ABSTRAK
Latar Belakang: Sistem pembayaran INA-CBGs adalah sistem pembayaran
pelayanan kesehatan di Indonesia yang digunakan BPJS kesehatan untuk
membayar kepada fasilitas kesehatan rujukan tingkat lanjutan. Berdasarkan teori,
sistem pembayaran ini memiliki kelebihan kualitas pelayanan yang baik. Namun
berdasarkan data penelitian terakhir menunjukan bahwa sistem ini dirasa
membuat pelayanan menjadi lama dan menyulitkan. Selain menggunakan BPJS,
Indonesia masih menerapkan sistem pembayaran langsung. Sistem ini
mengakibatkan ekspektasi provider terhadap pasien meningkat sehingga akan
memengaruhi pada dimensi kualitas pelayanan yang diberikan. Penelitian ini
bertujuan untuk mengetahui adakah hubungan antara sistem pembayaran langsung
dan INA-CBGs dengan kualitas pelayanan kesehatan Pasien Rawat Jalan di
RSUD Dr Moewardi
Metode Penelitian: Penelitian ini merupakan penelitian observasional analitik
dengan pendekatan cross-sectional, dilaksanakan di RSUD Dr Moewardi. Sampel
terdiri dari 80 pasien rawat jalan yang diambil dengan teknik quota sampling
dengan restriksi kriteria inklusi dan eksklusi. Semua responden diminta mengisi
kuesioner kualitas pelayanan kesehatan berdasarkan model SERVQUAL. Metode
analisis yang digunakan adalah uji t berpasangan dan analisis regresi linier
berganda .
Hasil Penelitian: Uji t berpasangan antara persepsi harapan kualitas pelayanan
dengan persepsi kenyataan kualitas pelyanan diperoleh nilai mean kenyataan
(100.36) lebih rendah dari harapan (114.30) dengan nilai P sebesar < 0.001. Hasil
analisis regresi linier berganda tentang hubungan sistem pembayaran langsung
dan INA-CBGs dengan kualitas pelayanan rawat jalan RSUD Dr Moewardi
menunjukkan bahwa hubungan antara sistem pembayaran terhadap kualitas
pelayanan secara statistik tidak signifikan (p = 0.259)
Simpulan: Terdapat kesenjangan antara kualitas pelayanan yang diharapkan
dengan kenyataan yang didapatkan. Perbedaan kualitas pelayanan kesehatan
antara sistem pembayaran langsung dan INA-CBGs secara statistik tidak
signifikan
Kata Kunci: bayar langsung, INA-CBGs, kualitas pelayanan, BPJS.
ABSTRACT
Background: INA-CBGs is a payment system used by BPJS Kesehatan, the
Indonesian healthcare insurance provider to provide reimbursement to advanced
referral healthcare facilities (FKRTL). Based on the theory, this payment system
has the advantage of providing a better service quality, but based on the latest
research data, it was found that the system led to a prolonged and difficult service
provision instead. As of now, Indonesia still supplements BPJS with a direct
payment system, causing an increased expectation of compensation from the
patient, which effects the service quality. The purpose of this research is to
determine whether or not a relationship is present between the direct payment
system and INA-CBGs with the quality of outpatient care in RSUD Dr Moewardi.
Methods: The research was an analytic observational with a cross-sectional
approach, performed in RSUD Dr Moewardi. The sample consisted of 80
outpatients from which data was taken through a quota sampling technique, with a
restriction through inclusion and exclusion criteria. All respondents were asked to
fill a questionnaire of the hospital’s healthcare service quality based on the
SERVQUAL model. The analysis method employed was a paired t-test and a
double linear regression analysis.
Results: The paired t-test between the perception of service quality expectation
with a perception of the service quality reality produced a mean reality score
(100.36) which was lower than expectation (114.30) with a P score of < 0.001.
The double linear regression analysis results about the relationship between a
direct payment method and INA-CBGs, with the quality of RSUD Dr Moewardi
outpatient care showed that the relationship between the payment system and
service quality was statistically insignificant (p = 0.259).
Conclusion: A disparity was found between expected service quality with the
obtained reality. The healthcare service quality difference between a direct
payment system and INA-CBGs was statistically insignificant.
Keywords: direct payment, INA-CBGs, Service quality, BPJS
