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Journal of Health Policy and Management
Published by Universitas Sebelas Maret
ISSN : -     EISSN : 25490281     DOI : -
Core Subject : Health,
Medicine & Pharmacology Public Health
Journal of Health Policy and Management (JHPM) is an electronic, open-access, double-blind and peer-reviewed international multidisciplinary and integrative journal, focusing on health policy, health system, and healthcare management. It began its publication on October 21, 2015. The journal is published twice yearly. It aims to improve the design and implementation of health policies, health systems, and healthcare management, primarily in low- and middle-income countries. JHPM analyzes policy initiatives and healthcare systems and provides evidence-based research to guide policymaking and management decision-making.
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Articles 8 Documents
 1 
Search results for , issue " Vol 2, No 2 (2017)" : 8 Documents clear
Factors Affecting Quality of Health Service and Patient Satisfaction in Community Health Centers in North Lampung, Sumatera Widayati, Mulia Yuli; Tamtomo, Didik; Adriani, Rita Benya
Journal of Health Policy and Management Vol 2, No 2 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Quality of health service and patient satisfaction are an important element in providing a health service. Assessing and evaluating a health service based on user perceptions are important for continuous improvement of health services. This study aimed to examine the factors affecting the quality of health service and patient satisfaction in community health centers in North Lampung, Sumatera, Indonesia.Subjects and Method: This was an analytic observational study with a cross-sectional design. This study was conducted in 25 community health centers in North Lampung, Sumatera, in January 2017. A total sample of 200 out-patients was selected for this study by simple random sampling and stratified random sampling for community health center. The dependent variables were quality of service and patient satisfaction. The independent variables were education, income, a frequency of visit, and accreditation status of community health center. The contextual effect was measured by accreditation status of community health center. The data were collected by questionnaire and analyzed by linear regression multilevel model.Results: Factors affecting quality of health service were income (b= -1.09, 95% CI= -5.71 to 3.52, p = 0.641), education (b = -11.48, 95% CI= -16.07 to -6.88, p< 0.001), and frequency of visits (b=6.88, 95% CI= 2.53 to 11.23, p=0.002). Intraclass correlation= 6%. Factors affecting patient satisfaction were income (b= -1.07, 95% CI= -1.58 to -0.56, p<0.001), education (b= -0.77, 95% CI= -1.31 to -0.23, p=0.005), frequency of visits (b= 0.88, 95% CI= 0.39 to 1.38, p<0.001), and quality of service (b=0.04, 95% CI= 0.02 to 0.06, p<0.001). Intraclass corelation= 13.79% indicating considerable contextual effect of accreditation status of community health center.Conclusion: Quality of service is affected by income, education, and frequency of visits in community health center. Patient satisfaction is affected by income, education, a frequency of visits, and quality of service. Accreditation status of community health center has a considerable contextual effect on patient satisfaction.Keywords: quality of service, patient satisfaction, accreditation status, community health center, multilevel analysisCorrespondence: Mulia Yuli Widayati. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A Surakarta. Email: muliayuli@yahoo.co.idJournal of Health Policy and Management (2017), 2(2): 165-175https://doi.org/10.26911/thejhpm.2017.02.02.08 
The Role of Community Health Workers in Maternal and Child Health Surveillance to Optimize Maternal and Child Health in Pasuruan District, East Java Pangestu, Ninil Dwi; Joebagio, Hermanu; Rahardjo, Setyo Sri
Journal of Health Policy and Management Vol 2, No 2 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Maternal mortality ratio, infant mortality rate, and underfive mortality rate are still high in Indonesia. Pasuruan is one of the districts in East Java with the highest infant mortality rate. One of the public health interventions that has been undertaken to address this issue is maternal and child health surveillance program with community health workers being the leading implementers. This study aimed to describe the role of community health workers in maternal and child health surveillance to optimize maternal and child health care services in Pasuruan District, East Java.Subjects and Method: This was a qualitative study using case study approach. It was conducted in Pasuruan, East Java. Key informants were selected by criterion sampling. The data were collected by in-depth interview, focus group discussion, observation, and document review. Data validity was checked by triangulation.Results: Community based maternal and child health surveillance program has been implemented for 4 years. However, only some of all community health workes have been trained in this program. The tasks of these community health workers included advocacy and monitoring of maternal and child health in the areas of posyandu. The implementation of these surveillance program had some obstacles, including low insentive of community health worker, inactive community health worker, lack of awareness among community members on maternal and child health issues, and medical factors of pregnant mothers that caused mortality.Conclusion: Community health workers help improve the quality of maternal and child health care by surveillance program, although their performances have yet to be enhanced.Keyword: maternal mortality rate, infant mortality rate, community health workersCorrespondence: Ninil Dwi Pangestu. Masters Program in Public Health, Sebelas Maret University,  Jl. Ir. Sutami No. 36A Surakarta 57126, Jawa Tengah. E-mail: pangestu.ninil@gmail.com. Mobile +62856553737.Journal of Health Policy and Management (2017), 2(2): 128-136https://doi.org/10.26911/thejhpm.2017.02.02.04
Path Analysis on the Effects of Motivation and Other Factors on Midwives Performance of Preeclampsia Management in Malang, East Java Jayanti, Nicky Danur; Tamtomo, Didik; Sulaeman, Endang Sutisna
Journal of Health Policy and Management Vol 2, No 2 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: The incidences of preeclampsia and eclampsia remain high worldwide. Preeclampsia and eclampsia remain a major cause (31.04%) of maternal mortality in East Java. It is essential to early detect preeclampsia in order to prevent mortality. Good performance of midwives in the management of preeclampsia may reduce maternal mortality attributable to eclampsia. It is hypothesized that motivation, leadership style, working atmosphere, insentive, skill, and training, all have impact on midwives performance. This study aimed to analyze the effects of motivation and other factors on midwives performance in preeclampsia management in Malang, East Java, using path analysis model.Subjects and Method: This was an analytic observational study with cross sectional design. The study was conducted in Community Helath Centers, Malang, East Java in September 2017. A total sample of 161 midwives were selected using total sampling technique. The endogenous variables were motivation and midwives performance. The exogenous variables were insentive, working atmosphere, leadership style, skill and training. The data were collected using a set of questionnaire and analyzed by path analysis.Results: Midwife performance were positively affected by working atmosphere (b= 0.11; SE=0.04; p= 0.004), leadership style (b= 0.06; SE= 0.02; p= 0.004), skill (b= 0.24; SE= 0.03, p<0.001), and motivation (b= 0.68; SE= 0.03; p<0.001). Motivation was positively afected by insentive (b= 0.25; SE= 0.09, p= 0.006), training (b= 0.89; SE= 0.28; p= 0.001), skill (b= 0.39; SE= 0.06; p<0.001), leadership style (b= 0.08; SE= 0.05; p= 0.110), and working atmosphere (b= 0.35; SE= 0.09; p<0.001).Conclusion: Midwives performance are positively affected by working condition, leadership, skill, and motivation.Keyword: preeclampsia, path analysis, motivation, midwives performanceCorrespondence: Nicky Danur Jayanti. Masters Program in Public Heath, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: nicky_daanty@yahoo.co.idJournal of Health Policy and Management (2017), 2(2): 137-146https://doi.org/10.26911/thejhpm.2017.02.02.05
Implementation of the Referral System Policy in the National Health Insurance Scheme at Community Health Centers, Ngawi District, East Java Eskawati, Maria Yeny; Murti, Bhisma; Tamtomo, Didik
Journal of Health Policy and Management Vol 2, No 2 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: It has been reported that there are some obstacles in the implementation of the National Health Insurance, one of which is its referral system. Community Health Center is expected to serve as a gatekeeper, such that most of the health problems can be tackled at the Community Health Center. However, anecdotal evidences had shown that the referral system did not run as expected. This study aimed to examine the implementation of the referral system in the National Health Insurance scheme with special attention on  the policy context and resources availability at Community Health Centers in Ngawi, East Java.Subjects and Method: This was a qualitative study conducted in Ngawi, East Java. The institutions under study included 3 Community Health Centers of different strata Geminggar Community Health Center (highest  strata), Ngawi Community Health Center (medium strata), Kasreman Community Health center (lowest strata). The other institution under study was Ngawi District Health Office. The informants for this study included 24 patients of various categories at Community Health Center: subsidy recipients, class I, class II, and class III. The other informants included 1 staff from District Health Office and 6 staff from Community Health Center. The data were collected by in-depth interview, observation, and document review. The data were analyzed by data reduction, presentation, and verification.Results: The policy on the referral system of the National Health Insurance (NHI) was good but its implementation was poor. Outpatient referral was still high because of community ignorance regarding referral system. It was often the case the referral was based on patient request.  The referral system problem also stemmed from the shortage of medical doctors and health equipment at the Community Health Center. Nevertheless, the availability of medicine and funding at Community Health Center were sufficient. The sources of funding included General Allocation Fund (DAU), Special Allocation Fund (DAK), Special Allocation Fund for Operational Affairs (BOK), and capitation. Community Health Center only managed capitation and BOK.Conclusion: There is a need for socialization to the community regarding the current referral system of the National Health Insurance either through the media or the BPJS representative at the Community Health Center. In addition, there is a need for recruitment of doctors with a clear salary regulation, and health equipment upgrade at Community Health Center. Keywords: Referral system, resources, National Health InsuranceCorrespondence: Maria Yeny Eskawati. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Mobile: 082230898979.Journal of Health Policy and Management (2017), 2(2): 102-111https://doi.org/10.26911/thejhpm.2017.02.02.01
Analysis of Patient Safety Management in Committee for Quality Improvement and Patient Safety at Sumbawa Hospital, West Nusa Tenggara Sulahyuningsih, Evie; Tamtomo, Didik Gunawan; Joebagio, Hermanu
Journal of Health Policy and Management Vol 2, No 2 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Patient safety is a crucial issue and a focus of policy standard in internationally accredited organizations. The specific committee responsible for quality improvement in patient safety is the committee for quality improvement and patient safety (PMKP). Incidence of malpractice often occurs but are not reported. It indicates that the committee has not worked according to required accreditation standard. This study aimed to analyze patient safety management with the committee for quality improvement and patient safety at Sumbawa Hospital, West Nusa Tenggara. Subjects and Method: This was a qualitative study with phenomenology approach. Nine study participants were selected purposively, consisting of 3 committee members (chairperson, secretary, and patient safety sub-committee), 3 chiefs of ward (pediatrics, internal medicine, and surgery), and 4 nurses or midwives (pediatrics, surgery, ICU/ICCU, and obstetrics).Results: The committee for quality improvement and patient safety has been established at Sumbawa Hospital, West Nusa Tenggara to meet the requirement of hospital accreditation standard. It aimed to improve the quality of services and to assure patient safety. However, its work has not meet the required standard. The lack of knowledge among involving parties, including hospital management, PMKP member, medical professionals was identified as one important obstacle for the implementation of patient safety management. This has led to the incidence of malpractice at the hospital, sub-standard quality of services and patient safety.Conclusion: PMKP has been established at Sumbawa Hospital, West Nusa Tenggara. However, their work have not meet the required standard. The lack of knowledge among involving parties, including hospital management, PMKP, and health professional, has led to the incidence of malpractice at the hospital, sub-standard quality of services and patient safety.Keyword: quality improvement, patient safety management, committeeCorrespondence: Evie Sulahyuningsih. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Mobile: 08786410495.Journal of Health Policy and Management (2017), 2(2): 147-156https://doi.org/10.26911/thejhpm.2017.02.02.06 
The Effect of Maternal Education Level, Family Income, and Maternal Working Time to Basic Vaccine Service on 0-24 Infants in Kupang Regency, East Nusa Tenggara Salesman, Frans
Journal of Health Policy and Management Vol 2, No 2 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Vaccine stimulates immune system form to the infants to prevent the disease and death. However, the coverage of complete basic vaccine (IDL) has not reached the target yet in Kupang regency, Nusa Tenggara Timur. The study aims to analyze the factors that effect a completeness status of the effect basic vaccine for infants aged 0-24 months at the Oemasi regency, Kupang, East Nusa Tenggara.Subject and Method: The study was observational study using cross-sectional approach. The study was conducted at Oemasi community health center, Kupang regency, Nusa Tenggara Timur. The total of the population were 527 infants aged between 0-24 months. The sample were 60 infants by using quota sampling technique. The independent variable were maternal age, education, and working time, family income, and number of family members. The dependent variable was complete basic vaccine status. The data were collected using questionnaire and analyzed by multiple logistic regression.Result: The maternal education level increased the infants’ possibility to get complete basic vaccine and stasticially significant (OR= 11.47; CI 95%= 1.28  up to 102.63; p= 0.029). Parents’ income increased infants’ possibility to get complete basic vaccine, however it was not statistically signicant. Family member ≥5 people and mother’s working time ≥7 hours/day decreased infants’ possibility to get complete basic vaccine, however it was not statistically significant. Mother’s age did not influence the infants getting complete basic vaccine. Conclusion: mother’s education is a factor which has the strongest effect to increase infants’ possibility to get complete basic vaccine. Keyword: complete basic vaccine, mothers’ education level, family income, family members                                                                                             Correspondence: Frans Salesman. School of Health Polytechnics Citra Husada Mandiri, Kupang, East Nusa Tenggara. Email: franssalesman@gmail.com.Journal of Health Policy and Management (2017), 2(2): 112-116https://doi.org/10.26911/thejhpm.2017.02.02.02
Evaluation of Community Health Center Management Information System (SIMPUS), Primary Care (P Care), and Bridging Data System in Sukoharjo District Kurniawan, Agung; Tamtomo, Didik; Murti, Bhisma
Journal of Health Policy and Management Vol 2, No 2 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Community health center (puskesmas) management information system or often referred to as SIMPUS is a local health system aimed at providing health information at primary health care level. P Care (Primary Care) application is an information system that is designed to serve BPJS patients. The bridging system links SIMPUS with P care application. These three systems have been used in all puskesmas in Sukoharjo district since 2017. This study aimed to evaluate the implementation of community health center management information system (Simpus), Primary Care (P Care), and bridging data system, in Sukoharjo District, Central Java.  Subjects and Method: This was a qualitative study. The study was conducted in Sukoharjo, Kartasura, Bendosari, Mojolaban community health centers, in Sukoharjo District, Central Java, from October to December, 2017. Four community health centers were selected randomly from 13 community health centers in Sukoharjo. The dependent variables were information service, performance, efficiency, and security. The independent variable was health information system (SIMPUS, P care, and bridging system). The data were collected by in-depth interview, direct observation, and document review. Data credibility was checked by triangulation method.Results: Three health information systems (SIMPUS, P care, and bridging system) have been implemented in Sukoharjo District. However, their performance is yet to be improved. Loading time was lengthy and error often occured. Patients often complained of the lengthy service. Some items in the information system form were left blank. Data entry occasionally was inconsistent with examination outcome. Security system of the health information existed, but sometimes unauthorized individuals can access and use that information. There was a lack of human resources and hardware. The health information system had not met the information need.Conclusion: Three health information systems (SIMPUS, P care, and bridging system) have been implemented in Sukoharjo District. However, their performance is yet to be improved. Some obstacles have yet to be resolved.Keyword: evaluation, SIMPUS, P care application, bridging systemCorrespondence: Agung Kurniawan. Masters Program of Public Health,  Jl. Ir. Sutami No. 36A Surakarta 57126, Jawa Tengah. E-mail: agungkurniawan991@gmail.com. Mobile +6285257292206.Journal of Health Policy and Management (2017), 2(2): 157-164https://doi.org/10.26911/thejhpm.2017.02.02.07  
Factors Influencing the Difference between Indonesian Case-Based Group Reimbursement and Medical Cost for Patients with Chronic Renal Disease Cases in Kasih Ibu Hospital, Surakarta -, Mardhatillah; Tamtomo, Didik; Murti, Bhisma
Journal of Health Policy and Management Vol 2, No 2 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Backgorund: JKN program has stipulated the INA CBGs reimbursement for the payment of treatment in referral health facilities, including for chronic renal disease which is a disease burden. This study aimed to analyze factors influencing the difference between Indonesian case-based group reimbursement and medical cost for patients with chronic renal disease cases in Kasih Ibu Hospital, Surakarta.Subjects and Method: The study design was an analytic observational with cross sectional design. The study was conducted in Kasih Ibu Hospital Surakarta in August-October, 2017. With a total of 231 subjects sample which was selected by using proportional random sampling. The dependent variable was the difference between Indonesian case-based group reimbursement and medical cost. The independent variables were length of stay, type of class, medical treatment/ surgery, ICU treatment, and medication use. The data were analyzed using multiple linear regression.Result: INA CBGs reimbursement (mean= Rp 6,120,000; SD= Rp 2,330,000) paid by BPJS Kesehatan was lower than actual hospital’s medical care cost (mean= Rp 7,070,000; SD= Rp 4,650,000). Factors profitable for hospitals were medical treatments/ surgery (b= 0.032; p= 0.552). Factors that inflicted financial loss were class 1 care (b= -0.104; p= 0.094), class 2 care (b= -0.033; p= 0.590) compared to class 3 care, length of stay (b= -0.541; p<0.001), medication use in accordance with national formulation (b= -0.183; p= 0.008) and the use of ICU (b= -0.045; p= 0.543). Patients who upgraded the class type (mean= Rp 5,526,074; SD= Rp 1,449,621) was higher than hospital’s medical cost for class 2 (mean= Rp 3,933,767; SD= Rp 1,887,900).Conclusion: Mean of INA CBGs reimbursement on inpatient care of chronic renal disease is lower than the mean of hospital’s medical care cost. Length of stay and doctors’ compliance in using national medication formulation are important determinants to increase medical care cost. Hospital obtains profit from patients who upgrade type of class.Key words: care cost, INA CBGs reimbursement, chronic renal diseaseCorrespondence: Mardhatillah. Kasih Ibu Hospital, Surakarta, Central Java. Email: mardhatillah.bws@gmail.com. Mobile: 089510610891.Journal of Health Policy and Management (2017), 2(2): 117-127https://doi.org/10.26911/thejhpm.2017.02.02.03

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