Mohamad Mirza Fauzie1, Darmanto2, M. Arifai3
BACKGROUND : A hospital is a public facility which has highly acceptable to get nosocomial infection and pollution of the environmental hospitals in its daily activities. In order to avoid and to decrease those kinds of risks, a hospital is necessary to carry out environmental health program of hospitals and those activities were based on the Ministry of Health’s decision Number 1204/ Menkes/SK/X/2004 discussing about the requirement of environmental health of hospitals. The aim of this research is to know the unit cost, quantity, and output quality which were resulted from the environmental health activities and to know the most effective hospital in terms of cost disbursement for environmental health of hospitals.
RESEARCH METHODOLOGY : This study has used analytic descriptive research while its research plan is cross sectional study. The population of this research is 17 general hospitals and the samples of this research are 7 hospitals which were selected by purposive sampling. The variables which were studied compare total cost of investment cost, operational cost, maintenance cost, and administration cost. In addition, the output quantity of activities is amount of water which was produced (m3), the amount of waste water which was treatment (m3), the amount of which was annihilated (kg), and the volume of room which was sterilized (m3), while the output quality consists of quality of laboratorial diagnostic result based on the request from every sanitation installation which is inline with the parameter request. Furthermore, unit cost is total cost that is divided by output quantity, and it is effective when output quality fulfills requirements and it has the lowest unit cost.
RESULT : To accomplish the quality of bacteriology in water supply is not as good as the quality of its chemistry and physic and also the quality of microbiology at waste water treatment. Otherwise, to handle quality of microbiology is easier in technology and cheaper in cost side if comparing to handle the quality of chemistry and physics. From the quantity of water side after becoming waste water, only 0,25 that is processed to waste water treatment. The cost of fuel in destroying the solid medical waste becomes the highest cost so it is needed an efficient fuel of burner. To accomplish the quality of sterilization result so standart operating procedure accomplishment becomes important. By knowing the output quantity, the number of patient and length of stay, the cost that must be paid by the patient for the cost of water reserve is Rp.640/day/patient, the recycling of waste water is Rp.886/day/patient, the processing of solid medical waste is Rp.590/day/patient and cost of room sterilization for the patient that being surgered is Rp.3.098/surgery/patient.
CONCLUDING REMARKS : The average of actual unit cost for processing of health water is Rp 798/m3, while for recycling of waste water, processing of solid medical wasted, and sterilization are Rp 8.907/m3, Rp 6.703/kg, and Rp 1.567/m3 respectively. The higher the unit cost for water supply the better the quality of microbiology and physic. In waste water treatment, the higher unit cost the better the quality of bacteriology and chemistry. Otherwise for sterilization, the less sterilized room volume the higher the unit cost. All common hospital have not been effective yet in using the cost of environmental healthfulness because the requirement of environmental healthfulness, all can not be accomplished.
Key words: unit cost, quality, effectiveness, sanitation, hospital
1 Polytechnic of Health, Yogyakarta
2 Health Engineering Laboratory, Faculty of Civil Engineering and Environment, Gadjah Mada University, Yogyakarta
3 Magister, Hospital Management, Departement of Public Health Post Graduate, Faculty of Medicine, Gadjah Mada University, Yogyakarta