Analisis Pembayaran Kapitasi terhadap Perubahan Budaya Organisasi Perawatan Primer di Puskesmas Kota Banda Aceh Tahun 2019

Abstract

The National Health Insurance (JKN) in Indonesia began to be implemented in 2014. As the beginning of the implementation of JKN, it is undeniable that there are still many things that must be addressed, from health facility providers, health human resources to the quality of health services. The government and the Health Insurance Administering Body are always trying to make improvements. In supporting these efforts, a continuous monitoring and evaluation program for the implementation of JKN is very much needed. To see the effect of Capitation Payments on Primary Care Organizational Culture at the Banda Aceh City Health Center. This research is analytic observational with cross sectional design. Data was collected by interview using a questionnaire. The population in this study were all public health centers in Banda Aceh who received capitation services. Samples were taken by purposive sampling technique as many as 83 people. The statistical test used is the paired t-test. Normality test with Shapiro-Wilk, if the data analysis of the independent variables is normal so that the bivariate analysis uses a paired t test with the help of the Stata 14 program. If the data is not normal use the sigrank test. The results showed that the current culture that success criteria is dominated by the current average clan culture (with a score of 25.79 points). With a strong enough cultural power, although it does not qualify as a strong culture according to Cameron and Quinn. (The biggest difference between the current clan culture is with the adhocarsi culture, the current average is 2.29 points. It has not yet reached a strong cultural requirement. Meanwhile, on average, the expectation is dominated by the clan culture (with a score (28.17 points). That the criteria for success are dominated by current average clan culture (with a score of 25.79 points). With a fairly strong cultural strength even though it does not meet the requirements as a strong culture (the biggest difference between culture and expectations is with a hierarchical culture, the average is now 7.03 points. Payments to health workers using the concept of capitation can also cause dissatisfaction from health workers because the amount of services received by health workers is based on the amount of capitation funds received by the health center. It is hoped that the health center can build better communication with fellow employees and apply organizational culture to further strengthen the family system and make it easier in running p programs that have been implemented such as the capitation program.