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"Optimalisasi tarif Polindes selama ini belum mengacu kepada suatu hasil analisis biaya satuan pelayanan dan tingkat kemampuan dan kemauan masyarakat membayar pelayanan kesehatan. Apakah dengan tarif yang sekarang berlaku sudah mendekati biaya satuan pelayanan dan tingkat kemampuan dan kemauan masyarakat membayar, maka dilakukan suatu penelitian/analisis tentang tarif ini di wilayah kerja Puskesmas Kolelet Kecamatan Rangkasbitung Kabupaten Lebak yang secara purposive dipilih mewakili daerah yang miskin dengan tigkat penghasilan masyarakat rendah tetapi ada sebagian wilayahnya yang bebatasan dengan perkotaan. Penelitian ini merupakan analisis deskriptif dengan rancangan cross sectional. Hasil penelitian menunjukkan bahwa di hitung dari total biaya Puskesmas biaya satuan BP Rp 5.266,00 , KIA/KB Rp 21.736,00 dan Persalinan Rp 92.787,00 sedangkan kalau dihitung dari biaya operasional dan pemeliharaan (tanpa AFC + Gaji) biaya satuan BP Rp 3.420,00 , KIA/KB Rp 10.539,00 Persalinan Rp 42.166,00. Mengenai kemampuan masyarakat, pengeluaran bukan makanan sebesar Rp146.364,00 pengeluaran makanan tanpa pesta Rp 112.173,00 dan pengeluaran non esensial Rp 11.153,00.Dilihat dari 5% pengeluaran bukan makanan kemampuan masyarakat adalah Rp 7.318,00. Kemauan masyarakat pada pengandaian sakit rata - rata adalah Rp 4.833,00. dan pengandaian periksa KIA/KB rata - rata sebesar Rp 2.600,00 titik temu dengan kemampuan berdasarkan pengeluaran non esensial pada nilai Rp 1.600,00 dengan menyingkirkan 20% masyarakat. Sedangkan kemauan masyarakat dilihat dari pengandaian peningkatan kulitas pelayanan Polindes rata - rata sebesar Rp 5.265,00 titik temu dengan kemampuan masyarakat berdasarkan pengeluaran non esensial pada nilai Rp 3.600,00 dengan menyingkirkan 28% masyarakat.Tarif Rp 800,00,- ini ternyata pada saat sekarang dengan memandang tingkat kemauan masyarakat dapat ditingkatkan menjadi Rp 1.400,00 dengan menyingkirkan 12 % masyarakat walupun belum dapat menutupi biaya satuan (tanpa AFC + Gaji). Tarif dapat ditingkatkan menjadi Rp 3.000,00 asalkan kualitas pelayanan ditingkatkan dengan konsekuensi menyingkirkan 29% masyarakat.Masyarakat yang tidak mampu (tersingkir) perlu mendapat subsidi Pemerintah Daerah dan dikelola secara khusus. Hasil penelitian ini dapat dijadikan pertimbangan oleh Pemerinah Daerah Kabupaten Lebak dalam menetapkan tarif Polindes.

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An Analysis of Unit Cost and the Optimum Rate for Polindes Kolelet Kecamatan Rangkasbitung Kabupaten Lebak Propinsi Banten on 2000The optimum rate prices for Polindes haven?t referred to outcome analysis unit cost in services, capability degree and community desire to pay the health service. Is the rate now, have come near to unit cost of services, capability degree and community disire to pay, so it be done an analysis of rate in Polindes Kolelet, Rangkasbitung, Kabupaten Lebak, it is looked for destitute and peripheral areas. This analysis constitutes descriptive analysis by planning cross sectional. The results of experiment showed an unit cost such as : Balai Pengobatan Rp 5.266,00 , KIAIKB Rp 21.736,00, Persalinan Rp 92.787,00 , if it is counted for an operational fee and maintenance (without AFC + salary) unit cost BP Rp 3.420,00 , KIA/KB Rp 10.539,00 , Persalinan Rp 42.166,00. Referring to society ability, expending of not foods is Rp 146.354,00, expending of foods without party Rp 112.173,00 and expending non essential Rp 11.153,00.If we see for 5 % expending of not foods, the community ability is Rp 7.318,00, community desire for sick assumption is Rp 4.833,00 on an average and inspection assumption KIAIKR is Rp 2.600,0000 on an average so it is met with expending of non essential is Rp 1.600,00 which must evacuate 20% of society. If it is seen community desire for upgrading service quality Polindes by average is Rp 5.265,00 referring to society ability, expending of non essential is Rp 3.600,00 which must evacuate community about 28%.The rate for Rp 8.00,00 in this time if we see community desire, it can be risen Rp 1.400,00 by evacuating 12% of society. Although it can't cover an unit cost (without AFC + salary). The rate for Polindes can be risen Rp 3.000,00 if the service quality risen. So it will evacuate 29% of society.The poor community need subsidy from territory government by specific management. The results of experiment can be used for judgment by territory government in determining rate for Plindes."

"Pemberlakuan Otonomi Daerah menyebabkan perubahan pola sistem pemerintahan dari sentralisasi ke desentralisasi dan hal tersebut juga berdampak pada sektor kesehatan. Dengan adanya otonomi daerah, Pemerintah Daerah harus semakin fokus terhadap masalah pembiayaan pelayanan kesehatan karena pada hakekatnya penyelenggaraan Puskesmas Unit Swadana Daerah merupakan penjabaran tujuan otonomi daerah yaitu untuk mewujudkan peningkatan pelayanan masyarakat secara efisien dan efektif.Selama ini Puskesmas Kecamatan Tebet memberlakukan tarif berdasarkan SK Kepala Dinas Kesehatan tahun 2001 tentang tarif di Puskesmas dan tidak berdasarkan dengan Perda No.3 tahun 1999 yang berlaku.Permasalahan yang dihadapi yaitu rendahnya tarif pelayanan rawat imp persalinan berdasarkan Perda dan belum diketahuinya biaya satuan untuk persalinan, khususnya persalinan normal sebagai dasar pendekatan kebijakan pentarifan yang baru. Oleh karena itu tujuan dari penelitian ini adalah untuk mendapatkan gambaran tentang besarnya biaya satuan rawat inap persalinan normal di RB Puskesmas Kecamatan Tebet.Jenis penelitian adalah observasi dengan pendekatan kuantitatif dan bersifat analitik. Metode analisis biaya mempergunakan Activity Based Costing (ABC). Data yang digunakan adalah data primer tercatat pada tahun 2002 pada Puskesmas Kecamatan Tebet dan RB.Dari hasil penelitian, didapat biaya satuan normatif untuk kelas I Rp. 327.741,-, kelas II Rp. 318.411; , kelas III Rp. 3I 3.747,-. CRR tanpa biaya investasi untuk kelas I Rp. 64,70 %, kelas II 56,62 % dan kelas M Rp. 48,53%.Maka dengan hasil tersebut, disarankan untuk menjadi pertimbangan bagi Dinas Kesehatan Prop.DKI Jakarta serta Panda DKI Jakarta sebagai penentu kebijakan dan pengambil keputusan mengenai tarif untuk pelayanan rawat inap persalinan normal di Puskesmas dengan memperhatikan kemampuan membayar masyarakat. Bagi Puskesmas Kecamatan Tebet sendiri, agar mulai melakukan penghematan biaya semaksimal mungkin dengan maksud menekan pengeluaran biaya.

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Unit Cost Analysis of Overnight Stay Service of Normal Childbirth in Tebet Public Health Center, 2002The conduct of regional autonomy causes the changes in government system from centralization to desentralization and it also affects the health sector. Regarding the regional autonomy, the Regional Government should focus on the problem of health service funding so that in fact the self financing public health center can be a clarification of regional autonomy purpose, that is to create an increase on public service efficiently and effectively.

All this time , Tebet Public Health Center conducts the tariff based on Letter Decree of Health Department Chief, 2001 and not on Regional Regulation No. 3, 1999 as directed.

The problem that is faced is the low tariff of overnight stay service of childbirth based on Regional Regulation and unclear unit cost for normal childbirth as a basic approach to a new tariff Therefore, the general purpose of this research is to get description about the amount of unit cost and rational tariff of overnight stay service of normal childbirth at RS Tebet Public Health Center.

The research design is observation with quantitative approach and analytical. The method used in cost analysis is Activity Based Costing (ABC). Whereas the data used in the research is primary recorded data year 2002 at Tebet Public Health Center and RB.

It can be conclude from the research that the normative unit cost for class l is Rp. 327.741,- , class II is Rp. 318.411,- , class III is Rp. 313.747,-.

The result of the research hopefully can be consideration for the Health Department of DKI Jakarta Province and the Regional. Government of DKI Jakarta Province as decision makers for tariff of overnight stay service of normal childbirth at public health center by considering to ability to pay. It will be good for Tebet Public Health Center to save money in order to decrease the big expense."

"Rumah sakit Tangerang telah menjadi unit swadana tahun 1996, sebingga pembiayaan operational dari penghasilan fungsionalnya sendiri, tetapi fungsi social dari rumah sakit tersebut tetap masih dilaksanakan terbukti dengan menangani pasien tidak mampu dilaksanakan sebagaimana mestinya serta sebagai pusat pelayanan dan rujukan Terlihat dengan penanganan pelayanan dasar pada ibu bersalin terjadi pertumbuhan 14,9 % dari tahun 2001 - 2002. Dari pertumbuhan pelayanan persalinan tersebut ,penanganan persalinan normal pertumbuhannya adalah 23,4 % dan diikuti persalinan dengan tindakan sebesar 13,6 %. Bila dilihat dari sisi kenaikan pendapatan pada kamar bersalin terdapat pertumbuhan sangat signifikan yaitu sebesar 99,6%, Bila dibandingkan antara pertumbuhan pelayanan persalinan dengan pedapatan di kamar bersalin, indikasi adanya kenaikan biaya yang sangat berarti. Salah satu upaya untuk mendukung peningkatan cakupan layanan kepada ibu bersalin diperlukan informasi mengenai struktur biaya satuan tindakan persalinan normal dan persalinan dengan ekstraksi vakum di kamar bersalin. Penelitian ini bertujuan untuk memperoleh informasi biaya satuan persalinan normal dan persalinan dengan ekstraksi vakum di kamar bersalin RSUD Tangerang khususnya teridentifikasinya besaran & elemen total biaya di kamar bersalin dan teridentifikasinya besaran biaya satuan layanan tindakan persalinan normal dan persalinan dengan ekstraksi vakum di kamar bersalin RSUD Tangerang. Penelitian ini merupakan penelitian deskriptif analitik secara operational research , dengan analisis biaya menggunakan metode Activity Based Costing. Dari hasil penelitian dapat disimpulkan bahwa biaya satuan persalinan normal adalah Rp 146.828,-(semua komponen biaya dihitung), apabila mengabaikan perhitungan biaya investasi dan gaji PNS maka besarnya adalah Rp 36.940; , Pada persalinan dengan eksiraksr vakum menghasilkan biaya satuan sebesar Rp 198.048,-(semua komponen biaya dihitung), apabila mengabaikan biaya investasi dan gaji PNS maka besamya adalah Rp 59.255,- . RSUD Tangerang adalah rumah sakit umum pemerintah maka peneliti melakukan perhitungan dengan mengabaikan biaya investasi dan biaya gaji PNS. Sehingga terlihat ada efisiensi biaya satuan sebesar 79 %pada persalinan normal dan persalinan ekstruksr vakum sebesar 78 %.

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Tangerang Hospital has been included in self funding hospital program by the Government therefore they have to maintain their social function as hospital in general. It is proven by caring poor patients and been appointed to be service center and reference hospital for Tanggerang district. In implementing such function during year 2002 Tangerang Hospital has served and cared mothers delivering babies almost 15% higher compare to previous year. Normal childbirth itself has grown up by 23% while Childbirth with Vacuum Treatment has grown by almost 14%. Meanwhile when we take a look at revenue growth at Delivery Unit for 2002 compare to 2001 it was a tremendous growth of almost 100%, it was interesting case to be analyzed that in terms of revenue it was significant growth compare to 23% growth of number of services then our rough assumption is it was higher price/tariff and basic assumption of higher price/tariff is higher coast. Coast efficiency and effectiveness can produce lower price/tariff so that can serve more patients, especially poor patients. One way to increase the quality of service to the pregnant is to get information of unit cost structure for Normal Childbirth with Vacuum Treatment in Delivery Room.

The objective of this research is to get information on information of unit coast structure for Normal Childbirth and childbirth with Vacuum Treatment at Delivery Room in Tangerang Hospital, especially identifying cost components and total cost in delivery room and unit cost for Normal Childbirth service and Childbirth with Vacuum Treatment service as weel. This research is a descriptive and analytical operation research, with cost analysis using Activity Based Costing as An approach.

From the research it is concluded that unit cost for normal Childbirth is 146.828,- this calculation charged all cost components while if investment cost and civil servants (PNS) salary was not included the unit cost was only Rp. 36.940,- For Childbirth with Vacuum Treatment service the unit cost was 198.048,- for all cost components included in the calculation but if investment cost and PNS salary is not included then the unit cost become Rp. 59.255,-. The reason for this kind of cost calculation is Tangerang Hospital is Public hospital where all facilities and salaries for civil servants is government subsidy so there is a potential cost efficiency for normal childbirth is about 79 and 78 for childbirth with vacuum treatment. With this potential cost efficiencies in both Normal Childbirth and Childbirth with Vacuum Treatment services then more patients can be served and more services can public as social functionality of Tangerang Hospital. "

"ABSTRAKA successful project requires a convenient cost estimation. The fragmentary of a construction project starts with an imperfect cost analyze and estimation. This paper is discussing about the analyze of cost estimation with different methods, the study is conducted by two different cost estimation coefficient which is SNI Indonesian standard MPW Ministry of Public Work 2016, price journal DKI Jakarta 2017 and private contractor perspective Expert Judgment . The work of raft foundation is a construction project with repetitive work activities. In this research, there were two analyses, namely comparison the cost analysis Identifying aspects, which makes different in cost analyzing result. This writing will compare the analysis of construction costs for raft foundation that done in the field with the value of the contract, so in this paper we will see the difference of cost estimation based on Indonesia standard MPW 2016, price journal of DKI 2017 and expert judgment with contractor.X who complete this project. The analysis done in this research is to study the use of coefficient value or index and unit price and wage on a materials, tools and workers in cost analysis at raft foundation job. The method used is a case study conducted at the Pesona City Mall Project. The data collection done by collecting the documents, materials and labor, then analyzing the data. The analysis done by comparing the contract value on raft foundation job with the result of project cost analysis using MPW 2016, Journal DKI Jakarta price list and expert judgment. So that obtained comparison of Analysis of Construction Cost between contractors values with project cost based on MPW 2016, Journal 2017 DKI Jakarta and expert judgment to identify the method and aspects, which affect cost estimation. In result the cost estimation based on Expert judgment have lower price than MPW 2016 coefficient and Jakarta price list 2017, but still it is higher than contractor.X price.

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AbstractA successful project requires a convenient cost estimation. The fragmentary of a construction project starts with an imperfect cost analyze and estimation. This paper is discussing about the analyze of cost estimation with different methods, the study is conducted by two different cost estimation coefficient which is SNI Indonesian standard MPW Ministry of Public Work 2016, price journal DKI Jakarta 2017 and private contractor perspective Expert Judgment . The work of raft foundation is a construction project with repetitive work activities. In this research, there were two analyses, namely comparison the cost analysis Identifying aspects, which makes different in cost analyzing result. This writing will compare the analysis of construction costs for raft foundation that done in the field with the value of the contract, so in this paper we will see the difference of cost estimation based on Indonesia standard MPW 2016, price journal of DKI 2017 and expert judgment with contractor.X who complete this project. The analysis done in this research is to study the use of coefficient value or index and unit price and wage on a materials, tools and workers in cost analysis at raft foundation job. The method used is a case study conducted at the Pesona City Mall Project. The data collection done by collecting the documents, materials and labor, then analyzing the data. The analysis done by comparing the contract value on raft foundation job with the result of project cost analysis using MPW 2016, Journal DKI Jakarta price list and expert judgment. So that obtained comparison of Analysis of Construction Cost between contractors values with project cost based on MPW 2016, Journal 2017 DKI Jakarta and expert judgment to identify the method and aspects, which affect cost estimation. In result the cost estimation based on Expert judgment have lower price than MPW 2016 coefficient and Jakarta price list 2017, but still it is higher than contractor.X price. "