People really crave the availability of health services, especially hospitals (RS) that are of high quality at affordable prices and Public Private Partnerships (PPP) are part of the solution to make this happen. One of the PPP Service delivery models to improve service quality and hospital efficiency is Contracting in-out or in the Indonesian context known as Operational Cooperation (KSO).


The statement was made by Dr. Drg. Masyitoh, MARS in a doctoral promotion in the field of Administrative Sciences, Faculty of Administrative Sciences, University of Indonesia (FIA UI) with the dissertation title “The Effect of System Context, Drivers and Collaboration Processes on the Output of Operational Cooperation (KSO) at Regional Hospitals (RSD) with Public Service Agency Status Regions (BLUD) in Indonesia” on Wednesday, July 6, 2022 noon.


“The practice of collaboration in KSO is marked by a win-win solution between the hospital and partner companies. Along the way, the implementation of KSO in RSD faced a number of problems and an unequal position was found between RSD and partner companies. The practice of KSO RSD is also often considered to be detrimental to the state so that it becomes a finding,” he said.


Masyitoh in this study marries the science of public administration and health through the use of collaborative governance instruments. In addition, he also uses Emerson and Nabatchi’s theory which provides a collaborative governance analysis framework consisting of system context variables, drivers, processes and outcomes.


In his research, Masyitoh found several facts, namely that the implementation of KSO at the BLUD Hospital did not run in accordance with good governance due to policy barriers, human resources and corrupt practices. In addition, the researchers found that there are policies that are not in tune between ministries, policies that are interpreted differently, incomplete policies and other influencing sector policies.


“Besides policy, the issue of human resources (HR) is also a strong issue through the dimensions of leadership and capacity for joint action. This issue is colored by limited competence,” said Masyitoh.


Masyitoh also said that the absence of a regional head regulation did not dampen the RSD’s steps to implement KSO because it opened up opportunities from higher regulations and corrupt practices. The high needs of the community and the limitations then encourage the director of the RSD to be creative to take advantage of the existing opportunities.


In addition, he also stated that the autonomy of the RSD was limited, even though it was a BLUD. On a more technical level, it’s difficult for RSD to run with various regulations attached. In addition to autonomy, collaboration also requires capacity where the capacity that is not balanced between RSD and partner companies is coupled with a culture of corruption that permeates every level and stage of KSO implementation.


In his presentation, Masyitoh said that a public administration approach is needed in the management of RSD to deal with problems that involve many stakeholders from various sectors and across many jurisdictions who may see, understand and have different solutions. Solutions to RSD problems should be a priority considering that RSD is the backbone of JKN.


In his research, Masyitoh provides recommendations for policy makers at the central and regional levels. He said that the issuance of Presidential Instruction number 1 of 2022 regarding the Optimization of JKN Program Services became the right momentum for the Ministry of Health and the Ministry of Home Affairs to “sit together” to evaluate, review and refine regulations related to health service governance at BLUD Hospitals so as not to cause confusion and multiple interpretations. at the implementing level.


“Meanwhile, the Regional Government is expected to stipulate and or update the Regional Head Regulation regarding KSO at the RSD along with the guidelines. Recommendations are also given to RSD managers to be more proactive in encouraging local governments to issue rules for cooperation in RSDs,” he said.


Masyitoh closed his dissertation presentation by saying that Path analysis proves that the context system can only affect the process through the mediation of driver variables.


After delivering the presentation, the examiners and promoters gave questions and input related to their dissertation. In this doctoral promotion session, Masyitoh managed to become a doctor of the 15th Faculty of Administrative Sciences in the field of Administrative Sciences with cum laude predicate.


Also acting as Chair of the Session in the promotion session, Prof. Dr. Irfan Ridwan Maksum, M.Sc., Prof. Dr. Eko Prasojo, Mag.rer.publ. as a promoter, Prof. Dr. Amy Yayuk Sri Rahayu, M.Sc., as the co-promoter, as well as a member of the examiner consisting of Dr. Phil. Reza Fathurrahman, MPP, Dr. Pantius D. Soeling, M.Sc., who was present online, Dr. dr. Slamet R. Yuwono, DTM&H, MARS, M.Kes., and Prof. Dr. Amal Chalik Sjaaf, SKM, Dr.P.H.