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Analysis of the Governance System of National Health Insurance Referral Patients at the Outpatient Polyclinic of Dian Harapanjayapura Hospital, Papua Situmorang, Ance Melimda; Utami, Tri Niswati; Nasution, Ramadhani Syafitri
PROMOTOR Vol. 7 No. 4 (2024): AGUSTUS
Publisher : Universitas Ibn Khaldun Bogor

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32832/pro.v7i4.1014

Abstract

The National Health Insurance (JKN) program, which has been running since January 1, 2014, has been widely benefited by most of the community. This program makes it easy for the public to access health services. However, the implementation of JKN for nine years often faces problems and challenges, one of which is governance. Many parties involved in this JKN program include BPJS Kesehatan as the organizer, the Ministry of Health as a regulator, Health Facilities (hospitals) as service providers and Professional Associations. This research is a qualitative research with a type of program review (governance system). The data collection process is carried out by conducting observations, interviews, analysis and documentation. Data analysis is in the form of an explanation of the situation being studied, while the presentation is in the form of a story explanation. This is in accordance with descriptive research which is the study of observations on the object of research to obtain an overview and actual circumstances. This research has been conducted at Dian Harapan Jayapura Hospital in Papua in February 2024. Based on the results of the study, it was found that inputs, processes and outputs related to the governance of National Health Insurance referral patients at the Outpatient Polyclinic of Dian Harapan Jayapura Hospital Papua were based on an assessment of human resources, facilities and infrastructure, Standard Operational Procedures, constraints and problem solving processes. The results of the study based on the influence of Human Resources show that training related to BPJS has not been carried out evenly for all personnel, including the evaluation of services has not been carried out regularly. The Assessment of Facilities and Infrastructure is considered to have been fulfilled only due to disturbances in the queue machine, the V-Claim application and Scan Finger interference. The assessment of SPO is considered to be available and understood, but there has been no routine evaluation to assess the progress of SPO implementation. The assessment of the obstacles that are often experienced is the disruption of the V-Claim Application and the queue system is still offline because the patient has not used the Mobile JKN Application so that the patient comes early in the morning to take the queue number. In terms of handling problems in stages starting from internal, if necessary, coordination between units or coordination with management with higher authority will be carried out. The conclusion in this study is that Human Resources have a great influence on services, in terms of the number that has been fulfilled, it is still necessary to evaluate the progress of services such as obstacles to delays in the doctor's practice schedule to be corrected according to the agreement so as not to affect service satisfaction. Regarding Facilities and Infrastructure, it is still considered good, it only needs to be added to facilitate online registration by increasing the benefits of the Mobile JKN Application, including the Queue Display facility at the Polyclinic. The applicable Standard Operational Procedures have been implemented, but there has not been a routine evaluation of the implementation of the SPO has been carried out appropriately or still requires additional SPOs to support services. Regarding obstacles and the solution of obstacles, it is considered good. Each officer is already independent in handling problems.
THE FACTORS INFLUENCING DECREASE IN STUNTING PREVALENCE AMONG TODDLERS IN THE WORKING AREA GLUGUR DARAT COMMUNITY HEALTH CENTER, EAST MEDAN DISTRICT, MEDAN CITY Turnip, Rita; Efendy, Ismail; Nasution, Ramadhani Syafitri
HEARTY Vol 12 No 3 (2024): AGUSTUS
Publisher : Fakultas Ilmu Kesehatan, Universitas Ibn Khaldun, Bogor

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32832/hearty.v12i3.16511

Abstract

The World Health Organization (WHO) estimates that 165 million children under the age of 5 in the world will be affected by malnutrition if efforts to reduce the prevalence of stunting continue on an ongoing basis, this is projected to be 127 million in 2025. Data from the Glugur Darat Health Center, the incidence of stunting in 2023 was 5 people cases, while 24 people experienced malnutrition. The aim of the research is to determine the factors that influence the reduction in the incidence of stunting among toddlers in the Glugur Darat Health Center Working Area, East Medan District, Medan City. The research design uses quantitative with a cross sectional approach. The population in this study were all mothers who had toddlers at the Glugur Darat Community Health Center, East Medan District, Medan City, namely 6,672 toddlers, with a sample size of 99 mothers who had toddlers. Data analysis uses univariate, bivariate and multivariate analysis. The results of the research show that there is an influence of food provision, personal hygiene, parenting patterns, utilization of health services on reducing the incidence of stunting among toddlers in the Glugur Darat Health Center Working Area, East Medan District, Medan City. Meanwhile, the most dominant factor is food provision. The conclusion of this research is that there is an influence of food provision, personal hygiene, parenting patterns, utilization of health services on reducing the incidence of stunting in toddlers in the Glugur Darat Health Center Working Area, East Medan District, Medan City. It is recommended that the Glugur Darat Health Center be able to create interesting education for mothers with toddlers so that they want to monitor their children at the puskesmas or posyandu, such as conducting workshops/demonstrations on how to provide good and correct and nutritious food for their children, as well as how to process it. diverse and nutritious food so that children get good nutritional intake as an early effort to reduce the incidence of stunting and improve family health.
FAKTOR-FAKTOR YANG MEMENGARUHI KINERJA KEPALA RUANGAN RAWAT INAP DI RSUD SULTAN ABDUL AZIZ SYAH PEUREULAK KABUPATEN ACEH TIMUR Noelvizar; Theo, Deli; Nasution, Ramadhani Syafitri
Scientica: Jurnal Ilmiah Sains dan Teknologi Vol. 2 No. 4 (2024): Scientica: Jurnal Ilmiah Sains dan Teknologi
Publisher : Komunitas Menulis dan Meneliti (Kolibi)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.572349/scientica.v2i4.1162

Abstract

Kinerja merupakan suatu elemen penting untuk mengukur kualitas mutu pelayanan kesehatan di rumah sakit. Kinerja kepala ruangan rawat inap berpengaruh terhadap kualitas pelayanan yang dilakukan oleh perawat. Kinerja yang dilakukan oleh pimpinan kadang kala dipengaruhi oleh faktor-faktor yang terdapat dalam diri perawat itu sendiri. Pimpinan cenderung memperhatikan hal-hal yang tidak berkaitan dengan kemajuan pemberian pembinaan yang didapat dalam karakteristik perawat dengan mempertimbangkan usia, pendidikan, masa kerja, etnis (budaya). Begitu juga dengan faktor gaya kepemimpinan, supervisi, motivasi dan rekan kerja yang diterapkan oleh kepala ruangan. Tujuan penelitian untuk mengetahui faktor-faktor yang memengaruhi kinerja kepala ruangan rawat inap di RSUD Sultan Abdul Aziz Syah Peureulak Kabupaten Aceh Timur. Jenis penelitian ini adalah survey analitik dengan pendekatan crossectional study. Populasi sebanyak 102 orang perawat di ruangan rawat inap dan seluruhnya dijadikan responden. Teknik pengumpulan data menggunakan kuesioner. Data dianalisis secara univariat, bivariat dan multivariat menggunakan uji regresi logistik berganda pada taraf kemaknaan 95 %. Hasil penelitian menunjukkan bahwa faktor umur (0,000), pendidikan (0,000), masa kerja (0,000), gaya kepemimpinan (0,000), supervisi (0,019) dan motivasi (0,035) berpengaruh terhadap kinerja kepala ruangan rawat inap karena lebih kecil dari 0,05, serta faktor etnis (budaya) (0,275) dan rekan kerja (0,076) tidak berpengaruh. Variabel paling dominan memengaruhi adalah pendidikan dengan nilai Exp(B) 28.806. Disarankan kepada RSUD Sultan Abdul Aziz Syah Peureulak Kabupaten Aceh Timur untuk memberikan pelatihan tentang kepemimpinan kepada kepala ruangan rawat inap agar dapat melaksanakan sikap profesionalitas kinerjanya dan memonitoring dan evaluasi kinerja kepala ruangan di rumah sakit serta bagi perawat agar melanjutkan pendidikan formal yang linier.
ANALISIS FAKTOR YANG MEMPENGARUHI KUNJUNGAN ANTENATAL CARE (ANC) Tanjung, Faisah; Effendy, Ismail; Utami, Tri Niswati; Asriwati, Asriwati; Nasution, Ramadhani Syafitri
Jurnal Kebidanan Khatulistiwa Vol 10, No 2 (2024): Jurnal Kebidanan Khatulistiwa
Publisher : Poltekkes Kemenkes Pontianak

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30602/jkk.v10i2.1317

Abstract

Background: Based on WHO data (2020), Indonesia's Antenatal Care (ANC) coverage percentage (82%) is still far from the standards set compared to other countries, where pregnancy checks for ANC (K1) coverage are 96.1%, and ANC (K4) coverage is 96.1%. amounting to 74.1%. The target of the strategic plan (Renstra) related to K1 is 100& and K6 coverage of pregnant women is 78%, in general it has not reached the target. The aim: of the research is to determine the analysis of factors influencing Antenatal Care (ANC) visits in the Sambas Port Health Center Working Area, Sibolga City in 2022 Metodh: The design of this research is analytical research using retrospective. The population in the study was all postpartum mothers ≤2 months, namely 216 people in October 2023. The sample used the Slovin formula, namely 68 respondents. The data used uses primary and secondary data. Data analysis using univariate, bivariate and multivariate using binary regression tests. Resulth: The research results were obtained using the chi square test, there was an influence of knowledge with Antenatal Care (ANC) visits (p= 0.017), there was no influence of employment with Antenatal Care (ANC) visits (p= 0.514), there was an influence of the role of health workers with Antenatal visits Care (ANC) (p= 0.001), there is an influence of husband's support with Antenatal Care (ANC) visits (p= 0.004), There is an influence of the attitude of health workers with Antenatal Care (ANC) visits (p= 0.027) and there is no influence of health facilities with Antenatal Care (ANC) visits (p= 0.017). The most dominant factor is the role of health workers with Antenatal Care (ANC) visits (p= 0.002) with an OR value of 6.160 (2.018-18.807). Conclusion:  the is that there is an influence of knowledge, attitude, role of health workers, husband's support, attitude of health workers with Antenatal visits in the Sambas Port Health Center Working Area. It is hoped that health workers at the Sambas Harbor Health Center will improve the quality of KIA services so that they can increase KIA patient satisfaction.
Key Factors Influence the Expenditure of Breast Milk in Post-Sectio Cesareana Mothers at Regional Hospital Batam, Indonesia Novitasari, Jennie; Nadapdap, Thomson; Nasution, Ramadhani Syafitri
Jurnal Perilaku Kesehatan Terpadu Vol. 3 No. 1 (2024): Jurnal Perilaku Kesehatan Terpadu (Jupiter)
Publisher : Hasanuddin Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61963/jpkt.v3i1.93

Abstract

Aim and objective of this research is to establish the relating and contributory factors to the formation of breast milk among post-caesarean section (SC) mothers at Embung Fatimah Regional Hospital Batam City. Breastfeeding is known to offer lots of health benefits to the baby, and the mother as well; unfortunately, many post-SC mothers face difficulties in lactation. Sequential exploratory design was used: quantitative data was collected from 54 post-SC mothers, qualitative data from post-SC mothers, midwives and health staff. Some of the factors that were examined in the study included; frequency of feedings, breast care, rooming-in, maternal diet, birth weight, feeding techniques employed and the gestational period. Altogether, quantitative findings pointed towards the association of independent variables with smooth breast milk production as follows: regularly frequency of breastfeeding (p = 0. 000), proper care of the breasts (p = 0. 002), rooming in (p = 0. 002), adequate diet of the mothers (p = 0. 000), mothers’ gestational age /full term/b (p = 0. Other observable variables such as mode of feeding which includes the combined nursing care and birth weight do not significantly predict each other. Most dominant factors considered by the logistic regression analysis were maternal nutrition and the frequency of breastfeeding. The qualitative results that supported the significance of educating women on how to breast feed, proper care of the breast and the value of family support on breastfeeding results. There was also an indication that mothers who were closely monitored by midwives and other health care givers experienced less problems in their milk flow. These results emphasise the need to enhance the provisions of breastfeeding education, healthcare and nutrition; especially for post-SC mothers to ease successful breastfeeding and improve the health of both mother and child.
Determinants of Patient Loyalty in a Regional Hospital: The Impact of Satisfaction, Image, and Trust Ep Lubis, Asyifa Zulinanda; Nuraini, Nuraini; Nasution, Ramadhani Syafitri
Jurnal Perilaku Kesehatan Terpadu Vol. 3 No. 1 (2024): Jurnal Perilaku Kesehatan Terpadu (Jupiter)
Publisher : Hasanuddin Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61963/jpkt.v3i1.99

Abstract

This study examines the key factors influencing patient loyalty at RSU Dr. R.M. Djoelham Binjai, focusing on patient satisfaction, hospital image, and trust. The purpose is to determine how these factors impact patients' intentions to return for future healthcare services. A quantitative research design was employed, using a cross-sectional analytical survey conducted on 93 inpatients from Super VIP, VIP, and Class 1 rooms. Data were collected through structured questionnaires and analysed using univariate, bivariate, and multivariate methods to explore the relationships between satisfaction, image, trust, and revisit intentions. The results demonstrate that higher patient satisfaction significantly increases the likelihood of returning to the hospital. A positive hospital image also plays a crucial role in fostering patient trust, which further enhances revisit intentions. The multivariate analysis confirms that patient satisfaction is the most significant predictor of loyalty, followed closely by trust and hospital image. In conclusion, the study highlights the importance of maintaining high service quality, a positive hospital image, and strong patient trust to enhance patient loyalty. Hospital management should focus on these areas to improve patient retention and ensure ongoing patronage.
Analisis Faktor yang Memengaruhi Kepuasan Pasien BPJS Rawat Jalan Rini Lestari; Nadapdap, Thomson Parluhutan; Nasution, Ramadhani Syafitri; Nur Aini
JURNAL KESEHATAN MERCUSUAR Vol. 7 No. 2 (2024): Jurnal Kesehatan Mercusuar
Publisher : STIKes MERCUBAKTIJAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36984/jkm.v7i2.503

Abstract

Kemenkes RI menyatakan kualitas pelayanan kesehatan merupakan segala hal yang meliputi kinerja yang menunjukkan tingkat kesempurnaan pelayanan kesehatan, tidak saja yang dapat menimbulkan kepuasan bagi pasien sesuai dengan kepuasan rata-rata penduduk tetapi juga sesuai dengan standar dan kode etik profesi yang telah ditetapkan. Mutu menjadi salah satu elemen penting dalam setiap pelayanan kesehatan. Oleh sebab itu, dalam memberikan pelayanan kesehatan bagi masyarakat, pihak penyedia jasa pelayanan kesehatan harus selalu menjaga mutu pelayanan yang diberikan. Tujuan yang ingin dicapai dalam penelitian ini adalah untuk menganalisis pengaruh pelayanan terhadap kepuasan pasien BPJS. Jenis penelitian ini menggunakan survei analitik deskriptif dengan rancangan cross sectional. Populasi dalam penelitian ini adalah seluruh pasien rawat jalan di klinik spesialis mata SMEC Palu tahun 2023 dengan rata-rata pasien yaitu sebanyak 322 orang pasien kunjungan pengambilan sampel dengan metode accidental  sampling, dengan sampel berjumlah 76 orang. Analisa data dilakukan dengan analisis univariat, bivariat dan multivariat. Berdasarkan hasil uji chi-square diketahui bahwa kepuasan pasien berpengaruh terhadap bukti fisik p-value = 0.054, kehandalan p-value  = 0.007, daya tanggap p-value = 0.025, jaminan p-value = 0.572 dan empati p-value p = 0,001, artinya ada pengaruh bukti fisik, kehandalan, daya tanggap, jaminan dan empati terhadap kepuasan pasien. Dari hasil analisis multivariat diketahui variabel yang paling berpengaruh dalam penelitian ini adalah variabel kehandalan dengan nilai OR 83.966. Kesimpulan dalam penelitian ini adalah variabel Kehandalan  bernilai lebih dominan, artinya variabel Kehandalan paling berpengaruh terhadap kepuasan pasien di Klinik Spesialis Mata SMEC Palu. Bagi rumah sakit dapat mengambil kebijakan guna meningkatkan kinerja petugas kesehatan sehingga menghasilkan kinerja yang optimal.
Implementasi Strategi Pemasaran Di Rumah Sakit Gigi Dan Mulut Universitas Sumatera Utara (RSGM-USU) Nasution, Dheina Lianisa; Nuraini, Nuraini; Nasution, Ramadhani Syafitri; Asriwati, Asriwati; Yuniati, Yuniati
JURNAL KEBIDANAN, KEPERAWATAN DAN KESEHATAN (BIKES) Vol 4, No 1 (2024): J-BIKES JULI
Publisher : Mata Pena Madani

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51849/j-bikes.v4i1.61

Abstract

Rumah sakit sebagai salah satu sarana kesehatan yang memberikan pelayanan kesehatan kepada masyarakat memiliki peran yang sangat strategis dalam mempercepat peningkatan derajat kesehatan masyarakat. Tujuan penelitian ini adalah untuk menganalisis implementasi strategi pemasaran di Rumah Sakit Gigi dan Mulut Universitas Sumatera Utara (RSGM-USU).Penelitian ini menggunakan metode deskriptif dengan pendekatan kualitatif melalui teknik in-depth interview (wawancara mendalam). Sumber data diperoleh secara langsung (data primer) dan tidak langsung (data sekunder). Informan sebanyak 10 orang yang terbagi menjadi informan utama dan informan pendukung. Analisis data dengan melakukan pengecekan hasil penelitian dengan teknik pengumpulan data yang berbeda yakni wawancara, observasi, dan dokumentasi.Hasil penelitian berdasarkan wawancara terhadap responden diketahui strategi pemasaran yang dilakukan hanya sebatas penyuluhan-penyuluhan di sekolah dan instansi lainnya serta mengikuti event-event yang dilaksanakan pihak ketiga, jenis layanan yang ditawarkan sudah lengkap didukung sarana dan prasarana lengkap, tarif layanan mampu bersaing dengan rumah sakit lain, lokasi mudah dijangkau dengan transportasi umum, promosi yang dilakukan masih belum maksimal, mengikut sertakan para staf dalam berbagai jenis pelatihan, menyiapkan admission dan papan penunjuk arah, alat-alat yang digunakan sudah modern serta selain keterbatasan sumber daya manusia juga terkendala pada dana.
Positive Deviance in Nutritional Practices for Two-Year-Olds in Poor Fisherman Families in the Belawan Health Center Area, 2022 Nasution, Ramadhani Syafitri; Mouliza, Nurul; Pratiwi, Debby
International Journal of Public Health Excellence (IJPHE) Vol. 4 No. 1 (2024): June-December
Publisher : PT Inovasi Pratama Internasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55299/ijphe.v4i1.1110

Abstract

The problem of malnutrition is still the main problem faced in human resource development. The problem of growth and development of Baduta is a serious problem because at this age the process of physical and intellectual growth and development is critical. Malnutrition problems mostly occur in poor families but are not caused by poor families who have well-nourished children. The Belawan Community Health Center working area is one of the community health centers with the highest number of cases of malnutrition in Medan City. To overcome this, a program is needed that is believed to be effective and sustainable. One of the existing programs to overcome the problem of malnutrition and malnutrition is positive deviation. This research aims to identify positive behavior in feeding (type of food, processing of food ingredients, mealtimes and method of feeding) of toddlers who are well-nourished in poor fishing families in the Belawan Community Health Center Working Area in 2022. This research method is qualitative research with a narrative approach. Researchers studied individual lives by asking one or several individuals to tell stories about their lives related to positive behavior in feeding well-nourished animals. This information is then retold by the researcher in a narrative chronology. The findings of this research indicate that addressing nutritional challenges in children can be effectively achieved by leveraging the potential and resources within the community. This is done through the identification of positive deviant behaviors, particularly those related to beneficial feeding practices. These practices encompass aspects such as the types of food provided, the methods of food preparation, the timing of meals, and the approach to food administration. Keep up the great work! The way you’re thinking about integrating community strengths is spot-on for creating sustainable solutions.
Comparison of Positive Deviance between Normal Nutrition and Undernutrition in Children Under Five Years Old from Low-Income Families at Community Health Centres in Medan Nasution, Ramadhani Syafitri; Mat, Khairi Che; Mohamad, Marhazlina
International Journal of Public Health Excellence (IJPHE) Vol. 4 No. 1 (2024): June-December
Publisher : PT Inovasi Pratama Internasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55299/ijphe.v4i1.1129

Abstract

Positive deviance in low-income families is a mechanism by which individuals or groups continue to thrive or meet standards despite facing challenging conditions. One of the goals of positive deviance is to prevent child malnutrition by changing community habits about feeding, caring, hygiene, and health seeking practices. Malnutrition early in life will affect the growth and development of children and the quality of life thereafter. The study aims to compare the positive deviances between children with normal nutrition and undernutrition. This cross-sectional study was conducted in 39 public health centres in Medan, West Indonesia, where a total of 80 children (40 with normal nutrition and 40 with undernutrition) were recruited using purposive sampling. Nutritional status (normal or undernutrition) was determined using body mass index-for-age (BMI-for-age) z-scores, according to WHO reference values. Positive deviance behaviours were assessed using a validated questionnaire, and anthropometric parameters such as weight, height, BMI, and triceps skinfold were measured. Haemoglobin levels were taken as a biological measurement of the condition. The Mann-Whitney test demonstrated that the positive deviance practices of feeding, caring, hygiene, and health-seeking behaviours were significantly better among normal nourished children than undernourished children (p<0.05). Children from families with positive deviance practices have better nutritional status despite living in economically limited conditions. This indicates that family behaviours and practices can play a crucial role in enhancing children's nutritional and health status, regardless of financial or environmental constraints. Integrating positive deviance approaches alongside additional interventions could be effective in improving children's nutritional status.