EFISIENSI PELAYANAN KESEHATAN DASAR DI KABUPATEN PEMALANG MENGGUNAKAN DATA ENVELOPMENT ANALYSIS EFFICIENCY

ABSTRACT Background. Limited availability of health resources has in- fluenced the health care performance at the health centers. In addition, the health office and health centers are required to be able to manage the available resources to provide optimally healthcare by putting priority on the efficiency in every opera- tional of health centers. The objective of the study is to ana- lyze relative efficiency of primary health care, to find out the efforts for efficiency increase on the inefficient health cen- ters, and to estimate the influence of environmental/ contex- tual factors on the efficiency of primary health care in the health centers. Methods. A descriptive quantitative study was conducted using two-stage data envelopment analysis (DEA). The first stage was to measure efficiency of primary health care, and the second stage was to determine the influence of environ- mental/ contextual factors on the efficiency of primary health care. This study using secondary data of the outpatient per- formance reports in 2013 on 22 health centers in Pemalang regency. Results: Efficiency measurement using DEA-VRS model with output orientation obtained 50% of health centers technically efficient and 50% of health centers technically inefficient. From the efforts of increasing efficiency on the inefficient Health Centers obtained targets of reducing input of workforce re- sources as much as 49 personnels and targets of increasing output of primary health care as much as 154.911 outpatient visits. In the tobit regression analysis showed the population was statistically significant with positive sign, while the popu- lation density, the proportion of visits the poor society and the other primary health facilities are not significant with positive sign. Conclusion. Inefficiencies of health centers was caused by the excessive number of health workforce and low utilization of primary health care by the society. DEA method can be used as a tool to measure the level of efficiency of primary health care in health centers , to provide information on the cause of inefficiency, and to determine the target of efficiency increas- ing on the inefficient health centers. Keyword: Technical efficiency, primary health care, public health center, data envelopment analysis.