Abstract

Remuneration can influence worker`s motivation, and improve their performance. Likewise in hospital as capital-intensive, human resources-intensive as well as knowledge and technology-intensive health care institution. This study aimed to analyze employee’s perception of remuneration system implementation and adult cardiac surgery services unit’s performance at hospital. This study used a mixed method approach (quantitative and qualitative). Quantitative study design was cross-sectional using questionnaire for self-assesment. Meanwhile, qualitative study design was descriptive conducted through focus group discussion and document review on data in forms of schedule book, registration book, nursing notes and medical records. Data collection was conducted in 2013 at one hospital in Jakarta. Respondents/informants were functional medical staff, nurses, and administration staff amounted to 29 people. Data was analyzed using univariate and content analysis techniques. Results showed most functional medical staff dan nurse were unsatisfied (71.2%) with several things in remuneration system implementation, such as in payroll system and grading determination. However, adult cardiac surgery services unit’s performance is increasing every year before and after the implementation of remuneration system. This hospital is expected to improve the remuneration system in accordance with policy and arrange incentive formulation that is more appropriate with current condition as well as followed with proper socialization and periodical evaluation. Remunerasi dapat memengaruhi motivasi pegawai sekaligus meningkatkan kinerjanya. Demikian halnya di rumah sakit sebagai institusi pelayanan kesehatan yang padat modal, sumber daya manusia serta padat ilmu dan teknologi. Penelitian ini bertujuan untuk menganalisis persepsi pegawai terhadap implementasi sistem remunerasi dan kinerja unit pelayanan bedah jantung dewasa (UPBJD) di rumah sakit. Penelitian ini menggunakan pendekatan mixed methods (kuantitatif dan kualitatif). Desain penelitian kuantitatif adalah potong lintang menggunakan instrumen kuesioner self-assessment. Sedangkan desain penelitian kualitatif adalah deskriptif, dilakukan melalui focus group discussion dan telaah dokumen pada data berupa buku jadwal, buku registrasi, catatan keperawatan, dan rekam medis. Pengambilan data dilakukan pada tahun 2013 di salah satu rumah sakit di Jakarta. Responden/informan adalah staf medis fungsional, perawat, dan petugas administrasi berjumlah 29 orang. Data dianalisis secara univariat (metode kuantitatif), dan content analysis (metode kualitatif). Hasil penelitian menunjukkan bahwa sebagian besar staf medis fungsional dan perawat tidak puas (71,2%) dengan beberapa hal dalam penerapan sistem remunerasi, seperti pada sistem penggajian dan penentuan grading. Terlihat kinerja unit pelayanan bedah jantung dewasa mengalami kenaikan setiap tahun sebelum dan setelah penerapan sistem remunerasi. Diharapkan agar rumah sakit ini dapat memperbaiki sistem remunerasi yang sesuai ketentuan kebijakan dan menyusun formulasi insentif dan bonus yang lebih sesuai dengan kondisi saat ini serta perlu dilakukan sosialisasi yang tepat dan evaluasi secara berkala.

References

1. Trisnantoro L. Aspek strategis manajemen rumah sakit antara misi sosial dan tekanan pasar. Yogyakarta: ANDY offset; 2005.

2. Presiden Republik Indonesia. Undang-undang nomor 44 tahun 2009 Tentang Rumah Sakit. Jakarta: Sekretariat Negara Republik Indonesia; 2009.

3. Ilyas Y. Kinerja: teori, penilaian, dan penelitian. Depok: Pusat Kajian Ekonomi Kesehatan FKM Universitas Indonesia; 2002.

4. Keputusan Menteri Keuangan Nomor 165/KMK.05/2008 tentang penetapan remunerasi bagi pejabat pengelola, dewan pengawas, dan pegawai Badan Layanan Umum RSJPDHK. Jakarta: Kementerian Kesehatan Republik Indonesia; 2009.

5. Sulistiadi W. Sitem anggaran rumah sakit yang berorientasi kinerja untuk meningkatkan kualitas keuangan publik. Kesmas: Jurnal Kesehatan Masyarakat Nasional. 2008; 2 (5): 234-40.

6. Gray P. Remuneration, teaching business & economics. 2007; 11 (1): 13-5.

7. Cleveland-Clinic. Ejection fraction Ohio [online]. Updated 2013 [cited 2013 March]. Available from: http://my.clevelandclinic.org/.

8. Grytten J, Holst D, Skau I. Incentives and remuneration systems in dental services. International Journal of Health Care Finance and Economics. 2009; 9 (3): 259-78.

9. Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan Republik Indonesia. Riset kesehatan dasar tahun 2013. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan Republik Indonesia; 2013.

10. Kementerian Kesehatan Republik Indonesia. Situasi kesehatan jantung. Jakarta: Pusat Data dan Informasi Kementerian Kesehatan Republik Indonesia; 2014.

11. Siagian SP. Manajemen sumber daya manusia. Edisi kedua. Jakarta: PT Bumi Aksara; 2009.

12. Hasibuan M. Manajemen sumber daya manusia. Jakarta: PT Bumi Aksara; 2007.

13. Umar H. Riset sumber daya manusia dalam organisasi. Jakarta: PT Gramedia Pustaka Utama; 2000.

14. Dahrouge S, Hogg WE, Russell G, Tuna M, Geneau R, Muldoon LK, et al. Impact of remuneration and organizational factors on completing preventive manoeuvres in primary care practices. Canadian Medical Association Journal. 2012; 184 (2): E135-43.

15. Halimsetiono E. Peningkatan komitmen organisasi untuk menurunkan angka turnover karyawan. Kesmas: Jurnal Kesehatan Masyarakat Nasional. 2014; 8 (8): 339-45.

16. Casalino L, Gillies RR, Shortell SM, Schmittdiel JA, Bodenheimer T, Robinson JC, et al. External incentives, information technology, and organized processes to improve health care quality for patients with chronic diseases. JAMA. 2003; 289 (4): 434-41.

17. Brocklehurst P, Price J, Glenny AM, Tickle M, Birch S, Mertz E, et al. The effect of different methods of remuneration on the behaviour of primary care dentists. The Cochrane Database of Systematic Reviews. 2013; 11: Cd009853.

18. Flodgren G, Eccles MP, Shepperd S, Scott A, Parmelli E, Beyer FR. An overview of reviews evaluating the effectiveness of financial incentives in changing healthcare professional behaviours and patient outcomes. The Cochrane Database of Systematic Reviews. 2011; 7: Cd009255.

19. Ettner SL, Thompson TJ, Stevens MR, Mangione CM, Kim C, Neil Steers W, et al. Are physician reimbursement strategies associated with processes of care and patient satisfaction for patients with diabetes in managed care? health services research. 2006; 41(4 Pt 1): 1221-41.

20. Kim C, Steers WN, Herman WH, Mangione CM, Narayan KM, Ettner SL. Physician compensation from salary and quality of diabetes care. Journal of Generak Internal Medicine. 2007; 22 (4): 448-52.

21. Chaix-Couturier C, Durand-Zaleski I, Jolly D, Durieux P. Effects of financial incentives on medical practice: results from a systematic review of the literature and methodological issues. International Journal for Quality in Health Care. 2000; 12 (2): 133-42.

22. Shen J, Andersen R, Brook R, Kominski G, Albert PS, Wenger N. The effects of payment method on clinical decision-making: physician responses to clinical scenarios. Medicine Care. 2004; 42 (3): 297-302.

23. Rashidian A, Omidvari AH, Vali Y, Sturm H, Oxman AD. Pharmaceutical policies: effects of financial incentives for prescribers. The Cochrane Database of Systematic Reviews. 2015; 8: Cd006731.

24. Gosden T, Forland F, Kristiansen IS, Sutton M, Leese B, Giuffrida A, et al. Capitation, salary, fee-for-service and mixed systems of payment: effects on the behaviour of primary care physicians. The Cochrane Database of Systematic Reviews. 2000; 3: Cd002215.

25. Scott A, Sivey P, Ait Ouakrim D, Willenberg L, Naccarella L, Furler J, et al. The effect of financial incentives on the quality of health care provided by primary care physicians. The Cochrane Database of Systematic Reviews. 2011; 9: Cd008451.

26. Douglas M, Mueller K, Wrenn J. Mayo Clinic: multidisciplinary teamwork, physician-led governance, and patient-centered culture drive world class health care. Commonwealth Fund. 2009; 27 (1306): 1-16.

27. Witter S, Fretheim A, Kessy FL, Lindahl AK. Paying for performance to improve the delivery of health interventions in low- and middle-income countries. The Cochrane Database of Systematic Reviews. 2012; 2: Cd007899.

28. Jensen MC, Murphy KJ, Wruck EG. Remuneration: where we’ve been, how we got to here, what are the problems, and how to fix them. Massachusetts: The European Corporate Governance Institute; 2004.

Share

COinS