[ABSTRAK
Penelitian ini dilatarbelakangi oleh kenyataan bahwa kecenderungan angkapemamfaatan tempat tidur pada RSD dr.Fauziah Bireuen terus meningkat setiaptahun, pada tahun 2007 BOR (bed occupancy rate) rumah sakit mencapai 84%,dan khusus untuk ruang rawat kelas III BOR mencapai 98%, sehingga diperlukanpengembangan jumlah tempat tidur kedepannya. Tujuan penelitian ini adalahingin mendapatkan gambaran mengenai seberapa besar kebutuhan pengembanganruang rawat inap kelas III pada RSD dr.Fauziah Bireuen, dan mendapatkangambaran untuk perencanaan pengembangan nya. Penelitian ini merupakanpenelitian operasional (operasional reseacrh) dengan pendekatan kuantitatif dandidukung oleh pendekatan kualitatif, dengan menggunakan data sekunder 4 tahunterakhir untuk melihat trend analsis, dengan melakukan analsis faktor internal daneksternal pada RSD dr.Fauziah Bireuen.Dalam pengembangan rumah sakit diperlukan suatu pengkajian yangmendalam sehingga menghasilkan suatu perencanaan yang sesuai dengankebutuhan dan dapat dipertanggung jawabkan. Secara umum aspek-aspek yangdikaji meliputi: aspek hukum, aspek sosio ekonomi, aspek pasar, aspekmanajemen organisasi, aspek teknis, dan aspek sumber pendanaan.RSD dr.Fauziah Bireuen adalah rumah sakit type C, merupakan satusatunyarumah sakit milik pemerintah daerah kabupaten Bireuen, yang saat inistatusnya sebagai Unit Pelaksana Teknis Daerah.Hasil penelitian ini menunjukkan bahwa kinerja RSD dr.Fauziah Bireuendari tahun ketahun terus mengalami peningkatan baik untuk pelayanan rawat jalanmaupun pelayanan rawat inap yang diukur dari tingginya angka kunjungan pasiendan angka pemamfaatan tempat tidur setiap tahunnya. Dari angka tersebut dapatdiproyeksikan bahwa kedepan nya permintaan hari rawat di instalasi rawat inapakan terus meningkat, khususnya untuk ruang rawat kelas III. Untuk bisamenampung permintaan hari rawat pada ruang rawat kelas III tersebut maka pihakRSD dr.Fauziah Bireuen harus menambah kapasitas tempat tidur secara bertahapdan berkelanjutan, untuk perencanaan sampai dengan tahun 2012 direncanakanakan dilakukan penambahan 130 tempat tidur dengan perkiraan BOR pada akhirtahun tersebut sudah mencapai 80%. Selanjutnya di rencanakan kebutuhan SDMuntuk mendukung pelayanan dari rencana pengembangan tersebut denganmenggunakan standar ketenagaan dari Depkes RI.Analisis pengembangan..., Afdhal Zikri, FKM UI, 2008iiiDana investasi yang dibutuhkan untuk pengembangan pembangunangedung di rancang berdasarkan petunjuk teknis dirjen yanmed Depkes RI,sedangkan untuk pedoman harga bangunan dan peralatan berdasarkan ketentuanstandar harga yang ditetapkan oleh pemerintah daerah Kabupaten Bireuen,sehingga diperoleh kebutuhan dana investasi sebesar Rp. 4.349.500.000.-Sedangkan untuk kebutuhan biaya operasional dihitung atas dasar anggaran tahun2007 yang terpakai oleh RSD dr.Fauziah Bireuen, selanjutnya diproyeksikanberdasarkan tingkat utilisasi hari rawat tiap tahunnya dengan ikutmemperhitungkan pengaruh inflasi.Analisis kelayakan diukur dari aspek ekonomis dengan menggunakanPayback Period didapatkan bahwa proyeksi net cash flow dapat menyamaiinvestasi awal (intial invesment) pada tahun ketujuh (13 oktober 2015), proyeksiini atas asumsi bahwa kelas III hanya diperuntukan bagi pasien askeskin, danapabila ruangan kelas III tersebut juga diperuntukkan untuk pasien umum makamasa Payback Periodnya jatuh pada tahun keenam (2 juni 2014). Keadaan inimenunjukkan bahwa masa Payback Period lebih cepat dibandingkan dengan umurefektif investasi, sehingga dapat diambil kesimpulan bahwa investasi layak untukdirealisasikan.Selain dari aspek ekonomis kelayakan juga dapat dikaji dari aspek sosiopolitik, dimana pengembangan pelayanan ruang rawat kelas III yang pangsapasarnya adalah penduduk miskin, merupakan tanggung jawab pemerintah, inisesuai dengan amanat dari UUD negara yang menyatakan ?setiap pendudukberhak atas pelayanan kesehatan? selanjutnya dinyatakan pula bahwa ?Negarabertanggung jawab atas penyediaan fasilitas kesehatan dan fasilitas umum yanglayak.Diharapkan dari hasil penelitian ini dapat menjadi pedoman bagipemerintah daerah Kabupaten Bireuen untuk segera mewujudkan rencanapengembangan ruang rawat kelas III pada RSD dr.Fauziah Bireuen, sehinggamamfaatnya berupa pelayanan yang layak bagi pasien miskin dapat segeraterwujud.
ABSTRACT
Background of this study actually based on a number of bed utilization inRegional hospital tended to increase continually for every year, in 2007 hospitalBOR (bed occupancy rate) got up to 84% and especially for third class caring roomit?s BOR was 98%, therefore it need to develop amount of bed for the future. Thisstudy aimed to get description about how much the need of development of thirdclass caring room in Dr. Fauziah Bireuen Regional hospital, and to plan it?sdevelopment planning. This study is an operational research using quantitativeapproach supported by qualitative approach, secondary data for the last four years inobserving analysis trend, and make an analyzing of internal and external factor inRegional Hospital of Dr. Fauziah Bireuen.Hospital development required an in-dept analysis in order to reach anappropriate planning relevant to it?s need and amenable. Analyzing aspects generallyincluded: legal, socioeconomic, market, organization management, technical, andfoundation source aspect.Regional Hospital of Dr. Fauziah Bireuen is type C hospital, and the only onehospital of regional government of Bireuen sub-province, it?s status is RegionalTechnical Carrying Unit at this moment.Result of this study showed performance of Dr. Fauziah Bireuen RegionalHospital had increased well year by year either in-patient or outpatient treatmentmeasured from number of visited patient and bed utilization for every year. Fromthese cases it could be projected that demand of caring day in in-patient installationwill continue increasing, particularly caring room of third class. In order to supplyfor demand of it then Regional Hospital of Dr. Fauziah Bireuen side gradually andcontinually had to enhance amount of bed capacity, it had been planned to enhance130 beds with BOR estimation at the end of year will have reached 80% for 2012.Planning for the need of Human Resources supporting this planning had to relevantto standardization of labor of Health Department of Republic of Indonesia.Investment fund for construction building was considered based on technicalinstruction of directorate general of Yanmed of Health Department of Republic ofIndonesia, and for equipment and building material cost based on provision ofstandard cost provided by regional government of Bireuen sub-province, overallinvestment fund was Rp. 4..349.500.000,-. Operational cost calculated based uponAnalisis pengembangan..., Afdhal Zikri, FKM UI, 2008ivbudgeting on 2007 which had been spent by Dr. Fauziah Bireuen Regional Hospital,then it was projected based on utilization rate of caring day for each year and alsoestimated inflation effect.Feasibility analyzing measured from economic aspect using Payback Period itderived that net cash flow projection would compare to initial investment on theseventh year (October 13, 2015), this projection based on assumption that third classwas only for askeskin patient, and if it was permitted for general patient, PaybackPeriod would occur on the sixth year (June 2, 2014). This condition showed PaybackPeriod was faster than effective age of investment, the conclusion was thatinvestment appropriate to be realized.Besides an economic aspect, feasibility also could be studied from sociopolitic aspect due to market segment of caring room of third class is for poorresident, constituting the government responsibility, it related to mandate of countryconstitution which stated ?everyone has a right for health service? and also ?Countryresponsible in providing appropriate health and public facility?.Study result was expected could be a guidance for regional government ofBireuen Sub-province to implement development planning of caring room of thirdclass in Regional Hospital of Dr. Fauziah Bireuen, in order that it?s function ingiving an appropriate treatment for poor patient would be realized immediately., Background of this study actually based on a number of bed utilization inRegional hospital tended to increase continually for every year, in 2007 hospitalBOR (bed occupancy rate) got up to 84% and especially for third class caring roomit’s BOR was 98%, therefore it need to develop amount of bed for the future. Thisstudy aimed to get description about how much the need of development of thirdclass caring room in Dr. Fauziah Bireuen Regional hospital, and to plan it’sdevelopment planning. This study is an operational research using quantitativeapproach supported by qualitative approach, secondary data for the last four years inobserving analysis trend, and make an analyzing of internal and external factor inRegional Hospital of Dr. Fauziah Bireuen.Hospital development required an in-dept analysis in order to reach anappropriate planning relevant to it’s need and amenable. Analyzing aspects generallyincluded: legal, socioeconomic, market, organization management, technical, andfoundation source aspect.Regional Hospital of Dr. Fauziah Bireuen is type C hospital, and the only onehospital of regional government of Bireuen sub-province, it’s status is RegionalTechnical Carrying Unit at this moment.Result of this study showed performance of Dr. Fauziah Bireuen RegionalHospital had increased well year by year either in-patient or outpatient treatmentmeasured from number of visited patient and bed utilization for every year. Fromthese cases it could be projected that demand of caring day in in-patient installationwill continue increasing, particularly caring room of third class. In order to supplyfor demand of it then Regional Hospital of Dr. Fauziah Bireuen side gradually andcontinually had to enhance amount of bed capacity, it had been planned to enhance130 beds with BOR estimation at the end of year will have reached 80% for 2012.Planning for the need of Human Resources supporting this planning had to relevantto standardization of labor of Health Department of Republic of Indonesia.Investment fund for construction building was considered based on technicalinstruction of directorate general of Yanmed of Health Department of Republic ofIndonesia, and for equipment and building material cost based on provision ofstandard cost provided by regional government of Bireuen sub-province, overallinvestment fund was Rp. 4..349.500.000,-. Operational cost calculated based uponAnalisis pengembangan..., Afdhal Zikri, FKM UI, 2008ivbudgeting on 2007 which had been spent by Dr. Fauziah Bireuen Regional Hospital,then it was projected based on utilization rate of caring day for each year and alsoestimated inflation effect.Feasibility analyzing measured from economic aspect using Payback Period itderived that net cash flow projection would compare to initial investment on theseventh year (October 13, 2015), this projection based on assumption that third classwas only for askeskin patient, and if it was permitted for general patient, PaybackPeriod would occur on the sixth year (June 2, 2014). This condition showed PaybackPeriod was faster than effective age of investment, the conclusion was thatinvestment appropriate to be realized.Besides an economic aspect, feasibility also could be studied from sociopolitic aspect due to market segment of caring room of third class is for poorresident, constituting the government responsibility, it related to mandate of countryconstitution which stated ‘everyone has a right for health service’ and also ‘Countryresponsible in providing appropriate health and public facility’.Study result was expected could be a guidance for regional government ofBireuen Sub-province to implement development planning of caring room of thirdclass in Regional Hospital of Dr. Fauziah Bireuen, in order that it’s function ingiving an appropriate treatment for poor patient would be realized immediately.] |
