Faculty of Public Health Journal Universitas Indonesia
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Penerapan Metode ABC Indeks Kritis dalam Pengelolaan Persediaan Obat di Instalasi Farmasi Rumah Sakit XYZ Pekanbaru, Riau Tahun 2018
Get PDFABSTRAK Proses pembuatan formularium Rumah Sakit XYZ oleh Tim Farmasi Terapi (TFT) belum mempertimbangkan tingkat kritis suatu obat bagi pasien. Belum dilaksanakannya penilaian menyebabkan ada pembelian tidak terencanaobat diperlukan segera dan mempengaruhi keselamatan pasien. Metode ABC dapat mengidentifikasi jenis obat yang harus selalu tersedia dan bernilai investasi besar. Belum ada kontrol biaya persediaan obat di Rumah Sakit XYZ karena data nilai investasi obat belum dianalisis. Penelitian ini menggunakan desain penelitian kualitatif dengan menerapkan metode ABC indeks kritis terhadap data kebutuhan obat tahun 2018. Data penelitian diperoleh melalui wawancara mendalam, observasi dan telaah dokumen perencanaan dan pengadaan obat. Sebesar 82% jenis obat di gudang jarang digunakan, namun 53 diantaranya merupakan obat yang memiliki nilai investasi tinggi yang memerlukan perhatian khusus. Obat yang memiliki 5 (lima) nilai investasi terbesar namun sangat jarang digunakan (kelompok C nilai pemakaian) adalah: Albuminar 25%, Octalbin 25%, Terfacef injeksi, Trijec 1 gram dan Lanmer injeksi. Formularium RS XYZ berikutnya harus mengeluarkan 530 jenis obat yang tidak kritis dan tidak ada pemakaian. Jumlah jenis obat yang masuk ke dalam formularium yang lebih sedikit akan memudahkan proses kontrol dan penyimpanan persediaan ABSTRACT The process of making the XYZ Hospital formulary by the Therapy Pharmacy Team (TFT) has not considered the critical level of a medicine for patients. The failure to carry out the assessment has caused an unplanned purchase of the medicine that needed immediately and affecting patient safety. The ABC method can identify drugs that must always be available and worth a large investment. There is no cost control of drug supplies at XYZ Hospital because data on the value of investment in drugs have not been analyzed. This study uses a qualitative research design by applying the ABC index critical method to data on drug needs in 2018. The research data was obtained through in-depth interviews, observation and review of planning documents and drug procurement. 82% of the drugs in the warehouse are rarely used, but 53 of them are drugs that have high investment value that require special attention. Drugs that have the largest 5 (five) investment values but are very rarely used (group C usage value) are: Albuminar 25%, Octalbin 25%, Terfacef injection, Trijec 1 gram and Lanmer injection.The next XYZ Hospital formulary must issue 530 types of drugs that are not critical and have no use. The smaller number of types of drugs that enter the formulary will facilitate the process of control and storage of inventoryABSTRAK Proses pembuatan formularium Rumah Sakit XYZ oleh Tim Farmasi Terapi (TFT) belum mempertimbangkan tingkat kritis suatu obat bagi pasien. Belum dilaksanakannya penilaian menyebabkan ada pembelian tidak terencanaobat diperlukan segera dan mempengaruhi keselamatan pasien. Metode ABC dapat mengidentifikasi jenis obat yang harus selalu tersedia dan bernilai investasi besar. Belum ada kontrol biaya persediaan obat di Rumah Sakit XYZ karena data nilai investasi obat belum dianalisis. Penelitian ini menggunakan desain penelitian kualitatif dengan menerapkan metode ABC indeks kritis terhadap data kebutuhan obat tahun 2018. Data penelitian diperoleh melalui wawancara mendalam, observasi dan telaah dokumen perencanaan dan pengadaan obat. Sebesar 82% jenis obat di gudang jarang digunakan, namun 53 diantaranya merupakan obat yang memiliki nilai investasi tinggi yang memerlukan perhatian khusus. Obat yang memiliki 5 (lima) nilai investasi terbesar namun sangat jarang digunakan (kelompok C nilai pemakaian) adalah: Albuminar 25%, Octalbin 25%, Terfacef injeksi, Trijec 1 gram dan Lanmer injeksi. Formularium RS XYZ berikutnya harus mengeluarkan 530 jenis obat yang tidak kritis dan tidak ada pemakaian. Jumlah jenis obat yang masuk ke dalam formularium yang lebih sedikit akan memudahkan proses kontrol dan penyimpanan persediaan ABSTRACT The process of making the XYZ Hospital formulary by the Therapy Pharmacy Team (TFT) has not considered the critical level of a medicine for patients. The failure to carry out the assessment has caused an unplanned purchase of the medicine that needed immediately and affecting patient safety. The ABC method can identify drugs that must always be available and worth a large investment. There is no cost control of drug supplies at XYZ Hospital because data on the value of investment in drugs have not been analyzed. This study uses a qualitative research design by applying the ABC index critical method to data on drug needs in 2018. The research data was obtained through in-depth interviews, observation and review of planning documents and drug procurement. 82% of the drugs in the warehouse are rarely used, but 53 of them are drugs that have high investment value that require special attention. Drugs that have the largest 5 (five) investment values but are very rarely used (group C usage value) are: Albuminar 25%, Octalbin 25%, Terfacef injection, Trijec 1 gram and Lanmer injection.The next XYZ Hospital formulary must issue 530 types of drugs that are not critical and have no use. The smaller number of types of drugs that enter the formulary will facilitate the process of control and storage of inventor
Increasing Cigarette Excise Tax Prevents Smoking Initiation in Children and Finances National Health Insurance in Indonesia
Get PDFAbstractIndonesia has ranked third among countries with the highest number of smokers in Asia because the price of cigarettes in those countries is still affordable. The strategy to make the price of cigarettes is not affordable is increasing cigarette excise tax. This instrument is considered the most effective way to control cigarette consumption. The purpose of this study was to find out how the public perceive the increase of the cigarette excise tax to cover the National Health Insurance (NHI) deficit and to identify the factors which affect such perception. This study used mobile phone survey and the sample were 1000 respondents. The list of potential respondent’s mobile phone numbers was selected using the systematic random sampling method with an interval of 100,000 to 200,000. The result showed that 87.9% respondents agree to increase cigarette price so that the children do not start to smoke. The majority of respondents (86.2%) also agree to increase the price of cigarettes to finance the JKN deficit. Perceptions of respondents who agreed to increase the price of cigarettes to prevent smoking initiation in children also tended to accede the increase in cigarette prices for financing the JKN deficit. Abstrak Indonesia menempati peringkat ketika jumlah perokok tertinggi di Asia karena harga rokok masih terjangkau. Strategi agar harga rokok tidak terjangkau adalah menaikkan cukai rokok. Instrumen tersebut dinilai paling efektif untuk mengendalikan konsumsi rokok. Tujuan penelitian adalah untuk mengetahui bagaimana persepsi masyarakat terhadap kenaikan cukai rokok untuk pembiayaan Jaminan Kesehatan Nasional (JKN) dan mengidentifikasi faktor yang memengaruhi persepsi tersebut. Metode penelitian menggunakan survei melalui telepon dengan sampel 1000 responden. Daftar nomor telepon seluler calon responden dipilih dengan cara systematic random sampling interval 100.000 sampai 200.000. Hasil penelitian menunjukkan bahwa 87,9% setuju harga rokok dinaikkan agar anak-anak tidak mulai merokok. Mayoritas responden (86,2%) juga setuju mengenai kenaikan harga rokok untuk pembiayaan defisit JKN. Persepsi responden yang setuju terhadap kenaikan harga rokok agar mencegah inisisasi merokok pada anak-anak juga cenderung setuju terhadap kenaikan harga rokok untuk pembiayaan defisit JKN.
A SURVEY ON THE COMMUNITY SATISFACTION INDEX BASED ON KEPMENPAN NO. 25/M.PAN/2/2004 AT KANUJOSO DJATIWIBOWO REGIONAL GENERAL HOSPITAL, BALIKPAPAN IN 2018
Get PDFAbstract. Community Satisfaction Index (CSI) Survey is used to measure the community’s perception on the services that they receive. In hospitals, it is used to determine whether a service or facility needs to be improved or not, and where it must be improved. In 2018, a descriptive qualitative study was performed at RSUD Dr. Kanujoso which would measure the public’s perception on the services that the hospital provided. The survey was based on the 14 aspects of CSI of the State Apparatus Empowerment Minister Decree No. 25/M.PAN/2/2004. We discovered that the highest rate was held by the Hemodialysis Unit with 100% and the lowest was held by the Medical Rehabilitation Unit with 74.18%. The other units ranged between 74.89%-90.83%. While the average score for the hospital was 78.42%, which meant that the hospital’s perfoemance was good. In general, the hospital provided good service, as evident in the average score of 78.42%. 93.6% of patients prefer to return to the hospital and 97,6% would recommend the hospital. Although some improvements were necessary, such as in the speed and fairness. Therefore, the staff involved in those areas should received further training. Abstrak. Indeks Kepuasan Masyarakat adalah data dan Informasi mengenai tingkat kepuasan masyarakat yang diperoleh dari hasil pengukuran secara kuantitatif dan kualitatif atas pendapat masyarakat dalam memperoleh pelayanan dari aparatur penyelenggara pelayanan publik. Desain Survei Kepuasan Masyarakat terhadap Pelayanan di RSUD Kanujoso Wibowo 2018 ini bersifat deskriptif dengan pendekatan kualitatif yang akan mengukur tingkat kepuasan berbasis persepsi masyarakat pada saat menerima layanan kesehatan dikaitkan dengan 14 aspek Indeks Kepuasan Masyarakat dari Keputusan Menteri PAN Nomor: 25/M.PAN/2/2004. Berdasarkan unit layanan, indeks kepuasan masyarakat tertinggi ada di unit Hemodialisa dengan nilai 100,00 (sangat baik). 12 unit layanan lainnya masuk dalam kategori baik dan sangat baik dengan rentang nilai 74,18-90,83. Unit Rehab Medik menjadi unit layanan dengan indeks kepuasan masyarakat terendah yaitu hanya sebesar 74,18, walaupun nilai tersebut masih masuk dalam kategori baik. Nilai Indeks pelayanan dari 14 aspek indeks kepuasaan masyarakat untuk pelayanan di RSUD Kanujoso Djatiwibowo adalah 78,42 artinya kinerja unit pelayanan adalah baik
Analisis Standar Kompetensi Tenaga Kesehatan di Rumah Sakit Bhakti Yudha Depok Tahun 2017
Get PDFABSTRAK Kompetensi tenaga kesehatan adalah faktor yang sangat berpengaruh pada pencapaian kinerja rumah sakit. Pengukuran kompetensi tenaga kesehatan sangat penting untuk meningkatkan kualitas layanan kesehatan. Penelitian ini bertujuan untuk mengevaluasi kompetensi tenaga kesehatan di Rumah Sakit Bhakti Yudha dengan menggunakan standar kompetensi organisasi tenaga kesehatan nasional Indonesia kepada delapan unit tenaga kesehatan. Hasil penelitian menunjukkan bahwa tenaga kesehatan di Rumah Sakit Bhakti Yudha Depok belum memenuhi ekspektasi manajemen. Penelitian ini juga menyimpulkan bahwa lama kerja dan banyaknya jumlah pelatihan yang diterima merupakan faktor yang mempengaruhi tingkat kompetensi tenaga kesehatan. ABSTRACT Competency of healthcare provider has significant impact on performance of the hospital. Measuring competency of healthcare provider are essential to improve better quality of service provisioned. The study evaluates competency of healthcare provider at Bhakti Yudha Hospital by using the competency standards established by multiple organizations of Indonesian national healthcare provider association mapped against eight units of health provider. The result stated that competency level of healthcare providers at Bhakti Yudha Hospital have had not met the expectations. It is concluded that working experiences and number of relevant training received has significant impact on competency level of healthcare provider
Post Hypertension and Stroke: A Case Control Study
Get PDFThe purpose of this study was to determine the factors that influence the incidence of stroke including smoking status, past hypertension , past diabetes, diet, physical activity, alcohol consumption. The design of this study is case control with a ratio of 1: 1. The total number of respondents is 132 people. Research subjects were selected using systematic random sampling. This research was conducted at Ngudi Waluyo Hospital in Wlingi. Blitar, Indonesia in October till November 2017. Bivariate analysis showed that factors significantly related to stroke were smoking status (p=0.011, OR=2.6), history of past hypertension (p=0.00, OR= 6), past diabetes (p=0.015 ; OR=5,7), and unhealthy diet (p= 0,00; OR = 5,7). Multivariate analysis showed that factors that significantly influence stroke are smoking, having hypertension in the past, and unhealthy diet.Conclusion of this study was smoking, having hypertension in the past, and unhealthy diet are factors that influence the incidence of stroke. Maintaining normal blood pressure, maintaining a diet, and not smoking are precautions should be taken in order to prevent stroke
Determinan Cakupan Imunisasi Dasar Lengkap pada Penerima Program Keluarga Harapan
Get PDFAbstrak Kemiskinan merupakan permasalahan sosial bersifat multidimensi dan berhubungan dengan permasalahan kesehatan, pendidikan dan kesejahteraan sosial lainnya. Cakupan Imunisasi Dasar Lengkap (IDL) secara nasional mencapai 57,9%, 32,9% tidak lengkap dan sebanyak 9,2% tidak diimunisasi, sementara indikator cakupan secara nasional minimal 90% Penelitian ini bertujuan untuk mengetahui determinan apakah yang mempengaruhi cakupan imunisasi dasar lengkap pada bayi penerima Program Keluarga Harapan (PKH). Desain studi yang digunakan adalah cross sectional. Lokasi penelitian berada di 34 provinsi. Jumlah populasi sebanyak 9.205 responden dengan menggunakan data sekunder Survei Sosial Ekonomi Nasional (Susenas) tahun 2017. Hasil penelitian menunjukkan capaian imunisasi dasar lengkap sebesar 97,34% dan 2,66% tidak lengkap. Hasil penelitian menunjukkan variebel umur dan status perkawinan berhubungan positif serta berpengaruh secara signifikan, Variabel pendidikan dan pekerjaan berhubungan secara signifikan namun berhubungan negatif dalam cakupan imunisasi dasar. PKH telah memberikan kesempatan dan akses kepada rumah tangga miskin untuk melaksanakan program imunisasi dasar lengkap. Oleh karena itu diperlukannya penguatan supervisi terhadap ibu muda, ibu dengan status cerai, serta ibu yang bekerja guna meningkatkan pengetahuan, membangun kesadaran, menjaga serta memperkuat perubahan perilaku terkait, pengasuhan dan kesehatan untuk meningkatkan cakupan imunisasi dasar pada bayi. Abstract Poverty is a multidimensional social problem and related to the problems of health, education and other social welfare. National Basic Immunization Coverage (IDL) reached 57.9%, with 32.9% was incomplete and 9.2% were not immunized, while national coverage indicators were at least 90%. This study aims to determine the determinants that affects basic complete immunization coverage for babies receiving the Family Hope Program (PKH). The study design used was cross sectional. The research was located in 34 provinces. The total population is 9,205 respondents using secondary data from the National Socio-Economic Survey (Susenas) in 2017. The research shows that the achievement of complete basic immunization is 97.34% and 2.66% is incomplete. The results shows that age and marital status are positively related and significantly influence the basic immunization coverage, while education and employment variables are significantly associated but negatively related to basic immunization coverage. PKH has provided opportunities and access to poor households in implementing a complete basic immunization program. So it is necessary to intensify the supervision of young mothers, divorced mothers and working mothers to boost knowledge, build awareness, maintain and strengthen related behavioral changes, health and care to increase the coverage of basic immunization in infants
Determinan Sosial Ekonomi Rumah Tangga dari Balita Stunting di Indonesia: Analisis Data Indonesia Family Life Survey (IFLS) 2014
Get PDFAbstrakStunting merupakan masalah gizi kronis pada balita yang ditandai dengan tinggi badan yang lebih pendek dibandingkan dengan anak seusianya. Stunting pada balita memiliki risiko pada tingkat kecerdasan, kerentanan terhadap penyakit, menurunkan produktifitas yang dalam jangka panjang dapat menghambat pertumbuhan ekonomi. Ketika dewasa, anak yang menderita stunting rentan menderita penyakit tidak menular. Ini menyebabkan pengeluaran pemerintah dalam hal pembiayaan jaminan kesehatan nasional terus meningkat. Penelitian ini bertujuan untuk menganalisis determinan faktor sosial ekonomi rumah tangga dari balita stunting. Studi ini menggunakan data sekunder Indonesia Family Life Survey (IFLS) tahun 2014 dengan desain studi cross sectional dan aplikasi model logit ekonometrik. Jumlah observasi yang menjadi sampel analisis dalam penelitian ini sebesar 3.794 balita dalam skala nasional. Hasil penelitian menunjukkan kejadian balita stunting memiliki hubungan signifikan dengan status pekerjaan ibu, tempat tinggal, sanitasi dan status ekonomi. Ibu yang lebih banyak meluangkan waktu dan memperhatikan gizi anak, tempat tinggal balita yang dapat menjangkau fasilitas layanan kesehatan, akses sanitasi yang baik, status ekonomi keluarga, intervensi pemerintah yang tepat, dan peran lintas sektor dan tatanan masyarakat berdampak dalam penanganan masalah stunting di Indonesia. Abstract Stunting is a chronic nutritional problem in infants characterized by shorter stature compared to their age. Stunting in toddlers has risk at the level of intelligence, vulnerability to disease, lowering productivity which in the long run can hamper economic growth. When adults, children who suffer from stunting are prone to non-communicable diseases. This causes government spending in terms of financing national health insurance to continue to increase. This study aims to analyze the determinants of household socioeconomic factors of stunting toddlers. It used the secondary data of the Indonesian Family Life Survey (IFLS) in 2014 with cross-sectional study design and the application of an econometric logit model. The number of observations as a sample in this study amounted to 3,794 toddlers on a national scale. The results showed the incidence of stunting toddlers had a significant relationship with the employment status of mothers, shelter, sanitation and economic status. Mothers who spend more time and pay attention to child nutrition, toddlers who can reach health care facilities, access to good sanitation, family economic status, proper government intervention, and the role of cross-sector and community order have an impact on the handling of stunting problems in Indonesia
Analisis Kesiapan Sistem Remunerasi Berdasarkan Peraturan Gubernur Provinsi DKI Jakarta Nomor 222 Tahun 2016 Di RSUD Pesanggrahan Tahun 2017
Get PDFABSTRAK RSUD Pesanggrahan adalah sebagai Unit Pelaksana Teknis (UPT) Dinas Kesehatan Pemerintah Provinsi DKI Jakarta yang telah menerapkan pola keuangan Badan Layanan Umum Daerah (BLUD). Penelitian ini menggunakan metode kuantitatif dengan simulasi penghitungan sistem yang akan diterapkan dan penggalian persepsi kesiapan stakeholder melalui wawancara mendalam. Hasil penelitian diketahui bahwa secara umum informan sudah puas dengan penghasilan yang diterima sekarang, namun hasil simulasi penerapan sistem remunerasi dan berbagai skenario pada periode transisi memperlihatkan bahwa rumah sakit belum mampu memberlakukan sistem remunerasi. Dinas Kesehatan diharapkan dapat menurunkan berbagai kebijakan memberi kesempatan bagi RS BLUD untuk menerapkan sistem remunerasi. Dinas Kesehatan sebagai regulator dapat memberikan regulasi bagi RS dengan pola keuangan BLUD yang dipandang mampu memerapkan sistem remunerasi, melakukan evaluasi terhadap pendapatan BLUD, membuat standar kinerja adalah beberapa rekomendasi yang diajukan kepada Dinas Kesehatan sebagai hasil dari penelitian ini. ABSTRACT RSUD Pesanggrahan as a Health Service Unit of Special Capital Region of Jakarta which has applied financial pattern of Regional Public Service Board (BLUD). This research uses quantitative with simulation of system calculation to be applied and qualitative with explore stakeholder perception readiness with indepth interview. From the result of research it is known that in general the informant is satisfied with the income received now. And from the simulate conducted, RSUD Pesanggrahan has not been able to apply the system based on Governor Regulation No. 222/2016 yet. Suggestion to the Health Department as a regulator is to give the opportunity to the hosital that its BLUD income is capable to apply Remuneration system is supported by regulation, to evaluate the potential income of RSUD to make standard of employee performance target as indicator of hospital as some recommendation as a result from this research
ANALYSIS OF TRADITIONAL HEALTH CARE IN THREE COMMUNITY HEALTH CENTERS IN WEST JAVA PROVINCE, INDONESIA, 2018
Get PDFThe National Traditional Health Care set up three objectives for its implementation at the health centers, whereby health staff to be trained on traditional health and provide accupressure care, able to collect data, register and provide technical guidance to traditional healers and guide individuals in the use of traditional medicine and herbs. This qualitative research aimed to analyze the implementation of traditional health care at 3 subdistrict health centers Ciomas, Ciawi and Caringin in district Bogor. Data was collected through document analysis, observation and indepth inteview. Each health center has trained staff in accupressure but care is hindered by lack of room and community prefers to go to traditional masseur. Data collection, registration and technical guidance to traditional healers exist due to support from local funding. Individual guidance on the use of traditional medicine and herbs do not happen due to no fund for home visits. Traditional health care at health centers to focus on the activity that is working which is data collection, registration and technical guidance to traditional healers. District Health Office Bogor should develop local policy and Standard Operating Procedure for traditional health care at health centers
Effect of Self-Regulated Learning for Improving Dietary Management and Quality of Life in Patients with Type-2 Diabetes Mellitus at Dr. Ramelan Naval Hospital, Surabaya, Indonesia
Get PDFSelf-regulated learning is a process of learning how to manage and regulate oneself to obtain skills and knowledge without depending on others. It is expected that diabetes patients can manage their diabetes by themselves. This study aimed to analyze the effect of self-regulated learning-based educational intervention on quality of life for patients with type-2 diabetes mellitus (DM) at Dr. Ramelan Naval Hospital, Surabaya. This was a quasi-experimental study in the form of pretest and posttest with a control group design. A total of 20 patients with DM were randomly divided into intervention and control groups to undergo a 4-week intervention. The intervention group received dietary education with self-regulated learning, while the control group received standard education. The results revealed differences in variables such as dietary obedience, food intake at home, fasting blood sugar, diastolic blood pressure, and quality of life. The intervention group experienced a positive impact on the quality of life and resulted in better dietary obedience than that of the control group. In conclusion, the implementation of self-regulated learning-based dietary education can improve dietary obedience, knowledge, intention, family support, social support, physical activity, and quality of life for patients with type 2 diabetes