Pengaruh Variasi Metode Pembayaran Kapitasi Kepada Dokter Keluarga Terhadap Efisiensi Biaya Dan Kualitas Pelayanan

Background: Payment method may influence the behavior of doctors, so it may affect efficiency, quality of health services, and population health status. In the UU No 40/ 2004 on National Social Security System (SJSN), the government aims to develop the role of family doctors. Accordingly there is a need to investigate the most appropriate method of payment to the doctors. This study aimed to investigate the effect of payment method to the family doctors on cost-efficiency and quality of health care. Methods: This was an analytic study using cross-sectional design. It was conducted in Surakarta municipality and Sukoharjo district, from October to November 2007. The target population was family doctors and participants of the compulsory health insurance scheme of PT Askes. The indepndent variable under study were capitation method for paying doctors’ fee with or without drug cost. The dependent variables included cost per member per month, cost-effectiveness ratio, referal per visit ratio, and the quality of health care. This study collected primary data using a pre-tested questionnaire and secondary data available at the PT Askes office. The data was analyzed by t test and Mann- Whitney, which were run under SPSS v. 15. Results: Results showed that there was no statistically signficant difference between capitation method for paying doctors’ fee with and without drug cost in cost per member per month (p= 0.940), costeffectiveness ratio (p= 0.604), referal per visit ratio (p= 0.148), and the quality of health care (p= 0.073). Conclusion: This study concludes that there is no significant difference between capitation method for paying doctors fee with and without drug cost in performance measures such as efficiency and quality of health care. It is suggested that similar studies be conducted using longer time and larger sample size. Keywords: payment method, family doctor, cost-efficiency, quality of health care