Indonesian Journal of Health Administration
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PHYSICIAN KNOWLEDGE AND RESPONSIBILITY OF PRESCRIPTION POLICY
Get PDFBackground: The minimum standard of generic prescription drugs at a hospital is at 90%. However, the preliminary study discovered the use of generic drugs at Kalisat District Hospital, Jember from 2009 to 2011 was amounted to 57.50%, while the use of patent medicines was at 42.50%. This difference indicates unachieved standard of generic prescription drugs at the Hospital. Aims: This study identified doctors' knowledge and responsibility of drug prescription policy at Kalisat District Hospital.Methods: This descriptive and observational study employed a cross-sectional design. The data were collected randomly from 50 prescription documents of Kalisat District Hospital, Jember from April to July 2013. This study involved 6 general practitioners, 2 dentists, and 4 specialists. Results: There was a strong correlation between doctors' specialization and responsibility for pescribing generic drugs. Doctors' knowledge about prescription policy of generic drugs was still lacking at 58.3%, while doctors' responsibility for prescribing generic drugs was satisfying. Conclusion: Doctors at Kalisat District Hospital have an excellent sense of responsibility in prescribing generic drugs even though they have insufficient knowledge. The Hospital should conduct trainings, provide incentives, improve policies, monitor and evaluate generic prescriptions. Keywords: generic drugs, prescription, doctors' responsibility, doctors' knowledge.
IMPLEMENTATION PROCESS OF STRATEGIC PLANNING AT DISTRICT GENERAL HOSPITAL
Get PDFBackground: A strategic plan is the main reference for the management in carrying out activities to be better and more developed according to the customer's needs. A preliminary study on documents was conducted at the District General Hospital of Dr. (H.C) Ir. Soekarno in Bangka Belitung Province which has implemented a strategic plan. It showed that there were gaps between expectation and implementation of strategic plan.Aim: This study aimed to analyze aspects affecting the strategic plan implementation, including communication, resources, disposition, and bureaucratic structure.Methods: This study was a descriptive study using a qualitative approach. Primary data were obtained through in-depth interview with 10 (ten) informants while secondary data were obtained from document analysis. The data processing and analysis were done using content analysis. The research was conducted from 2 to 31 January 2019 at the District General Hospital of Dr. (H.C) Ir. Soekarno.Results: The findings showed that the implementation process of strategic plans has some gaps. They include (1) ineffective communication, (2) resource factor (lack of quality and quantity of Human Resources, inadequate information, insufficient effectiveness of budget utilization), (3) weak disposition of some implementers, and (4) irrelevant and unadjusted bureaucratic structure.Conclusion: The implementation process of strategic plan has not worked appropriately because some aspects, such as communication, resources, disposition, and bureaucratic structure are not well-provided. This study suggests that formulators should represent all elements. The strategic planning has to be formulated by involving internal and external parties. Monitoring, evaluation, communication, and coordination among stakeholders have to be carried out. Resources need to be improved, and the hospital needs to develop organization structure and conduct disposition guide for executives and implementors.Keywords: implementation, strategic plan, hospital.
PRESCRIBING GENERIC DRUGS: PERCEPTION, OBEDIENCE, AND SUPERVISION AT KALISAT DISTRICT HOSPITAL
Get PDFBackground: The average of generic drugs prescription at Kalisat District Hospital, Jember, in 2009-2011, reached 57.50%, while patent medicine prescription amounted to 42.50%. It showed that the use of generic drugs at Kalisat District Hospital was higher than the use of patent medicine. However, the prescription has not obeyed the service standard with the supposed minimum standard of 90%.Aim: This study aims to determine the doctors' obedience and their perception toward the supervision of prescribing generic drugs as well as the correlation between doctors' supervision and obedience in prescribing generic drugs.Methods: This study is a descriptive and observational study by employing a cross-sectional design. This study was conducted starting from April to July 2013 at Kalisat District Hospital, Jember. The samples were 50 prescription documents taken randomly in April 2013. Besides, questionnaires were distributed to 12 doctors in July 2013.Results: The supervision on prescribing generic drugs at Kalisat District Hospital was considered insufficient by the doctors with the percentage of 58.3%. The level of doctors' obedience in prescribing generic drugs at Kalisat District Hospital reached 68%, while the national standard in April 2013 amounted to 90%. It means that they had not reached the standard of prescribing generic drugs.Conclusion: Based on the cross-tabulation analysis used to investigate the correlation between doctors' supervision and obedience in prescribing generic drugs at Kalisat District Hospital in July 2013, the results suggested that generic drug supervision correlates with the doctors' obedience in prescribing generic drugs. The correlation between these two factors is considered moderate. The hospital should increase the supervision of prescribing generic drugs. Thus, doctors should prescribe generic drugs optimally. The hospital management should also perform continuous socialization on the use of generic drugs.Keywords: generic drugs, supervision, obedience, perception.
IMPROVING THE PERFORMANCE OF PRIMARY HEALTHCARE CENTERS IN SURABAYA: A COMPARISON OF LEADERSHIP STYLE AND VERTICAL DYAD LINKAGE
Get PDFBackground: Leadership style and Vertical Dyad Linkage have a significant influence on organization's performance, especially public health service providers. Leadership style is one factor that will influence the performance and management of primary healthcare center (PHC).Aim: This study aims to investigate the influence of leadership style and leader-member exchange to the performance of PHC.Methods: The research is an observational study with a cross-sectional design. There were 27 PHCs involved in the study. Each PHC was represented by 11 respondents including the directors, five health program coordinators, and their five members. Data were collected with questionnaires and then analyzed using Multinomial Logistic Regression (α=0.05).Results: The results of the research show that (37.05%) of PHCs use supportive leadership style, and (33.33%) of them use participative leadership style. Most of the Vertical Dyad Linkage of PHC were imbalanced social overinvestment (40.7%), and the work performance showed enough performance (59.3%). Path-Goal leadership had the most influence on the performance of PHC.Conclusions: Excellent performance of PHC is related to achievement-oriented leadership style. Work performance of PHC can be improved by improving real neutral leader-member exchange. Furthermore, identifying employees' maturity can be chosen as the leadership style. Employees' self-esteem can be developed to improve the work performance of PHC. Keywords: Leadership style, Vertical Dyad Linkage, Performance of primary healthcare centre
BACK-REFERRAL PROGRAM IN THE ERA OF NATIONAL HEALTH INSURANCE AT BALUNG DISTRICT GENERAL HOSPITAL OF JEMBER IN 2017
Get PDFBackground: In 2014, National Health Insurance Program (BPJS Kesehatan) implemented Back-Referral Program (BRP) to facilitate access to health care for patients with chronic diseases in stable conditions. However, the program did not run well at District General Hospital of Balung which had the lowest back-referral program (6 participants) in 2015-2016.Aim: The study aims to examine the BRP at Balung District General Hospital of Jember in 2017.Methods: This study is designed as qualitative case study. The informants consisted of head of treasury verification, secretary of JKN service controlling, officers of local government's free care scheme, coordinator of internal and neurological disease, specialists in internal and neurological diseases, officers of Social Security Agency for Health, officers of patient eligibility verification, and participants of Back-Referral Program. The study was conducted from October to December 2017.Results: Results show that the attendance of BPJS Kesehatan officers has no contribution to the services of BPJS Kesehatan in the hospital. Participants also find it difficult to follow the steps of BRP due to unavailability of drugs at primary healthcare centers. Moreover, neurologists have not written any referral recommendation since 2016, so there was no patient admittance.Conclusions: The BRP at Balung District General Hospital did not achieve its target (<5 cases/week). In the contrary, the average number of patients referred to the hospital was 86 patients per week. Balung District General Hospital should implement Standard Operating Procedure for letters signed by responsible physician for patients and evaluate the BRP. Keywords: National Health Insurance, Back-referral program, Hospital, Social security
THE CORRELATION BETWEEN DEMAND FACTORS AND HEALTH CARE SERVICE UTILIZATION BY CONTRIBUTION BENEFICIARY PATIENTS
Get PDFBackground: National Health Insurance is the government's effort to increase public access to health care services. As the implementer of the National Health Insurance, the Outpatient Unit of Haji General Hospital, Surabaya has undergone the decrease of contribution beneficiaries' visits from 2010-2013. This condition indicates a decrease in health care utilization by the low-income community.Aim: This study aims to identify the correlation between health care demands and health care utilization by the contribution beneficiary patients.Method: The study was an observational analytic using a cross-sectional design. A systematic random sampling technique was used to determine the sample of the study. The respondents were 74 contribution beneficiary patients who possessed a district government free care scheme and had ever utilized the health care services at the Outpatient Unit of Haji General Hospital, Surabaya, and at least 13 years old. The data were collected through questionnaires and analyzed with Spearman and Chi-Square tests (α =0.05).Results: Health status, insurance needs, additional costs, gender, ethnicity, education, and income did not have a significant correlation with the health care service utilization by the contribution beneficiary patients at the Outpatient Unit of Haji General Hospital. It was identified that the older the people are, the higher the frequency of health care utilization is. Besides, service time was proven to be the determinants of health care utilization (p = 0.006).Conclusion: The most influential factors in utilizing the health care services by contribution beneficiary patients are service time and age. Based on those factors, the Haji General Hospital requires to improve its services and service timeliness for the elderly contribution beneficiary patients.Keywords: demand, contribution beneficiary patients, utilization
THE EQUITY OF ANTENATAL CARE STANDARD IN DIFFERENT AGES
Get PDFBackground: Antenatal care standard ensures the health of pregnant woman with early detection of risk factors, prevention and treatment provided by competent health practitioners. Health equality does not always mean improving the same service for everyone, but the services are provided according to everyone's needs.Aim: This research was to examine the antenatal standards based on patients' needs in the Public Health Centre of Medokan Ayu.Methods: This research was observational by using cross-sectional design. The population in this study was 518 pregnant women who gave birth from June 2011 to May 2012 in the Primary Healthcare Center of Medokan Ayu. There were 88 mothers as samples obtained by a cluster random sampling.Results: This study determines the need for antenatal care standards can be fulfilled more for the age of <20 years and >30 years to avoid the high risk of maternal death and needs and equity based on the standards. There were no differences in the acceptance standard of antenatal care (5T and 7T) based on the age group between <20 years, 20-30 years, and> 30 years.Conclusions: Reproductive women need to recognize the importance of antenatal care. The availability and quality of antenatal care need to be further maintained by the healthcare providers, and they need to be more aware to the importance of antenatal care. Women in later reproductive period need to be aware of the prevailing risks in circumstances. Keywords: Equity, Antenatal care standard, Age
THE RELATIONSHIP BETWEEN DISCIPLINE AND EMOTIONAL INTELLIGENCE TOWARDS EMPLOYEE PERFORMANCE
Get PDFBackground: One of problems in an organization or company is poor performance of employees. For instance, they do not complete tasks or finish their job responsibilities on time. The preliminary data taken from one of companies in Surabaya showed that 184 employees did not come to work without any explanations, and 288 employees worked late.Aim: This study analyzed the relationships between discipline and emotional intelligence towards employee performance at the company.Method: The design of this research was analytical using a cross sectional approach. The population of this study was employees at Production and Maintenance Section of one company in Surabaya comprising of 155 people. Out of 155 employees, 89 respondents were taken as samples using a stratified random sampling technique. Then, the data were collected through a questionnaire and analyzed using Spearman's rank correlation test with a significance level of α 0.05.Results: This study showed that most of the respondents were very highly disciplined (94.4%) and had a highly emotional intelligence (74.2%). Lastly, most of them perform satisfyingly (50.6%). The results of the analysis test with Spearman's rank correlation yielded p-value of 0.002 <α 0.05. It means there was a correlation between discipline attitude and employee performance. The p-value 0.001 which was less than α-value of 0.05 showed that there was a correlation between emotional intelligence and employee performance.Conclusion: Discipline and emotional intelligence are prominent to determine employee performance at PT X. In order to improve the discipline and intelligence in the performance of the employees, the company should provide rewards based on employee's achievements in the workplace. Key words: Emotional intelligence, Employee performance, Discipline
SUCCESS FACTORS OF MENTORING AND SUPERVISION BY HOSPITAL SUPERVISORY AGENCY
Get PDFBackground: A Hospital Supervisory Agency was established to assist hospitals to maintain their service quality. However, not all provinces have an effective Hospital Supervisory Agency. One of the Hospital Supervisory Agency that have run properly is Yogyakarta Provincial Hospital Supervisory Agency.Aim: This study analyzed the success factors of Yogyakarta Provincial Hospital Supervisory Agency in implementing supervision and mentoring to hospitals in Yogyakarta according to the Indonesian Government Regulation Number 49 of 2013.Methods: This study employed a secriptive-qualitative approach and was conducted in Yogyakarta from January to June 2019. Data were collected with in-depth interview to informants chosen by purposive sampling technique.Results: Yogyakarta Provincial Hospital Supervisory Agency could construct a mindset that hospitals will get benefits when partnering with them. Also, the members of Yogyakarta Provincial Hospital Supervisory Agency had strong commitment and work ethic to create innovative strategies and networking to many related stakeholders in spite of low funds from Yogyakarta Provincial Health Office or Yogyakarta Government.Conclusion: The success factors of Yogyakarta Provincial Hospital Supervisory Agency is determined by the high commitment of the members and well-built cooperation between Yogyakarta Provincial Hospital Supervisory Agencyand all hospitals in Yogyakarta.Keywords: Hospital Supervisory Board, success factors, mentoring, supervision