Faculty of Public Health Journal Universitas Indonesia
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Strategi Implementasi Jaminan Kesehatan Nasional dengan Metode Balanced Scoredcard: Studi Kasus di Rumah Sakit X Tangerang Tahun 2018
Get PDFAbstrakRS X merupakan salah satu rumah sakit swasta di Tangerang yang berhasil mengimplementasikan JKN (Jaminan Kesehatan Nasional) dengan efisiensi biaya tanpa mengabaikan mutu layanan. Penelitian ini bertujuan untuk mengetahui strategi RS X dalam pelaksanaan Program JKN dengan metode Balanced Scorecard. Penelitian dilakukan pada Mei 2018 dengan pendekatan kualitatif. Data dikumpulkan melalui wawancara mendalam kepada 7 informan pihak RS dan 2 informan dari BPJS Kesehatan. Subjek dipilih berdasarkan purposive sampling dan dianalisis dengan analisis tematik. Hasil penelitian menunjukkan ada beberapa strategi yang telah dikembangkan dan diterapkan yaitu dari (1) Perspektif keuangan (menambah jenis layanan, meningkatkan kapasitas pada rawat inap dan poliklinik, menerapkan prinsip low cost dan meningkatkan modal kerja, menambah slot dokter, melengkapi perawatan medis menerapkan prinsip low cost, dan meningkatkan modal kerja); (2) Perspektif pelanggan (menentukan target market, mengembangkan 5 nilai tambah, dan manajemen komplain); (3) Perspektif proses bisnis internal (pembuatan standar operasional prosedur, menyusun formularium dan clinical pathway, melakukan pengendalian dan audit operasional, menetapkan bisnis model, pembentukan tim casemix, serta manajemen klaim); (4) Perspektif pembelajaran dan pertumbuhan (reward dan gaji bagi karyawan, lingkungan kerja kompetitif serta memperhatikan jenjang karir karyawan). Melalui strategi tersebut, RS X mampu mengimplementasikan Program JKN dengan baik dan tetap membukukan surplus tanpa mengorbankan kualitas pelayanan. AbstractOne of the private hospital successful implementation the National Health Insurance with cost efficiency without neglecting the quality of service is X Hospital. This study aimed to finding out the strategy of X Hospital in the implementation of the National Health Insurance with Balanced Scorecard. The research was conducted in May 2018 using qualitative approach. Data was collected through in-depth interview to 7 informants from hospital and 2 informants from BPJS Kesehatan. The subjects were selected purposively and the data was analyzed using thematic analysis. The results show that there are several strategies that have been developed and implemented, including: (1) financial perspective (adding types of services, increasing the capacity of inpatients and polyclinics, increasing doctor practice slots, completing medical equipment, applying the principle of low cost and increasing working capital); (2) customer perspective (choosing target market, develop 5 values propotition, complaint management); (3) internal business processes perspective (develop standard operating procedures, develop drug formulary and clinical pathways, carry out operational and audit controls, build business models, form case mix teams and claim management); (4) learning and growth perspective (develop training, giving reward and good salaries, build a competitive work environments, and pay attention to employee career paths). Through this strategy, X Hospital is able to implement the JKN Program well and still record a surplus without sacrificing service quality.Keywords: Balanced scorecard, hospital strategy, national health insuranc
Determinan Sosial Ekonomi Terhadap Berat Badan Lebih dan Obesitas di Indonesia: Analisis Data IFLS 2014
Get PDFAbstrakFenomena berat badan lebih dan obesitas menjadi masalah yang serius di berbagai negara khususnya di Indonesia. Menurut WHO, pada tahun 2016 terdapat 2,8 juta orang yang meninggal akibat masalah berat badan lebih dan obesitas, sedangkan menurut Kementerian Kesehatan Indonesia prevalensi berat badan lebih dan obesitas di Indonesia pada tahun 2018 mencapai angka 13,6% dan 21,8%. Salah satu faktor penyebab berat badan lebih dan obesitas adalah faktor sosial ekonomi. Namun sering terdapat perbedaan mengenai pengaruh status sosial ekonomi terhadap obesitas di negara berkembang dan negara maju. Penelitian ini bertujuan untuk mengetahui determinan dari status sosial ekonomi terhadap berat badan lebih dan obesitas. Data yang digunakan berasal dari Indonesian Family Life Survey (IFLS) 5 tahun 2014 pada sampel berusia lebih dari 18 tahun. Analisis dilakukan dengan model Ordered Logistic Regression. Hasil penelitian ini menunjukkan bahwa secara statistik individu dengan status sosial ekonomi yang lebih tinggi memiliki peluang yang lebih tinggi untuk mengalami berat badan lebih dan obesitas. Oleh karena itu, sosialisasi program layanan kesehatan perlu ditingkatkan khususnya di lingkungan masyarakat dan sekolah guna meningkatkan pengetahuan, kesadaran, dan merubah pola hidup menjadi lebih sehat.AbstractThe phenomenon of overweight and obesity has become a serious problem in various countries, especially in Indonesia. According to WHO in 2016 there were 2.8 million people who died due to the problem of overweight and obesity, while according to the Indonesian Ministry of Health the prevalence of overweight and obesity in Indonesia in 2018 reached 13,6% and 21.8%. One of the factors that cause overweight and obesity is socio-economic status. However, there are often differences regarding the effect of socioeconomic status on obesity in developing and developed countries. This study aims to identify the determinant factors of socioeconomic status on overweight and obesity. The data used comes from the Indonesian Family Life Survey (IFLS) 5 in 2014 with samples are aged more than 18 years. The analysis was conducted by using the Ordered Logistic Regression model. The results of this study indicate that statistically, individuals with higher socioeconomic status have a higher chance of experience overweight and obesity. Therefore, the socialization of health care programs needs to be improved, especially in the community and schools to increase knowledge, awareness, and change lifestyles to be healthier
Factors Shaping Uptake of Antenatal Care in Surabaya Municipality, Indonesia: A Qualitative Study
Get PDFFive focus group discussions (FGDs) with 61 pregnant women were conducted in June and July 2019 at primary health care (PHC) services within five urban areas of Surabaya, Indonesia. In addition, five semi-structured interviews with five midwives were carried out to explore the experiences of pregnant women accessing Antenatal Care (ANC) and the factors shaping uptake of ANC services. Data were audio-recorded, transcribed, and translated into English, and analyzed using thematic analysis. Findings from focus group discussions suggested that fears of negative diagnosis before initial ANC appointment and personal beliefs and myths surrounding pregnancy may delay uptake of ANC. Further, the influence of husbands, family, and friends and long waiting times with overcrowding leading to limited seating shaped timely access and return visits. In addition, feeling comfortable with the quality of the service and receiving a friendly service from the practitioners assisted women in feeling comfortable to return. Finally, midwives acknowledged feeling afraid of being referred to a hospital if deemed a high-risk pregnancy-shaped return ANC visits. The findings highlighted several factors needing to be addressed to increase the promptness of first ANC visits and ensure return visits to achieve great ANC coverage
Economic or Public Health? Southeast Asia’s Tackling of COVID-19 a Year Later
Get PDFThe world has been challenged by rapidly spreading COVID-19 outbreaks for a year now. Southeast Asian countries have had different strategies to deal with the pandemic. This review aimed to elaborate on Southeast Asian countries’ strategies in managing the trade-off between economic and public health, with further consideration of how such approaches were associated with the dynamics of the number of cases and the speed of economic recovery. This review evaluated the COVID-19 mitigation efforts spanning one year in the Southeast Asian (SEA) countries listed based on the Bloomberg COVID Resilience Ranking. As of May 24, 2021, three SEA countries (Thailand, Malaysia, and Indonesia) were chosen from the better (27th), moderate (35th), and worst (42nd) SEA country rankings. Peer-reviewed articles were obtained from Google Scholar and PubMed databases, and news articles were retrieved from GoogleNews. The data from government websites were also included. Sources were limited to those in the English and Indonesian languages that could be accessed between January 2020 and May 2021. Thailand, Malaysia, and Indonesia were found to have significantly prioritized consideration of the economy in handling the pandemic. Malaysia and Thailand had more stringent policies of imposing national lockdowns, while Indonesia had a partial lockdown. It was found that a weak pandemic response may result in substantial economic loss
Preventing and Controlling COVID-19: A Practical-Based Review in Offshore Workplace
Get PDFAn offshore platform is a workplace with complex facilities and limited space due to the complex installed equipment and components. Therefore, the offshore as enclosed area platform is more likely to have a high risk of COVID-19 outbreak. Furthermore, a company must strictly follow health protocols to prevent workers from being exposed to COVID-19 in the offshore workplace. However, workers are often forced to onboard without proper health protocols because of operational needs and production targets. This paper aimed to explore the essence of the steps in preventing and controlling COVID-19 in the offshore workplace and the challenges. The analysis found that the company must take preventive measures against COVID-19 before workers are on board and in the workplace and control it using the hierarchy of control: engineering control, administrative control, and personal protective equipment (PPE)
Hubungan Health Locus of Control dengan Kepatuhan Diet pada Pasien Diabetes Mellitus Tipe 2 di RSUD Kota Depok Tahun 2020
Get PDFLatar Belakang. Diabetes Mellitus (DM) telah menyebabkan 4,2 juta kematian pada tahun 2019. Di Indonesia, penyakit DM merupakan salah satu PTM yang menyebabkan kematian utama. Kepatuhan diet menjadi perilaku yang sangat penting dan diperlukan kendali diri.Tujuan. Tujuan penelitian adalah mengetahui hubungan lokus kendali diri untuk sehat baik dimensi internal, orang berpengaruh, keberuntungan dan faktor lainnya dengan kepatuhan diet pasien DM tipe 2 di RSUD Kota Depok tahun 2020.Metode. Penelitian menggunakan desain cross-sectional, pengambilan data dilakukan melalui convenience sampling pada 52 pasien DM tipe 2 yang berkunjung ke poli penyakit dalam RSUD Kota Depok.Hasil. Pasien memiliki nilai kepatuhan diet yang cukup yaitu 66,23 dari skala 100. Hasil uji korelasi pearson menunjukkan terdapat hubungan yang signifikan dengan kekuatan sedang dan positif antara lokus kendali untuk sehat dimensi internal dan dimensi orang berpengaruh dengan kepatuhan diet (r= 0,46 dan r= 0,28) diikuti dengan dimensi keberuntungan menunjukkan kekuatan sedang dan negatif terhadap kepatuhan diet (r= -0,28).Kesimpulan. Terdapat hubungan yang signifikan antara health locus of control dimensi internal, powerful others dan chance dengan kepatuhan diet dengan kekuatan hubungan sedang dan arah korelasi positif pada dimensi internal dan powerful others sedangkan negatif pada dimensi chance. ABSTRACTBackground. Diabetes Mellitus (DM) caused 4.2 million deaths in 2019. In Indonesia, DM is an NCD that causes major deaths. Dietary adherence becomes a vital behavior and requires self-control. Objective. This study aimed to determine the relationship between health locus of control on internal, powerful-others, chance dimensions and other factors with dietary adherence among type 2 DM patients at Depok City Hospital in 2020.Method. This study used a cross-sectional design and data collection through convenience sampling on 52 type 2 DM patients who visited internist poly in Depok City Hospital.Results. This study indicates that patients have adequate dietary adherence values 66,23 on a scale of 100. Pearson correlation test results show a significant relationship between health locus of control on internal and powerful-others dimensions with a moderate and positive relationship with dietary adherence (r= 0,46 and r= 0,28). Meanwhile, the chance dimension shows a moderate and negative relationship with dietary adherence (r= -0,28).Conclusion: There is a significant relationship between health locus of control internal, powerful others and chance dimensions with dietary compliance with moderate strength. The direction of the correlation is positive on the internal dimension and powerful others while negative on the chance dimension
Analisis Hubungan Kebisingan Terhadap Keluhan Gangguan Pendengaran pada Pekerja di Departemen Spinning, Weaving, dan Dyeing PT X Tahun 2020, Kota Jakarta Timur, DKI Jakarta
No full textLatar Belakang. PT X merupakan salah satu industri tekstil di Indonesia yang memiliki berbagai mesin dan peralatan yang dapat menimbulkan kebisingan dengan intensitas tinggi di beberapa area kerjanya. Penelitian ini bertujuan untuk menganalisis hubungan antara kebisingan yang lebih dari 85 dBA dengan keluhan gangguan pendengaran pada pekerja di departemen spinning, weaving, dan dyeing PT X. Metode. Metode yang digunakan dalam penelitian ini adalah analitik kuantitatif dengan desain studi cross sectional. Jumlah sampel dalam penelitian ini sebanyak 84 pekerja di departemen spinning, weaving, dan dyeing yang dipilih menggunakan teknik sampling proportionate stratified random sampling. Variabel independen dalam penelitian ini adalah tingkat kebisingan dan variabel dependen adalah keluhan gangguan pendengaran, dengan variabel konfounding meliputi karakteristik dan perilaku pekerja. Hasil. Hasil penelitian menunjukan sebnyak 37 pekerja (44%) mengalami keluhan gangguan pendengaran tinggi. Berdasarkan uji chi square, terdapat hubungan yang signifikan antara kebisingan > 85 dBA (p value=0,039, OR=2,8), usia (p value=0,012, OR=3,457) dan penggunaan alat pelindung telinga (APT) (p value=0,046, OR=2,761) dengan keluhan gangguan pendengaran. Sedangkan variabel masa kerja, riwayat penyakit telinga, riwayat hipertensi, riwayat diabetes, merokok, dan hobi terpajan bising tidak menunjukan hubungan yang signifikan. Hasil analisis multivariat menunjukan pekerja yang terpajan kebisingan diatas NAB memiliki risiko 4,512 kali lebih tinggi dibandingkan pekerja yang terpajan kebisingan dibawah NAB setelah dikontrol oleh variabel usia. Kesimpulan. Pekerja yang terpajan kebisingan berisiko untuk mengalami keluhan gangguan pendengeran. Pekerja yang berusia lebih dari 40 tahun dan tidak menggunakan APT saat berkeja memiliki risiko lebih besar untuk mengalami keluhan gangguan pendengaran.Kata Kunci: Keluhan Gangguan Pendengaran, Kebisingan, Industri Teksti
Hubungan Kepadatan Nyamuk Aedes aegypti di Rumah dengan Kejadian Demam Berdarah Dengue (DBD) di Kelurahan Tegal Alur Kecamatan Kalideres, Jakarta Barat, Tahun 2019
No full textLatar Belakang. Demam berdarah dengue (DBD) merupakan salah satu masalah kesehatan masyarakat utama di Indonesia. Populasi nyamuk Aedes aegypti dewasa yang padat adalah faktor risiko dari kejadian DBD. Keadaan ini juga bisa dipengaruhi oleh karakteristik individu dan diperparah dengan kondisi lingkungan, perilaku individu dalam memberantas sarang nyamuk serta mencegah gigitan nyamuk. Metode. Penelitian kuantitatif dengan desain cross-sectional ini bertujuan untuk menganalisis hubungan antara kepadatan nyamuk Ae. aegypti dewasa di rumah dengan kejadian DBD di Kelurahan Tegal Alur, Kalideres, tahun 2019. Pengambilan data dilakukan dengan wawancara pada 152 responden dan menangkap nyamuk di 55 rumah terpilih di 4 RW dengan kasus terbanyak. Pengukuran kepadatan dilakukan dengan menghitung sampel nyamuk Ae. aegypti menggunakan rumus angka istirahat per rumah (RR). Hasil. Hasil studi memperlihatkan bahwa ada hubungan bermakna antara kepadatan nyamuk Ae. aegypti di rumah dengan kejadian DBD. Analisis juga menunjukan faktor lingkungan yang berhubungan signifikan dengan kejadian DBD adalah penggunaan AC, sedangkan karakteristik individu yang berhubungan termasuk usia, jenis kelamin, dan keberadaan individu. Kesimpulan. Faktor perilaku yang memiliki hubungan dengan kejadian DBD ialah penggunaan kawat anti nyamuk. Peningkatan keterampilan petugas kesehatan untuk survei entomologi nyamuk dan melakukan pemetaan kepadatan nyamuk dewasa di wilayah lain sangat disarankan. Kata Kunci: Aedes aegypti, angka istirahat per rumah, demam berdarah dengue, kepadatan nyamuk dewas
Exclusive Breastfeeding History Risk Factor Associated with Stunting of Children Aged 12–23 Months
Get PDFStunting (low height-for-age) remains a global and national health problem because it increases the risk of disturbances in growth and development and mortality. Banjar Margo District, Tulang Bawang Regency, has the second-highest prevalence in Lampung Province, Indonesia. This study aimed to analyze the association of exclusive breastfeeding history and stunting in children aged 12–23 months in Banjar Margo District. This study used a cross-sectional design on 193 children aged 12–23 months. It was primary data conducted between April and May 2018 with a questionnaire. Data analysis was performed using the chi-square test and multiple logistic regression. The result showed that of 193 children, 29.5% were stunted. Children who were not exclusively breastfed were 3.1 times (95%CI = 1.5–6.4) more at risk of stunting than those exclusively breastfed, after controlling for mothers with low education and unemployment factors as confounding variables. Health promotion activities in primary/integrated health care should be focused not only on mothers but also on other people involved in child care, such as grandparents, at-home caregivers, and day carers