Gratification Control in Local Culture-Based Health Services at Prof. Dr. I.G.N.G. Ngoerah Central General Hospital, Denpasar

Abstract

Prof. Ngoerah General Hospital as a government institution tasked with providing health services to the community, should be able to provide optimal services according to the standards set by the government, especially clean and integrated services. However, in reality there are still obstacles faced, such as the practice of giving gratuities, which are disguised under the pretext of friendship and kinship. Departing from this reality, the management of Prof. Ngoerah General Hospital formed a gratuity control institution to prevent the giving of gratuities which could possibly lead to acts of corruption. By referring to this reality, this study formulated three main problems, namely (1) Why is gratuity control in local culture-based health services implemented at Prof. Ngoerah General Hospital? (2) How is the process of implementing gratuity control in local culture-based health services implemented at Prof. Ngoerah General Hospital? (3) What are the implications of the implementation of gratuity control in local culture-based health services, on social, cultural, economic life, and public trust in the health services provided by Prof. Ngoerah General Hospital?

The general objective of this study is to explore these three problems based on three grand theories, namely the theory of McDonaldization and new consumption tools, Management theory and Reception theory. This study uses a qualitative research type with a religious and cultural approach and an interpretative paradigm. Data collection techniques are carried out using participant observation techniques, in-depth interviews, and document studies. The results of the study are, first, there are several reasons for the implementation of gratification control at Prof. Ngoerah General Hospital, namely ideological reasons, such as the ideology of McDonaldization, and capitalist ideology, reasons to avoid gratification becoming an act of bribery, and legal reasons. Second, the implementation of gratification control at Prof. Ngoerah General Hospital is carried out by applying management functions, namely planning, organizing, mobilizing, and evaluating. Third, gratification control at Prof. Ngoerah General Hospital turns out to have implications for several dimensions of life, such as the social dimension, namely the realization of harmonious relations between the medical team and patients and their families, among fellow health workers, and between management and the medical team; Then, in the cultural dimension, it increases public knowledge of the values of Balinese local wisdom. Furthermore, in the economic dimension, controlling gratification can save patients money on treatment costs and increase the integrity of Prof. Ngoerah General Hospital, which has implications for public trust in the services provided by the hospital to its users. A key finding of this study is the emergence of an adaptive or hybrid work ethic within Prof. Ngoerah General Hospital, known in Balinese culture as "Ajeg Bali," an effort to maintain cultural identity without turning a blind eye to the influx of modern cultural elements or globalization.