Incentive Distribution of Specialist Doctors in Government General Hospital
Abstract
Abstract
Maintaining and fulfilling the needs of specialist doctors in government public hospitals is still a challenge. Government general hospitals have not been able to meet the minimum standard for specialist doctors. The distribution of personnel and the incentives received by specialist doctors varies between regions. This study aims to provide recommendations related to policies to meet the needs of specialist doctors at government general hospitals. This cross-sectional research study was conducted in May - December 2017 in 19 hospitals in 18 districts/cities. A total of 134 specialist doctors and dental specialists were respondents in this study. The fulfillment of non-financial incentives for specialist doctors, 28.4% lived in official homes, 41.8% received official vehicles and 73.1% were facilitated to attend seminars/education and training. Fulfillment of financial incentives shows that 73.1% of their income is sufficient for the family’s needs for 1 month and 63.5% can save. Further east, the incentives received by specialist doctors are greater. The combined capacity of central and local budgets can be optimized to provide adequate and equitable incentives to retain specialist doctors in government hospitals, especially in less desirable areas and with limited budgets.
Keywords: adequacy, disparity, incentive
Abstrak
Keberadaan dan kecukupan dokter spesialis di rumah sakit umum pemerintah masih menjadi kendala. Masih banyak rumah sakit yang belum memenuhi standar minimal dokter spesialis di rumah sakit dan masih adanya disparitas distribusi tenaga dan insentif dokter spesialis di tiap daerah. Penelitian ini bertujuan untuk menyediakan rekomendasi kebijakan terkait pemenuhan kebutuhan dokter spesialis dari aspek penyediaan insentif bagi dokter. Penelitian ini dilakukan secara cross-sectional dan dilaksanakan pada bulan Mei - Desember 2017 di 19 RS di 18 kabupaten / kota. Sebanyak 134 dokter spesialis dan dokter gigi spesialis yang menjadi responden penelitian ini. Sebanyak 28,4% tinggal di rumah layanan yang disediakan, 73,1% dari pendapatannya mencukupi kebutuhan keluarga selama 1 bulan, 63,5% dapat menabung, 41,8% dapat kendaraan, 73,1% telah difasilitasi untuk mengikuti seminar / pendidikan dan pelatihan. Semakin ke timur, insentif yang diterima dokter spesialis semakin besar. Kombinasi kemampuan anggaran pusat dan daerah dapat dioptimalkan untuk memberikan insentif yang memadai dan merata untuk mempertahankan dokter spesialis di rumah sakit pemerintah, terutama di daerah yang tidak diminati dan dengan kendala anggaran.
Kata kunci: kecukupan, disparitas, insentif
References
Indonesia, Undang-Undang No. 36 Tahun 2014 tentang Tenaga Kesehatan.
Indonesia, Undang-Undang No. 5 Tahun 2014 tentang Aparatur Sipil Negara.
Sumantri U. Program Pemenuhan Tenaga Kesehatan. In: Rakerkesnas 2017. Jakarta; 2017.
Global Health Workforce Alliance, GIZ. Rencana Pengembangan Tenaga Kesehatan Tahun 2011 – 2025. Jakarta; 2011.
Slamet S. Kebijakan Kementerian Kesehatan dalam Pengaturan Dokter dan Dokter Gigi di Era Global. [Powerpoint presentation]. Presented at the; 2018; Makassar.
Singapore Medical Council. Annual Report 2017. Vol 21.; 2017.
Elflein J. Physician Specialty Data Report. [Internet]; 2019. [cited April 15 2020]. Available at : https://www.statista.com/statistics/209424/us-number-of-active-physicians-by-specialty-area/. Published 2019.
European Commission. Healthcare personnel statistics-physicians. Eurostat. 2017;28(August):1.
Dambisya MY. A Review of Non-Financial Incentives for Health Worker Retention in East and Southern Africa. [Internet]; 2007. Available at: https://chwcentral.org/wp-content/uploads/2013/07/A-review-of-non-financial-incentives-for-health-worker-retention-in-east-and-southern-Africa.pdf
Bhatnagar A. Determinants of Motivation and Job Satisfaction among Primary Health Workers: Case Studies from Nigeria and India [dissertation]. Baltimore, Maryland: John Hopkins University; 2014.
Christianson JB, Leatherman S, Sutherland K. Paying for Quality: Understanding and Assessing Physician Pay-for-Performance Initiatives. Princeton: The Robert Wood Johnson Foundation; 2007.
Meliala A, Trisnantoro L. Penyebaran dan Pendapatan Dokter Spesialis Pemerintah di Indonesia. In: The Second National Forum: Indonesian Health Policy Networks. ; 2011.
Priyatmoko H, Lazuardi L, Hasanbasri M. Analisis determinan ketersediaan dokter spesialis dan gambaran fasilitas kesehatan di RSU pemerintah kabupaten/kota Indonesia (analisis data rifaskes 2011). J Kebijak Kesehat Indones. 2014;03(04):175-182. doi:10.22146/jkki.v3i4.25532
O’Connell BO. The Average Doctor Salary by State and Specialty What is an Average Salary of a Doctor ? Physician Incomes by Specialty Key Trends in the Physician Field That Impact Income Potential. TheStreet [Internet]. 2018 [cited April 14 2020]. Available at: https://www.thestreet.com/personal-finance/how-much-do-doctors-make-14779617 1/3
Bank Indonesia. Laporan Perekonomian Indonesia Tahun 2017. Jakarta: Departemen Komunikasi Bnak Indonesia; 2018.
Rutten FFH, Van Der Gaag J. Referrals and demand for specialist care in the Netherlands. Health Serv Res. 1977;12(3):233-249.
Pembantjanawati EK, Meiyanto S, Meliala A. Evaluasi Sistem Remunerasi Di RS Dr. R. Soetijono Kabupaten Blora. Blora [Powerpoint presentation]; 2008.
Irawati P, Suwendra IW, Yulianthini NN. Pengaruh Kompensasi Finansial dan Non Finansial Terhadap Produktivitas Kerja Karyawan. e-Journal Bisma Univ Pendidik Ganesha. 2014;2(1):632-642.
Kalimantan Timur, Kepala Dinas Kesehatan Kalimantan Timur. Dukungan Pemerintah Daerah (Insentif Finansial dan Non-Finansial) dalam rangka Pemerataan dan Retensi Dokter dan Dokter Spesialis di Provinsi Kalimantan Timur. [Powerpoint presentation]. Yogyakarta: Fakultas Kedokteran Universitas Gadjah Mada; 2013.
Indonesia, Kementerian Kesehatan. Peraturan Menteri Kesehatan RI No. 14 Tahun 2018 tentang Program Bantuan Pendidikan Dokter Spesialis-Subspesialis Dan Dokter Gigi Spesialis-Subspesialis.
Hutauruk CJH. Faktor-Faktor yang Memengaruhi Pemilihan Karier sebagai Dokter Spesialis pada Dokter Muda Fakultas Kedokteran Universitas Lampung. [skripsi]. Lampung: Fakultas Kedokteran Universitas Lampung; 2017.
Ayuningtyas D. Sistem Pemberian Insentif yang Berpihak pada Sumber Daya Manusia Kesehatan di Daerah Terpencil: Studi Kasus Provinsi Lampung. J Manaj Pelayanan Kesehat. 2006;9(2006):87-93.
Clemens J, Gottlieb JD. Do Physicians' Financial Incentives Affect Medical Treatment and Patient Health? Am Econ Rev Author manuscript; available PMC. 2014. doi:10.1257/aer.104.4.1320
Jamison DT, Breman JG, Measham AR, et al., editors. Disease Control Priorities in Developing Countries (Second Edition). 2 nd. New York: Oxford University Press; 2006. doi:10.1596/978-0-8213-6179-5
