Ach. Mudjib Afan, 099612094 (2002) STUDI AWAL PENERAPAN BALANCE SCORECARD PADA EVALUASI KINERJA RUMAH SAKIT SWADANA :ANALISIS TEKANAN PADA BIDANG KEUANGAN RSUD DR. SOETOMO. Thesis thesis, UNIVERSITAS AIRLANGGA.

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Abstract

Dr Soetomo Hospital has been self-financed since 1999. A self-financed hospital should have financial guidelines that maintain the hospital 039;s independent survival and allow it to grow and develop to meet people's demand for professional health care. A hospital should therefore have "Financial Budgeting" guidelines in its management to provide a reliable financial capability. Knowledge on financial management may provide a holistic frame of reference needed in managing finance in hospital. The aim of this research was to evaluate the performance of Dr Soetomo Hospital, after acquiring status of self-financed hospital, by the use of Balance Scorecard" method in order to study self-finance policy and its implementation. This research was a case study, evaluating a hospital by analyzing implementation of self finance policy and its correlation to the performance of Dr Soetomo Hospital. Based on "Balance Scorecard" method, this study used four-pillar perspectives. First, learning and growth perspective. The indicators in this perspective were employee empowerment and satisfaction in which the employee had optimal knowledge, skill, and capability to empower themselves. Seventy-one (43.8%) respondents occasionally had opportunity to empower themselves and they had used the opportunity. Concerning employee empowerment in expressing opinion, from 162 respondents, 89 (54.9%) occasionally had and used the opportunity, while concerning employee empowerment in participation in skill training, 50.6% respondents explained- that they had the opportunity and did participate in the training. About employee's satisfaction of salary, from 162 respondents, 85 (52.5%) were unsatisfied. Seventy-one percent of the respondents said that the incentive given was unsatisfactory, and 66.1 % explained that job promotion was also unsatisfactory. In internal business perspective, the indicators were evaluation on payment process in outpatient and inpatient counters, and the ordering of patients administrative system from admitted-patient recording to the detail of treatment costs and rapidity in the acceptant of hospital's income. In customer perspective, from 80 respondents, 62 (77.5%) said that the process was unsatisfactory. Seventy-one individuals (91.3%) explained that the payment process in inpatient counter was unsatisfactory, and 55% of the respondents stated that the attention of financial officers to the customer was very satisfactory. Concerning the possible presence of discriminative service for the customers, 91.2% of the respondents said that it was satisfactory, indicating that there was no discriminative service for them. In financial perspective, before self-financed the income rose 7 - 8%, and after self-financed it rose 40%, so that the resulting saved fund as much as 14% could be held as a balance for the following year. However, the rise was actually unreal, because the rise of income was caused by increased tariffs regulated in Provincial Regulation No. 7/1998, which was effective in 1999 when the hospital began to be self-financed. In the long run, the unreal rise of the hospital's income will be disadvantageous for the hospital itself, so that improvement should be focused on non-financial process. The author recommends that employee's empowerment and job satisfaction should be increased. Problems of unsatisfactory payment process either in outpatient and inpatient counters should be solved, particularly by installing more representative cashiers. Patient's satisfaction on financial officers' service should also be increased. The income of Dr Soetomo Hospital should be raised to meet the operational cost and the increase of employee's welfare. Further studies are needed to measure the success of a self-financed hospital by means of "Balance Scorecard" method. description

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