Journal of Health Policy and Management (JHPM)
Not a member yet
212 research outputs found
Sort by
Meta-Analysis the Effect of Pharmaceutical Care on Blood Glucose Level in Type 2 Diabetes Mellitus Patients
Full text linkBackground: Pharmaceutical care is a patientoriented program carried out by pharmacists. In the management of type 2 diabetes mellitus (T2DM) several parameters have been determined as targets for the success of pharmaceutical care such as HbA1c and the level of patient compliance. This paper aims to evaluate the role of pharmaceutical care in improving clinical outcomes and compliance of patients with T2DM.Subjects and Method: This study was conducted using a Systematic Review and Metaanalysis study design using PICO, population: Diabetes mellitus type 2 patients, Intervention: Obtaining pharmaceutical care. Comparison: Did not receive pharmaceutical care, Outcome: Hba1c. The articles used in this study came from 4 databases, namely Pubmed, ScienceDirect, ProQuest and Google scholar. Article keywords are Diabetes Mellitus, Type 2 OR T2DM OR Type 2 diabetes AND Pharmaceutical care OR Clinical pharmacy OR Community pharmacy OR Pharmacist* OR Pharmaceutical services OR Education OR Intervention OR Medication Management AND Knowledge OR adherence OR HbA1c OR glycemic control” Included articles in this study is a full paper article, RCT study design for 20112021.Results: A total of 12 RCT studies with 1,746 T2DM patients in Asia (Jordan, Hong Kong, Northern Cyprus, Thailand, China, Malaysia and Indonesia), Americas (Brazil) and Europe (France and England). From the data processing, it was found that the provision of pharmaceutical care reduced HbA1c levels by 0.81 in patients with type 2 diabetes mellitus compared to those without pharmaceutical care. (SMD= 0.81; 95% CI= 1.11 to 0.52 p<0.0001).Conclusion: The provision of pharmaceutical care can improve clinical outcomes in the form of decreasing HbA1c values.Keywords: Pharmaceutical Care, Type 2 Diabetes Mellitus, HbA1c, Glycemic Control.Correspondence: Muthia Syafira. Masters Program in Public Health Sciences, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email [email protected]. Mobile: +6285920660180.Journal of Health Policy and Management, (2022), 07(02): 112-124https://doi.org/10.26911/thejhpm.2022.07.02.0
Policy Implementation of Mayor Regulation Number 21 of 2020 concerning the Implementation of an Integrated Public Safety Service Center in Padang, West Sumatera, Indonesia
Full text linkBackground: Public service is an important element in improving the quality of life in the community. The government plays an important role in providing public services, especially in the emergency department. This study aims to analyze the implementation of the Padang mayor's regulation number 21 of 2020 regarding the implementation of an integrated safety service center in the city of Padang.Subjects and Method: This was a descriptive qualitative study. The study was conducted in Padang, West Sumatera, Indonesia, from April 18 to May 31, 2022. The primary data were obtained directly through interviews with selected informants. Results: The Policy Implications of the Padang Mayor's Regulation Number 21 of 2020 concerning the Implementation of an Integrated Safety Service Center (Public Safety Center) in the City of Padang is based on the Regulation of the Minister of Health of the Republic of Indonesia Number 19 of 2016 concerning the Integrated Emergency Management System. In its implementation, the Padang City Health Office still relies on health workers at the Puskesmas because PSC 119 does not yet have its own special team or officers. The Padang City Health Office has not officially disseminated to the public and has not officially collaborated with external parties.Conclusion: The policy of Padang Mayor Regulation Number 21 of 2020 as a whole is the authority and responsibility of the Padang City Health Office. The Padang City Health Office has not officially disseminated to the public and has not officially collaborated with external parties. In its implementation, the Padang City Health Office still relies on health workers at the Puskesmas because PSC 119 does not yet have its own special team or officers.Keywords: Policy Implementation, PSC 119, Integrated Service Center.Correspondence: Viola Fathia Irwan. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: [email protected]. Mobile: +6281270403409.Journal of Health Policy and Management, (2022), 07(02): 139-148https://doi.org/10.26911/thejhpm.2022.07.02.05
Utilization of Telestroke during Pandemic COVID-19: A Scoping Review
Full text linkBackground: Telehealth in the setting of patient with stroke or widely known as a telestroke has been researched and practiced in various ways in past decades, but recently with the appearance of pandemic Covid-19 the utilization of telestroke needs to synthesis of the existing literature. This has been reported that there are changes in the utilization of of technology-based health services, includes in the use of telestroke. This study aims to review the utilization of telestroke during this recent pandemic Covid-19. Subjects and Method: This study used scoping review as a method to answer the research question. The study was permormed by searching PubMed, Science Direct, BMJ, and Wiley Online Library databases from 2020 to June 2022. The studies that investigating the uses of telestroke during the period of pandemic Covid-19 were included to this scoping review. The PEOS framework and PRISMA flowchart has been utilized as a method to identifying and selecting the studies, as well as inclusion and exclusion criteria. Results: There were 8 studies that relevant to inclusion criteria and reviewed in this study. The majority of telestroke studies were observational study using retrospective method. Five studies stated that the decreased number of utilization of telestroke during pandemic. Demographic characteristics of the study shown the mean age were >60 years old (87.5%), female patients were more than male (62.5%), primary diagnosed with ischemic stroke (87.5%), severity from mild to severe (62.5%), stroke patients were received thrombolysis (75%), and two studies stated shorter duration for patient to receive treatment.Conclusion: Telestroke has been proven as an effective way in caring patient with stroke. Significant decreased number of telestroke admission was shown from most of the studies due to the Covid-19 while the explanation for this phenomena is still unclear.Keywords: Telestroke, Covid-19, Scoping Review.Correspondence: Nandang DD Khairari. Bachelor in Nursing Program of Hamzar Institute of Health Science. Jalan TGH. Zainuddin Arsyad, No : 100, Wanasaba District, East Lombok Region, West Nusa Tenggara. [email protected]. Mobile. 0877-6505-6560.Journal of Health Policy and Management (2022), 07(03): 235-242 https://doi.org/10.26911/thejhpm.2022.07.03.0
Hospital Financial Strategy in Response to COVID-19: A Systematic Review
Full text linkBackground: The COVID-19 pandemic had resulted in an unprecedented strain on healthcare systems. Hospitals are faced with the unexpected influx of patients, increasing need for protection equipment and infection control procedures, increased workload and operational hours, and the depleting revenues due to closure of elective services. This study aims to further analyze the financial strategies used by hospitals to ensure its operations and to overcome financial challenges presented by the COVID-19 pandemic.Subjects and Method: A systematic review has been identified using four databases: MEDLINE (PubMed), Google Scholar, SCOPUS, and MedSci. This search in literature was published articles from January 2020 to June 2021 using PRISMA guidelines. The keywords used “COVID-19” OR “SARS-CoV-2” AND (ii) "hospital" OR "hospital cost" OR "cost" AND (iii) "strategy" OR "financial strategy" OR "economic" OR "economic analysis".Results: 6 studies were included in our final analysis. We found that effective financial strategies to cover for reduced revenues and increasing cost of care include: (1) Ensuring incentives from external agencies, including the government; (2) Creating new budgets or modifying existing budgets to cover for COVID-19-related cost of care; and (3) Use of contactless health system such as telehealth. Specifically for modifying existing budgets, studies have found that implementing proper health protocol and infection control measures is the most effective, as it has been reported to yield a return of investments.Conclusion: Government funds and relief aids remain the most important source of financial support for hospitals in caring for COVID-19 patients. Without sufficient financial support, hospitals have to get creative in adding additional service fees or finding innovative solutions such as telehealth to cover the dwindling revenues from their closed service units.Keywords: COVID-19, hospital cost, financial strategiesCorrespondence: Suci Kirana Yulius. Hospital Administration Studies Program, Faculty of Public Health, Universitas Indonesia. Universitas Indonesia Pondok Cina, Beji, Depok City, West Java. Mobile: 081273874947. Email: [email protected] of Health Policy and Management (2002), 07(01): 81-93https://doi.org/10.26911/thejhpm.2022.07.01.0
Modified-TAM Analysis of the Implementation of the e-Hospital System on Polyclinic Service
Full text linkBackground: Technology in the field of health services allows an individual to get a productive life and a longer life expectancy. The purpose of this study was to provide describe of obstacles in the implementation of the e-Hospital system, especially EMR services at the Dermatology & Venereology (DV) Polyclinic "X" Hospital from the perspective of service providers.Subjects and Method: This qualitative descriptive research was done with natural observation and using electronic questionnaire based on Modified-TAM Analyses. It was conducted since February-June 2022. The study participants were determined based on the Non-Random Purposive Sampling technique which included all of DV Polyclinic staff at “X” Hospital (3 doctors, 2 nurses, and 2 administrative staff).Results According to the results, it was found that the implementation of the e-Hospital system at the DV Polyclinic was still not running optimally. The most commonly encountered barrier factors based on the Perceived Usefulness (PU), Perceived Ease of Use (PEOU), and Behavioural Intetion (BEI) components was the perception that “e-Hospital cannot replace the conventional system” (50%); and for the PTH & SI components was “the hospitals are not ready to run e-Hospital system” (60%).Conclusion: The hospital management needed to re-evaluate which constraint factors cause these perspectives, which could be an obstacle in implementing the e-Hospital system. In addition, it was necessary to re-emphasize the e-Hospital system and its benefits through periodically training, affirm the vision and mission related to the system, and do periodic feedback evaluations from service providers so that the hospital management could comprehend which obstacles were found and were able to make changes and increase the motivation of service providers to use the e-Hospital system.Keywords: e-Hospital System, Polyclinic Services, Service Provider, TAMCorrespondence: Devina Gracia Pratama. Master of Management Postgraduate Program, Adhirajasa Reswara Sanjaya University. Terusan Sekolah st. No.1-2, Cicaheum, Kec. Kiaracondong, Kota Bandung 40282, West Java. Email: [email protected]. Mobile: +6281220811014.Journal of Health Policy and Management (2022), 07(03): 218-226https://doi.org/10.26911/thejhpm.2022.07.03.0
Meta-Analysis: Intervention Using Midfulness Training to Reduce Burnout in Medical Doctors
Full text linkBackground: Burnout is one of the mental health problems caused by a high workload that causes excessive stress characterized by symptoms such as anxiety and even depression, because of the seriousness of this burnout problem, the WHO classifies burnout as a disease. Burnout is a very serious problem in many countries, so efforts are needed to prevent and/or reduce the negative consequences and impacts of burnout syndrome. One of the interventions that can be done to achieve this is using the mindfulness method. This study aims to examine the effectiveness of mindfulness in reducing burnout levels in doctors.Subjects and Method: This meta-analysis study was conducted using PICO as follows: The population is doctors (general and specialist) who work in hospitals. Intervention is mindfulness. Comparison in the form of mindfulness therapy. The outcome is a low level of burnout. Sources of meta-analysis studies were accessed using: Clinical Key, Google Scholar, MEDLINE/PubMed, Science Direct. The articles used in this study are full-text articles with a Randomized Controlled Trial (RCT) study design. This meta-analysis used 10 articles with a total sample of 539 doctors who were divided into two groups (mindfulness group and no mindfulness group). Analysis of the data using the application Review Manager 5.4.1. The purpose of this study was to determine the Standardized Mean difference (SMD) and heterogeneity in the study sample.Results: The results showed that this study was homogeneous (I2=47%; P<0.001) so the Fixed Effect Model (FEM) was used. Mindfulness intervention was effective in reducing burnout levels in doctors 0.20 units lower than without using mindfulness and the results were statistically significant (SMD -0.20; 95% CI -0.37 to -0.03; p=0.020).Conclusion: Mindfulness is effective in reducing burnout levels in doctors 0.20 units lower than without using mindfulness and the results are statistically significant. Keywords: mindfulness, burnout, doctor.Correspondence: Maika Ratri. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java. Email: [email protected]: +6285702081870.Journal of Health Policy and Management (2022), 07(01): 24-33https://doi.org/10.26911/thejhpm.2022.07.01.0
Implementation of Context Input Process Product Model on Healthy Indonesia Program Policy with a Family Approach
Full text linkBackground: The Healthy Indonesia Program with a Family Approach started in 2017, has now reached the first visit coverage rate of 26.80% as of October 3, 2018, with a Healthy Family Index (IKS) value of 0.165. This figure is still far below the expected target, namely in 2019 it is expected that the visit coverage rate has reached >90% so that in 2019 an intervention plan at the community health center (puskesmas) level can be carried out in accordance with the roadmap of the Ministry of Health. This study aimed to investigate the implementation of the context input process product (CIPP) model in the healthy Indonesia program policy with a family approach.Subjects and Method: This research is a qualitative descriptive study using a sample of policy makers and implementers of the Healthy Indonesia program with a Family Approach (PIS – PK), namely: Head of Public Health Center, Head of Health Service Division of Karanganyar District Health Office, Person in Charge of Healthy Indonesia Program, implementer of PIS – PK visits, and the surrounding community. The research was conducted in August 2021. Data were collected by means of document review, in-depth interviews, focus group discussions (FGD), and participatory observations. Data is presented in analytical descriptive form.Results: Data were collected from 16 research respondents. In the input aspect, the implementation of PIS PK is supported by sufficient human resources, although there are still gaps in the fulfillment of types of positions. Financial support, infrastructure, methods, implementation time and cross-sectoral support look very good and in accordance with the mandate of the Minister of Health 39 of 2019 concerning PIS PK. There are still problems in the application of healthy families, making the PIS PK output results not in accordance with manual calculations, so that family interventions both individually and in groups cannot be carried out optimally. Not all puskesmas have also implemented total coverage in the implementation of PIS PK, nor have all puskesmas used IKS value data as one of the inputs in planning puskesmas in the form of RUK and RPK.Conclusion: The Healthy Indonesia Program (PIS PK) in Karanganyar Regency can be implemented well in terms of context, input and process, but it is still not optimal in the aspect of output because of obstacles in the application of healthy families and the output of PIS PK has not been fully used as a basis for planning at the puskesmas level.Keywords: : context, input, process, product, Healthy Indonesia ProgramCorrespondence: Ninawati. Masters Program in Public Health, Universitas Sebelas Maret. Jalan Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 08112632356.Journal of Health Policy and Management (2022), 07(01): 34-45https://doi.org/10.26911/thejhpm.2022.07.01.04.
Meta-Analysis: Effects of Unsafe Action and Work Experience on Occupational Exposure to Needlestick Injury among Health Workers in the Hospital
Full text linkBackground: Needlestick injury is a dangerous work accident that causes blood contact with pa-tients and is at risk of being infected with blood borne diseases such as hepatitis B virus (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). The purpose of this study was to analyze the influence of unsafe behavior factors on the incidence of accidents due to needlestick injury to health workers in hospitals. Subjects and Method: This research was conducted using a systematic review and meta-analysis study design using PICO, population: health workers, intervention: unsafe action and lack of work experience. Comparison: safe action and good work experience, Outcome: Needlestick Injury (NSI) incident. The articles used in this study came from 4 databases, namely Pubmed, ScienceDirect, ProQuest and Google scholar. The keywords of the article are ("Needle Stick Injury" or "Sharp Injury") AND aOR. The articles included in this study are full paper articles, observational study designs, 2011-2021 and the size of the relationship between Adj Odds Ratio Results: A total of 19 observational studies (case-control and cross-sectional) with 28,487 health workers from the African Continent (Egypt and Ethiopia), the Asian Continent (Thailand, Taiwan, Malaysia and Indonesia) and the European Continent (Bosnia and Herzegovina) were analyzed. From data processing, it was found that unsafe action increased the incidence of Needlestick Injury (NSI) in health workers in hospitals by 2.79 times higher than health workers who behaved safely (safe action) and statistically significant (aOR= 2.79; 95% CI= 2.18 to 3.67; p<0.001). Work Experience increases the incidence of Needlestick Injury (NSI) in health workers in hospitals by 1.97 times higher than health workers who have good work experience and is statistically significant (aOR= 1.97; 95% CI= 1.16 to 3.34; p = 0.010) . Conclusion: The influence of human factors, especially unsafe action, in increasing the incidence of needlestick injuries in health workers.Keywords: needlestick injury, sharp injury, unsafe actionCorrespondence:Nurul Dwi Andriani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: [email protected]. Mobile: +6282137279586.Journal of Health Policy and Management, 07(01): 58-71https://doi.org/10.26911/thejhpm.2022.07.01.06
Meta-Analysis: Association between Empowerment of Home-Based Rehabilitation Intervention on the Escalation of Functional Ability in Post Stroke Patients
Full text linkBackground: Stroke is a disease that is the third leading cause of death in the world after heart and cancer. Stroke is also a disease that causes serious and permanent disability in the first order in the world. The rehabilitation program or recovery of stroke patients will greatly affect the improvement of functional abilities and independence of post-stroke patients, one of the keys to functional improvement is the intensity of therapy and family involvement in supporting the rehabilitation process. This study aims to analyze the relationship between empowering home-based recovery interventions to improve the functional ability of post-stroke patients, with a meta-analysis of primary studies conducted by previous authors.Subjects and Method: This study is a systematic review and meta-analysis with the following PICO, Population: stroke patients. Intervention: home-based recovery. Comparison: not home based recovery. Outcomes: functional ability. The articles used in this study were obtained from several databases, namely PubMed, Springer Link, Cochrane Database, Hindawi, Elsevier, JBBA, LWW, Google Scholar. Search keywords “home-based” AND “intervention” OR “rehabilitation” OR “exercise” OR “therapy” OR “care” AND “stroke” AND “functional ability” OR “functional capacity” AND “Randomized Controlled Trial “ OR “ RCT". The articles included are full-text English and Indonesian languages with a study design of a Randomized Controlled Trial from 2000 to 2021 and reporting on the Mean and SD in multivariate analysis. The selection of articles is done by using PRISMA flow diagram. Articles were analyzed using the Review Manager 5.3 application.Results: A total of 9 randomized controlled trials from Iran, Turkey, Australia, Taiwan, China, Thailand and the Netherlands were selected for a systematic review and meta-analysis. The data collected showed that the home-based recovery intervention improved functional ability in post-stroke patients compared to usual care (SMD = 2.70; 95% CI = 1.53 to 3.87; p<0.001). There is a publication bias that indicates an overestimation). Conclusion: Home-based recovery interventions improve functional ability in post-stroke patients.Keywords: Home-based recovery, functional ability, stroke patients, meta-analysisCorrespondence: Muhammad Husein Syawaludin. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6285728989309.Journal of Health Policy and Management (2022), 07(01): 46-57https://doi.org/10.26911/thejhpm.2022.07.01.0
Association between Heat Stress, Work Fatigue, and Elevated Blood Pressure among Construction Workers in Yogyakarta
Full text linkBackground: Excessive heat stress will cause fatigue and drowsiness, reduce stability and increase the number of work errors. The purpose of this study was to analyze the relationship between heat stress and work fatigue and increased blood pressure in construction workers at PT PP Urban Development Project at the University of Nahdlatul Ulama Yogyakarta. Subjects and Method: Research with a cross sectional design was conducted at PT PP Urban Development Project, Nahdlatul Ulama University, Yogyakarta, from March to April 2022. A sample of 107 workers was selected by purposive sampling. The dependent variable is work fatigue and an in-crease in blood pressure. The independent variable is heat stress. Heat stress was measured by Heat Stress Monitor, work fatigue by reaction timer and increase in blood pressure was measured by digit-al sphygmomanometer. Test analysis using chi-square and the value of Odds Ratio (OR). Results: Construction workers who experience high heat stress have a risk for an increase in blood pressure of 3.10 times compared to normal heat stress and are statistically significant (OR= 3.10; 95% CI= 1.01 to 9.24; p= 0.020), and have a risk of work fatigue 2.73 times compared to normal heat stress and statistically significant (OR= 2.73; 95% CI= 0.97 to 7.52; p= 0.020). Conclusion: There is a relationship between high heat stress and work fatigue and an increase in blood pressure.Keywords: heat stress, fatigue, blood pressure Correspondence:Nisa Nur Kusuma. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A,Surakarta 57126, Central Java, Indonesia. Email: [email protected]. Mobile: +6282225229919 J Health Policy Manage. 07(01): 72-80. https://doi.org/10.26911/thejhpm.2022.07.01.0