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Implementation of Interprofessional Collaboration in Type 2 Diabetes Mellitus Care in Health Service Facilities Rahmat Bakhtiar; Krispinus Duma; Muhammad Aminudin
Husada Mahakam Vol 10 No 2 (2020): Nopember 2020
Publisher : Poltekkes Kemenkes Kalimantan Timur (URL: http://poltekkes-kaltim.ac.id/)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35963/hmjk.v10i2.241

Management of Type 2 Diabetes Mellitus (T2DM) treatment in Indonesia had not been optimal, marked by the increasing incidence of both macro and micro complications which have an impact on high morbidity and mortality rates. As a chronic disease, the priority of T2DM management strategies was early detection and prevention of complications that could be done with a collaborative multi-disciplinary team approach. This study aimed to analyze the application of inter-professional collaboration in T2DM services in health care facilities in East Kalimantan. This research method was cross-sectional. A total of 120 T2DM patients who had received treatment both at the hospital and at the Primary Health Centre were involved in this study. The research variables were interpersonal collaboration, communication, team decision making, and conflict management. The results of the observations showed that the interaction of officers in the T2DM service activities went well and gave each other information among the team about conditions and management plans. Team communication played a role in the implementation of inter-professional collaboration on the treatment of T2DM in both hospitals and health centers. We believe that effective communication will reduce various barriers such as professional egos, skill gaps, or team knowledge which will increase the team's motivation to provide quality service.

THE EFFECTS OF THE UTILIZATION OF INTEGRATED MANAGEMENT POST OF MEDICAL FACULTY OF MULAWARMAN UNIVERSITY ON RISK INDICATORS OF NON-COMMUNICABLE DISEASE Irma Kania Safitri; Krispinus Duma; Rahmat Bakhtiar; Evi Fitriani
Jurnal Ilmu Kesehatan Vol 7 No 2 (2019): Jurnal Ilmu Kesehatan
Publisher : Universitas Muhammadiyah Kalimantan Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30650/jik.v7i2.1215

Non-communicable diseases have become a major public health problem in the last decade. In Indonesia, it was more than 36 million people dying from non-communicable diseases related to several risk factors including behavioral, metabolic and social risk factors. Several indicators can be considered to detect the risk factors of non-communicable diseases. They are blood pressure, cholesterol, glucose, uric acid, and body mass index. Efforts to prevent and control non-communicable diseases that are being developed in Indonesia are integrated management posts for non-communicable diseases that provide facilities and guidance to the community to take part in controlling the risk factors for non-communicable diseases. This research is an observational analytic study with the cross-sectional method based on data obtained from the monitoring book of members of the Medical School of Mulawarman University. The sample of this study was all individuals in the population that met the inclusion criteria of the study. Sixty-five samples were obtained to see the posbindu effect on blood pressure and 61 samples saw the effect of posbindu on total cholesterol levels that met the inclusion criteria. The variables observed in this study were posbindu utilization, sample blood pressure, and total cholesterol levels in the sample. The results of the research, there was the effect of using posbindu on sample blood pressure (p = 0.042), and there was no effect on the use of total cholesterol level in the sample (p = 0.590).

Analisis Rentang Waktu Pemeriksaan Penderita Kanker Payudara di Pelayanan Kesehatan Samarinda Widia Rahmadhani; Rahmat Bakhtiar; Eko Nugroho; Hadi Irawiraman; Krispinus Duma
Jurnal Kesehatan Andalas Vol 8, No 4 (2019): Online December 2019
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v8i4.1143

AbstrakKanker payudara merupakan penyebab kematian nomor satu akibat kanker dan tingginya angka kematian akibat kanker payudara disebabkan karena banyak penderita kanker payudara yang terdiagnosis saat stadium lanjut. Hal ini disebabkan oleh keterlambatan penderita kanker payudara melakukan pemeriksaan di pelayanan kesehatan. Banyak faktor risiko yang berperan dalam mempengaruhi rentang waktu pemeriksaan penderita kanker payudara di pelayanan kesehatan. Tujuan: Mengidentifikasi hubungan faktor-faktor yang terkait dengan rentang waktu pemeriksaan kanker payudara di pelayanan kesehatan Samarinda. Metode: Desain penelitian ini adalah analitik cross-sectional terhadap 46 penderita kanker payudara di RSUD Abdul Wahab Sjahranie Samarinda. Analisis data menggunakan uji Chi-square dan uji Fisher. Hasil: Terdapat hubungan antara usia dengan rentang waktu pemeriksaan (p=0,022) dan Pemeriksaan Payudara Sendiri (SADARI) dengan rentang waktu pemeriksaan (p=0,000). Faktor risiko lain yang tidak berhubungan adalah keluhan awal, riwayat keluarga kanker payudara, faktor ekonomi, dan pengobatan alternatif. Simpulan: Terdapat hubungan antara usia dan SADARI dengan rentang waktu pemeriksaan penderita kanker payudara di pelayanan kesehatan Samarinda dan tidak terdapat hubungan antara faktor risiko yang lain dengan rentang waktu pemeriksaan penderita kanker payudara di pelayanan kesehatan Samarinda.

Pembiayaan Kesehatan dan Efektifitas Pelayanan Kesehatan Ibu dan Anak di Kalimantan Timur Krispinus Duma
Jurnal Kebijakan Kesehatan Indonesia Vol 5, No 2 (2016)
Publisher : Center for Health Policy and Management

ABSTRACTBackground: Financing is one of the main factors in improving health care in general and maternal and child health services in particular. East Kalimantan area, which has an abundant source of revenue, ideally has either adequate financing on health care costs and the costs associated with health managed by other agencies. Improved health status can not be handled only by health institutions but needs to be strongly supported the role of other institutions, such as the maternal and child health services to reduce maternal mortality and child according to MDG targets. But the effectiveness of health care services in addition to financing is also determined by the commitment, cooperation and cross-sectoral health policy.Purpose: To determine the effectiveness of the financing of provincial health and maternal and child health services with indicators of maternal and child mortality rates according to the MDG targets in eastern Kalimantan.Methods: This research is descriptive using secondary data from East Kalimantan health profile and health-related financing in other institutions 2013-2013 period. Results: Health financing in the province of East Kalimantan varies widely each year, the health budget in 2013 amounted to Rp. 1.875 trillion, in 2012 amounted to Rp. 1.421 trillion, and in 2011 amounted to Rp. 148.731 billion, with per capita health budgets consecutive are Rp. 572 632, Rp. 385 130 and Rp. 47,581,888. Financing associated with other health institutions in 2013 amounted to Rp. 26 632, in 2012 amounted to Rp. 21 630 and in 2011 amounted to Rp. 11 338 per person. Maternal mortality, maternity and postpartum in 2013 as many as 113, in 2012 as many as 147, and in 2011 as many as 87. The death of infants and toddlers in 2013, 2012 and 2011 as many as 623, 648 and 971.Conclusion. The number of health financing does not determine the effectiveness of maternal and child health services, but a more important thing is the commitment and collaboration services and inter-sectoral programs that support maternal and child health services to achieve the MDGs. Keywords. Financing health, maternal and child health services. ABSTRAKLatabelakang: Pembiayaan salah satu faktor utama dalam meningkatkan pelayanan kesehatan secara umum dan pelayanan kesehatan ibu dan anak secara khusus. Kalimantan timur daerah yang mempunyai pendapatan asli daerah (PAD) yang tinggi idealnya mempunyai pembiayaan yang memadai baik biaya pada pelayanan kesehatan maupun biaya yang terkait dengan kesehatan yang dikelolah oleh instansi lain. Peningkatan derajat kesehatan tidak dapat ditangani hanya oleh institusi kesehatan tetapi sangat didukung peranan institusi lainnya, seperti dalam pelayanan kesehatan ibu dan anak untuk menurunkan angka kematian ibu dan anak sesuai target MDGs. Tetapi efektifitas pelayanan kesehatan selain adanya pembiayaan juga ditentukan oleh komitmen, kerjasama lintas sektoral dan kebijakan kesehatan.Tujuan: untuk mengetahui pembiayaan kesehatan provinsi dan efektifitas pelayanan kesehatan ibu dan anak dengan indikator angka kematian ibu dan anak menurut target MDGs di Kalimantan timur.Metode: Penelitian ini bersifat Deskriptif dengan menggunakan data sekunder berupa profil kesehatan Kalimantan Timur dan pembiayaan yang berkaitan dengan kesehatan di institusi lain periode 2011-2013. Hasil. Pembiayaan kesehatan di provinsi Kalimantan Timur sangat bervariasi setiap tahun, anggaran kesehatan pada tahun 2013 sebanyak Rp. 1,875 Triliun, tahun 2012 sebesar Rp. 1,421 triliun dan pada tahun 2011 sebesar Rp. 148,731 triliun dengan anggaran kesehatan perkapita berturut-turut Rp. 572.632, Rp. 385.130 dan Rp. 47,581,888. Pembiayaan yang terkait dengan kesehatan di institusi lainnya pada tahun 2013 sebesar Rp. 26.632, tahun 2012 sebesar Rp. 21.630 dan tahun 2011 sebesar Rp. 11.338 per orang. Kematian ibu hamil, bersalin dan nifas pada tahun 2013 sebanyak 113, tahun 2012 sebanyak 147 dan tahun 2011 sebanyak 87. Kematian bayi dan balita pada tahun 2013, 2012 dan 2011 sebanyak 623, 648 dan 971.Kesimpulan: Banyaknya pembiayaan kesehatan tidak menentukan efektifitasnya pelayanan kesehatan ibu dan anak namun yang terpenting adalah komitmen pelayanan dan kerjasama lintas program dan sektoral yang mendukung pelayanan kesehatan ibu dan anak untuk mencapai target MDGs. Kata Kunci: Pembiayaan kesehatan, pelayanan KIA.

Studi Kebijakan Sistem Manajemen Kesehatan dan Keselamatan Kerja (SMK3) di Propinsi Kalimantan Timur Krispinus Duma
Jurnal Kebijakan Kesehatan Indonesia Vol 3, No 2 (2014)
Publisher : Center for Health Policy and Management

Background : East Kalimantan is a destination for job seekers whether local, national, regional or international professionals due to its rich natural resources. Therefore East Kalimantan requires an occupational health and safety management (in Indonesia: SMK3) comprehensively. SMK3 policy is necessary both at the central and at the local level prior to the enactment of the Asean Free Trade Agreements (AFTA) in 2015. SMK3 policy at the national level generally accepted in Indonesia that can be seen by the presence of laws and regulations on health, employment and industrialization. The generally accepted policy needs to be adjusted to the conditions and situation in the region through Regulation or the Governor Decree in accordance PP RI number 25 of 2000 and Government Regulation Number 38 in 2007. Method: This is a qualitative research method using triangulation approach which collects data from various sources in the institutions of legislative, executive and implementing agency supervisors and supervisory policies of health system and SMK3 in the province of East Kalimantan. Results : Out of a total of 89 province regulations and decrees from 2003 to 2012, only approximately 12 of them which are related to health policy, but generally relates to levy income and expenditures on health. Application of health policy for the East Kalimantan by the Health Office and the Department of Labor’s Office is still guided by the central regulation. The new health policy initiated through Regulation number 20 in 2008 regarding the health system, but there are no local regulations yet nor governor decree regarding SMK3 in East Kalimantan province yet. Recommendation: A serious commitment from all stakeholders in East Kalimantan is required to achieve more concrete and tangible policies in the form of local regulations or decisions of the governor. Latarbelakang: Kalimantan Timur sebagai tujuan pencari kerja dalam skala lokal, nasional, regional maupun internasional yang profesional karena sumber daya alamnya, memerlukan sistem manajemen kesehatan dan keselamatan kerja (SMK3) yang komprehensif. Kebijakan SMK3 tersebut perlu kesiapan baik ditingkat pusat maupun di tingkat daerah sebelum diberlakukannya Asean Free Trade Agreements (AFTA) pada tahun 2015. Kebijakan SMK3 di tingkat pusat yang berlaku umum di Indonesia dapat dilihat dari adanya undang-undang dan peraturan tentang kesehatan, ketenagakerjaan dan industrialisasi. Kebijakan yang berlaku umum tersebut perlu disesuaikan dengan kondisi dan situasi di daerah melalui Peraturan Daerah (Perda) atau Keputusan Gubernur, sesuai PP RI nomor 25 tahun 2000 dan PP RI nomor 38 tahun 2007. Metode: Penelitian ini bersifat kualitatif dengan metode pendekatan triangulasi yaitu mengumpulkan data dari berbagai sumber-sumber di institusi legislatif, eksekutif maupun instansi pelaksana pembina dan pengawas kebijakan sistem kesehatan dan SMK3 di Provinsi Kalimantan Timur. Hasil: Sebanyak 89 produk peraturan daerah dan keputusan gubernur selama tahun 2003-2012, sekitar 12 diantaranya yang berhubungan dengan kebijakan di bidang kesehatan, namun umumnya berkaitan dengan retribusi pendapatan dan belanja daerah mengenai kesehatan. Penerapan Kebijakan kesehatan selama ini di Kalimantan Timur oleh Kantor Dinas Kesehatan dan Kantor Dinas Tenaga Kerja masih berpedoman pada peraturan pusat. Kebijakan di bidang kesehatan baru dimulai melalui Perda 20 tahun 2008 tentang sistem kesehatan namun belum ada perda atau kepgub yang berkaitan dengan kebijakan SMK3 di Provinsi Kalimantan Timur. Kesimpulan: Diperlukan komitmen serius dari seluruh pemangku kepentingan (stakeholder) untuk mewujudkan kebijakan yang lebih konkrit dan nyata dalam bentuk peraturan daerah atau keputusan gubernur.

Ketanggapan Pemerintah Daerah terhadap Sasaran Tata Kelola Roadmap Jaminan Kesehatan Nasional Tahun 2014 – 2019 di Provinsi Kalimantan Timur Rahmat Bakhtiar; Hilda Hilda; Krispinus Duma
Jurnal Kebijakan Kesehatan Indonesia Vol 10, No 3 (2021)
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.66042

Peta Jalan Jaminan Kesehatan Nasional 2014-2019 merupakan wujud komitmen Pemerintah untuk mengintegrasikan perencanaan program pembangunan nasional untuk mengimplementasikan program jaminan kesehatan dalam mencapai kepesertaan menyeluruh program jaminan kesehatan. Sebanyak 24 stakeholder potensial diwawancarai secara mendalam dan dianalisa secara deskriptif dalam aspek kebijakan dan ketanggapan sesuai dengan peran masing masing. Hasil evaluasi peta jalan di provinsi Kalimantan Timur menunjukkan sasaran tata kelola yaitu sasaran 1, 5 dan 8 belum sepenuhnya tercapai. Jumlah kepesertaan belum mencapai target UHC (93,64%). Keterbukaan akses terhadap data diawal periode peta jalan mengakibatkan Pemerintah Daerah dan BPJS kesulitan mencapai target universal health coverage. Ketanggapan Pemerintah Daerah terlihat meningkatnya intensifitas koordinasi stakeholder dengan BPJS serta adanya aturan sinkronisasi kegiatan yang dibuat secara bersama. Memperbaiki tata kelola dan dukungan stakeholder program JKN-KIS diperlukan dalam upaya memeratakan pelayanan kesehatan dan mencapai target universal health coverage.

Kajian Capaian Tata Kelola dan Ekuitas Layanan ISPA dalam Implementasi Program JKN di Provinsi Kalimantan Timur Rahmat Bakhtiar; Hilda Hilda; Krispinus Duma; Laksono Trisnantoro
Jurnal Kebijakan Kesehatan Indonesia Vol 10, No 3 (2021): Special Issues
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.68513

JKN adalah instrumen negara berupa jaminan kesehatan yang diselenggarakan untuk mengalihkan risiko individu secara nasional melalui mekanisme asuransi sosial, kepesertaan bersifat wajib, dan asas keadilan sosial. Sementara, pemerataan layanan kesehatan merupakan masalah yang kronis di wilayah kabupaten atau rural Provinsi Kaltim. Jenis penelitian yang dilakukan adalah mixed methods dengan pendekatan studi kasus di Provinsi Kaltim tahun 2018-2019. Data sekunder dianalisa secara kuantitatif dilanjutkan wawancara mendalam secara kualitatif. Hasil penelitian menunjukkan bahwa tata kelola kepesertaan PBPU yang belum adaptif menyebabkan belum optimalnya perlindungan layanan kesehatan bagi pekerja informal. Capaian ekuitas sudah cukup baik pada layanan ISPA di wilayah perkotaan. Namun, pemerintah perlu membentuk kebijakan yang bersifat afirmatif untuk menutup kesenjangan utilisasi layanan ISPA di wilayah pedesaan. Capaian tata kelola dan ekuitas ini perlu dijawab dengan praktik agile governance dalam program JKN.

Reliability and Validity Test of the Indonesian Version of the Nordic Musculoskeletal Questionnaire (NMQ) to Measure Musculoskeletal Disorders (MSD) in Traditional Women Weavers Iwan Muhamad Ramdan; Krispinus Duma; Dina Lusiana Setyowati
Global Medical & Health Communication (GMHC) Vol 7, No 2 (2019)
Publisher : Universitas Islam Bandung

Musculoskeletal disorder remains to be a health and safety problem. One of measuring instrument often use to assess musculoskeletal disorders worldwide is the Nordic musculoskeletal questionnaire (NMQ). This questionnaire translated into various languages and tested for its validity and reliability. However, it has limitations, such as the difficulty of application in countries that do not speak English. This study aims to test the validity and reliability of the Indonesian version of NMQ in women weavers working using traditional handlooms in East Kalimantan Indonesia from March to May 2018. The validity of items obtained ranges 0.501 (min.) to 0.823 (max.), and Cronbach's alpha reliability was 0.726. In conclusion, the NMQ in Indonesian version has satisfactory psychometric properties with adequate validity and reliability. UJI VALIDITAS DAN RELIABILITAS NORDIC MUSCULOSKELETAL QUESTIONNAIRE (NMQ) VERSI INDONESIA UNTUK MENGUKUR GANGGUAN MUSKULOSKELETAL PADA PENENUN TRADISIONAL WANITAGangguan muskuloskeletal masih menjadi masalah kesehatan dan keselamatan kerja. Salah satu alat ukur yang sering dipakai untuk mengkaji gangguan muskuloskeletal di seluruh dunia adalah Nordic musculoskeletal questionnaire (NMQ). Kuesioner ini telah diterjemahkan ke berbagai bahasa di dunia dan terbukti valid serta reliabel, tetapi memiliki keterbatasan di antaranya sulit diaplikasikan di negara yang tidak menggunakan bahasa Ingris sebagai bahasa sehari-hari. Penelitian ini bertujuan menguji validitas dan reliabilitas NMQ versi bahasa Indonesia pada penenun tradisional wanita di Kalimantan Timur periode Maret sampai Mei 2018. Didapatkan hasil uji validitas item berkisar antara 0,501 (min.) sampai 0,823 (maks.) dan indeks reliabilitas Cronbach's alpha sebesar 0,726. Simpulan, NMQ versi bahasa Indonesia cukup valid dan reliabel untuk mengukur gangguan muskuloskeletal.

Implementasi Manajemen Risiko Berdasarkan ISO 31000:2009 pada Program Perawatan Mesin di Area Workshop PT. X Sari Delima Fitri; Dina Lusiana Setyowati; Krispinus Duma
Faletehan Health Journal Vol 6 No 1 (2019): Faletehan Health Journal, Maret 2019
Publisher : Universitas Faletehan

Machine maintenance programs in workshop area are high risk working units in terms of work accidents. This research purpose was to explore implementation of risk management based on ISO 31000:2009 of machine maintenance program in workshop area. This research was a qualitative research according to ISO 31000:2009. The informants in this research were head workshop as main informant, maintenance department head as key informant and worker in workshop as supporting informant. The engine maintenance program in the workshop area consists of 3 work stages namely fabrication, assembly and service (finishing). The results showed that from hazard identification results found physical hazard, chemical hazard, biological hazard, ergonomic hazard and psychological hazard. Risk analysis results were not found to be hazards with extreme risk, 3 dangers on the level of high risk, 13 dangers in the level of moderate risk hazards and 11 dangers in the level of low risk. Forms of risk treatment is in the initial treatment using risk mitigation methods for each of the risks faced, then the next treatment includes risk transfer, avoiding risk and accepting risks. Based on the result of a defined risk treatment, the recommendation or treatment of possible risks is an effective control measure and appropriate treatment in dealing with various possible risks.

Relationship between understanding of COVID-19's infographics and the efforts to prevent COVID-19 transmission Rahmat Bakhtiar; Hilda Hilda; Krispinus Duma; Riries Choiru Pramulia Yudia
Journal of Community Empowerment for Health Vol 3, No 2 (2020): Special Issue of COVID-19
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jcoemph.56749

The prevention of disease transmission is an effective cost-strategy in controlling COVID-19. The scenario of the control of COVID-19 in Samarinda City consists of 3 phases, namely initial, advanced, and recovery. The outcome of the advanced phase is flattening the transmission curve of the COVID-19 pandemic, with an increased proportion of patients in recovery, and an increased culture of preventing disease transmission in society. This study aimed at knowing the influence of the understanding of COVID-19 infographics on the efforts to prevent COVID-19 transmission at the advanced phase. A survey was conducted via social media from April 21st to April 30th, 2020. The preventive actions for the disease transmission as the dependent variable in this study were social distancing, wearing a mask, washing hands, and efforts to enhance the body’s immunity, while the independent variable was the understanding of COVID-19 infographics updated daily. The results of the study showed that the proportion of the population who understood the infographics well was 79.5%, the community participation in practicing social distancing (81.6%), wearing a mask (50.9%), washing hands as frequently as possible (74.3%), and the efforts to strengthen the body’s immune system (73.6%) with a consistency level of 55.12%. The lowest rate for the activity of social distancing was visiting elders or the people suffering from comorbidities with 54.71%. A good understanding of infographics could increase adherence to the recommendations of social distancing. The implementation of social distancing, wearing a mask, washing hands as frequently as possible, and the efforts to improve the body’s immune system need to be done consistently to prevent the COVID-19 transmission and as a result, the potential transmission could be minimized to optimize the recovery phase and anticipate the possible second wave of the COVID-19 pandemic.

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