Jurnal Manajemen Pelayanan Kesehatan
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PENGALAMAN PASIEN DIRAWAT INAP SEBAGAI UPAYA PERENCANAAN BAURAN PEMASARAN (STUDI FENOMENOLOGI DI RUMAH SAKIT X KABUPATEN MALANG, JAWA TIMUR)
Get PDFBackground: A good exploration of patient’s behavior inchoosing hospital and patient’s experience will build anopportunity for hospital, especially on how hospital could makea customer oriented product. Suitability of hospital product andpatient’s need can assure that the marketing process is drivenby the patients. Hospital mixed marketing as a marketing toolcan be used by hospital in order to get a right positioning attarget market, it was influenced the patients to chose hospitalas well.Methods:It is a qualitative study with phenomenology approachto descriptively know about patient’s experience duringhospitalization at Hospital X, District Malang. The baselinephenomenon was consistently high visiting patients at HospitalX among hospital competition in District Malang. We purposivelytake six patients to include this study.Results: We got some assessment regarding patient’s services,hospital environment, and patient’s reason in choosingHospital X. Patient feel comfort during hospitalized, They reportedas: they were served by ‘friendly doctors’, ‘caring andefficient nurses’ and ‘diligent cleaning services’. They enjoyhospital environment such as: fresh air, no unpleasant odor,clean room and toilet, a good clean maintenance, even at aquite a big building hospital. A fast response time also was feltby patients, with no class differentiation. Patient and relativescan know well about hospital rule and direction, they feel wellinformed. Patient feel happy with hospital payment, because itwas charged after all service finished. The reasons on howpatients chose this hospital X were components of: distance(place), price, doctors (people), fast response time (process),hospital environment (physical evidence). All these reasonscalled mixed marketing components. Other reason out of mixedmarketing component is prestige.Conclusion: By phenomenological approach, a good exploringpatient’s experience can use as marketing planning byHospital. A good marketing planning and strategy made hospitalbe better during massive competition era.Key words: patient’s behavior, experience, phenomenology,mixed marketin
PENGGUNAAN SEPEDA MOTOR SEBAGAI AMBULAN KOMUNITAS DALAM RUJUKAN PELAYANAN: STUDI KASUS DI LOMBOK UTARA
Get PDFBackground: Community participation can be based on a spiritof mutual trust and mutual assistance. Health services in ruraland remote areas may survive if they are based on socialnetworks and become part of community life. Conversely, pooraccess to services happen if he only relies on the efforts ofthe parties in reaching out to community health facilities. Cooperationbetween the public and management of health facilitiescould build a community that is the key to the success ofcommunity based health services. Motorcycle can also serveas an alternative income. Although the fund concerned, thepractice is voluntary and not burdensome. An important factorof community health services is openness between primaryhealth care facilities with community organizations.This studyaims to assess the referral on a motorcycle as a social networkingcommunity in the health services.Method: This study is a case study that tries to show apattern of social networks in community based health services.The subjects of this study is the Nipah Pustu officers,officials of polindes Setangi and Malaka, motorcycles and thepeople who use taxi services in the referral. The collection ofdata were carried out with in-depth interviews and observation.Result: This study shows that informal motorbike ambulancewhich grows in the community can help increase visits to healthfacilities. Acceptance of the motorcycle by the public andhealth professionals make an impact on the economic conditionsof transportation service providers. Wide availabilitythroughout the hamlet, 24-hour service, low cost, helps intaking care of patients’ health card are the unique features forwhich many people use motorcycle service. Also importantis that motorcycles are also used by the clinic staff for deliveryof examination materials and referral of patients.Conclusion: Motorcycle ambulance is an important community-based resources that facilitate access to health care facilityin villages in remote areas.Keywords: two-wheeled bicycle ambulance, community participation,community based health services in remote
GELOMBANG KEDUA PENGEMBANGAN JURNAL MANAJEMEN PELAYANAN KESEHATAN
Get PDFJurnal Manajemen Pelayanan Kesehatan(JMPK) telah mencapai tahun ke 15 penerbitannyadan merupakan satu-satunya jurnal di Indonesia yangmendedikasikan isinya untuk pengembangan kebijakandan manajemen pelayanan kesehatan. Berawaldari naskah-naskah yang disusun oleh penulisdari kalangan internal Fakultas Kedokteran UGM(termasuk kontribusi dari peserta yang sedang menempuhpendidikan berbagai program), selamabeberapa tahun terakhir kontribusi naskah telahberasal dari berbagai penjuru dan institusi di Indonesia.Dalam setiap penerbitan, separoh halamanjurnal diperuntukkan bagi penulis di luar FakultasKedokteran UGM. Hal ini menunjukkan bahwaeksistensi JMPK telah diterima dan dibutuhkansecara nasional.Sejak tahun 1998, Prof Laksono Trisnantoro sebagaipemimpin redaksi JMPK telah menginisiasi,mengembangkan, meningkatkan profil dan kualitasjurnal yang dibuktikan melalui status akreditasibersama tim editor: Prof. dr. Adi Utarini, M.Sc.,MPH.,Ph.D., Prof.dr. Hari Kusnanto, SU., Dr.PH.,Dr. Dra. Sri Suryawati, Apt., drg. Yulita Hendrartini,M.Kes., dr. Mubasysyir Hasanbasri, MA., dan dr.Yodi Mahendradhata, M.Sc, Ph. D.Sejumlah 483 artikel telah diterbitkan di JMPKsejak dimulainya penerbitan jurnal ini. Kami mengucapkanterima kasih atas dedikasi tim editor selamaini untuk JMPK, dan tetap mengharapkan kontribusinyasebagai mitra bestari dalam perjalanan panjangjurnal ini selanjutnya. Semoga jurnal baru yang akandirintis, yaitu Jurnal Kebijakan Kesehatan, akan segerahadir di Indonesia untuk mendorong pengembanganilmu dan implementasi kebijakan kesehatan.Dengan rencana penerbitan jurnal baru tersebut,maka sesuai dengan namanya, JMPK akan memfokuskanmisinya untuk menyebarluaskan dan mendiskusikanberbagai tulisan ilmiah mengenai manajemenpelayanan kesehatan. Isi jurnal berupa artikelhasil penelitian yang berkaitan dengan manajemenrumah sakit, manajemen pelayanan kesehatan, manajemenpelayanan klinis, asuransi kesehatan, danmasalah yang relevan dengan manajemen pelayanankesehatan. Rubrik makalah kebijakan menjadiditiadakan. Mulai edisi Juni 2012, naskah-naskahyang lebih mengarah pada kebijakan kesehatan akandikirim ke Jurnal Kebijakan Kesehatan dan terdapatrevisi petunjuk bagi penulis. Selain naskah berupahasil penelitian, kami tetap mengharapkan kontribusiaktif para penulis/pembaca untuk resensi buku-bukubaru yang terbit dua tahun terakhir dan korespondensi.Saran-saran terhadap pengembangan JMPKsecara umum juga sangat diharapkan.Bagaimana pengembangan jurnal ini ke depan?Beberapa pemikiran untuk pengembangan padagelombang JMPK selanjutnya akan berfokus padaupaya untuk: (1) Mendorong sistem yang mempermudahkomunikasi antara pengelola jurnal, mitra bestaridan penulis sehingga penulis dapat mengetahuistatus review naskahnya, yaitu melalui sistemonline-submission; (2) Membuat call for paper untuktopik-topik khusus dalam manajemen pelayanankesehatan secara periodik; (3) Meningkatkan kerjasama dengan pihak lain untuk penerbitan edisikhusus; (4) Meningkatkan kualitas artikel yang terbitdi JMPK melalui proses review yang berkesinambungandan edukatif untuk mendukung para penulis.Keempat pengembangan tersebut diharapkan dapatkami kembangkan bersama tim editor JMPK yangbaru, dengan meningkatkan keterlibatan perguruantinggi di luar UGM. Terima kasih kepada, dr, AriProbandari MPH, PhD (Universitas Sebelas MaretSurakarta), dr. Vierra Wardhani M.Kes (UniversitasBrawijaya), akan kesediaannya untuk bergabungdalam tim editorial JMPK serta kepada dr. YodiMahendradhata MSc, PhD (Universitas GadjahMada), Prof.dr. Hari Kusnanto, SU., Dr. PH (UniversitasGadjah Mada) yang tetap bergabung dalamtim. Kami percaya bahwa pengalaman tim editorserta pengembangan riset manajemen pelayanankesehatan yang semakin kuat akan membawa energibaru untuk menghasilkan sinergi yang kuat dalammempertahankan kelangsungan JMPK.Akhir kata, edisi Desember 2012 akan mengangkattema manajemen pelayanan kesehatan dankeselamatan pasien. Untuk itu, kami mendorong parapenulis dari berbagai institusi pendidikan, penelitian,organisasi pelayanan kesehatan (rumah sakit,Puskesmas dan lainnya), Kementerian Kesehatan,Dinas Kesehatan, lembaga asuransi kesehatan sertaasosiasi profesi untuk mengirimkan naskahnya yangsesuai dengan tema tersebut
KINERJA BALAI KESEHATAN MATA MASYARAKAT MAKASSAR DENGAN PERSPEKTIF BALANCED SCORECARD
Get PDFBackground: The Community Eye Medical Clinic (CEMC) as aspecialized eye hospital has been using the service performanceindicators for outpatient visits and financial indicators.However, non-financial performance indicators were not yetassessed.Objectives: To analyze performance of CEMC with the BalancedScorecard (BSC) perspectives (customer’s perspective,internal process perspective, learning and growth perspectiveand financial perspective), and its interrelation amongeach perspective, to identify the potentials and the developmentplans of CEMC in MakassarMethods: This was an explanatory research employing aqualitative approach. Samples were selected using a purposivesampling tehnique to include 100 respondents for thecustomer performance and 43 respondents for employee performance.The data were analysed descriptively.Results: Applying BSC, performance of CEMC is 51.00% andthis belongs to the category of less healthy. The interrelationof each pespective starts with training to improve staff capacity.Along with use of information technology and financialperspective, this will improve staff productivity in the learningand growth perspectives. Staff satisfaction will improve thetechnical quality related to the internal standard. This will leadto increased number of visits and number of surgeries. Staffcommitment and capacity, increased of service velocity anddevelopment of customer capital are potential to be improved.The development plan includes making the performance basedon the reward system, the value creation process for customersand the development of the customer capital. The developmentplans focuses on increased staff commitment and capacity(learning and growth perspective), improvement processthrough reengineering and development of customer capitalthrough service attributes, relationship and image building.Conclusion: Using BSC, we found a mismatch between highcustomer satisfaction with low internal satisfaction. The managementshould improve the reward based on remunerationsystem, transparency on training opportunities to staff, anddevelop integrated planning.Keywords: balanced scorecard, performance achievement,the community eye medical clinic
PERSIAPAN RUMAH SAKIT SWASTA DALAM MENERAPKAN TARIF PELAYANAN JAMINAN PERSALINAN: STUDI KASUS DI RUMAH SAKIT KHUSUS IBU DAN ANAK DI KOTAMADIA MALANG
Get PDFBackground: High maternal death is mainly caused by limitedaccess to maternity services due to unaffordable cost of services.Therefore, a special insurance scheme named JaminanPersalinan (Jampersal) was launched and it is expected to beable to solve this problem.The Muhammadiyah Maternal andChild Hospital in Malang is a private hospital that offers obstetricand neonatal emergency service for those with Jampersal.The Jampersal fee was already set similar to that of JaminanKesehatan (Jamkesmas)scheme, using INA-CBG. Therefore,it is important to elicit the possibility of Jampersal fees beingaccomodated by private hospital.Objective:This research aimed to compare between Jampersaland hospital fees and analyse efforts of a private hospital inaccomodating the INA-CBG’s pricing scheme.Methods:This study was carried out at Muhammadiyah MalangMaternal and Child Hospital. Unit cost calculation and hospitalpricing were collected using the secondary data available fromthe department of finance in the hospital, while Focus GroupDiscussion (FGD) was held with the management level to understandwillingness and opportunity of hospital managersto collaboratewith the government in providing Jampersal services.Results: The results showed that INA-CBG’s tariff was lowerthan both unit cost and hospital pricing for normal delivery anddelivery with cesarean section.The unit costand tariff of normaldelivery were Rp1.633.704,00 and Rp2.070.275,00, respectively.Both of them were higher than the INA-CBG’s tariff(i.e., Rp1.487.770,00).The INA-CBG’s tariff for cesarean section(i.e. Rp2.712.943,00) was lower than both the unit costand hospital tariff of similar service (i.e. Rp4.782.072,00 andRp 5.110.500,-, respectively). From the FGD, it was found thatunlike for cesarean section, efforts to accommodate the Jampersalpricing for patients with normal delivery are possible.Conclusions: The findings indicate that Jampersal feesarelower than both the Muhammadiyah Malang Maternal and ChildHospital’s pricing and unit cost.Development of clinicalpathwaymay become a solution for the hospital to apply theINA-CBG’s tariff.Keywords: fees, Jampersal, private hospita
PENGARUH NILAI ORGANISASI TERHADAP KINERJA KARYAWAN DI RUMAH SAKIT WAVA HUSADA KEPANJEN
Get PDFBackground: Organizational value is the foundation to createorganizational culture. Hospital is an organization with distinctivecharacter due to its multiple professionals, technologies,and problems. Wava Husada private hospital builds threeorganizational values, namely dedication to serve, professionalismand teamwork.Objective: The objective of this study is to measure the effectof organizational value on employee performance.Method: This was a descriptive cross-sectional study usingprimary and secondary data. All managerial staff (30 respondents)and 50 nurses selected randomly were chosen to fill ina questionnaire. Descriptive analysis of dependent and independentvariables and multilinier regression were applied toshow the effect of organizational value on employee performance.Result: The findings show that overall, organizational valueinfluences the performance of managerial and nurse staff.Partially, dedication to serve organizational value has a significanteffect on the managerial staff and nurse performance.Conclusion: Professionalism doesnot influence the performanceof managerial staff and nurses, while teamwork hassignificant effect on nurse performance. Among the three organizationalvalues, dedication to serve is the most dominantvalue in both groups.Keywords: organizational value, work performance, privatehospita
EDITORIAL
No full textOver 1700 participants from over 100 countriesattended the Second Global Symposium on HealthSystem Research in Beijing from October 31 toNovember 3, 2012. The Symposium discussed stateof-the art health system research and strategies forstrengthening health systems research through keynotes,plenaries, concurrent sessions, satellites,posters, films, informal discussions and debates.One of the symposium sessions presented aconceptual framework for health system researchwhich encompasses systems at macro-, meso- andmicro- levels. Health service research was depictedat the meso- and macro- level of the systems, andmanagement research was noted as part of thehealth service research domain. Thus, health servicemanagement was viewed as a part of the overallhealth system research domain.The panelists highlighted that there are importantdifferences between research to support policymakingat macro-level and research to support managementdecision making. They first emphasizedthat the nature of the evidence required would differ,depending much on whom the evidence is supporting,e.g. goverment official, hospital manager, healthprofessional, citizens. Second, they noted that itwould also be different depending on whether we aresupporting them: (1) to select which programs, servicesand drugs to fund; or (2) to strengthen governance,financial and delivery arrangements withinsystems.They further argued that decisions about servicesand programmes are typically a single decisionmade at a single point in time by a clearly defineddecision-maker as part of routine decisionmaking. In contrast, policy making decisions aretypically consisted of a number of heterogenousdecisions, made over a long period of time, by abroad range of different decision makers, with littleor no routinization. They also highlighted that thebenefits, harms and costs of programs, services anddrugs are less context dependent, while the prosand cons of policies at macro-level is much morecontext dependent. Hence, in health policy research,local tacit knowledge, views and experiences mattermuch more.The debate described above represents an effortto clarify the boundaries of health system research,health policy research and health serviceresearch. There are however critical issues whichneeds to be examined further, particularly in the interestof health services management research.Firstly, it is rather misleading to portray health servicemanagement decision as typically technical,routine and clear cut. The health service managementdecision spectrum arguably spans from completecertainty in one end to absolute ambiguity onthe other end, and many in between. There can bepolitical dimensions to these decisions, eventhoughthey are at the organization or sub-organization level,as they often entail allocation of scarce resources.Thus, there are considerable rooms for local tacitknowledge, views and experience as well withinhealth service management research. Secondly,many management interventions are also contextspecific. A management decision to adopt clinicalpathway may lead to significantly better clinical outcomesin one hospital, but may result in minuteimprovement of clinical outcomes in anotherhospital.Thus, it is too risky to emphasize that healthservice managementdecisions are not so much influencedby context. Health service managementresearchers who fail to discuss contextual matters,may risk having their results haphazzardly generalizedor replicated. These points suggest that importantcharacteristics of health service managementresearch have not been adequately considered inthe symposium discourse above.The relative neglect of health service managementresearch in the current discourse reflects thelack of active contribution from health service managementresearchers, and perhaps also reflects thenature of a field which has not been much well developedscientifically. This calls for efforts to strengthenhealth service management research as a scientificfield. Drawing from efforts to strengthen health systemresearch as a field, we can think of several possibleways to do this. First, we need to establish acommon language by developing authoritative textbooks,journals and courses in health service managementresearch. Secondly, we need to promotecross-disciplinary learnings as heallth service managementresearch is typically multidisciplinary. Third,we need a society for health service managementresearch at national and international level. Fourth,we need more professors, authoritative scientific leaders,in health service management research.98 Jurnal Manajemen Pelayanan Kesehatan, Vol. 15, No. 3 September 2012Yodi Mahendradhata & Adi Utarini: What do we mean by health service ...JMPK, the Indonesian Journal of Health ServiceManagement, remains committed to contributetoward strengthening health service managementresearch by providing an accessible common peerreviewedplatform for state-of-the art health servicemanagement researches since more than a decadeago. We have attempted to make JMPK as accessibleas possible by providing online access to publishedcontent. We will soon expand further by providingpossibility for online submission as well.However, we are still left with the absence ofauthoritative textbooks and society of health servicemanagement research community in the country, incontrast to what we have in epidemiology or clinicalresearch for instance.In the field of epidemiology,there is the International Epidemiological Associationwhich publishes the International Journal of Epidemiologyand organizes the World Congress ofEpidemiology. At the national level, we also havethe National Epidemiology Network (JEN). The fieldof epidemiology also benefits from authoritative textbooks,such as those written by Kenneth J Rothman.For clinical research, there is the International Clinicalepidemiology network and the field benefits fromauthoritative textbooks such as those written by DavidSackett or Robert Fletcher. At the national level, theIndonesian Clinical Epidemology and EvidenceBased Medicine Network has also been established.We are looking forward to work with the healthservice management research community to moveforward with strengthening health service managementresearch as a scientific endeavour
A PILOT PROJECT ON INACTIVATED POLIO VACCINE IN YOGYAKARTA PROVINCE: THE COVERAGE AND TIMELINESS PILOT PROJECT VAKSIN POLIO INAKTIF DI PROPINSI YOGYAKARTA:
Get PDFBackground: Yogyakarta Province is the only province inIndonesia that piloted IPV immunization since September 2007.Therefore, it is essential to evaluate the implementation of thisnew program. This study was aimed to determine the coverageand timeliness of the IPV immunization after 2.5 years ofits introduction.Method: A cross sectional study was carried out using theWHO standard cluster sampling to estimate the immunizationcoverage in urban Yogyakarta City and the remaining ruraldistricts in Yogyakarta Province. The subjects consisted ofchildren aged 12-23 months old and their parents. A questionnairewas used to acquire information from parents/caregiverson demographic, socioeconomic, and IPV immunization status,dates, location, and access of immunization. Epi InfoTM 2003software was used for data entry and analysis.Result: Overall, 426 children were involved in the study (215in urban and 211 in rural areas). The coverage for IPV1 throughIPV4 was 100%, 99.8%, 99.3%, and 96.7%, respectively. Therewas no difference in coverage by urban/rural location, parents’education level, number of siblings, and distance to healthservice. The coverage is very similar to that of survey in 2004when this province still used oral polio vaccine. The meanages of IPV administration were 2.3, 3.5, 4.8, and 9.4 and nosignificant difference among urban and rural areas was found.More than 95% children received IPV immunization at appropriateage.Conclusion: The IPV pilot project in Yogyakarta Province hasbeen implemented well with high coverage and appropriatetimeliness.Keywords: immunization, polio eradication, IPV, coverage, timelines
KEBIJAKAN SUBSIDI KESEHATAN BAGI KELUARGA MISKIN DAN KONSUMSI ROKOK DI INDONESIA TAHUN 2001 DAN 2004
Get PDFBackground: There has been increasing trends of tobaccoconsumption among the poor families in the midst of governmenteffort to improve population health through health subsidyprograms for the poor.Objective: To analyse the effect of policy on health subsidyprovisions to the poor with cigarette expenditures and utilizationof health service facilities.Method: This study consists of two parts. Part one of thestudy was a cross-sectional study using the Susenas datayear 2001 and 2004. The sample involved 69,166 households(2001) and 60,832 households (2004) in all provinces inIndonesia. Univariate and bivariate analysis with Chi Squaretest were used in the statistical analysis. The second part ofthe study was a documentary study on Indonesian tobaccocontrol policy.Result: A significant increase in the proportion of smoking inthe household who receive subsidized health care was foundin 2004 (p <0.001). Smoking habits at home among those healthcare subsidy recipients, increased 35.06 percent in 2004compared to 2001, and this was significant (p 0.002). Outpatientutilization significantly increased by 28.86% (p <0.001).Frequency of hospitalization was decreased significantly in2004 compared with 2001, amounting to 36.62% (p 0.020).Tobacco control policy was stated in government regulationNo. 38/2000 which was then revised in No. 19/2003. Thesewere weaker than government regulation No. 81/1999.Conclusion: The provision of health care subsidies has animpact on the prevalence of smoking among the head of thepoorest households. Cigarette expenditures on householdsreceiving health subsidies are greater than expenditures oneducation and health.Keywords: health subsidy, smoking, utilization of healthservices, and the poorest households
ANALISIS KEBIJAKAN BERBASIS KESELAMATAN DAN KESEHATAN EVALUASI DAMPAK KEBIJAKAN LIMBAH CAIR RUMAH SAKIT
Get PDFLatar belakang: Implementasi kebijakan internalisasi limbahcair rumah sakit secara adhoc berupa pembuatan instalasipengolahan air limbah (IPAL) telah menimbulkan keluhan darimasyarakat sekitar rumah sakit. Fenomena paradoksinternalisasi ini menarik untuk diteliti dengan mempertanyakanapakah implementasi kebijakan limbah cair rumah sakit tersebutergonomik.Metode: Penelitian deskriptif-normatif yang menunjang analisiskebijakan ini dilaksanakan di empat rumah sakit yang ada diDaerah Istimewa Yogyakarta (DIY). Responden diambil secarapurposive (purposive sampling). Penelitian kualitatif ini mengikutialur proses dedukto-hipotetiko-verifikatif.Hasil: Hasil penelitian menunjukkan adanya IPAL di dalam rumahsakit menimbulkan kondisi tidak sehat, tidak aman, dan tidaknyaman bagi civitas hospitalia. Semuanya itu meverifikasi tidakserasinya hubungan sosio prosesual dengan tekno struktural.Dalam aspek analisis kebijakan secara ad hoc denganpembuatan IPAL limbah B3 dalam rumah sakit, menjadikan tidakergonomik, sehingga dapat menimbulkan bahaya dan risikobagi rumah sakit.Kesimpulan dan saran: Implementasi kebijakan yang tidakmemperhatikan lingkungan dimana kebijakan itu akan diterapkan,dapat menimbulkan kondisi yang tidak ergonomic. Perludisarankan agar pelaksana kebijakan memperhatikan grandtheory of policy implementation yang tidak hanya melihat faktorkebijakannya saja, tetapi juga organisasi/pelaku dan lingkungandimana kebijakan akan diterapkan.Kata kunci: kebijakan internalisasi, IPAL, paradoks internalisasi,ergonomik, grand theory of policy implementatio