Berdasarkan pemantauan dilapangan, bahwa ada kecenderungan motivasi Para dokter spesialis merawat pasien disuatu rumah sakit atas pertimbangan imbalan finansial disamping aspek pengabdian masyarakat dan dewasa ini di era globalisasi masalah imbalan finansial dipandang sebagai salah satu tantangan yang harus dihadapi oleh manajemen suatu organisasi maka pada bulan Mei 1996, Direktur RSVP Dr. Hasan Sadikin membuat kebijakan melalui surat keputusan no. 15A1 DI - 32 1 KU.06.02/ VJ 1996 yang antara lain berisi tentang pemberian imbal jasa ( insentif ) kepada dokter spesialis. Penelitian dilakukan secara "cross sectional" dengan pendekatan kualitatif dan memilih secara acak 45 dokter spesialis (16 % dari total populasi ) sebagai sampel dengan tujuan mengidentifikasi sistem imbal jasa dan mengetahui pandangan dokter spesialis terhadap sistem imbal jasa yang berlaku sekarang. Didalam mengidentifikasi sistem imbal jasa tersebut, peneliti mencari data mengenai BOR kelas Utama, I dan II; penerimaan fungsional kelas utama, I dan II serta faktor SDM dokter spesialis, sedangkan untuk mengetahui pandangan dokter spesialis peneliti mengumpulkan informasi tentang pengetahuan dan pendapat dokter spesialis terhadap sistem imbal jasa tersebut. Dari hasil penelitian ini ditemukan bahwa BOR kelas utama tahun 1996 ( 56,69 %) menurun dibanding BOR tahun 1996 ( 74,83 % ), BOR kelas I selalu dibawah 60 % sejak tahun 1992 sampai tahun 1996 dan BOR kelas II relatif tidak ada peningkatan yaitu sekitar 65 %. Penerimaan fungsional relatif tetap berkisar 676.000.000.rupiah dari kelas utama, dari kelas I, 980.000.000. rupiah dan dari kelas II, 1.4 milyar rupiah. Sebagian besar dokter spesialis ( 86,66 % ) setuju dengan adanya imbal jasa bagi mereka tetapi 71,11 % diantaranya merasakan ketidak adilan terhadap sistem imbal jasa yang berjalan sekarang dan 51, 11 % dokter spesialis menginginkan adanya pengurangan besarnya potongan jasa medis. Peneliti menyarankan agar dibentuk suatu unit kerja khusus yang melibatkan dokter spesialis dalam membuat sistem imbal jasa dan merubah porsi pembagian jasa medis yang 70 % menjadi 80 % untuk jasa medis dokter spesialis.

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Working as a pediatrician for years at Hasan Sadikin Provincial Hospital, it is felt that many medical specialists ( OB Gynt, surgeons, pediatricians, neurologist etc ) in this hospital are not quite satisfied with the new regulation on incentives for medical specialists. The regulation was declarated in 1996 through a letter of decree Na I5AIDI-32 I KU.06.021 V/1996 issued by the hospital director. In general it is said that every medical specialist working as a full timer and government employee at the hospital receives Rp 100.000, 1 month incentive; without differentiating whether she or he sent or took care of any single patient.

This study intended to portray and analyze factor related to the incentive system for medical specialists and at once also find out details on the unsatisfactory conditions felt by these specialist using a cross sectional survey design, 45 out of 225 medical specialists (16 % of total medical specialists ) were interviewed. The flow of income from various resources received by the hospital, how, where and what proportion goes to the incentives, were 'described and analyzed. Bed Occupancy Rate (BOR ), the number & qualification of the medical specialists are other 2 factors, beside income, which are theoretically related to the incentive system for medical specialists at Hasan Sadikin Provincial Hospital.

The study found that the BOR at the VIP class tends to decrease from 74.83 % in the year 1995 to 56.69 % in the year 1996; at the first class the BOR is always below 60 % and no improvement at all for BOR at the 3rd class. The hospital income tends to remain unchanged in 1966, with total of Rp 676.000.000,- from VIP class; Rp 980.000.000,- from first class and 1.4 million from the 2nd class inpatient wards. This means that the BOR which is still below the MOH standard of BOR ( 60 % ) and the revenue of the Hasan Sadikin Provincial Hospital must and is necessary to be increased.

Majorly of the medical specialists ( 86.66 % ) agrees that incentives must be arranged through regulation, however; 71.11 % is unsatisfied with the current rule. 51,11 % of them suggests the director to reviset the rule and make changes for more fair deal.

The researcher suggests 1) the director to establish a functional team who will work continuously on this matter; 2) to increase medical incentives for medical specialists who refers to and take care their patients at the Hasan Sadikin Hospital. The latter suggestion in the long run is expected to increase the BOR and the revenue of Hasan Sadikin Hospital.