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HUBUNGAN KUALITAS PELAYANAN DENGAN KEPUASAN PASIEN DI RUMAH SAKIT : SYSTEMATIC REVIEW Hidayah, Nikmatul; Bachtiar, Adang; Candi, Cicilya
PREPOTIF : JURNAL KESEHATAN MASYARAKAT Vol. 8 No. 3 (2024): DESEMBER 2024
Publisher : Universitas Pahlawan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/prepotif.v8i3.37178

Kualitas pelayanan kesehatan di rumah sakit merupakan faktor krusial yang mempengaruhi tingkat kepuasan dan loyalitas pasien terhadap institusi tersebut. Penelitian ini bertujuan untuk menganalisis elemen-elemen yang mempengaruhi kepuasan pasien di rumah sakit dengan mengaplikasikan pendekatan SERVQUAL, yang digunakan untuk mengidentifikasi perbedaan antara harapan dan pengalaman pasien dalam lima dimensi: tangible, reliability, responsiveness, assurance, dan empathy. Metode yang diterapkan dalam penelitian ini adalah systematic review, mengacu pada pedoman PRISMA, dengan melakukan pencarian literatur di berbagai database seperti ProQuest, ScienceDirect, Scopus, dan Google Scholar yang mencakup periode 2014 hingga 2024. Temuan dari tinjauan literatur menunjukkan bahwa dimensi responsiveness dan empathy memiliki pengaruh yang paling signifikan terhadap kepuasan pasien, diikuti oleh dimensi tangible, reliability, dan assurance. Layanan yang konsisten, cepat tanggap, aman, dan memperhatikan kebutuhan individu pasien terbukti meningkatkan kepercayaan serta loyalitas mereka, sekaligus memperkuat reputasi rumah sakit. Penelitian ini menekankan pentingnya evaluasi layanan secara terus-menerus untuk memenuhi harapan pasien dan meningkatkan daya saing rumah sakit. Hasil temuan ini diharapkan dapat memberikan kontribusi dalam pengembangan kebijakan yang lebih tepat dalam meningkatkan kualitas pelayanan kesehatan di rumah sakit.

Urban Health for the Development of Healthy Cities in Indonesia Christian, Deyo Alfa; Bachtiar, Adang; Candi, Cicilya
JKMP (Jurnal Kebijakan dan Manajemen Publik) Vol 11 No 2 (2023): Oktober
Publisher : Universitas Muhammadiyah Sidoarjo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21070/jkmp.v11i2.1759

Sustainable urban development, healthy cities and rapid urban growth have become a major focus in Indonesia. This research aims to identify the key factors needed to achieve optimal Urban Health in Indonesia. Currently, DKI Jakarta Province is the largest metropolitan city in Indonesia, but in 2022 DKI Jakarta will be ranked 238th in the world and 48th in Asia regarding the Quality of Life Index. A symbol of success and progress in the country of Indonesia, there are 98 cities spread across all provinces, but only 8 cities are included in the metropolitan category. This research uses the PRISMA extension for Scoping Review (PRISMA-ScR) guidelines, 93 articles published between 2000 and 2022 meet the inclusion criteria that look at Urban Health for city development. In an effort to build a healthy city, Urban Health needs to be implemented using several key factors that encourage good urban health. The policy approach in Indonesia must be to improve the quality and accessibility of health services which are important factors in the effectiveness of urban health services, so as to achieve good urban health. well in Indonesia requires a holistic approach that includes green energy, a clean environment, high levels of physical activity and good stress management, adequate health services, good nutrition and equitable health.

Navigating the aftermath: Risk factors of recurrence following coronary bypass surgery in Indonesia Bachtiar, Adang; Candi, Cicilya; Hasibuan, Syarif R.; Widyasanti, Nisrina; Kusuma, Dian
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.969

Coronary heart disease (CHD) remains a leading cause of mortality in Indonesia, and coronary artery bypass graft (CABG) surgery is frequently employed to manage arterial blockages. Despite its efficacy, the recurrence of heart disease post-surgery is a significant concern, highlighting the need for a deeper understanding of its influencing factors. The aim of this study was to examine the factors associated with the incidence of heart disease recurrence after coronary bypass surgery. This study employed a prospective observational design, analyzing hospital claim data from Indonesia's Social Security Agency for Health, known as Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan, from 2017 to 2022. The analysis included 5,947 patients who survived CABG surgery. Multivariable logistic regression was utilized to assess the relationship between patient demographics, comorbidities, socioeconomic status, and compliance with follow-up visits, as well as their impact on the recurrence of cardiovascular disease. The study found that 24.1% of patients experienced hospitalization recurrence. Patients with irregular follow-ups were less likely to experience recurrence (adjusted odds ratio (AOR): 0.63; 95%CI: 0.51–0.78). Other significant risk factors for recurrence included being self-employed (AOR: 2.09; 95%CI: 1.72–2.55), having comorbid conditions such as disorders of fluid, electrolyte, and acid-base balance (AOR: 3.55; 95%CI: 2.97–4.24), and experiencing cerebral infarction or stroke (AOR: 10.85; 95%CI: 8.24–14.29). In contrast, older age (AOR: 0.89; 95%CI: 0.88–0.91) and the presence of non-insulin-dependent diabetes mellitus (AOR: 0.35; 95%CI: 0.29–0.42) were associated with a lower risk of recurrence. Sex did not significantly influence the risk of recurrence (AOR: 1.18; 95%CI: 0.86–1.62). In conclusion, the study indicates a considerable rate of cardiovascular disease recurrence post-CABG in Indonesia, highlighting several key risk factors. Tailored postoperative management and strict adherence to follow-up protocols are essential for mitigating recurrence. These findings offer crucial insights for improving post-CABG health management strategies in Indonesia.

Analisis Perbaikan Respond Time Door to Needle R-TPA Pada Pasien Code Stroke di IGD RSPON Prof. Dr. Mahar Mardjono Jakarta Tahun 2022 - 2023 Trisetiawati, Lami; Modjo, Robiana; Bachtiar, Adang; Candi, Cicilya
Cerdika: Jurnal Ilmiah Indonesia Vol. 5 No. 7 (2025): Cerdika: Jurnal Ilmiah Indonesia
Publisher : Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/cerdika.v5i7.2651

Stroke merupakan penyebab kematian tertinggi di Indonesia, dengan angka kejadian 131,8 per 100.000 penduduk (WHO, 2023). Penanganan stroke iskemik akut yang optimal harus dilakukan dalam waktu ? 4,5 jam sejak onset, dengan pemberian terapi trombolitik (rtPA) idealnya dalam waktu ? 60 menit sejak pasien tiba di instalasi gawat darurat (door-to-needle time/DTN). Namun, di IGD RS Pusat Otak Nasional Prof. Dr. dr. Mahar Mardjono Jakarta, waktu DTN tahun 2021 masih mencapai 91 menit. Tujuan penelitian ini adalah untuk menganalisis dan memperbaiki alur penanganan pasien code stroke guna mempercepat waktu pemberian rtPA. Metode penelitian menggunakan pendekatan kuantitatif deskriptif berbasis Six Sigma melalui tahapan DMAIC (Define, Measure, Analyze, Improve, Control). Data dikumpulkan melalui observasi, wawancara tenaga medis, dan telaah rekam medis tahun 2022. Hasil penelitian menunjukkan bahwa intervensi terhadap sembilan titik proses pada lima fase utama—triase, pendaftaran, pemeriksaan penunjang, konsultasi DPJP, dan keputusan rtPA—berhasil menurunkan waktu DTN menjadi 40 menit pada triwulan IV tahun 2023. Penurunan ini melampaui standar pelayanan yang ditetapkan (<60 menit), menandakan keberhasilan reformasi alur penanganan stroke. Implikasi penelitian menunjukkan bahwa penerapan sistem code stroke terstruktur dan berbasis monitoring waktu efektif dalam meningkatkan kecepatan dan kualitas layanan stroke akut serta menurunkan risiko kecacatan.

The Structural Equation Modelling of First Level Health Facilities’ Performance-Based Capitation Payment in National Health Service Aryani, Ari Dwi; Bachtiar, Adang; Candi, Cicilya
Kesmas Vol. 19, No. 1
Publisher : UI Scholars Hub

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The BPJS Healthcare Security implemented performance-based capitation/Kapitasi Berbasis Kinerja(KBK) payments to conduct structured and ongoingmonitoring of the First Level Health Facilities/Fasilitas Kesehatan Tingkat Pertama(FKTP)'s performance throughout Indonesia. This study aimed to examinethe direct and indirect effects of FKTP capacity on KBK and FKTP performance. This study was conducted in February 2023, and Structural EquationModelling analysis was performed with secondary data from the BPJS Healthcare Security system database in 2021. Human resources were defined as theavailability of doctors in FKTP, infrastructure as credentialing value, ownership and type of FKTP, and KBK, and performance as first contact, non-specialistoutpatient referral ratios, and Chronic Disease Management Program/Program Pengelolaan Penyakit Kronis(Prolanis) participant ratio. The analytical resultsrevealed that human resources directly and positively affected the KBK. The indirect effect analysis results suggested that only human resources impactedFKTP performance. In conclusion, human resources are critical in achieving the KBK and FKTP performance.

The Potential of Private Health Insurance Ownership Based on the 2018-2020 National Socioeconomic Survey Data Hasan, Arief Rosyid; Bachtiar, Adang; Candi, Cicilya
Kesmas Vol. 17, No. 4
Publisher : UI Scholars Hub

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In 2014, the Indonesian Government introduced a social security program in the health sector. However, Indonesia’s out-of-pocket expenses remain high due to a lack of public interest in National Health Insurance services. Financing expensive health services with high out-of-pocket expenses has the potential to cause poverty. Private health insurance is considered a solution to this problem. This study aimed to determine the socioeconomic factors of private health insurance ownership and its potential in Indonesia. This study used secondary data from the 2018, 2019, and 2020 National Socioeconomic Surveys. Logistic regression analysis showed that the variables related to private health insurance ownership were age, sex, education, economic status, employment status, marital status, household status, and location of residence. The most dominant variable in 2018 was per capita expenditure (economic status), while education was the most dominant variable in 2019 and 2020. The result of this study can be used to formulate a strategy for increasing participation in private health insurance. The socioeconomic health sector should use this information to target specific markets for private health insurance.

Information-Motivation-Behavioral Skill in Diabetes Self-management Using Structural Equation Modeling Analysis Kurtanty, Dien; Bachtiar, Adang; Candi, Cicilya; Pramesti, Alya; Rahmasari, Almira Fanny
Kesmas Vol. 18, No. 1
Publisher : UI Scholars Hub

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Diabetes is the “mother” of various diseases increasing the risk of morbidity and mortality. Diabetes self-management, an effort made by patients to control blood sugar levels, is an important part of the management strategy. Therefore, this study analyzed information, motivation, and behavioral skills associated with diabetes self-management. Data were collected in the Special Capital Region of Jakarta, with 277 diabetic patients selected using a questionnaire by a systematic random sampling method. The analyzed variables were information (with indicator variables of information on physical activity, nutritional intake, drug consumption, and blood sugar monitoring); sociodemographic (age, sex, occupation, education level, and duration of diabetes); motivation (barrier, benefit, self-efficacy, severity, and susceptibility); and behavioral skills (new motor, self-regulatory, and social skills), which were analyzed to identify their influence on diabetes self-management using structural equation modeling. The results indicated that information and motivation significantly and positively affected behavioral skills; while, sociodemographic did not. Behavioral skills had a significant and positive effect on diabetes self-management. Accordingly, people with diabetes information, motivation, and behavioral skills need to be improved to increase the success of diabetes self-management.

Data Mining Analysis with Orange in the Development of Tuberculosis Among Diabetes Mellitus Patients Bintang, Malahayati Rusli; Bachtiar, Adang; Candi, Cicilya
Kesmas Vol. 19, No. 5
Publisher : UI Scholars Hub

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Prevention and treatment of diabetes will have a positive influence on tuberculosis (TB) since people may get TB because they have diabetes mellitus (DM). Recording and reporting through the TB Information System are not run optimally because of many factors. The information system must be strengthened to be used by private health facilities. This study used secondary data from the 2013 and 2018 Indonesian Basic Health Research (IBHR). The data was analyzed univariately and analyzed further using Orange Data Mining Tools to test the screening tool model used to predict TB in diabetic individuals. The total sample in this study from each data was 38,136 people. The 2013 IBHR stated that 749 people (2%) were diagnosed with pulmonary TB, while the 2018 IBHR stated that 97 people (0.3%) were diagnosed in the previous six months. The results of the Orange analysis showed that precision and recall calculations in this study were quite good, at 0.9. Therefore, the model would likely predict the occurrence of TB in diabetic individuals. According to Orange, the TB-DM electronic screening tool model tends to estimate the incidence of TB in diabetic individuals.

PATIENTS SATISFACTION ANALYSIS OF PRIMARY HEALTHCARE SERVICE QUALITY IN BONDOWOSO, INDONESIA Nazhifah, Naurah; Bachtiar, Adang; Oktamianti, Puput; Candi, Cicilya
Jurnal Kesehatan Tambusai Vol. 4 No. 4 (2023): DESEMBER 2023
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jkt.v4i4.20120

Indicators of efficiency and quality in healthcare often include patient satisfaction with the care they received. Health managers and policymakers may benefit greatly from the information gleaned from patient satisfaction surveys when conducting analyses of the existing state, awareness, quality, and quantity of process improvement initiatives and quality improvement. Improving patient satisfaction and providing patient-centered care relies heavily on meeting and even exceeding patients' expectations of the health care they get. There is still limited data about patients’ satisfaction and service quality in Bondowoso’s Primary Health Care. Therefore, this study was made to measure patients' satisfaction toward service quality in Bondowoso‘s Primary Healthcare. This is quantitative cross-sectional primary research. The data was collected using a questionnaire with 22 pairs of questions (organized in two aspects of service importance and performance) in 5 dimensions of tangibility, reliability, responsiveness, assurance and empathy. The importance-performance analysis (IPA) was used to determine the weaknesses of service quality and prioritizing the aspects requiring improvement. Data was collected at Primary Health Care Raider 514 Bondowoso from February to March 2023. Samples were filtered with several inclusion criteria based by age, residence, and their status as a patients in Primary Health Care Raider 514 Bondowoso. From 72 respondents, 54.2% (n=39) was Male, 81.9% (n=59) age were under 46 years old, 37.5% (n=27) had university degree, and 65.3% (n=47) were employed. The result of IPA showed that the Assurance in the QI (concentrate here), and reliability and responsiveness in the Q II (keep up the good work). tangible in the Q III (low priority), empathy was located in the Q IV (possible overkill). According to our findings, assurance was an aspect which was prioritized for improvement. A more comprehensive operational standard could improve assurance. Results are limited only to 1 primary health care site from February to March 2023 and limited to first level health facility patients only.

Analisis Perbaikan Respond Time Door to Needle R-TPA Pada Pasien Code Stroke di IGD RSPON Prof. Dr. Mahar Mardjono Jakarta Trisetiawati, Lami; Modjo, Robiana; Bachtiar, Adang; Candi, Cicilya
Cerdika: Jurnal Ilmiah Indonesia Vol. 5 No. 7 (2025): Cerdika: Jurnal Ilmiah Indonesia
Publisher : Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/cerdika.v5i7.2651

Stroke merupakan penyebab kematian tertinggi di Indonesia, dengan angka kejadian 131,8 per 100.000 penduduk (WHO, 2023). Penanganan stroke iskemik akut yang optimal harus dilakukan dalam waktu ? 4,5 jam sejak onset, dengan pemberian terapi trombolitik (rtPA) idealnya dalam waktu ? 60 menit sejak pasien tiba di instalasi gawat darurat (door-to-needle time/DTN). Namun, di IGD RS Pusat Otak Nasional Prof. Dr. dr. Mahar Mardjono Jakarta, waktu DTN tahun 2021 masih mencapai 91 menit. Tujuan penelitian ini adalah untuk menganalisis dan memperbaiki alur penanganan pasien code stroke guna mempercepat waktu pemberian rtPA. Metode penelitian menggunakan pendekatan kuantitatif deskriptif berbasis Six Sigma melalui tahapan DMAIC (Define, Measure, Analyze, Improve, Control). Data dikumpulkan melalui observasi, wawancara tenaga medis, dan telaah rekam medis tahun 2022. Hasil penelitian menunjukkan bahwa intervensi terhadap sembilan titik proses pada lima fase utama—triase, pendaftaran, pemeriksaan penunjang, konsultasi DPJP, dan keputusan rtPA—berhasil menurunkan waktu DTN menjadi 40 menit pada triwulan IV tahun 2023. Penurunan ini melampaui standar pelayanan yang ditetapkan (<60 menit), menandakan keberhasilan reformasi alur penanganan stroke. Implikasi penelitian menunjukkan bahwa penerapan sistem code stroke terstruktur dan berbasis monitoring waktu efektif dalam meningkatkan kecepatan dan kualitas layanan stroke akut serta menurunkan risiko kecacatan.

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