Indonesian Journal of Health Administration
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DETERMINE THE TARGET TO INCREASE PRIMARY HEALTHCARE UTILIZATION IN INDONESIA'S DISADVANTAGED AREAS
Full text linkBackground: Primary health care (PHC) is the closest institution known to people in disadvantaged areas.
Aims: The study determines the policy target based on the demographic characteristics to increase PHC utilization in a disadvantaged area.
Methods: The cross-sectional research explored 42,644 respondents. In addition to PHC utilization, the study examined eight independent variables: residence, gender, marital, age, wealth, insurance, education, and travel time. We employed a binary logistic regression in the last stage.
Results: Live in urban areas had 1.967 more likely to utilize the PHC (95%CI 1.942-1.992). Males could be 1.412 higher than females (95%CI 1.402-1.421). All marital types had more chances than never married. All education was more likely than no education. The employed had 0.972 less likely than the unemployed (95%CI 0.965-0.980). All wealth groups had less possibility than the poorest. Those with government-run insurance were likelier than other types. The ≤10 minutes travel time was more likely than the >10 minutes.
Conclusion: There were seven policy target characteristics to increase PHC use in disadvantaged areas in Indonesia: live in a rural area, female, never married, have no education, employed, not the poorest, don't have government-run insurance, and have a travel time of more than ten minutes.
Keywords: disadvantaged area, healthcare evaluation, primary health care, public healt
DEVELOPMENT OF SUSTAINABLE HEALTHCARE MODEL FOR THE HOSPITALS IN NORTHERN INDIA
Full text linkBackground: Healthcare organizations incorporate products and services at economical prices to deliver healthcare services of good quality. All the operations performed in the organizations aimed to achieve a higher level of environmental sustainability governed by the Sustainable Developmental Goals of 2030.
Aims: This study aims to develop a sustainable healthcare model using Analytical Hierarchy Process (AHP).
Methods: First and foremost, the authors have identified the factors associated with the sustainable healthcare system through a literature review. Based on these factors, a questionnaire was developed and administered to 25 healthcare organizations from December 2020 to March 2021. An Analytical Hierarchy Process is utilized to rank the factors, and a conceptual model is developed. The Felix Hospitals substantiate this model. The authors have also applied sensitivity analysis to validate the results achieved via AHP.
Results: The AHP model demonstrates the focus is on the environment first, followed by the economic and social dimensions sustainably. The validated model was also substantiated by the hospital (Felix) results and sensitivity analysis.
Conclusion: It can be concluded that hospital sustainability highly depends on the environment in the first stage and economic and social sustainability in the second and third stages. The same result was achieved through AHP.
Keywords: analytical hierarchy process, hospital, sustainable healthcare
PHYSICIANS AND DISRUPTION ON TELEMEDICINE: A SYSTEMATIC LITERATURE REVIEW
Full text linkBackground: Telemedicine has developed rapidly since the COVID-19 pandemic. Telemedicine applications have marked significant transformations in healthcare. Rapid changes in healthcare services inevitably affect health service providers, specifically physicians.
Aims: This study examines physicians' responses to a disruptive era in the healthcare industry.
Methods: This paper applies a systematic literature review approach to characterize physicians' experiences, challenges, and obstacles in managing disruption in the health service delivery context. A comprehensive literature review was conducted using the Scopus database and borrowing PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method. There were 78 articles included in the analysis.
Results: This study found that doctors who use telemedicine experience several types of disruption. The studies that examine physicians' experience in health service disruption tend to be dominant in 4 (four) out of 5 (five) disruption types. First, disruption to the current delivery mode. Second, disruption to clinical practice role and responsibility. Third, disruption to clinical practice role and responsibility. Fourth, disruption to the work environment. Meanwhile, the disruption in personal life becomes less elaborated in the telemedicine studies debate.
Conclusion: It is essential to pay close attention to the disruptions that have an effect on physicians' personal lives. Personal life is essential because it benefits physicians and directly supports the quality and sustainability of telemedicine services.
Keywords: Disruption, Physician, and Telemedicine
FACTORS ASSOCIATED WITH THE UTILIZATION OF PUBLIC HEALTH CENTER IN CENTRAL JAVA
Full text linkBackground: The Public Health Center (PHC) is a gatekeeper to formal healthcare in Indonesia. PHCs in Central Java have met the basic health facility readiness standard, but there are still numerous challenges to increasing the utilization of PHCs.
Aims: This study aimed to analyze the factors related to the utilization of PHC in Central Java.
Methods: This cross-sectional study used secondary data from the 2018 Indonesia Basic Health Research, with 63,118 total samples. The independent variables were residence, age, gender, marital status, education, insurance, and socioeconomic, while the dependent variable was the utilization of PHC. The data were analyzed using a binary logistic regression.
Results: The average rate of utilization of PHC in Central Java in 2018 was 5.7%. Those aged 46-65 and >65 years old, women, married and widowers, and those with health insurance had a higher possibility of utilizing PHC. Meanwhile, those who graduated from secondary and tertiary school, the employed, and the wealthiest group had a lower possibility of utilizing PHC.
Conclusion: The factors related to the utilization of PHC in Central Java are age group, gender, marital status, education level, working status, health insurance ownership, and socioeconomic status.
Keywords: basic health service, health service access, public health, public health cente
THE EFFECT OF PARTICIPATION IN JKN ON UNMET NEEDS FOR HEALTHCARE SERVICES
Full text linkBackground: The National Health Insurance or Jaminan Kesehatan Nasional (JKN) program is one of the steps taken by the Indonesian government in developing Universal Health Coverage (UHC). However, increased participation in the National Health Insurance is not followed by an increase in met needs for healthcare services.
Aims: This study aimed to examine the effect of participation in the National Health Insurance on unmet needs for healthcare services in poor and non-poor population groups.
Methods: This study used data from the 2018 National Socio-Economic Survey/ Survei Sosial Ekonomi Nasional (SUSENAS) and Village Potential Survey/ Survei Potensi Desa (PODES). Data were processed using binary logistic model analysis to identify the effect of participation in the National Health Insurance on the unmet needs for healthcare services.
Results: Participation in the National Health Insurance, including beneficiary program for poor groups could reduce the risks of unmet needs for healthcare services by 7.7%, while non-beneficiary program could reduce the risks of unmet needs for health services for non-poor groups by 10.4%.
Conclusion: Both beneficiaries and non-beneficiaries affect the unmet needs for health services for both poor and non-poor groups. However, the non-beneficiary program is more elastic than beneficiary program to fulfill needs for both sample groups.
Keywords: Healthcare services, national health insurance, logit, unmet nee
HAS INCLUSIVE HEALTH ACCESS IN JAKARTA'S PUBLIC HEALTH CENTER BEEN FULFILLED?
Full text linkBackground: Each individual, including persons with disabilities, has a guaranteed right to access healthcare services. Indonesia has ratified the United Nations Convention on the Rights of Persons with Disabilities (CRPD) through Law No. 19 of 2011. However, PWDs still experience difficulties and restrictions in accessing health services.
Aims: Examine the fulfillment of inclusive health access for PWD in public health services as a form of inclusivity in health development in Jakarta. This research will finally analyze whether local regulations have accommodated the fulfillment of health rights for PWDs.
Method: Using qualitative and descriptive methods by raising case studies that are used in-depth and thoroughly. This study was conducted in three public health centers in South Jakarta. The reason for choosing the location is because Jakarta is an area that has regional regulations on PWD, and the proportion of PWD is 22.1% nationally. The informants in this study were selected by purposive sampling techniques involving 15 informants who conducted in-depth interviews.
Results: The mandate of local regulations has not realized inclusive health services for PWD. Marked by lack of information, the absence of health services specifically even though there has been social assistance in the form of KPDJ (Jakarta Disability Card), accessibility that is not yet disability-friendly, and commitment from local governments that are lacking because there is no evaluation, especially in the health sector so that the environment is not inclusive.
Conclusion: Providing access to health services for PWD in South Jakarta public health centers is still not inclusive. Policy evaluation is needed, considering that local regulations on PWD have been revised in 2022. Data collection on the number of PWDs in the Puskesmas work area needs to be carried out to meet their health needs.
Keywords: access, disability, health, inclusive, public health cente
COST ANALYSIS OF HOME PHARMACY CARE PROGRAM AMONG DIABETES PATIENTS IN PHARMACY
Full text linkBackground: Home pharmacy care is expected to be able to provide a pharmaceutical service that not only reduces the incidence of drug interactions and side effects but also increases the effectiveness of therapy and patient compliance in using drugs.
Aims: The study aimed to analyze the costs incurred for the home pharmacy care program for diabetic patients at the pharmacy.
Methods: This analysis used the independent variable by providing a program of home pharmacy care. The dependent variable was the cost of running the program of home pharmacy care. The sample was the pharmacist in charge of the pharmacies in the Banyumas and Cilacap districts, which provide a home pharmacy care service program. The sample was conducted by purposive sampling method. Sampling was done by direct interviews with pharmacists who signed informed consent. Break Even Point (BEP) was calculated to determine the number of patients who must be served. The pharmacoeconomic analysis used is Cost Analysis using the activity-based costing (ABC) method.
Results: The lowest rate for home pharmacy care services is Rp. 17,000, and the highest is Rp.31,000 without including home pharmacy care services.
Conclusions: Pharmacies continue to benefit from the home pharmacy care program, and there is no provision for home pharmacy care service rates.
Keywords: Activity Based Costing (ABC), Diabetes Mellitus, Home pharmacy care (HPC
ENGAGING PATIENTS FOR PATIENT SAFETY: A QUALITATIVE STUDY ON HEALTHCARE RECIPIENTS' PERSPECTIVES
Full text linkBackground: Patient safety (PS) is a global priority for achieving quality healthcare. Although patient engagement (PE) is a crucial risk-reduction strategy, research on this subject in Indonesia is scarce.
Aim: This study aims to explore healthcare recipients' (HCRs') perspectives and their potential role in PS.
Methods: Exploratory qualitative research was conducted with in-depth interviews (IDIs). This study purposively selected fourteen patients and fifteen caretakers in chronic wards. Content analysis was subjected to the IDIs data that has been transcribed verbatim.
Results: HCRs showed inadequate knowledge, perception, and willingness to engage in patient safety. Four themes were identified from data analysis: (1) complexity barriers to PE Implementation; (2) enabling factors for PE; (3) HCRs' expectations; and (4) existing and potential HCRs' roles in PS. HCRs' roles were still limited to communication, positive attitude and behavior, aided healthcare process, and error prevention.
Conclusion: The limited roles of HCRs resulted from their unreadiness to participate more in PS. For patients to be engaged in safety measures, it was essential to improve the ability of patients and caregivers and eliminate obstacles encountered by healthcare professionals and the broader health system.
Keywords: patient engagement, patient safety, quality healthcar
