Abstract

This study aimed to find an appropriate model of autonomous self-finance management in primary health care (PHC) to enhance workers' satisfaction. This was a cross-sectional study in which data were collected through self-administered questionnaires from 204 workers in ten Regional Public Service Agency for Primary Health Care (RPSAPHC)/Badan Layanan Umum Daerah Pusat Kesehatan Masyarakat (BLUD Puskesmas) in Tangerang District, Banten Province, Indonesia using the partial least squares and structural equation model (PLS-SEM). A total of 73 indicators were used to examine the PHC transformation process to enhance workers' satisfaction. The indicators were grouped into three variables depending on workers' satisfaction: intrinsic, extrinsic, and general satisfaction. In addition, there were five independent variables: financial accountability, generating income, structuring human resources, increasing service quality, and consumer satisfaction. Model autonomy was reflected by all the indicators (cross-loading > 0.70, Cronbach’s alpha > 0.70, average variance extracted > 0.5) affecting workers’ satisfaction (path coefficient = 0.196, p-value = 0.002). The management should apply five indicators (financial accountability, increasing income, structuring human resources, improving service quality, and customer satisfaction) affecting workers' satisfaction to transform the PHC.

References

1. Winengan W. Menakar penerapan new public management dalam birokrasi Indonesia. J Ilm Adm Publik. 2018; 4 (1): 66–74.

2. Al Khashan H, Abogazalah F, Alomary S, Nahhas M, Alwadey A, AlKhudhair B, et al. Primary health care reform in Saudi Arabia: progress, challenges and prospects. East Mediterr Health J . 2021; 27(10): 1016–26.

3. Nunes AM, Ferreira DC. The health care reform in Portugal: Outcomes from both the New Public Management and the economic crisis. Int J Health Plann Manage. 2019; 34 (1): 196–215.

4. Indrayathi PA, Ulandari LPS. Basis for development of local public service primary health care business strategic plan in Gianyar District, Bali. Kesmas. 2016; 11 (2): 86–93.

5. Singh T, Kaur M, Verma M, Kumar R. Job satisfaction among health care providers: A cross-sectional study in public health facilities of Punjab, India. J Family Med Prim Care. 2019; 8 (10): 3268-75.

6. Ab Rahman N, Husin M, Dahian K, Mohamad Noh K, Atun R, Sivasampu S. Job satisfaction of public and private primary care physicians in Malaysia: analysis of findings from QUALICO-PC. Hum Resour Health. 2019; 17: 82.

7. Wasson JH, Sox HC, Miller HD. Aligning payments, services, and quality in primary care. JAMA. 2021; 326 (9): 805–6.

8. Fein O. Primary care physicians, health promotion and health care reform. J Healthc Commun. 2017; 2 (4): 1–2.

9. Menteri Dalam Negeri Republik Indonesia. Peraturan Menteri Dalam Negeri (Permendagri) Tentang Pedoman Teknis Pengelolaan Keuangan Badan Layanan Umum Daerah. Jakarta: Kementerian Dalam Negeri Republik Indonesia; 2007.

10. Burhan FA. Syncore Indonesia dorong puskesmas jadi BLUD. Jogjapolitan; 2018.

11. Espinosa-González AB, Normand C. Challenges in the implementation of primary health care reforms: a qualitative analysis of stakeholders' views in Turkey. BMJ Open. 2019; 9 (7): e027492.

12. Widaningtyas E. Kesiapan tata kelola puskesmas menjadi badan layanan umum daerah (BLUD). J Manaj Inf Kesehat Indones. 2018; 6 (1): 20-6.

13. Mahmoud MH, Othman R, Taher Mahmoud M Al. Performance Management System of Jordanian Public Sector Organizations: Greater Amman Municipality's (GAM) Experience. International Journal of Human Resource Studies. 2020; 10 (2): 308329-3083.

14. Irawan T, Latif RVN, Wahyuningsih W. Analisis existing dan forecasting Puskesmas BLUD Kota Pekalongan: upaya menuju kemandirian pengelolaan layanan kesehatan primer. J LITBANG KOTA PEKALONGAN. 2016; 11.

15. Jones GR. Organizational theory, design, and change. London: Pearson Education; 2010.

16. Waheduzzaman W. Challenges in transitioning from new public mana - gement to new public governance in a developing country context. Int J Public Sect Manag. 2019; 32 (7): 689–705.

17. Adyas AJ. An Implementation of self-financed management in Public Health Centre (Puskesmas Blud) to enhance workers satisfaction in Indonesia: moderation effect of demographic factors [Dissertation]. Malaysia: Lincoln College University; 2021.

18. BPPKD. Kementrian Dalam Negeri Republik Indonesia. Permendagri No.79 Tahun 2018 Tentang Badan layanan Umum Daerah; 2018.

19. Susanti G, Rifany R. Public service bureaucratic reform: a case study on coordination in one stop services (KPTSP) in Takalar Regency. Publik (Jurnal Ilmu Adm. 2020; 9 (2): 125–31.

20. Nilsen P, Seing I, Ericsson C, Birken SA, Schildmeijer K. Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses. BMC Health Serv Res. 2020; 20: 147.

21. Mahdavi M, Parsaeian M, Jaafaripooyan E, Ghaffari S. Recent Iranian health system reform: an operational perspective to improve health services quality. Int J Heal Policy Manag. 2018; 7(1): 70–4.

22. Schroeder RG, Goldstein SM, Rungtusanatham MJ. Operations management in the supply chain: decisions & cases, 7th ed. New York: McGraw-Hill Education; 2017.

23. Ringle CM, Sarstedt M, Mitchell R, Gudergan SP. Partial least squares structural equation modeling in HRM research. Int J Hum Res Manag. 2018; 31 (12): 1617–43.

24. Badan Pusat Statistik Kabupaten Tangerang. Kabupaten Tangerang Dalam Angka 2019. Badan Pusat Statistik Kabupaten Tangerang; 2019.

25. Krejcie RV, Morgan WD. Determining sample size for research activities. Educ Psychol Meas. 1970; 30 (3): 607–10.

26. Kang H. The prevention and handling of the missing data. Korean J Anesthesiol. 2013; 64 (5): 402-6.

27. SmartPLS GmbH. SmartPLS 3 Free 30-days trial; 2022.

28. Weiss DJ, Dawis R, England G. Manual for the Minnesota Satisfaction Questionnaire. Minnesota Stud Voc Rehab. 1967; 22.

29. Levin KA. Study design III: Cross-sectional studies. Evid Based Dent. 2006; 7 (1): 24–5.

30. Hinson RE, Madichie N, Adeola O, Nyigmah Bawole J, Adisa I, Asamoah K. The new public management and the way forward in Africa. New Public Manag Africa. 2022; 317–26.

31. Apeloko OD, Jombo CO. Institutional reforms and mechanisms for public financial accountability in Nigeria: finding a recourse to horizontal arrangement. Int J Res Innov Soc Sci. 2019; 3 (3): 1–10.

32. Nilasari D. Pola Pengelolaan Keuangan Badan Layanan Umum Daerah (PPK-BLUD) Puskesmas di Wilayah Kota Mojokerto [Undergraduate Thesis]. Universitas Jember: 2021.

33. Kringos D, Nuti S, Anastasy C, Barry M, Murauskiene L, Siciliani L, et al. Re-thinking performance assessment for primary care: Opinion of the expert panel on effective ways of investing in health. European J Gen Pract. 2018; 25 (1): 55–61.

34. Li X, Krumholz HM, Yip W, Cheng KK, De Maeseneer J, Meng Q, et al. Quality of primary health care in China: challenges and recommendations. Lancet. 2020; 395 (10239): 1802–12.

35. Suryawati C, Nandini N, Handayani N. Kepuasan Pasien Terhadap Layanan Puskesmas BLUD di Kota Semarang. J Manaj Kesehat Indonesia. 2019; 7 (1): 39–45.

36. Owili PO, Hsu YHE, Chern JY, Chiu CHM, Wang B, Huang KC, Miriam AM. Perceptions and attitudes of health professionals in Kenya on National Health Care Resource allocation mechanisms: a structural equation modeling. PloS One; 2015.

37. Mahmoud M, Othman R. New public management in the developing countries: effects and implications on human resource management. J Gov Integr. 2021; 4 (2): 73–87.

38. Riambodo RM, Suryawati C, Arso SP. Analisis perencanaan anggaran pada Badan Layanan Umum Daerah (BLUD): studi kasus pada Puskesmas Halmahera dan Ngesrep di Kota Semarang. J Kebijak Kesehat Indonesia. 2020; 9 (1): 44–50.

39. Gumilang AA, Mahanggoro TP, Aini Q. Motivasi dan kepuasan kerja pegawai puskesmas BLUD dan non-BLUD Kabupaten Semarang. Heal Sci Pharm J. 2018; 2 (3).

40. Menteri Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Tentang Pedoman Pelaksanaan Program Jaminan Kesehatan Nasional. Jakarta: Kementerian Kesehatan Republik Indonesia; 2014.

41. Oktavia DA, Jati SP, Budiyanti RT. Hambatan penggunaan dana sisa perhitungan anggaran studi kasus di Puskesmas Kota Semarang. J Kesehat Masy. 2020; 8 (3): 304–10.

42. Cashin C, Bloom D, Sparkes S, Barroy H, Kutzin J, O'dougherty S. Aligning public financial management and health financing: sustaining progress toward universal health coverage. World Health Organization; 2017.

43. Liu D, Wu Y, Jiang F, Wang M, Liu Y, Tang YL. Gender differences in job satisfaction and work-life balance among Chinese physicians in tertiary public hospitals. Front Public Heal. 2021; 9: 635260.

44. Ayudia NPC, Hidayat AC, Setiawan Z. Analisis perbedaan motivasi kerja perawat Pegawai Negeri Sipil (PNS), perawat Badan Layanan Umum Daerah (BLUD) dan perawat Tenaga Harian Lepas (THL) di RSUD Dr. Soedirman Kebumen Berdasarkan Teori Dua Faktor Herzberg. J Ilm Ekon Glob Masa Kini. 2020; 11 (2): 103–8.

45. Rostami F, Babaei-Pouya A, Teimori-Boghsani G, Jahangirimehr A, Mehri Z, Maryam FA. Mental Workload and Job Satisfaction in Healthcare Workers: The Moderating Role of Job Control. Front Public Heal. 2021; 9: 683388.

46. Wahyudi W. The influence of job satisfaction and work experience on lecturer performance of Pamulang University. Sci J Reflect Econ Accounting Manag Bus. 2018; 1 (2): 221–30.

47. Dixit J, Goel S, Sharma V. A comparative study on the level of satisfaction among regular and contractual health-care workers in a Northern city of India. J Fam Med Prim Care. 2017; 6 (2): 416-23.

48. Robbins SP, Odendaal A, Roodt G. Organisational behaviour: global and Southern African perspectives. Cape Town: Pearson Education South Africa; 2003.

49. Insani N. Apparatus professionalism and public service ethics. J La Soc. 2020; 1 (1): 25–8.

50. Eranov A, Nuraliev S. Performance management in the civil service: evidence from Uzbekistan. Int J Civ Serv Reform Pract. 2021; 6 (2).

Share

COinS