Indonesian Journal of Health Administration
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LESSONS FROM PRIMARY HEALTH CARE IN THE UNITED KINGDOM
Get PDFThe health system in Indonesia is facing the persistent burden of maternal mortality and infectious diseases (including COVID-19) and an increasing burden of non-communicable diseases. Thus, health system reform and innovations at all levels are needed, including through lessons learned from other countries. There are at least five lessons from primary health care in the United Kingdom: easy access, digital and online services, continuity of care, managing chronic conditions, and referral and counter-referral system. There are lessons that policymakers and stakeholders at the national and local (city/district) level could potentially learn from. Despite the differences between the UK and Indonesia (e.g. country income level, national health systems), these lessons could be adapted or piloted in some settings
ECONOMIC INSECURITY AND STRESS AS DETERMINANTS OF COVID-19 PREVENTIVE BEHAVIOUR IN DENPASAR
Get PDFBackground: The COVID-19 pandemic has constituted concurrent public health and economic crises. An inter-correlation between economic and public health impacts due to the COVID-19 pandemic needs to be studied to improve mitigation measures.Aims: This study identified a correlation of the economic insecurity and perceived stress with adherence to recommended preventive behaviours Methods: This across-sectional analytic study was conducted to adults in the working areas of East Denpasar Primary Healthcare Center I. Respondents were selected using consecutive sampling and given a self-administered questionnaire. The research variables included demographic characteristics, economic insecurity indicators, perceived stress, and adherence to handwashing, mask-wearing, physical distancing, and limitation on the social gathering. Correlations, linear regressions, and path analyses were conducted using IBM SPSS 23.0.Results: As many as 161 respondents of which 34.2% males were involved had a mean age of 36.31 (± 7.16) years. Sex, job insecurity, income insecurity, and perceived stress were found as independent determinants in females. Female sex and job insecurity was associated with better preventive behaviours with an adjusted β value of 0.276 and 0.306, while income insecurity and perceived stress had the opposite association with a β value of -0.247 and -0.224.Conclusion: There are correlations between economic insecurity and preventive behavioural practices during COVID-19. It is suggested that public health policies against COVID-19 cover measures of economic safety nets to improve adherenceKeywords: behaviour, COVID-19, economic insecurity, perceived stress, prevention
PHYSIOTHERAPY SERVICE WITHOUT STANDARDIZED OPERATING PROCEDURES FROM PHYSIOTHERAPIST'S PERSPECTIVE: A CASE STUDY
Get PDFBackground: Treatment variations have been considered as a sign of an inappropriate healthcare service whether due to the underuse or the overuse of resources. To reduce these variations, establishing and implementing well-developed standardized operating procedures (SOPs) and evidence-based standardized clinical guidelines is required. A rehabilitation unit for children with disabilities in Makassar did not implement any SOPs or standardized clinical guidelines in their service and treatment. This conduct may have an adverse effect on physiotherapists' professionalism.Aims: The study aimed to explore the possible impact of community-based rehabilitation (CBR) practice with no SOPs and evidence-based standardized clinical guidelines on the physiotherapists. Method: This study was a qualitative case study. The CBR unit was observed for 278-hours and the study conducted three semi-structured interviews. Three physiotherapists voluntarily participated in the study. Open, axial, and selective coding were conducted to encode the interview findings. The findings from observation encoded interview, field, and self-reflective notes were triangulated, analyzed thematically, and illustrated by the explorative model.Results: Working with no SOPs and guidelines was associated with variations in procedures by physiotherapists, irregularity in their treatment choices, liability feeling toward errors making, and Low self-confidence in their professionalism.Conclusion: Working without SOPs and guidelines was associated with psychological exertion of the physiotherapists. They showed uncertainty in their professional capabilities as a physiotherapist. It is recommended for YPAC Makassar city to develop SOPs and evidence-based standardized clinical guidelines for their organization.Keywords: children, community-based rehabilitation, disability, guidelines, standard-operating procedure
BEST PRACTICE OF HOSPITAL MANAGEMENT STRATEGY TO THRIVE IN THE NATIONAL HEALTH INSURANCE (JKN) ERA
No full textBackground: The implementation of the National Health Insurance (JKN) program has created a transformation in the health care system in Indonesia. Many hospitals were stuttering and unable to adapt to the new payment system. Some hospitals complained about INA-CBG rates that were lower than the real rates, so that hospitals suffered losses.Aims: This research aims to take the best practice from one government hospital and one private hospital that is able to thrive in the JKN era.Methods: This study used qualitative research methods through in-depth interviews.Results: The similarity of strategies carried out by the two best practice hospitals to thrive in JKN era are efficiency in business process, investment in human resources, customer relationship management, and stakeholders collaboration.Conclusion: The results of this study can be used as a reference for government and private hospitals in Indonesia to be able to thrive in the JKN era.Keywords: best practice, hospital, National Health Insurance, strateg
THE CORRELATION AVAILABILITY NURSES AND EQUIPMENT WITH ACUTE MISSED NURSING CARE AT HOSPITALS
Get PDFBackground: One of the nurse's roles is to provide nursing care regards of patient safety, consistently and timely. The availability of nurses and equipment can be considered as a primary constraint contributing to acute missed nursing care.Aims: This study aimed to determine the correlation between the availability of nurses and equipment with incidences of acute missed nursing care in medical and surgical wards at hospitals.Methods: This study used quantitative research with a cross sectional approach. This research was conducted at six private hospitals in Malang from October 2020 to November 2020. The population in this study were selected using consecutive sampling, and the study sample consisted of 206 nurses. The acute MISSCARE Survey was used to collect data. The relationship between the availability of the number of nurses and equipment with acute missed nursing care was analyzed by applying SPSS version 26 with the Spearman test.Results: The relationship between the availability of nurses and acute missed nursing care yielded results of Ï = 0.016 (<0.05) and R = -0.168. Equipment availability and acute missed nursing care had values of Ï = 0.026 (<0.05), and R = -0.155. This shows correlation between the availability of the number of nurses and equipment with incidences of acute missed nursing care.Conclusion: The availability of the number of nurses and equipment are the reasons for the incidence of acute missed nursing care. Therefore, nursing managers are needed in managing and allocating the necessary number of nurses and equipment.Keywords: equipment, missed nursing care, nurs
POLICY PERSPECTIVES OF MITIGATION AND RECOVERY DURING COVID-19 PANDEMIC: A NARRATIVE REVIEW
Get PDFBackground: The world is in the grip of an unprecedented novel COVID-19 pandemic. These have resulted in massive impacts on humans as well as on economies invariably. Hence, planning for a future pandemic is vital in minimizing deleterious effects.Aims: The current review aimed to derive common policy perspectives that are important in future planning of a pandemic.Methods: A narrative review was conducted by searching published articles from PubMed, Medline, Scopus, CINAHL, and Google Scholar. Forty-eight articles were selected for the review.Results: The policy perspectives derived under mitigation were rearranged into surveillance, epidemiology, and lab activities. The policy perspectives under recovery derived were related to economy, supply chain management, sustainable and green concept, and health system.Conclusion: Understanding common policy perspectives is important in the mitigation and recovery planning of a pandemic with similar nature in the future. The spillover effects in response to the mitigation measures are deemed vital in planning mitigation and recovery measures for future pandemics. Global and regional resource sharing mechanisms are vital when a universal shortage of healthcare resources occurs.Keywords: mitigation, pandemic management, policy perspectives, recover
ECONOMIC EVALUATION FOR HEALTH ADVOCACY AND INFORMED POLICY
Get PDFBackground: Healthcare resources are limited therefore, adequate, appropriate and timely allocation of resources are important. Decision to invest on health care program can be made from the analysis of the information obtained on the cost and consequences of the various alternative health programs, often known as economic evaluation of health interventions.Aims: This write-up emphasizes on the importance of evidence driven policy of health intervention whereby economic evaluation should be performed to indicate whether investment on health intervention would benefit the country.Methods: Literature review on economic evaluation studies conducted by the first author during her 14 years tenure as academician had been performed. Various studies which applied the cost-effectiveness analysis tools to economically evaluate health interventions and programs in Malaysia and other countries are shared.Results: The economic evaluation studies cut across different programs such as disease prevention and treatment, public health monitoring and control, and implications of health issues to the healthcare system. Many of the findings have been used for advocacy to shape the delivery of more effective health intervention programs in the country.Conclusion: The country will benefit from economic evaluation studies which could provide evidence to assist in policy making on health programs for the country.Keywords: economic evaluation, health programs, policy makin
INVENTORY CONTROL OF DISPOSABLE MEDICAL MATERIALS AT THE BALI MANDARA EYE HOSPITAL
Get PDFBackground: As a health service institution, hospitals have characteristics and management complexities which have an impact on their financing aspects. Controlling the supply of pharmaceutical supplies aims to create a balance between supply and demand in order to realize effective and efficient health services.Aims: This study aimed to design a method for controlling the optimal supply of disposable medical materials at the Bali Mandara Eye Hospital, Bali. Methods: This is a qualitative study based on in-depth interviews with three informants, and involving 11 doctors (users) to determine the critical value of disposable medical materials.Results: ABC analysis was used to classify all types of goods based on their importance to determine priorities based on the value of use. The budget allocation was dominated by only a small portion or only a few types of pharmaceutical supplies. The results show that there was a decrease in the total cost of inventory by 19.14% after the application of the EOQ method. The application of the reorder point (ROP) method can anticipate the occurrence of stock outs or vacancies.Conclusion: The EOQ method is more efficient than the conventional method applied at the Bali Mandara Eye Hospital Pharmacy Installation. The EOQ and ROP methods greatly affect the efficiency and effectiveness of controlling the inventory of medical disposable materials at the Bali Mandara Eye Hospital.Keywords: : inventory control, effective and efficient, medical disposable material
EXAMINING THE GATEWAY HYPOTHESIS OF DRUG USE IN INDONESIA
Get PDFBackground: Drug misuse is a global threat, including in Indonesia. Solving issues of drug use is by understanding the drug patterns. One of the important concepts related to public policy in drug addiction is the gateway hypothesis. However, not all researchers support this theory as the initation of drug use is debatable in terms of how a person starts to consume tobacco and alcohol, marijuana, and then other drugs.Aim: This study identified a initiation sequence of drug use, particularly the gateway from soft to hard drugs and its reverse from hard to soft drug patterns.Methods: This study employed a dataset of drug user patients aged 14–67 years from the Rehabilitation Center of National Narcotics Board in 2014-2018. The dataset was assessed using the Addiction Severity Index (ASI). Purposive sampling was utilized in the sample selection. The dataset was divided into three subsamples to identify the pattern. The subsamples included regular soft-drug users, regular intermediate-drug users, and regular hard-drug users. This study used a quantitative method and cross-tabulation approach along with descriptive statistics.Results: Most of the drug users began consuming intermediate drugs and then soft drugs. Only early users followed the gateway pattern, while those in the intermediate and hard drug pattern mostly did not have the gateway pattern.Conclusion: A policy about prevention of soft drug use (marijuana) in early use may be effective to reduce harder drug use in the future.Keywords: drug use, gateway hypothesis, reversal patter
HOW CRUCIAL IS THE WORKING ENVIRONMENT IN SUPPORTING THE PERFORMANCE OF HEALTH WORKERS?
Get PDFIn the last semester of the second year of the COVID-19 pandemic, our journal emphasizes its current issue on the life of health workers as humans. We choose to underline the working environment condition as one of the super significant predictors of health workers' performance, leading to a stronger health system in the future