Jurnal Manajemen Pelayanan Kesehatan
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HUBUNGAN KUALITAS PELAYANAN DAN PROMOSI TERHADAP HASIL PELAYANAN KESEHATAN GIGI MULUT DI BALAI PENGOBATAN GIGI PUSKESMAS DATI II BLORA
No full textTERSEDIA DALAM FIL
PELEMBAGAAN SISTEM PEMANTAUAN DAN EVALUASI: PELAJARAN DARI BERBAGAI NEGARA
Full text linkThis article provides lessons learned on the experience ofseveral countries that have succeeded in building a wellfunctioning government monitoring and evaluation (M&E)system. Discussions on this article are focused on: terms andconcepts in the field of M&E, outputs of M&E, utilization of M&Einformation, key success and pre-requisite to succes ininstitutionalizing M&E as well as actors M&E. The result indicatesthat ouputs of M&E system are used oftenly for: (i) supportingpolicy making, performance budgeting and national planning;(ii) helping ministries in their policy development and policyanalysis work, and in program development; (iii) managingactivities at the sector, program and project levels; and (iv)enhancing transparency and support accountabilityrelationships. The successful institutionalization of M&E involvesthe creation of a sustainable, wellfunctioning M&E system withina government, where good quality M&E information is usedintensively. This implies that key success for institutionalizingM&E system depends on: utilization of M&E information, qualityof M&E information and sustainability. Meanwhile prerequisiteto successful in institutionalizing of the M&E system must besupported by a substantive demand from the government,insentive mechanisms, powerful champion, and provision oftraining in a range of M&E tools, methods, approaches andconcepts. Actors involved in M&E system are not onlygovernment. Civil society (i.e., universities, NGOs, researchinstitutes, think tanks and the media) also can play a role inM&E in several ways, including as a user and producer ofM&E information.Keywords: monitoring, evaluation, policy, program, projec
ANALISIS BIAYA PER KAPITA SEBAGAI UPAYA ADVOKASI PENGENDALIAN BIAYA PROGRAM JAMINAN KESEHATAN JEMBRANA
Full text linkIntroductions: Jembrana Health Insurance (JHI) program isintended to provide health insurance at first level (PPK I) forinhabitants of Jembrana District. Up till now, financing of JHIdepends on subsidy in which it is growing up and has a trendto be out of target. Therefore, it needs to manage cost byimplementing capitation payment system. Aim of this researchwas to analyze cost per capita and to identify perceptions ofJHI stakeholders towards capitation system.Methods: This research was case study through analyzingsecondary data and performing in-depth interview. Data onmember’s utilization and claim cost were collected using forms.Results: Result of cost per capita calculation based on realutilization of PPK I namely Rp5.262,- per month per member is63 % higher than cost per capita based on normal utilization ofPPK I namely Rp1.949,- per month per member. Furthermore,result of in-depth interview shows that both policy makersand providers have a bad perception towards capitationsystem and results of cost per capita calculation.Conclusions: Local government could apply principles ofmanaged care by controlling cost and quality by developingcapitation payment system for PPK I based on normal utilization.Keywords: health insurance, cost per capita, capitatio
PENETAPAN PAKET PELAYANAN KESEHATAN DAN PERHITUNGAN PREMI PROGRAM PEMELIHARAAN KESEHATAN MAHASISWA UNIVERSITAS JENDERAL SOEDIRMAN TAHUN 2007
Full text linkBackground: In an effort to provide health service access toits students, University of Jenderal Soedirman develops ascheme of health insurance in the program of student healthcare assistance during academic year 2006/2007. During thisperiod there were some problems which caused the schemeunable to cover all needs of students for health services. It isexpected that next time there is development in health servicepackage and premi calculation in order that the program ofstudent health care assistance can operate better.Objective: To develop alternative health service package andrational premi calculation for the implementation of student healthcare assistance based on the coverage of participation at theUniversity of Jenderal Soedirman in the future.Method: This case study used complementary qualitative andquantitative approach. Major research design was quantitative.Result: Service package of Soedirman Health Center for theprogram of student health care assistance included primaryoutpatient, continuing outpatient and inpatient health serviceswith particular limitation either on cost or length of stay. Unitcost calculation of primary outpatient health service at StudentHealth Center for Medication clinic was Rp24,423 and for DentalMedication clinic was Rp96,387. Premi calculation was madeusing actual utilization for Student Health Center as much asRp6.180/student/semester and for Purbalingga CommunityHealth Care Insurance was Rp67.062/student/semester.Conclusion: The establishment of health service packageand rational premi calculation should enable the developmentof health insurance program for students of the University ofJenderal Soedirman and become an instrument for advocacyfor the policy makers in developing the program in the future.Keywords: health service packages, premi calculation, unitcos
PRAKTIK PERAWAT KELILING: STUDI KASUS TIGA PERAWAT DI KABUPATEN INDRAGIRI HULU PROVINSI RIAU
Full text linkBackground: Professional service in isolated areas is verylimited because the policy on the placement of doctors tendsto put priority on urban areas. Nurses are health staff mostcommonly available at isolated areas and utilized by thecommunity as medical staff in Indonesia for a long time. Theyhave been working on mobile basis from one village to anotherbecause the community needs express and affordableservices. Legally, mobile nurses have infringed regulationsbecause they do not have permit for their practice and theyprovide services beyond their expertise. Meanwhile, thepresence of mobile nurses greatly helps the government insolving health problems in the community.Objective: The study aimed to describe health servicesprovided by mobile nurses at District of Indragiri Hulu.Method: This case study was carried out in February – April2008. Data were obtained through participative observationand in depth interview. The researcher followed the nursesobserved with open agreement from respondents and studiedthe activities they carried out in their work.Result: The result of the study showed that types of servicesprovided by mobile services at District of Indragiri Hulu wererelatively complete, comprising service of care to medication.The service was accessible and inexpensive and paymentmethod was flexible. These nurses were willing to providehealth services as demanded by patients. They provided mobileservice because health staff available in marginal areas wasnurses. This caused high demand for health service providedby nurses; however this mobile service was not protected byregulations because so fan there was no regulation whichconcerned with practicing nurses at District of Indragiri Hulu.The only regulation that protected them was issued by nationalassociation of nurses. Absence of regulation on nurses causedcontrol to practice of mobile nurses could not be enacted. Thecontrol was needed to protect the community and the serviceof mobile nurses itself.Conclusion: The study proved that unavailability of doctorshad put nurses in a central position as medication providers inisolated areas. Besides, proactive approaches made by thenurses had become major factor of acceptance to theirpresence in the community. Considering their control role, itwas suggested that the government issued administrative andprofessional act on nurses order that control to quality ofnurses could ensured.Keywords: availability of health staff, mobile nurses, socialmotivation, isolated area
DEVELOPING A FRAMEWORK FOR CIVIL AVIATION OCCUPATIONAL HEALTH AND SAFETY SYSTEM IN INDONESIA
Full text linkA series of aircraft accidents in the past three years exposedserious safety problems in Indonesian civil aviation. Latestaviation accident investigations reported that flight crews weremainly responsible for two major accidents happened in 2007.This indicates that occupational health and safety (OHS) is anintegral part of civil aviation. Improvement in OHS system wouldthen contribute to the development in Indonesian civil aviationsafety in general. This paper seeks to present applicable OHSdesigns in Indonesian civil aviation by carefully consideringlocal situations, current problems and their determinants.Furthermore, ideal designs based on literature reviews andgood practices in some developed countries were examinedto show the main principles and components needed indesigning a civil aviation OHS system.Keywords: OHS system, civil aviation, IndonesiaABSTRAKSerangkaian kecelakaan pesawat udara dalam tiga tahunterakhir telah menunjukkan masalah keselamatan yang seriusdi dunia penerbangan sipil Indonesia. Dari hasil investigasiterbaru, kru penerbang dilaporkan bertanggung jawab terhadapdua kecelakaan maut yang terjadi tahun 2007. Hal inimengindikasikan bahwa kesehatan dan keselamatan kerja (K3)merupakan bagian yang sangat penting dalam penerbangansipil. Perbaikan dalam sistem K3 akan memberikan kontribusidalam peningkatan keselamatan penerbangan sipil di Indonesiasecara umum. Tulisan ini menunjukkan desain K3 yang bisaditerapkan di penerbangan sipil Indonesia denganmempertimbangkan situasi lokal, permasalahan saat ini danfaktor-faktor penentunya. Lebih jauh, desain yang idealberdasarkan studi kepustakaan dan praktik-praktik yang baikdi beberapa negara maju dianalisis untuk menunjukkan prinsipprinsipdan komponen-komponen utama yang diperlukan dalammerancang sebuah sistem K3 penerbangan sipil.Kata Kunci: sistem K3, penerbangan sipil, Indonesi
MEDICAL ERROR DAN PERILAKU KLINIS PETUGAS KESEHATAN DALAM PENATALAKSANAAN MALARIA DI RSU GUNUNG SITOLI NIAS
Full text linkBackground: Malaria is a major health problem in Nias. Inrecent, resistance to Choroquin has occurred in Nias. One ofthe potential factors is provider behaviour in diagnosing andtreating malaria cases. In Nias district hospital, malaria is oneof the ten most frequent diseases. This hospital functions asreferral for 18 health centres in the area.Objective: This study focused on malaria case managementand aimed to: (1) describe occurrence of diagnostic andtreatment errors; (2) describe occurrence of error of omissionand error of commission; (3) to explore provider behaviour inmanaging the disease; and (4) identify predisposing,enabling,and enforcing factors to medical errors.Method: A combination of quantitative and qualitative researchwas applied in this study. One hundred forty six (146) bloodslides available in May 2007 were re-examined in UniversitasGadjah Mada (UGM) laboratory to measure diagnosticagreement. In addition, all medical record of malaria caseswere used to identify diagnosis and treatment errors.Interviews were carried out with general practitioners,specialists, laboratory staff and nurses who dealt with malariacase management.Result: Kappa index was low (0.04). Among all patientsdiagnosed or treated as malaria (n=92), the occurrence ofmedical error was 1.87 per patient. Among these, this studyidentified 98 diagnostic errors, consisting of 16 cases of errorof ommission (17.39%) and 82 cases of error of commission(89.13%). Treatment errors occurred in 92 cases, i.e. 19 casesof error of ommission (20.65%) and 73 cases of error ofcommission (79.35%). Provider behaviour contributed tomedical errors. The behaviour was supported by lack oftraining on malaria for the hospital staff, absence of standardoperational procedure in managing malaria cases, incompetentlaboratory staff and lack of reward for good performance.Conclusion: The occurrence of medical error in casemanagement of malaria was high. Improvements in clinicalquality should be prioritized, taken into account the underlyingfactors.Keywords: medical errors, malaria case management, hospital,Nia
PERAN TENAGA TEKNIS KEFARMASIAN DALAM MENURUNKAN ANGKA KEJADIAN MEDICATION ERROR
Full text linkIntroduction: Medication error in term is the incidence thatcan be harmful to the patient due to human error in handlinghospitalized patient care that actually can be avoided. Medicationerror can be classified as: dispensing errors, prescribingerrors and administration errors. Among of medication errorcaused by less communication, loading work, distribution systemand a role of occupational health care was low enough.Objective: The aim of this research was to evaluate the frequencyand type’s incidence of medication error by a role ofoccupational pharmacy working at hospitalized room care.Based on active participation they act to check the appropriateof Medical notes, Recipe (R/), Nursing drug administration notes;such as identity of patient, Medical record number, productname, quantity, posology, strengthening, doses ,and directionof doses.Methods: This research was pre-experimental, which tookpre-post intervention approach. Data Collection were conductedin three steps; pre-participation, being-participation andpost-partcipation. To indentify the incidence of medication errorof their active participant determined by Chi-Square statisticallyperformance.Result. As the result of 94 samples patient there were theinfluences of occupational pharmacy among inter variability inwhich the odds ratio value was 4,055, p value 0,0001. Amongof medication error the higher performance were administrationphase 81,32%, prescribing phase 15,88 % and transcribingphase 2,8%.Conclusion: Increasing a role of occupational pharmacy inthe hospitalized health care can be lowering the incidence ofmedication error due to their active participation.Keywords: medication error, RK Charitas Hospital, occupationalpharmac
ANALISIS PENGARUH KEPEMILIKAN ASURANSI KESEHATAN TERHADAP KEMAUAN MEMBAYAR PRODUK PELAYANAN LABORATORIUM
Full text linkBackground: The willingness to pay of society for theproducts of laboratory services as one of the healthprecautions need to be improved. Ownership of healthinsurance is one factor that wants to study its effect onwillingness to pay for laboratory services because healthinsurance is expected to have a society can allocate funds forpreventive healthObjective: The purpose of this study is to determine the effectof health insurance ownership of willingness to pay forlaboratory services.Methods: A cross sectional study design using the 100respondents who were taken proportionally from eight selecteddistricts in Banyuwangi. Variables that were examined includethe willingness to pay as measured by the method of contingentvaluation and ownership of health insurance. The datacollection tool is a questionnaire. Data were analyzed usinglogistic regression.Results: The results showed that the level of willingness topay of respondents for all types of laboratory examinations isstill low. Most respondents (76%) did not have health insurance.Only about 50% of respondents who do not have healthinsurance are willing to pay for laboratory examination.Respondents who have health insurance tend to want to payfor laboratory services. From 24 respondents who have healthinsurance, more than 50% of respondents (15 respondents)were willing to pay for laboratory services. The ownership ofhealth insurance of respondents did not significantly affectthe willingness to pay for laboratory examination product(sig. = 0.287, B =- 0.511). This may be due to the BanyuwangiRegency society has not so familiar with health insurance andstill less has it, so most of the out-of-pocket payments.Conclusion: The ownership of health insurance respondentsdid not significantly affect the willingness to pay for productslaboratory examination. It is need to introduce more productslaboratory services and health insurance benefits to theBanyuwangi community.Keywords: willingness to pay, laboratory services, ownershipof health insuranc