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All Journal Jurnal Kebijakan Kesehatan Indonesia Dentika Dental Journal Majalah Kedokteran Gigi Indonesia ODONTO Dental Journal Insisiva Dental Journal : Majalah Kedokteran Gigi Insisiva Dental Journal (Majalah Kedokteran Gigi) Public Health of Indonesia Padjadjaran Journal of Dentistry Kesmas Indonesia: Jurnal Ilmiah Kesehatan Masyarakat Jurnal Kesehatan Vokasional Open Access Jakarta Journal of Health Sciences (OAJJHS) Jurnal Teknologi Kesehatan Berita Kedokteran Masyarakat Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management) Praeparandi : Jurnal Farmasi dan Sains Odonto dental journal JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit)

Julita Hendrartini

Departemen Ilmu Kesehatan Gigi Pencegahan Dan Ilmu Kesehatan Gigi Masyarakat, Fakultas Kedokteran Gigi, Universitas Gadjah Mada, Yogyakarta

Author-ID : 279367

Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Economics, Econometrics & Finance Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Analisis Efisiensi Teknis Dana Kapitasi Puskesmas di Kabupaten Sleman Menggunakan Data Envelopment Analysis Mas’ud Mas’ud; Laksono Trisnantoro; Julita Hendrartini
Jurnal Kebijakan Kesehatan Indonesia Vol 5, No 3 (2016)
Publisher : Center for Health Policy and Management

ABSTRACTBackground. Presidential Decree No. 12/2013 states that BPJS Health in carrying out health insurance, using a capitation financing system in health care first level (primary). According to Minister Regulation No.19 / 2014, that the allocation of capitation funds used for the payment of health care services for health workers and non-health workers who perform services on health care first level. While the operational services allocated for drugs, medical devices, and medical consumable material and other health care operations. Necessary to study the use of the funds in question so that the operational and health services can run effectively, efficiently in order to determine the appropriate policies by local government and center.Methods. This type of study is a mixed analytic methods. In the quantitative data analysis method Data Envelopment Analysis (DEA) and qualitative data to explain the quantitative data. The study population includes all government-owned health centers in Sleman (25 health centers. This study will look at the efficiency of technical management puskesmas capitation funds for the implementation of individual health efforts in Sleman district PHC in 2014.Results. Based on the analysis with DEA method, only 3 of the 25 health centers health centers (12%) which has been technically cost efficiency and 13 health centers (52%) were technically efficient system. Tobit regression analysis shows that there are four variables that significantly, variable utilization figure (positive direction), reference number (positive direction), the ratio of non-medical personnel (negative direction), and capitation funds (negative direction).Conclusion and Suggestions. In general, health centers in Sleman yet technically efficient in the management of capitation funds. Policy-oriented technical efficiency costs will affect the value of the technical efficiency of the system. Expected DHO monitoring, evaluation and improvement of the efficiency of the management of Puskesmas capitation funds intensively and comprehensively on the quality of the performance of health centers as an indicator.Keywords. Capitation Funding, Primary Health Care, Technical Efficiency, Data Envelopment Analysis (DEA).ABSTRAKLatar Belakang. Perpres No. 12/2013 menyebutkan bahwa BPJS Kesehatan dalam menyelenggarakan jaminan kesehatan, menggunakan sistem pembiayaan kapitasi di faskes tingkat pertama (primer). Menurut Permenkes No.19/2014, bahwa alokasi dana kapitasi dipergunakan untuk pembayaran jasa pelayanan kesehatan bagi tenaga kesehatan dan tenaga non kesehatan yang melakukan pelayanan pada FKTP (60%). Sedangkan layanan operasional dialokasikan untuk obat, alat kesehatan, dan bahan medis habis pakai dan kegiatan operasional pelayanan kesehatan lainnya. Diperlukan kajian penggunaan dana yang dimaksud sehingga operasional dan layanan kesehatan dapat berjalan efektif, efisien guna menentukan kebijakan yang tepat oleh pemdah dan pusat.Metode. Jenis Penelitian ini merupakan analitik dengan pendekatan mixed methods. Pada data kuantitatif menggunakan metode analisis Data Envelopment Analysis (DEA) dan data kualitatif menjelaskan data kuantitatif. Populasi penelitian meliputi seluruh puskesmas milik pemerintah di Kabupaten Sleman (25 puskesmas). Penelitian ini akan melihat efisiensi secara teknis pengelolaan dana kapitasi puskesmas terhadap penyelenggaraan upaya kesehatan perorangan di puskesmas Kabupaten Sleman tahun 2014.Hasil. Berdasarkan hasil analisis dengan metode DEA, dari 25 puskesmas hanya 3 puskesmas (12%) yang telah efisiensi secara teknis biaya dan 13 puskesmas (52%) yang efisien secara teknis sistem. Hasil analisis regresi tobit menunjukkan terdapat 4 variabel yang berpengaruh secara signifikan, yaitu variabel angka utilisasi (arah positif), angka rujukan (arah positif), rasio tenaga non kesehatan(arah negatif), dan dana kapitasi (arah negatif).Kesimpulan dan Saran. Secara umum puskesmas di Kabupaten Sleman belum efisien secara teknis dalam pengelolaan dana kapitasi. Kebijakan yang berorientasi kepada efisiensi teknis biaya akan berpengaruh terhadap nilai efisiensi teknis sistem. Diharapkan Dinkes melakukan monitoring, evaluasi serta peningkatan efisiensi pengelolaan dana kapitasi puskesmas secara intensif dan komprehensif terhadap mutu kinerja puskesmas sebagai indikatornya.Kata Kunci. Dana Kapitasi, Puskesmas, Efisiensi Teknis, Data Envelopment Analysis (DEA).

Analisis Pembiayaan Kesehatan Program Kesehatan Ibu dan Anak (KIA) Berdasarkan Standar Pelayanan Minimal (SPM) di Kabupaten Nunukan Mustaqim Hariyadi; Julita Hendrartini; M.Arief Budiarto
Jurnal Kebijakan Kesehatan Indonesia Vol 4, No 3 (2015)
Publisher : Center for Health Policy and Management

Background: The role of regional government in decentralization period is very important to the health sector particularly in financing. This is because health is one of the sectors that was decentralized. Minimum service standard is the obligatory responsibility for the region that is the right of every citizen at a minimum level, and one of many basic services is Maternal and Child Health programs. Objectives: To asses the financing sufficiency for Maternal and Child Health Programs based on Minimum Service Standard cost calculation and the effectivity of financing for Maternal and Child Health programs to achieve program’s objectives and goals. Methods: This research is a descriptive study conducted in Nunukan in 2013 with quantitative data. Sufficiency analysis is done by calculating the cost of Maternal and Child Health program to the result of cost calculation based on Minimum Service Standard. Performance effectivity of the Maternal and Child Health Programs was analyzed by the achievement of Minimum Service Standard according to the national indicator target and Maternal Mortality and Infant Mortality to the target of RPJMN of 2010-2014. Results: The cost of Maternal and Child Health program that was available was Rp. 2.530.038.761, and the calculation result of the cost based on Minimum Service Standard at Rp. 3.707.719.364, thus there was fund deficit about Rp 1.177.680.603. The percentage of MCH programs financing by the central government was still hight that was about 75%. There are financing MCH programs for direct activities amounted to 74%, and indirect activities amounted to 26%. The financing performance of MCH program was not effective yet to achieve the target of national Minimum Service Standard indicator and maternal mortality was still high at 173 per 100.000 life birts and infant mortality at 14 per 1000 live births. Conclusion: The financing of MCH programs was not sufficient to perform activities in MCH programs, as there was fund deficit about Rp 1.177.680.603. There was high financing dependency to the central government at 75% because of the low regional government commitment to financing priority programs such as MCH programs.

Potret Masyarakat Sektor Informal di Indonesia: Mengenal Determinan Probabilitas Keikutsertaan Jaminan Kesehatan sebagai Upaya Perluasan Kepesertaan pada Skema Non PBI Mandiri Arih Diyaning Intiasari; Laksono Trisnantoro; Julita Hendrartini
Jurnal Kebijakan Kesehatan Indonesia Vol 4, No 4 (2015)
Publisher : Center for Health Policy and Management

Latar Belakang: Perluasan kepesertaan jaminan kesehatan pada masyarakat sektor informal masih merupakan permasa- lahan nyata di berbagai negara. Karakteristik spesifik yang dimiliki oleh masyarakat sektor informal mempunyai potensi negatif dan positif yang harus bisa dikenali oleh pembuat kebijakan dalam rangka memberikan rekomendasi kebijakan yang paling tepat. Penelitian ini bertujuan untuk menganalisis hubungan karakteristik masyarakat sektor informal terhadap kepemilikan jaminan kesehatan. Hasil penelitian ini diharapkan dapat memberikan kontribusi dalam upaya perluasan cakupan kepesertaan Non PBI Mandiri dimasa yang akan datang. Metode Penelitian : Penelitian ini merupakan studi observasio- nal analitik dengan rancangan Cross sectional dengan pende- katan data kuantitatif yang digunakan berhasil mendapatkan sebanyak 349.491 responden masyarakat sektor informal di Indonesia. Untuk memberikan gambaran karakteristik masyara- kat sektor informal dalam kepemilikan Jaminan kesehatan digu- nakan analisis data univariat dan bivariat. Hasil : Berdasarkan hasil analisis diketahui bahwa faktor yang berhubungan dengan kepemilikian asuransi sukarela adalah umur (p<0,001), pendidikan (p<0,001), pekerjaan (p<0,001), status perkawinan (p=0,002), status dalam keluarga (p=0,035), tempat tinggal (p<0,001), status ekonomi (p<0,001), status tempat tinggal (p<0,001), kepemilikan obat tradisional (p<0,001) dan kepemilikan riwayat penyakit kronis (p<0,013). Sebanyak 95,4% responden tidak memiliki akses terhadap pelayanan kesehatan Kesimpulan: Upaya perluasan cakupan kepesertaan Non PBI mandiri tidak hanya membutuhkan promosi kesehatan yang baik, akan tetapi juga harus diimbangi dengan kebijakan peme- rataan akses dan peningkatan kuantitas serta kualitas pelayan- an kesehatan. Upaya untuk mengkaji potensi pembiayaan kesehatan, utamanya melalui identifikasi revenue collection dan metode pengumpulan premi yang tepat bagi masyarakat sektor informal harus terus dilakukan.Background: The effort of extending of health insurance enrollment to the informal sector has risen to become an agenda in Man countries. The informal sector has a specific characteristic with positive and negative potential that should be recognized by all of the decision-makers in order to make appropriate policy. This research aims to analyze the informal sector characteris- tic regarding health insurance enrollment. The Renault may contribute to extending universal coverage in the enrollment of Non-PBI (voluntary scheme) on JKN in the coming years. Method: This study was observational analytic with a cross-sectional design. A quantitative approach was used to analyze 349.492 respondents from informal sector community in Indonesia. Univariate and bivariate data analysis was used to give information about the correlation between informal sector charac- teristic and health insurance enrollment. Result: Data analysis showed the variables correlate into health insurance enrollment are : Age (p<0,001), Education (p<0,001), jobs(p<0,001), marital status (p=0,002), role on family (p=0,035), place of resident (p<0,001), economic status (p<0,001), home status (p<0,001), traditional medication stock (p<0,001) and history of chronic illness (p<0,013). Many re- spondents ( 95,4% ) have no access to health care provider Conclusion: Effort on extending of non PBI (voluntary scheme) enrollment not only need a good health promotion but also balancing with policies in order to ensure many factors such as equity on health care access and increasing the quantity and quality of health care. There must be a policy analysis to explore health financing potential on informal sector communi- ty, especially to identify the appropriate and adequate me- thods on revenue collection and premium collection.

Analisis Pemanfaatan Dana Kapitasi Khusus di Kabupaten Nias Utara Karl Frizts Pasaribu; Julita Hendrartini; Firdaus Hafidz
Jurnal Kebijakan Kesehatan Indonesia Vol 8, No 3 (2019)
Publisher : Center for Health Policy and Management

ABSTRAKLatar Belakang: Permenkes No 90 Tahun 2015 mengatur tentang penetapan fasilitas kesehatan di daerah terpencil dan sangat terpencil. Permenkes No 52 Tahun 2016 menetapkan pembayaran kapitasi khusus untuk daerah terpencil dan sangat terpencil. Kapitasi khusus adalah dana kapitasi yang diperuntukkan bagi daerah terpencil dan kepulauan. Peraturan Presiden Nomor 111 Tahun 2015 Tentang Daerah tertinggal menetapkan Kabupaten Nias Utara sebagai daerah tertinggal. SK Bupati Nias Utara Nomor 640.2/310/K/TAHUN/2016 menyatakan tujuh kecamatan di kabupaten Nias Utara sebagai daerah terpencil dan sangat terpencil, sehingga mulai Oktober 2017 menerima dana kapitasi khusus. Belum ada laporan atau penelitian mengenai pemanfaatan dana kapitasi khusus yang pernah dilakukan di Kabupaten Nias Utara.Tujuan: Penelitian ini bertujuan untuk mengeksplorasi pemanfaatan dana kapitasi khusus di Kabupaten Nias Utara.Metode: Penelitian ini menggunakan rancangan penelitian deskriptif kualitatif dengan metode penelitian studi kasus. Penelitian ini dilakukan di tujuh puskesmas penerima kapitasi khusus penerima kapitasi khusus dan Dinas Kesehatan Kabupaten Nias Utara, Provinsi Sumatera Utara.Hasil: Dana kapitasi khusus dimanfaatkan sesuai peraturan bupati, 60% untuk pembayaran jasa pelayanan, 20% untuk bahan medis habis pakai, obat dan alat kesehatan, serta 20% untuk biaya operasional lainnya. Kendala pemanfaatan dana kapitasi khusus yaitu puskesmas terbentur regulasi pejabat pengadaan barang, kekurangan SDM puskesmas, pemahaman petugas belum baik tentang pemanfaatan dana kapitasi khusus. Dampak dana kapitasi khusus yaitu penguatan pelayanan kesehatan, peningkatan pendapatan petugas dan peningkatan semangat petugas.Kesimpulan: Dana kapitasi khusus dimanfaatkan sesuai dengan peraturan yang ada, meskipun persentasenya belum sesuai dengan regulasi. Regulasi dan pemahaman petugas yang belum baik menjadi kendala utama dalam memanfaatkan dana kapitasi khusus. Dana kapitasi khusus berdampak pada penguatan pelayanan kesehatan dan peningkatan semangat dan pendapatan petugas kesehatan.Kata Kunci: Daerah terpencil;Kapitasi khusus;Pemanfaatan dana

Faktor-Faktor yang Berpengaruh terhadap Komunikasi antara Dokter Gigi dan Pasien dalam Pelayanan Perawatan Kesehatan Gigi Factors That Influence Communication between Dentist and Patient in Dental Health Care Service Novitasari Ratna Astuti; Julita Hendrartini; Niken Widyanti Sriyono
Insisiva Dental Journal: Majalah Kedokteran Gigi Insisiva Vol 3, No 1 (2014)
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/di.v3i1.1730

Komunikasi dokter gigi dan pasien memainkan peranan penting bahkan menentukan dalamkeberhasilan perawatan serta meningkatkan efektifitas pelayanan dan kepuasan pasien. Keberhasilan perawatankesehatan gigi pada pasien, selain dituntut keahlian teknis profesional seorang dokter gigi juga dituntutkemampuan non teknis berupa keahlian berkomunikasi dalam menghadapi berbagai perilaku pasien, dandipengaruhi beberapa faktor-faktor lain. Tujuan: mengetahui faktor-faktor yang berpengaruh terhadapkomunikasi antara dokter gigi dan pasien dalam pelayanan perawatan kesehatan gigi di Rumah Sakit BethesdaDIY. Metode: Jenis penelitian adalah observasional dengan rancangan cross sectional. Subyek penelitian adalahpasien di poliklinik gigi Rumah Sakit Bethesda DIY sebanyak 100 pasien gigi yang diambil dengan simplerandom sampling. Adapun kriteria sampel, pasien berusia 12-55 tahun dan dapat berkomunikasi dengan baik dipoli gigi RS Bethesda DIY. Variabel pengaruh yakni frekuensi kunjungan, pendampingan kunjungan, tingkatpendidikan, jenis kelamin, usia. Variabel terpengaruh yakni komunikasi antara dokter gigi dan pasien. Alat ukurmenggunakan kuesioner dengan skala likert. Uji coba kuesioner dilakukan terhadap 30 responden .Penelitian inimenggunakan teknik korelasi product moment dengan r berkisar antara 0,416-0,698 dan p 0,05, hasilreliabilitas dengan teknik alpha cronbach r tt = 0,876 dan p 0,05. Data hasil penelitian dianalisis dengananalisis regresi berganda dengan tingkat kemaknaan 0,05. Hasil: menunjukkan adanya pengaruh yang bermaknaantara faktor usia (r=0,236 dan p=0,017), pendidikan (r=0,393 dan p=0,000),frekuensi kunjungan pasien kedokter gigi (r=0,291 dan p=0,004), pendampingan kunjungan pasien saat masuk ruang praktek dokter gigi(r=0,259 dan p=0,009) terhadap komunikasi antara dokter gigi dan pasien. Sedangkan jenis kelamin (r=0,166 danp=0,095) tidak terdapat pengaruh terhadap komunikasi antara dokter gigi dan pasien. Kesimpulan: Faktor usia,frekuensi kunjungan, pendidikan dan pendampingan kunjungan berpengaruh terhadap komunikasi dokter gigidan pasien sedangkan jenis kelamin tidak berpengaruh. Faktor yang memberikan bobot sumbangan terbesarterhadap komunikasi antara dokter gigi dan pasien adalah faktor tingkat pendidikan.

Uji sensitivitas dan spesifisitas perangkat lunak “Prediktor Karies Anak” (The sensitivity and specificity test of software for dental caries prediction in children) Quroti A’yun; Julita Hendrartini; Al. Supartinah Santoso; Lukito Edi Lugroho
Dental Journal (Majalah Kedokteran Gigi) Vol. 47 No. 1 (2014): March 2014
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: The prevalence of dental caries in children is high, therefore preventive actions is needed. So far the computer preventive actions is needed. So far the computer software that have been used for caries predictor is cariogram, which determine the condition of teeth and oral mouth. Recently which determine the condition of teeth and oral mouth. Recently and oral mouth. Recently mouth. Recently“Prediktor Karies Anak” (pediatric caries predictor) software have been developed not only determine the condition of teeth and software have been developed not only determine the condition of teeth and been developed not only determine the condition of teeth and oral mouth but also child’s behavior, maternal behavior, and the environment. behavior, maternal behavior, and the environment. Purpose: The objective of this study was to examine objective of this study was to examinethe sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of "Prediktor Karies Anak" a software for dental caries prediction in children. Methods: This study study was an observational study with cross-sectional plan, carried out on 67 primary school children aged 10-12 years. The research instrument was software of “Prediktor Karies Anak” (pediatric caries of “Prediktor Karies Anak” (pediatric caries predictor) and cariogram. The data of this research was the percentage of new caries occurrence and caries risk categorized into the percentage of new caries occurrence and caries risk categorized into high and low, and analyzed with a 2 x 2 table. results: The data of 67 children was analyzed using “Prediktor Karies Anak”software and revealed 38 children had low caries risk and 29 children had high caries. The data then re-analyzed using cariogram software had low caries risk and 29 children had high caries. The data then re-analyzed using cariogram software then re-analyzed using cariogram software showed that 37 children had low caries risk, and 30 children had high caries risk. Sensitivity of “Prediktor Karies Anak” software was that 37 children had low caries risk, and 30 children had high caries risk. Sensitivity of “Prediktor Karies Anak” software was Karies Anak” software was 87%, specificity was 92%, the PPV was 90%, and NPV was 89%. Conclusion: “Prediktor Karies Anak”software had high sensitivity, Karies Anak”software had high sensitivity, high sensitivity, specificity, PPV, and NPV and could be used as an instrument to predict new caries on children.Latar belakang: Prevalensi karies pada anak tergolong tinggi, sehingga perlu dilakukan tindakan pencegahan. Selama ini karies pada anak tergolong tinggi, sehingga perlu dilakukan tindakan pencegahan. Selama ini perangkat lunak komputer yang digunakan untuk memprediksi karies gigi adalah Cariogram, yang mengukur faktor keadaan gigi yang mengukur faktor keadaan gigi dan mulut. Baru-baru ini telah dikembangkan perangkat lunak ini telah dikembangkan perangkat lunak "Prediktor Karies Anak" yang tidak hanya mengukur kondisi gigi danrongga mulut tetapi juga perilaku anak, perilaku ibu, dan lingkungan. Tujuan: Tujuan penelitian ini adalah untuk menguji sensitivitas, sensitivitas, spesifisitas, nilai duga positif (NDP) dan nilai duga negatif (NDN) perangkat lunak duga positif (NDP) dan nilai duga negatif (NDN) perangkat lunak duga negatif (NDN) perangkat lunak (NDN) perangkat lunak "Prediktor Karies Anak" suatu perangkat lunak untuk memprediksi karies gigi pada anak. Metode: Jenis penelitian ini adalah observasional dengan rancangan cross sectional, yang dilakukan pada 67 anak sekolah dasar usia 10-12 tahun. Instrumen penelitian adalah perangkat lunak anak sekolah dasar usia 10-12 tahun. Instrumen penelitian adalah perangkat lunak dasar usia 10-12 tahun. Instrumen penelitian adalah perangkat lunak 10-12 tahun. Instrumen penelitian adalah perangkat lunak tahun. Instrumen penelitian adalah perangkat lunak "Prediktor Karies Anak" dan cariogram. Data penelitian ini berupa persentase terjadinya karies baru yang dikategorikan resiko karies tinggi dan rendah, dan terjadinya karies baru yang dikategorikan resiko karies tinggi dan rendah, dan yang dikategorikan resiko karies tinggi dan rendah, dan karies tinggi dan rendah, dan dianalisis dengan tabel 2 x 2. Hasil: Data dari 67 anak yang dianalisis dengan menggunakan perangkat lunak “Prediktor Karies Anak” menunjukkan bahwa 38 anak memiliki risiko karies rendah dan 29 anak-anak memiliki resiko karies tinggi. Data tersebut dianalisa kembali dengan perangkat lunak Cariogram, dan hasilnya menunjukkan bahwa 37 anak mempunyai resiko karies rendah, dan 30 anak anak mempunyai resiko karies rendah, dan 30 anak mempunyai resiko karies tinggi. Sensitivitas “Prediktor Karies Anak” 87%, spesifisitas 92%, NDP 90% dan NDN 89%. “Prediktor Karies Anak” 87%, spesifisitas 92%, NDP 90% dan NDN 89%. spesifisitas 92%, NDP 90% dan NDN 89%. NDP 90% dan NDN 89%. dan NDN 89%. Simpulan: “Prediktor Karies Anak” mempunyai sensitivitas, spesifitas, NDP dan NDN yang tinggi dan dapat dipakai sebagai instrumen untuk memprediksi terjadinya karies baru pada anak.

Faktor Risiko Terjadinya Karies Baru Pada Anak Sekolah Berdasarkan Pengukuran Dengan Cariogram Quroti A’yun; Julita Hendrartini; Al Supartinah
Jurnal Teknologi Kesehatan (Journal of Health Technology) Vol. 12 No. 2 (2016): September
Publisher : POLTEKKES KEMENKES YOGYAKARTA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (161.212 KB)

Caries risk factors were factors related to caries incidence in individu or population. Caries risk factors were different between individu. For illustrating the interaction between caries related factors may be used Cariogram. This research aimed to get the general overview of the order of caries risk factor in elementary school students in the distric of Sleman. The study was observational cross-sectional design. The sample was 76 children aged 10-12 years. New caries risk factors measured were caries experience, affecting disease, frequency of eating, the amount of plaque, Streptococcus mutans measurement, fluorine program, the secretion of saliva, buffer capacity, and clinical assessment. Results were analyzed with the software of Cariogram. The study showed that 63% of children was caries, 100% did not have a systemic disease, 53% of children had cariogenic food frequency with maximum of 3 times, 70% had plaque index of 0.04 to 1.0, measuring 47% of children have adhesion colony Streptococcus mutants 1-10, 100% brushing teeth with fluor toothpaste, 44% of children had secretion of 0.9-1.1 ml/mn, and 100% of children with a buffer capacity of saliva pH > 6. Cariogram measurement results showed the average percentage of vulnerability factors: 14% , meal pattern : 9%, bacteria : 5%, and suspect teeth and others factors: 3%. It can be concluded that the sequence of the risk factors in children from Cariogram measurement are vulnerability factors, meal pattern, bacteria, suspect teeth, and others factors.

STATUS SOSIAL EKONOMI TERHADAP UTILISASI DAN OUT OF POCKET PESERTA ASURANSI KESEHATAN (ANALISIS DATA INDONESIAN FAMILY LIFE SURVEY 2007 DAN 2014) Endra Dwi Mulyanto; Julita Hendrartini; Firdaus Hafidz As Shidieq
Journal of Health Service Management Vol 23 No 01 (2020)
Publisher : Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Background: The government has guaranteed equal rights for each individual to access health services. It is mandated in the Law Number 40 of 2004 on National Social Security System (SJSN) which emphasizing social insurance program. The social insurance is expected to improve the access and utilization of health services and to minimize the risk of out of pocket. Objective: To provide empirical evidence related to the impact of health insurance ownership toward the outpatient utilization and out of pocket based on socioeconomic status. It also examines the factors influencing outpatient utilization and out of pocket. Methods: The study used 2007 and 2014 Indonesian Family Life Survey (IFLS) data. The representative data were collected from individuals aged more than 15 years in 13 provinces in Indonesia through questionnaire with cross-sectional design. The data were analyzed step by step covering univariable, bivariable, and multivariable through Fixed Effect Model (FE). Results: The outpatient utilization indicated that: 1) The socioeconomic status influences the level of outpatient visit, specifically quantile 2 (OR=1,6), quantile 4 (OR=2,0), and quantile 5 (OR=1,8); 2) The outpatient utilization reached OR=1,8 for individual aged ≥60 years; 3) OR=3,6 for individuals completing junior high school and above; 4) OR= 2,7 for individual who was sick in the past one week; 5) OR= 1,4 for married individuals; and 6) OR= 1,9 for individuals suffering from heart disease. However, the individuals with socioeconomic status in quantile 4 spent higher Out of Pocket (54%); individuals in quartile 5 spent 46%; and individual with hypertension spent 48%. Conclusion: Changes in socioeconomic status affect the increase in outpatient utilization and out of pocket cost. In addition to socioeconomic status, outpatient utilization and out of pocket are affected by hypertension.

EVALUASI PERENCANAAN DAN PENGANGGARAN PROGRAM PROMOTIF DAN PREVENTIF DINAS KESEHATAN KABUPATEN TANA TIDUNG, KALIMANTAN UTARA Ranik Diastuti; Julita Hendrartini
Journal of Health Service Management Vol 23 No 02 (2020)
Publisher : Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Background: Planning and budgeting are important components of community health efforts. Budget allocation for health in Tana Tidung was small. Budget absorption in health office was also low. Achievement of some Minimum Service Standard (SPM) indicators still below 60%. This indicates the possibility of problems regarding the quality of planning, budgeting, or implementation of promotive and preventive programs. Research needs to be done to evaluate the process of planning and budgeting of promotive and preventive program in Tana Tidung district health office. Objective: To evaluate the process of planning and budgeting of promotive and preventive program in Tana Tidung district health office to be known the obstacles of SPM indicators achievement. Methods: The type of research is case study research with single case design. Data collected by documentation document review, observation and in-depth interview with 17 employees in health of fice and primary healthcare centers during the period of March-April Data were analyzed with qualitative method. Results: Achievement of promotive and preventive program indicators in Tana Tidung district health office influenced by planning, either from human resources, data and information also guidelines for planning. Budgedting of promotive and preventive programs was ineffective and inefficient to improve achievement of SPM indicators. Constraints encountered are human resources have not been sufficient in quantity and quality, less communication, lack monitoring and evaluation functions, weak commitment of the programs holders in targets achievement, as well as the commitment of local authorities to promotive and preventive programs that are also weak. Conclusion: Planning and budgeting of promotive and preventive program had not been able to increase achievement of SPM indicators. Improvement is needed, especially on human resources, data management, policy components and also need a strong commitment to improve the achievement of promotive and preventive program indicators.

ANALISIS TARIF PELAYANAN POLI PENYAKIT DALAM DI RUMAH SAKIT UMUM DAERAH DALAM ERA JAMINAN KESEHATAN NASIONAL Sri Wusono; Julita Hendrartini; Dwi Handono Sulistyo
Journal of Health Service Management Vol 23 No 03 (2020)
Publisher : Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Background: The Hospital as an advanced health facility has an essential role in implementing the National Health Insurance (JKN).Reimbursement mechanism of health services using INA-CBGs package tariff, which the objectives for controlling healthcare costsand improving service standards. However, this has not been implemented well. Therefore INA-CBGs has a disadvantage potentialto Hospital.Objective: To determine the difference between Hospital tariff and INA-CBGs for JKN patients.Methods: This study was descriptive with a qualitative approach and case study design. Review documents and in-depth interviewswith Hospital structural and functional management were used for data collection. Data analyzed used descriptive analysis for secondarydata and qualitative analysis to explore hospital policies and strategies to the tariff difference to deepen this study result. Theresearch was conducted from April to June 2018.Results: Healthcare cost of JKN patients in Internal Disease Poly has negative difference during January–June 2017 with an averageof 20,3%. The main factor causing the difference was pharmaceutical 63%. This tariff difference occurred due to several factorssuch as related with the most morbidity diseases: 61,7% chronic diseases, policies implemented for capacity building of human resourcesin JKN patient services, improvement of a referral program for stable patients, cross-subsidizing of other income and government,specific strategies in JKN services that listed in the strategic plan. Furthermore, for service output was planned to reach hospitalaccreditation and conduct excellent heart disease service.Conclusion: Healthcare cost in Internal Disease Poly had deficit due to hefty deviation tariff between hospital tariff and INA-CBGs.However, potential losses could be anticipated with policies and strategies that support cost control and improve service standards.

Co-Authors Agustinus Winarno Al Supartinah Al Supartinah Al. Supartinah Santoso Andi Sulaimana Andreasta Meliala Arif Budiarto Arih Diyaning Intiasari Arih Diyaning Intiasari Arih Diyaning Intiasari Arih Diyaning Intiasari Aris Iwansyah Bambang Udji Djoko Rianto Benidiktus Tulung Prayoga Carla Raymondalexas Marchira Damaris Pura Tanya Dewa Made Wedagama Dewi Agustina Dian Permata Sari Dibyo Pramono Dibyo Pramono Diyah Fatmasari Dwi Budi Santoso Dwi Handono Sulistyo Dwi Handono Sulistyo Endra Dwi Mulyanto Esfandyari, Eldo Fadhillah, Sri Firdaus Hafidz As Shidieq Gesti Bening Aulia Ghea Tri Khusnul Khotimah Gusti Ayu Yohanna Lily Haryo Mustiko Dipoyono Heribertus Dedy Kusuma Yulianto Irianto, Sugeng Kusuma Arbianti Laksono Trisnantoro Laksono Trisnantoro Lelyana, Shelly Lestari, I Gusti Agung Ayu Pradipta Lisdrianto Hanindriyo Lisma Evareny, Mohammad Hakimi, Retna Siwi Padmawati Lukito Edi Nugroho M.Arief Budiarto Margareta Rinastiti Mas’ud Mas’ud Muhamad Faozi Kurniawan Mustaqim Hariyadi Niken Widyanti Sriyono Novitasari Ratna Astuti Pasaribu, Karl Frizts Prihastutik, Yuli Putri Listiani Quroti A'yun Quroti A'yun Quroti A’yun Quroti A’yun Quroti A’yun Ranik Diastuti Ratna Astuti, Novitasari Rosa Amalia Selviasari, Chyca Sholahuddin Sanjaya Sri Widiati, Sri Sri Wusono Sundari, Retno Tresno Supartinah Santoso Suri Herlina Pratiwi Tjahjono Kuntjoro Widowati Siswomihardjo Widyanti Sriyono, Niken Yuniantika

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