ANALISIS BIAYA MUTU DALAM PENINGKATAN MUTU LAYANAN KESEHATAN DI PUSKESMAS

Abstract

Background: Customer complaints and even law suits reflect
poor quality of care. Supports for quality improvement has
been low. Therefore calculation of cost of quality in Public
Health Centers (PHC) is needed to allocated budget. This study
aims to obtain cost of quality and efforts to improve the quality
of PHC through commitment of top management and support of
stakeholders in Sleman PHC, Yogyakarta Special Province.
Method: The research used a case study with multiple-cases
embedded design. The cases were four PHCs that apply quality
management system (QMS) and two PHCs that have not apllied
it yet. The 2010 budget documents were analyzed with the
PAF instrument (prevention, appraisal, failure). Qualitative data
were collected from informant interviews.
Result: The average cost of quality in PHCs with QMS
implementation was IDR 70,000,803; while in the non-QMS
implementation reached IDR 31,421,450. The proportion of cost
of quality in PHCs implementing QMS was 67% for prevention,
33% for appraisal and none for internal-external failures. While
for the non-implementing QMS, the proportions were 92%,
7%, 0%, and 1% sub sequently.
Conclusion: The average cost of quality in PHCs with QMS is
2.2 times higher than the non-QMS. However, its cost for
prevention needs to be improved, through commitment of top
management and support from stakeholders.
Keywords: cost of quality, QMS, prevention, failure, appraisal
cost, Public Health Center