ignored and that service type/capacity at
the Health Centers was constrained by the availability of reagents
and medication. The health staffs tended to ignore service
quality and time and there was an indication of deviation in
the utilization/visit reports sent by the Health Centers.
Conclusion: The Local Health Office did not have adequate
tools to control/supervise the Health Centers, as evident from
the aspect of management, service time, service type/capacity,
and health staff attitude. Procurement of healthcare supplies
was hampered by bidding process and the health staffs need
continuous training and development.
Keywords: Health Office, Health Centers, Public Perception,
and Healthcare quality