Djaky Nanda Parita, Mohamad Adam, Mu’izzuddin
Jurnal Indonesia Sosial Teknologi, Vol. 5, No. 01, January 2024 80
has an important role in improving community welfare, so it is expected to continue to
improve and provide the best service, more effective and efficient, more economical, and
can also touch directly the needs the field of health of every existing community, therefore
hospitals are required to present adequate facilities and infrastructure to serve the
community (Korneles, Nangoi, & Kalangi, 2019).
In the implementation of regional general hospital activities, there are still many
obstacles in its management, both from management and operational aspects. This is
strongly influenced by various demands from the existing environment, including
hospitals requiring quality health services at affordable health service costs (Ariyanto &
Mangesti, 2016). Viewed from the segmentation of community groups, government
hospitals generally provide services for the lower middle class, while private hospitals
serve the upper middle class. Health costs will likely continue to rise, and hospitals must
address the problem independently. The increase in health costs causes this phenomenon
for government hospitals because they have a segment of health services for the lower
middle class (Korneles et al., 2019).
In addition, the aspect of government support greatly affects hospital management,
but in its implementation, government support is still very lacking; this can be seen from
the limited operational budget provided for hospitals, complicated financial management
rules that have an impact on bureaucratic flows that are too long in carrying out the
disbursement process. One of the right solutions to overcome the above is the
implementation of the Public Service Agency (BLU). By implementing PPK-BLUD, the
hospital can plan and manage every income directly and control all internal affairs more
flexibly, effectively, and efficiently, aiming to provide a better quality of public services
(Ekawati, Salaka, & Budiningsih, 2018).
UPTD organizes health healing and recovery efforts that are carried out
harmoniously, integrated, and sustainably with efforts to improve health and prevention,
carry out referral efforts, and organize education, training, and research (Farwitawati,
2020)v.
Siti Fatimah Hospital, South Sumatra Province, 2018, has become a Regional
Public Service Agency (BLUD) engaged in health, but there are still many obstacles that
result in services provided to the community are still not optimal; this is based on the
results of a preliminary survey through observations and interviews of researchers with
several speakers, namely the head of finance, head of accounting subdivision, and
financial staff at Siti Fatimah Hospital, South Sumatra Province. Several things were
obtained from the interview, including that the financial management of Siti Fatimah
Hospital was not optimal. This is due to several obstacles. Siti Fatimah Hospital still
depends on funding from the APBD because the income from health service services is
not optimal; the hospital has mostly come from the lower middle class, all of whom use
BPJS (Nurliah, Mus, & Dani, 2020).
Financial management still experiences obstacles, namely the lack of understanding
related to implementing PPK-BLUD, especially in preparing and presenting financial
statements. In addition, since its inception, several people in the financial department of