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ANALYSIS OF CST (CASE, SUPPORT AND TREATMENT) AT H ABDUL MANAP HOSPITAL IN JAMBI CITY IN 2018 Nopita, Cici Lia; Nadjib, Mardiati
Proceedings of the International Conference on Applied Science and Health No 4 (2019)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: The CST clinic of H. Abdul Manap, the regional public hospital is the only type-C a hospital which provides ARV (Anti Retro Viral) treatment service in Jambi City. However, in the past five years, the trend of CST clinic utilization has tended to decrease. This research aims to analyze the factors affecting the decrease in the utilization of the CST clinic of H. Abdul Manap regional public hospital, Jambi City. Method: This study was used the qualitative method with purposive sampling technique. This research conducted in 37 participants were employed to obtain the primary data sources from observation and in-depth interviews with key informants. Those key informants included the management team (3 people), CST Clinic team (7 people), PLWHAs (18 people) and peer counselors (8 people) as well as FGDs (Focus Group Discussions). Results: The commitment of the concerned stakeholders, especially the chairman of the hospital and the CST team members in administering the CST service, has not been maximum. The budget allocation for CST clinic in the hospital was only for and limited to staff incentives. There had been no position for team leaders and case managers, while the doctors and staffs had not received any CST training. Some staffs even served double jobs. Conclusion: The service SOP, as well as the scheduled and continuous monitoring on SOP implementation and progress evaluation according to CST Clinic performance indicators, are required. The necessary of regional policies related to CST service, especially for the provision of CD4 reagents and tariffs; and the hospital director's decree to instruct not to refuse to treat PLWHA are also required. The Implication is a strong commitment from all stakeholders, especially the chairman of the hospital and the CST team members are required to improve the clinic utilization.

Medication Adherence of Tamoxifen to Breast Cancer Patients and the Affectingâ€™s Factors in Dharmais Cancer Hospital Jakarta Halilintar, Via Dolorosa; Nadjib, Mardiati; Andalusia, Lucia Rizka
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol 9, No 2 (2020): August
Publisher : Universitas Muhammadiyah Yogyakarta in Clollaboration with ADMMIRASI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.92120

Several previous studies show that adherence to hormonal therapy increases the survival rate in Breast Cancer (BC) with ER+ or PR+. Tamoxifen is one of oral chemotherapy which is the most used hormonal therapy in breast cancer treatment regimens. The focus of the study was to determine the level of adherence and factors influencing the adherence of the treatment of BC patients undergoing hormonal therapy with Tamoxifen in patients at Dharmais Cancer Hospital in the year 2018. The study is an observational study with a cross-sectional design. The study was followed by 109 respondents. Medication adherence levels assessed via questionnaire modified MARS-5. Sociodemographic and clinical characteristics obtained from interviews using structured questionnaires. Medication adherenceâ€™s level of Tamoxifen was 90.9% with the proportion of adhering patients was 75.2% (82 of 109 patients). Multivariate analysis showed that the age of respondents, level of education, level of knowledge is the most influential factor and determine the level of treatment adherence. Education level is the variable that has the greatest effect on medication adherence. Through this study, it is recommended to pay more attention to patients with specific characteristics such as patients with low education and or low income.

ANALISIS IMPLEMENTASI BANTUAN OPERASIONAL KESEHATAN (BOK) DENGAN CAKUPAN PENANGANAN KOMPLIKASI KEBIDANAN DI PUSKESMAS KOTA BEKASI TAHUN 2019 Naftalin, Farida; Ayuningtyas, Dumilah; Nadjib, Mardiati
Jukema (Jurnal Kesehatan Masyarakat Aceh) Vol 6, No 2 (2020): Jurnal Kesehatan Masyarakat Aceh (JUKEMA)
Publisher : Fakultas Kesehatan Masyarakat, Universitas Muhammadiyah Aceh

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37598/jukema.v6i2.906

Latar Belakang: Dalam proses pembangunan kesehatan untuk meningkatkan kualitas hidup masyarakat, Kementerian Kesehatan memutuskan untuk mengeluarkan kebijakan dana BOK (Bantuan Operasional Kesehatan). Dimana anggaran yang digunakan untuk membiayai pelayanan kesehatan masyarakat. Akan tetapi tersedianya dana BOK tersebut dirasakan belum efektif, sehingga belum menekan angka kematian ibu dan anak. Tujuan dari penelitian ini adalah mengetahui implementasi Bantuan Operasional Kesehatan (BOK) dengan cakupan penanganan komplikasi kebidanan di Puskesmas Kota Bekasi tahun 2019. Metode: Penelitian ini merupakan penelitian kualitatif. Pengambilan data dilakukan dengan wawancara mendalam dan telaah dokumen kepada informan yang terlibat pengelolaan dana BOK tahun 2019. Sampel yang terlibat dalam pelaksanaan program bantuan operasional kesehatan di Puskesmas Kota Bekasi terdiri dari sembilan responden. Hasil: penelitian mengungkapkan bahwa perencanaan anggaran sudah sesuai dengan juknis, kebijakan sumber daya manusia belum memadai, jumlah dana sudah mencukupi dan proses akuntabilitasnya memerlukan pengawasan dan penyederhanaan pelaporan. Pada tingkat capaian program penanganan komplikasi kebidanan, cakupan layanan ada yang telah meningkat, tetapi ada beberapa layanan yang tidak memenuhi target Standar Pelayanan Minimal (SPM). Saran: Diharapkan kepada Dinas Kesehatan Kota Bekasi dapat meningkatkan capaian SPM bidang kesehatan di Kota Bekasi dengan mengoptimalkan dana bantuan operasional kesehatan menuju masyarakat kota bekasi yang lebih sehat.

Completeness of Inpatient Medical Record Files in Obstetric and Gynecology Cases During Pandemic Period Hadyan, Muhammad Farras; Nadjib, Mardiati
Jurnal Aisyah : Jurnal Ilmu Kesehatan Vol 7, No S1 (2022): Suplement 1
Publisher : Universitas Aisyah Pringsewu

The COVID-19 pandemic first appeared in Indonesia in March 2020, which created new problems for various public sectors. Hospitals as health care facilities are expected to provide optimal health services to patients. One of the services provided at the hospital is medical record service which is one of the determinants of the quality of health services. The incompleteness of the medical record file will cause patient documentation to become problematic and the patient's health information to be difficult to identify. Based on preliminary interviews conducted at the Taman Puring Muhammadiyah Hospital, it is known that the completeness of inpatient medical records is still low. Data obtained from the medical record unit in 2021 found that 64% of medical records were incomplete. This study uses a descriptive observational study design that identifies the percentage of completeness of medical record files where only 25.42% of inpatient medical records in obstetrics and gynecology cases are complete, this is influenced by several factors such as HR factors, supporting factors and driving factors studied. qualitatively which concludes that policy factors and the availability of SOPs, supervision from medical record officers, and the willingness of doctors affect the completeness of the contents of medical records. Abstrak: Pandemi COVID-19 muncul pertama kali di Indonesia pada bulan Maret 2020 yang menimbulkan permasalahan baru bagi berbagai sektor publik. Rumah sakit sebagai sarana pelayanan kesehatan diharapkan dapat memberikan pelayanan kesehatan yang optimal kepada pasien. Salah satu pelayanan yang diberikan di rumah sakit adalah pelayanan rekam medis yang merupakan salah satu faktor penentu kualitas pelayanan kesehatan. Ketidaklengkapan berkas rekam medis akan mengakibatkan pendokumentasian pasien menjadi bermasalah serta informasi kesehatan pasien menjadi sulit diidentifikasi. Berdasarkan wawancara pendahuluan yang dilakukan di Rumah Sakit Muhammadiyah Taman Puring diketahui bahwa masih rendahnya kelengkapan rekam medis pasien rawat inap. Data yang diperoleh dari unit rekam medis pada tahun 2021 didapatkan 64% rekam medis yang belum terisi lengkap. Penelitian ini menggunakan desain studi deskriptif observasional yang mengidentifikasi persentase kelengkapan berkas rekam medis dimana didapatkan sebesar 25,42% saja rekam medis rawat inap pada kasus obstetri dan ginekologi yang lengkap hal ini dipengaruhi dari beberapa faktor seperti faktor SDM, faktor pendukung dan faktor pendorong yang ditelaah secara kualitatif yang menyimpulkan bahwa faktor kebijakan dan ketersediaan SOP, pengawasan dari petugas rekam medis, dan kemauan dokter mempengaruhi kelengkapan isi rekam medis.

SUPERVISION OF TRADITIONAL MEDICINES CONTAINING UNDECLARED SUBSTANCE: ANALYSIS OF INDONESIAN FDA MONITORING DATA FOR 2012 - 2021 Dianasari, Widha; Nadjib, Mardiati
Journal of Indonesian Health Policy and Administration Vol. 7, No. 1
Publisher : UI Scholars Hub

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Background: At a time when people believe in the efficacy and minimal risk of traditional medicines, government agencies that oversee traditional medicines often find chemicals that are intentionally added to traditional medicines. The purpose of this study is to present the findings of Undeclared Substance that have been added to traditional medicines for ten years, to analyze their relevance to the real situation related to diseases or health problems in Indonesia, and to examine the violations of related policies. Methods: This study used an observational design based on quantitative and qualitative data and analyzed descriptively. Quantitative data based on Traditional Medicines Monitoring data are published through the website (www.pom.go.id) in the category of public warning OT-BKO in 2012-2021. Further analysis, conducted in-depth interviews to explore the root cause of the problem at the level of policy makers. Documents and literature review were conducted to analyze the findings. Interviews with policy makers were also conducted to confirm findings and explore problems that were not obtained from documents and literature. Results: For ten years, Paracetamol was the most common type of Undeclared Substance found every year in traditional medicines. This is relevant to the high number of complaints related to indications for the use of Paracetamol, both from reports from health facilities and results from household surveys. Meanwhile, the findings of the Ephedrine Undeclared Substance - with indications for reducing respiratory disorders - only appeared in 2021. These findings are not only relevant to the COVID-19 pandemic and the entry of traditional medicines from foreign aid, which also contain Ephedra sinica. The Undeclared Substance' findings are inconsistent with the objectives of a number of regulations ranging from those related to traditional medicine to consumer protection. Conclusion: The findings of Undeclared Substance on traditional medicine were relevant to public health problems at that time. The emergence of traditional medicines with Ephedra shows that domestic producers do not understand the safety of traditional medicines. In addition, the existing policies and violations of these policies have not been understood by traditional medicine manufacturers.

THE ROLES AND POLICIES FOR THE USE OF TELEMEDICINE IN HANDLING COVID-19 SELF-ISOLATION: LITERATURE REVIEW Yonathan, Rafika Stany; Nadjib, Mardiati
Journal of Indonesian Health Policy and Administration Vol. 7, No. 2
Publisher : UI Scholars Hub

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The current COVID-19 pandemic has had various impacts on the world. The unpredictable spike in cases led to an explosion in patient numbers. The problem of limited treatment facilities forces patients to self- isolate at home. Along with technological advances, various facilities have also been created, one of which is telemedicine. This study aims to look at the role of telemedicine as a strategy for handling COVID-19 self-isolated patients in various countries. This study was conducted descriptively with a literature review. The search was carried out on articles published in Indonesian and English through Google Scholar, Pubmed, and Science Direct searches with the keywords COVID-19, home isolation, self-isolation, telemedicine, and telehealth. The search results obtained that the handling of COVID-19 patients in self-isolation with telemedicine is a solution to the need for monitoring patient health, where hospitals have difficulty being able to serve all patients who need hospitalization. It can be concluded that COVID-19 is a newly emerging disease, clinical symptoms and emergencies of each patient can certainly be different and difficult to predict. Telemedicine as a remote health service can be a means to facilitate clinical monitoring of patients during self-isolation. The implementation of telemedicine ensures the continuity of health services quite effectively and efficiently, the way telemedicine works helps protect patients and health workers from exposure to infection and reduces the burden on hospitals, so it is quite appropriate to be used as a strategy in handling if there is a spike in COVID-19 cases in the future or application to other similar circumstances.

ANALYSIS OF PROLANIS POLICY IMPLEMENTATION DURING THE COVID-19 PANDEMIC IN 2021 Firdaus, D.Fitria Sari; Nadjib, Mardiati
Journal of Indonesian Health Policy and Administration Vol. 7, No. 3
Publisher : UI Scholars Hub

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Data from Basic Health Research (Riskesdas) in 2018 shows that Diabetes and Hypertension dominate chronic diseases. The Director of BPJS Kesehatan has issued Circular No. 14 of 2020 concerning health services for national health insurance participants during the COVID-19 prevention period, especially Prolanis. The policy contains an appeal to postpone the provision of services in the form of mass gathering activities such as Prolanis Gymnastics, Club Education, and and other activities. Hence, this research is needed to describe the implementation of Prolanis policies during the COVID-19 Pandemic. The study used a descriptive research design with qualitative methods and George C. Edward III's theory of policy implementation model. The number of informants is 11 people. The data collection is done using observation, in-depth interviews, and document review. The study was conducted in May-June 2022 at the Krui Health Center, Pesisir Barat Regency, Lampung Province. The findings show that Prolanis activities, which were stopped during the COVID-19 Pandemic, resulted in uncontrolled hypertension and diabetes in the participants. There are also many Prolanis implementing officers and supervisors who are not aware of Circular 14 of 2020. This transmission failure resulted in implementing the policy not fully running correctly.

Health Care Spending for Cardiovascular Disease under National Health Insurance Scheme in Indonesia Before and During COVID-19: Descriptive Analysis and PolicyRecommendations Nurwahyuni, Atik; Soewondo, Prastuti; Nadjib, Mardiati; Farianti, Yuli; Mukhlisa, Mazda Novi; Wahyuningsih, Helmi; Mangunsong, Emmy Ridhawaty; Athiyah, Athiyah; Yunita, Yunita; Sayekti, Sekar Arum Handarbeni; Sari, Kurnia; Megraini, Amila
Journal of Indonesian Health Policy and Administration Vol. 8, No. 2
Publisher : UI Scholars Hub

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The Cardiovascular disease (CVD) prevalence continues to increase. This study aims to identify the CVD spending and utilization in the Indonesia National Health Insurance (JKN) scheme 2017-2021 using the JKN claims classified by Disease Accounts analyzed descriptively. The CVD spending increased by $125,4 million in 2019 compared to 2017 and mostly for the hospital (91% in 2019) with the highest spending occurring in the age above 60 years. Moreover, the hospital inpatient spending was dominated during these five years. The highest portion of spending by severity level was at mild level, followed by moderate and severe levels. Health facilities’ capacities across the regions remain the issue in providing health services, especially for the CVD that require further treatment using advanced technology. The CVD cost continues to increase annually; fortunately, the JKN plays a key role as financial protection for participants. But, there was a decrease in the number of visits and spending on CVD during the COVID-19 pandemic because of lockdown policies and health systems shifting to provide capacity to overcome COVID-19. The decrease in the number of visits to health facilities raises the potential of being diagnosed later with more severe. As policy recommendations, strengthening primary care screening and hospital capacity across regions through implementing the Health System Transformation are expected to reduce the impact of these problems.

ANALISIS IMPLEMENTASI BANTUAN OPERASIONAL KESEHATAN (BOK) DENGAN CAKUPAN PENANGANAN KOMPLIKASI KEBIDANAN DI PUSKESMAS KOTA BEKASI TAHUN 2019 Naftalin, Farida; Ayuningtyas, Dumilah; Nadjib, Mardiati
Jukema (Jurnal Kesehatan Masyarakat Aceh) Vol 6, No 2 (2020): Jurnal Kesehatan Masyarakat Aceh (JUKEMA)
Publisher : Fakultas Kesehatan Masyarakat, Universitas Muhammadiyah Aceh

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37598/jukema.v6i2.906

Latar Belakang: Dalam proses pembangunan kesehatan untuk meningkatkan kualitas hidup masyarakat, Kementerian Kesehatan memutuskan untuk mengeluarkan kebijakan dana BOK (Bantuan Operasional Kesehatan). Dimana anggaran yang digunakan untuk membiayai pelayanan kesehatan masyarakat. Akan tetapi tersedianya dana BOK tersebut dirasakan belum efektif, sehingga belum menekan angka kematian ibu dan anak. Tujuan dari penelitian ini adalah mengetahui implementasi Bantuan Operasional Kesehatan (BOK) dengan cakupan penanganan komplikasi kebidanan di Puskesmas Kota Bekasi tahun 2019. Metode: Penelitian ini merupakan penelitian kualitatif. Pengambilan data dilakukan dengan wawancara mendalam dan telaah dokumen kepada informan yang terlibat pengelolaan dana BOK tahun 2019. Sampel yang terlibat dalam pelaksanaan program bantuan operasional kesehatan di Puskesmas Kota Bekasi terdiri dari sembilan responden. Hasil: penelitian mengungkapkan bahwa perencanaan anggaran sudah sesuai dengan juknis, kebijakan sumber daya manusia belum memadai, jumlah dana sudah mencukupi dan proses akuntabilitasnya memerlukan pengawasan dan penyederhanaan pelaporan. Pada tingkat capaian program penanganan komplikasi kebidanan, cakupan layanan ada yang telah meningkat, tetapi ada beberapa layanan yang tidak memenuhi target Standar Pelayanan Minimal (SPM). Saran: Diharapkan kepada Dinas Kesehatan Kota Bekasi dapat meningkatkan capaian SPM bidang kesehatan di Kota Bekasi dengan mengoptimalkan dana bantuan operasional kesehatan menuju masyarakat kota bekasi yang lebih sehat.

HOSPITAL READINESS TO IMPLEMENT ELECTRONIC MEDICAL RECORDS: A SYSTEMATIC LITERATURE REVIEW Fatmasari, Afni; Nadjib, Mardiati
Jurnal ARSI : Administrasi Rumah Sakit Indonesia Vol. 10, No. 3
Publisher : UI Scholars Hub

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Implementing electronic medical records (EMR) in hospitals can increase the efficiency and effectiveness of health services. However, hospitals' readiness to adopt this technology is influenced by various complex factors. This study aims to identify factors that affect hospital readiness in implementing EMR through a systematic literature review (SLR). The SLR process followed the PRISMA method and included a literature search from Scopus, PubMed, and Cochrane databases with keywords related to RME readiness, which yielded 412 articles. After the screening and eligibility stages, 19 articles were selected for further analysis. The findings of this research identify readiness factors based on the theory of technology organization and environment (TOE). In the context of technology, factors such as technology access, perceived benefits, perceived usefulness, and performance expectancy emerge as important determinants of readiness. In an organizational context, management support, organizational culture, computer competency, and knowledge of EMR are key factors. Meanwhile, societal influence and environmental conditions play a significant role in the environmental context. These findings provide valuable insights for policymakers and hospital management in designing strategies to increase RME adoption readiness. This research has limitations in geographic and language coverage and the use of a single database. Therefore, further research is needed to broaden the scope and deepen understanding of the interactions between various readiness factors.

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