Analisis Faktor Penyebab Melonjaknya Anggaran Obat Pemerintah Kota Batam Setelah Pembebasan Biaya Retribusi Pasien Puskesmas

Background: Batam municipal government has implementedthe program of patient retribution cost exemption in all healthcenters of Batam Municipality with no exception (includes thehaves and the have not) as long as they can show theirpopulation identity card when they visit health canters.Consequently health budget increases four times higher thanthe previous fiscal year. This is interesting to study further inorder to find out the effectiveness or ineffectiveness of theprogram implementation.Objective: The study aimed to analyze the policy of retributionexemption and increased drug expenditure budget.Method: The study was retrospective observational usingboth quantitative and qualitative data, analytical survey methodand cross sectional design. Quantitative data were obtainedwith cluster sampling from documents of health centers suchas monthly report, number of visits of the patients, prescriptionwithin three years (2005 2007) of samples of each yearwere taken three months during peak visits to health centers(June, July and August). Data obtained were tabulated andanalyzed using paired t-test at significance level 95%.Qualitative data were obtained from in-depth interview withrelated stakeholders.Result: Retribution exemption program led to sharp increaseof visits to health centers to twice. There was no difference indisease pattern before and after retribution exemption. Theresult of paired t-test to prescription pattern showed differencebefore and after retribution exemption. The Health Institution ofBatam succeeded to maintain good prescription pattern.Conclusion : Caused sharp increase of drug budget afterretribution exemption in health centers was over anticipate ofdrug procurement to forecast of visits health centre. The overprocurement can be anticipated by planning of drugprocurement the next years.Keywords: health centers, retribution exemption, drug budge