Jurnal Manajemen Pelayanan Kesehatan
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KEPASTIAN LAYANAN MENJADI PRIORITAS KEBUTUHAN PASIEN PADA RUMAH SAKIT PEMERINTAH DI PROVINSI BENGKULU
Full text linkBackground: Quality improvement in public service has becomea major concern in government institutions as an effortto provide the maximum public service. It is also a major concernfor government hospitals in Bengkulu Province.Objective: To analyzing the quality level of the service providedby three government hospitals namely RSUD M. Yunus,RS Jitra, and RS Dinas Kesehatan Tentara (DKT).Method: The study uses quantitative-positivistic approachwith sampling techniques performed by non probability samplethrough accidental sampling. This study uses analysis of theservice quality (Servqual) and the Importance-PerformanceAnalysis (IPA) through a survey of 300 respondents.Result and Discussion: Results showed the dimensions ofthe highest service priority level based on the ratings given byrespondents is the assurance. While at the lowest priority ofservice quality is different, there are differences in all threehospitals. If RSUD M. Yunus lowest on service quality of empathy,while RS Jitra and RS DKT lowest on physical appearance.Conclusion: The results of both analyzes using the Servqualand IPA are mutually reinforcing. The highest performance atRSUD M Yunus on the dimensions of assurance, RS Jitra onthe dimensions of reliability, and RS DKT on the dimensions oftangible. Recommendations for subsequent research is tocomplete a more in-depth analysis of this quantitative research,with mengesplorasi qualitative aspects of the reality of thequality of public services of government hospitals in BengkuluProvince. Continued research in this area is needed to determinethe readiness of Bengkulu Province in implementing thenational social security system in health to be held in January2014.Keywords: public service, government hospital, service quality,importance-performance analysi
MEMPERBAIKI PENCAPAIAN PRESTASI KESEHATAN DAN KESELAMATAN KERJA MELALUI PENDEKATAN PERILAKU TENAGA KERJA
Full text linkSo far, the approach used to assess the company’s achievementof occupational health and safety (OHS) performance are moreretrosfective and based on statistics of occupational accidentand work related disease in the past, though this approachcontains a lot of weaknesses. Likewise, prevention and reductionof occupational injuries and work related disease was not basedon behavioral approaches, whereas the main causes ofoccupational injuries and work related disease is a behavioralfactor of labor. In fact, until now the performance of IndonesianOHS has not been prideful yet.The research proves that the determinant of laborbehavior (self-efficacy and perceptions of OHS) has beensignificantly positively related to achievement of OHSperformance, and as a strong predictor for predictingachievement of OHS performance. To improve achievement ofOHS performance in the future, the results of this study isrecommended for use because it has several advantages overretrosfective approaches. This research also has mademeasuring tool that has proven valid, reliable and fit to assessself efficacy and perception of labor specific to the field ofOHS. This instrument can be used as additional tests inthe recruitment of new workers or for work rotation at thecompany.Keywords: achievement of OHS performance,proactive approach, self-efficacy questioner and OHSperceptions question
ANALISIS NILAI PELANGGAN PADA PASIEN POLI ONKOLOGI RS KANKER X DAN PELAYANAN PENYAKIT KANKER TERPADU RSUP Y TAHUN 2010
Full text linkBackground: It is crucial for hospitals to concentrate on whatis needed by service users, rather than what is provided atthe hospital. Customers will choose the health care providerthat offers maximum value. Creation and delivery of value tocustomers is an effective marketing strategy for hospitals. Sothat, hospitals need to know the position of its value in theeyes of customers and compared with competitors.Objective: To understand the overview of Customer Value inPoly Oncology Dharmais Cancer Hospital compared with PolyPPKT Y Hospital in 2010.Methods: This study uses quantitative research methods byinterviewing 100 respondents in Poly Oncology DharmaisCancer Hospital and Poly PPKT Y Hospital to obtain primarydata.Results: Results showed that customer value in PolyOncology lower than customer value in PPKT. However, in thevalue map, customer value in Poly Oncology is in quadrantexpensive, which means having the opportunity to gain marketshare greater than PPKT which value is in quadrant discount.Conclusion: Attributes of service at Poli Oncology and PPKTstill needs to be improved by conduct training for nurses aboutcustomer service, increase social activities in society, andgive more attention to health facilities.Keywords: customer value, benefits, cost
KEBIJAKAN INFORMED CONSENT DALAM PELAYANAN GIGI DI INDONESIA DENTAL CARE INFORMED CONSENT POLICY IN INDONESIA
Full text linkMore than 50% out patients in Puskesmas at Surabaya citycame to the dentist for dental permanent extraction. The targetratio between filling and extraction that government statedwere 1:1, but coveraged in Puskesmas at Surabaya City in2003 were 1:5,9. Informed consent was given to patientsbefore the actions, consisted the diagnoses, procedures, themedical purpose, alternative actions, risks, possiblecomplications and prognoses.In Indonesia, there were not the rules yet that regulated theinformed consent before dental extraction. The law ofIndonesian Medical Practices No. 29/2004 has described theresponsibilities to do the informed consent for the actions thatpurposed on preventive, diagnostic, teurapeutic andrehabilitative. So, a dental extraction which is the teurapeuticprosedured needs the informed consent. After all, the informedconsent should be protect both of patient as a subject anddoctor/paramedic from unpredictable conditions.Keywords: informed consent, dental permanent extraction,polic
POTENSI PARTISIPASI MASYARAKAT MENUJU PELAKSANAAN JAMINAN KESEHATAN DALAM RANGKA UNIVERSAL COVERAGE DI KOTA BANDUNG
Full text linkBackground: Community is one of the components that mustbe prepared to participate on funding the health insuranceaccording to their ability. The main problem in Indonesia is thatthere are many informal workers who have unsteady incomeand are not the target of Jamkesmas, but they have the abilityfunding for their health insuranceMethod: The study aim was to asses the ability and willingnessof informal workers funding for health insurance in BandungCity. A survey with multy stage random sampling wasconducted using questionnaire for 700 respondents.Descriptive analysis technique was performed.Result: The results were average nonfood expenditure was1.62 times greater than average food expenditure, average“nonprimary” expenditure such as personal expenditure,“arisan”, recreation and saving, was 2.13 times greater thanaverage health expenditure. 94.4% of respondents did nothave any health saving, 87.1% of respondents would like toparticipate funding their health insurance.Conclusions: In Bandung City, the informal workers have theability and willingness to participate on funding their healthinsurance, so that the policy of “free health care” should bereconsidered. On the other hand, there are some actions stillneed to be developed, those are socialization; the collectingmethod; motivating this group to save money for health as theyhave an unsteady income.Keywords: community participation, health insurance, “free”health car
IDEOLOGI APA YANG DIANUT OLEH KEBIJAKAN KESEHATAN DI INDONESIA?
Full text linkAda pertanyaan menarik: sebenarnya ideologiapa yang dianut oleh pemerintah Indonesia dalampenerapan kebijakan kesehatannya? Apakahsosialisme, kapitalisme, etatisme, neoliberal, atauPancasila? Sebuah pertanyaan yang cukup sulitdijawab karena ternyata dalam perjalanan sejarahterjadi pergeseran bahkan pencampuran berbagaiideologi. Hal ini nampak contohnya dalam kebijakanpendirian rumah sakit swasta. Sejak jaman Belanda,pihak swasta diberi peran yang cukup signifikanuntuk turut serta dalam membangun rumah sakit.Dengan demikian, sejak awal berdirinya, sebenarnyaIndonesia sudah mempunyai ideologi yang berbasispasar. Hal ini juga tampak dari adanya kelas-kelas(VIP, kelas 1, kelas 2, dan kelas 3) dalam rumahsakit yang menunjukkan adanya pengakuan akanstruktur masyarakat yang didasarkan pada hierarkisosial ekonomi.Ideologi berbasis pasar ini semakin tampakpada masa orde baru yang semakin lama semakinmengurangi peran pemerintah. Contohnyaberkurangnya subsidi negara dan didorongnya“kemandirian” dan peran serta masyarakat dalammembiayai pengobatan sehingga RS bolehmemungut tarif dari masyarakat langsung. Dari tahunke tahun, tampak bahwa pembangunan RS swastayang berbentuk PT semakin meningkat. Antara tahun2002 sampai dengan 2008, ada penambahan 25 RSberbentuk PT yang tadinya berasal dari bentukYayasan. Sebaliknya hanya 5 PT berubah bentukmenjadi Yayasan. Tidak mengherankan bahwa RSberbentuk PT ini melayani kelompok pasarmenengah atas.Namun menarik untuk diamati bahwa dalambeberapa tahun belakangan ini, terjadi penguatanperan pemerintah yang mencerminkan ideologi yangtidak menyerahkan ke pasar. Sebagai contoh adalahprogram Jaminan Kesehatan Masyarakat(Jamkesmas) yang dananya berasal dari pemerintahpusat dan berfungsi “membeli” premi asuransikesehatan bagi orang miskin. Kebijakan inimenunjukkan bahwa pemerintah merasa perlu untuklebih berperan dalam pembiayaan kesehatan.Adanya pemilihan presiden dan kepala daerahlangsung nampaknya juga berpengaruh terhadapkebijakan yang cenderung mengandung ciri-ciri“welfare-state” ini. Hal ini nampak pada janji janjikampanye yang seringkali berupa “pengobatangratis”. Kemudian disusul dengan adanya programJaminan Persalinan (Jampersal) yang bahkanmembolehkan mereka yang tidak miskin untukdigratiskan biaya persalinannya asal mau dirawat dikelas 3 RS yang dikontrak. Pada saat yang samaPemerintah Indonesia melalui Kementrian Kesehatanmenggulirkan 7 Reformasi Pembangunan Kesehatanyaitu: 1) revitalisasi pelayanan kesehatan, 2)ketersediaan, distribusi, retensi dan mutusumberdaya manusia, 3) mengupayakanketersediaan, distribusi, keamanan, mutu, efektivitas,keterjangkauan obat, vaksin dan alkes, 4) Jaminankesehatan, 5) keberpihakan kepada daerah tertinggalperbatasan dan kepulauan (DTPK) dan daerahbermasalah kesehatan (DBK), 6) reformasi birokrasi,dan 7) world class health care.Bila dicermati dari ketujuh reformasi ini terdapatideologi berbasis pasar dan sosialis sekaligus. Butirkeberpihakan pada daerah tertinggal danpemerataan mencerminkan ideologi sosial liberalnamun “world class health care” cenderung berbasispada intervensi pemerintah terhadap pasar dengancara memberikan subsidi agar mampu bersaingdalam pasar kesehatan Asia Tenggara yang semakinbebas.Penerapan beberapa ideologi dalam satu negaraini berkembang menarik. Terdapat negara yangmenerapkan multi ideologi seperti Cina yang sistempolitiknya komunis dan sosialis ternyata sistemekonominya kapitalis. Amerika Serikat yangkapitalis juga cenderung ke “kiri” atau “sosialis”dengan UU reformasi kesehatan yang meningkatkanperan pemerintah dalam kesehatan.Ideologi sebagai pedoman penetapankebijakan dan pelaksanaanyaKebijakan kesehatan memerlukan mekanismekontrol dan pola pengelolaan yang tepat. Dalam halini ideologi dapat dipergunakan menjadi pedoman.Sebagai gambaran dalam Jampersal diharapkan,“jangan sampai orang kaya masuk VIP sebuah RSlalu meminta Jampersal membiayai persalinannyadi kelas 3, dan dia membayar selisihnya”. Hal inipenting ditekankan karena Indonesia yang sangatluas ini mempunyai infrastruktur layanan kesehatanyang amat beragam. Daerah NTT dan Papuakekurangan dokter dan fasilitas kesehatan yangmemadai sehingga Jampersal atau pelayanankesehatan gratis tidak akan dirasakan manfaatnyaoleh masyarakat jika di daerahnya tidak ada fasilitaskesehatan yang memadai dan tenaga kesehatanyang cukup. Bila orang kaya menggunakanJampersal tanpa kontrol, maka akan ada kegagalanJampersal untuk meratakan pelayanan ke daerahsulit. Dana Jampersal akan tersedot oleh masyarakatkaya atau yang tinggal di dekat sarana dan SDMkesehatan.Untuk itu, sebenarnya Jamkesmas danJampersal saja tidak cukup kalau tidak diiringipembangunan infrastruktur kesehatan. Pemerintahharus juga memikirkan alokasi biaya investasi danpemerataan SDM kesehatan, bukan hanya biayaoperasional saja. Dengan pedoman ideologi,kebijakan pemerintah dalam konteks Jampersal inidapat lebih terarah untuk membantu masyarakatyang memang perlu dibantu. (Laksono Trisnantorodan Sigit Riyarto)
HUBUNGAN KARAKTERISTIK MANAJER DAN KESADARAN BIAYA MANAJER RUMAH SAKIT DI LINGKUNGAN YAKKUM
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BAGAIMANA STRATEGI PENGEMBANGAN SISTEM SURVEILANS DALAM ERA DESENTRALISASI?
Full text linkSurveilans merupakan kegiatan yang sampaisekarang masih belum berjalan secara baik diIndonesia. Dengan diterbitkannya PeraturanPemerintah (PP) No. 38/2007 yang salah satu isinyamengatur mengenai wewenang pemerintah pusatdan daerah dalam pengelolaan dan penyelenggaraansistem surveillance maka ada momentum baru untukpengembangan. Kehadiran PP No. 38/2003 menjadijembatan yang baik mengenai pengelolaan danpenyelenggaraan sistem surveilans karena dapatmeneguhkan standar dan uniformitas sistemsurveilans di tingkat pusat maupun daerah,menegaskan implementasi surveilans di eradesentralisasi, memperhatikan kondisi spesifiklokal, dan dapat meningkatkan compliance dalamsistem surveilans.Pada tahun 2004 WHO1 mengajukan beberaparekomendasi untuk pengembangan surveilans:Integrasikan beberapa surveilans penyakit khusus;bentuk badan koordinasi kegiatan surveilans ditingkat pusat dan provinsi; kaji ulang penyakitpenyakitprioritas, melibatkan klinisi, ahli mikrobiologidan epidemiologi; bagi peran surveilans dalam sisteminformasi kesehatan nasional dengan semua pihakyang berkepentingan; kembangkan perananlaboratorium dalam surveilans; mengembangkanumpan balik dan supervisi efektif; implementasikanrencana kesiapan respons terhadap wabah di semuatingkat pelayanan; mengimplementasikan pelatihanberkesinambungan.Adanya rekomendasi dari WHO, perluditindaklanjuti dan direspon guna perbaikan sistemsurveilans yang ada dilapangan. Tindak lanjut yangdilaksanakan dapat berupa perbaikan sistempencatatan dan pelaporan baik di level Puskesmasmaupun dinas kesehatan, penggalangan komitmenuntuk pemerintah daerah menyediankan anggaranpelaksanaan sistem surveilans, penyediaan danasewaktu-waktu jika terjadi kejadian luar biasa, danperbaikan sistem organisasi surveilans.Isu-isu penting dalam pengembangan surveilansdi masa mendatang adalah: Adanya dasar akademikyang mantap dimana sebaiknya surveilans harusterkait dengan respons; dukungan sisteminformatika, tersedianya penganggaran surveilansdari berbagai sumber; dukungan regulasi, dan adanyaperbaikan struktur organisasi surveilans di daerahdan pusat. Salah satu hal penting dalam masa depansurveilans adalah penggunaan prinsip surveilansyang dihubungkan dengan respon. Berdasarkananalisis situasi saat ini, sebagai salah satu halpenting dalam pengembangan surveilans, perluditegaskan bahwa surveilans bukan hanya urusankelompok yang mengurusi penyakit menular.Surveilans tidak terbatas pada tugasepidemiolog, namun juga menjadi tugas paramanajer dan pengambil keputusan di pemerintahpusat dan daerah untuk melaksanakan. Kesan inimuncul karena di Indonesia surveilans secara tradisiberada pada Direktorat Jendral P2M dan Seksi P2di Dinas Kesehatan. Hal ini perlu diperbaiki denganmengacu pada prinsip delapan Fungsi Pokok SistemSurveilans Respon yaitu: deteksi kasus, registrasi,konfirmasi epidemiologis atau/dan laboratoris;pelaporan, analisis dan interpretasi, kesiapanmenghadapi wabah, respons dan pengendalian, sertafeedback. Laksono Trisnantoro ([email protected])Kepustakaan1. WHO. WHO comprehensive assessment of theNational Disease Surveilan in Indonesia. 200
TINJAUAN PELAKSANAAN STRATEGIC LEADERSHIP AND LEARNING ORGANIZATION TERHADAP PERUBAHAN INDIVIDU DAN INSTITUSI DI CIANJUR DAN BOGOR TAHUN 2004 - 2006
Full text linkBackground: Reformation’s journey made the Indonesiangovernment system changed from centralistic to decentralist.Those were pushed health program’s handling changed too.Unfortunately, the majority of health sector reformation focusedfor finance aspect and organization structure only and forgetedhuman resources which is the key of sources and a leadershipability. Therefore, Decentralization Unit of The Department ofHealth anticipated transition with created learning organizationthrough Strategic Leadership and Learning Organizationtrainings (SLLO). Those studies have been started on January2004 in The Faculty of Public Health, The University of Indonesia,with experiment area is Cianjur and control area is Bogor.Methods: Methods research is action research and usingquasi-experiment, pre and post test design for control. Thecontrol’s characteristic is unequal.Result: Generally, individual changes have been occurred ashave a desire and care to discuss and action together in theirproblem (RCA about IPM). Institutional changes have beenoccurred as created local’s policy and work climate better.Conclusion: Preferable SLLO have been implemented thetop leader before others to set an example for and reward forthe staff that is implemented SLLO better than others.Keywords: Strategic Leadership and Learning Organization(SLLO), individual changes, and institutional change
POTRET PELAKSANAAN REVITALISASI PUSKESMAS
Full text linkBackground: Health services by Public Health Centres (PHC)in the era of decentralization experienced a decline in someregion. The important role of PHC in health development is thereason to optimize its performance. PHC’s revitalization whichproclaimed by Health Department has the intend to returningPHC to its concepts, health manpower and facility accordingto based values in Kepmenkes 128/2004. The aim of PHC’srevitalization is to increase PHC’s performance in supportinghealth development.Method: The objective of this study was to describe theimplementation of PHC’s revitalization in supporting healthdevelopment. Study area was elect using purposive samplingdesign that is Jombang and Bojonegoro Districts in East JavaProvince, Cianjur District in West Java province and Sikkadistrict in East Nusa Tenggara Province. Data was collectthrough in-depth interview and focus group discussion andwas analyzed descriptive.Result: The result showed that although socialization of PHC’srevitalization has been done, but not yet understood asexpected by Health Department with priority returning PHC’sfunctions according to Kepmenkes 128/2004. Several effortshas been done by several PHCs in this study to improve PHC’sservices using government funding. Kinds of proposals aboutthe form of PHC’s revitalization were the potrait of the PHC’scondition nowadays. This is the reflection of the localspecification of each region.Conclusion: The recommendation of this study is to implementrevitalization of PHC on public health services with attention onthe PHC’s principals wich describe in Kepmenkes 128/2004Keywords : revitalisation, public health centr