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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.
Arjuna Subject : -
Articles 215 Documents
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Relationship Between Motivation, Competence, Workload, and Nurse Performance, at Dr. Soediran Mangun Sumarso Hospital, Wonogiri, Indonesia Sutarto, Agus; Joebagio, Hermanu; -, Pawito
Journal of Health Policy and Management Vol 1, No 2 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Health worker performance is one of the key elements that determine the quality of hospital service. Health worker performance therefore is the target forimprovement. This study aimed to analyze the relationship between motivation, competence, workload of nurses, and nurse performance.Subjects and Method: This was an analytical observational study with cross sectional design. This study was conducted at Dr. Soediran Mangun Sumarso Hospital, Wonogiri, Indonesia. A total of 50 nurses was sampled for this study.The independent variables consisted of motivation, competence, and workload. The dependent variable was performance of nurse. The data were collected by a questionnaire and analyzed by multiple linear regression model.Results: This study did not find relationship between motivation and performance of nurse (b = 0.02; 95% CI=-0.19 to 0.24; p= 0.823). Similarly there was no relationship workload and perfor­mance of nurse (b=0.05; 95% CI= -0.15 to 0.26; p = 0.607). There was a positive and statististically significant relationship between competence and performance of nurse (b = 1.10; 95% CI= 1.75 to 0.46; p= 0.001).Conclusion: There is a positive and statistically significant relationship between competence and performance of nurse.Keywords: motivation, competence, workload, performance, nurseCorrespondence: Agus Sutarto. dr. Soediran Mangun Sumarso Hospital, Wonogiri, East Java. Email: agus_skh70@yahoo.co.idJournal of Health Policy and Management (2016), 1(2): 78-94https://doi.org/10.26911/thejhpm.2016.01.02.03
Determinants of Midwife Performance in Lactation Management in Surakarta and Karanganyar, Central Java Wahidah, Nurul; Sulaeman, Endang Sutisna; Budihastuti, Uki Retno Setia
Journal of Health Policy and Management Vol 3, No 1 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Exclusive breastfeeding has been recommended by World Health Organization for reduction of infant illness and death. Midwives have an important role in lactation management, which includes: (1) Teaching all lactating mothers on how to successfully breastfeed and sustain it up to 2 years or more; (2) Coming in contact with mothers and infants to promote, protect, and support breastfeeding. However, exclusive breastfeeding coverage was still low at 80% nationally, 76.7% in Surakarta, and 61.1% in Karanganyar in 2016, suggesting low midwife performance in lactation management. This study aimed to determine factors associated with midwife performance in lactating management in Surakarta and Karanganyar, Central Java.Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted in community health center in Surakarta and Karanganyar, Central Java, from April to June 2018. A sample of 200 midwives was selected by simple random sampling. The dependent variable was performance in lactation management. The independent variables were skill, motivation, experience, health facility, and work load. The data were collected by questionnaire and analyzed by a multilevel logistic regression.Results: Midwife performance in lactation management increased with better skill (b= 2.06; 95% CI= 0.48 to 3.65; p= 0.011), strong motivation (b= 1.15; 95% CI= -0.09 to 2.41; p= 0.070), work experience (b= 2.06, 95% CI= 0.69 to 3.44, p= 0.003), and available facility (b= 2.29, 95% CI= 0.89 to 3.68, p= 0.001). Performance decreased with higher workload (b= -1.47; 95% CI= -2.76 to -0.18, p=0.025). Community health center had a contextual effect on midwives performance with ICC= 34.8%.Conclusion: Midwife performance in lactation management increases with better skill, strong motivation, work experience, and available facility. Performance decreases with higher workload. Community health center has a contextual effect on midwives performance.Keywords: performance, lactation management, determinant, midwifeCorresp ondence:Nurul Wahidah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami No. 36 A, 57126, Surakarta, Central Java. Email: wahidahnurul246@gmail.com.Journal of Health Policy and Management (2018), 3(1): 26-33https://doi.org/10.26911/thejhpm.2018.03.01.04
Exclusive Breast Feeding Management: Qualitative Study on Working Mothers in Kalibawang District, Kulon Progo Yogyakarta Putriningrum, Eva; Joebagio, Hermanu; P, Eti Poncorini
Journal of Health Policy and Management Vol 1, No 1 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Coverage of exclusive breastfeeding in Kalibawang, Kulon Progo, Yogyakartawas 688 in mothers (69.8%)in 2015, which mean did not reach intended target set by Health Ministry of 80%. One of the factors that can affect the failure of exclusive breast feeding is the flurry of mother andstart working. This study was aimed to investigate the exclusive breast feeding lactation management of qualitative study on working mother.Subject and Methods: This was a qualitative study, conducted in Yogyakarta, in July-September 2016. A total of 12 mothers with breast feeding and start working and 4 midwives who came from four Posyandu in Kalibawang. The data collected using the in-depth interviews, observation, document, and the data analyzed was using interactive analysis Miles and Huberman.Results: The result showed that knowledge management of lactation nursing mothers on mother and started working pretty well. Lactation management socialization barriers still prevailing lack of consciousness of mothers against the practice of lactation management because of lack of support from family, while the barriers experienced by mothers and started working in the lactation management do was the lack of opportunity is flushed and the unavailability of facilities in the workplace, as well as the existence of the syndrome of exclusive breastfeeding for less.Conclusion: the implementation of lactation management on mom and started the work influenced factor, there is cake and family support. Mothers tagline enhanced his motivation for coming to the meeting heldby the Clinics in order to be knowledgeable about lactation management can better yet so that the scope of exclusive breast feeding can match target. belonging to the Ministry of health.Keywords: lactation management, exclusive breastfeeding, working mothersCorrespondence: Eva Putriningrum. School of Health and Sciences, STIKes Jenderal Ahmad Yani, Yogyakarta.Journal of Health Policy and Management (2016), 1(1): 13-19https://doi.org/10.26911/thejhpm.2016.01.01.03
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
Implementation of Community Mental Health Service in Malang, East Java Ulya, Zuhrotun; Sulistyono, Adi; Novianto, Widodo T.
Journal of Health Policy and Management Vol 3, No 2 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: The culture of mental-health care in Indonesia relies heavily on backward pseudo-science rooted in dated spiritual traditions. In Indonesia, some people with mental disorder was shackled in sheds or backyards for years on end, which is known as pasung. Based on report, 1 in 7 mental disorder patients were at risk of pasung. The success of mental health service program need a collaboration from community as preventive and promotive besides curative component. This study aimed to analyze the legal system working based on legal, substance, and laws culture in Wonorejo, Malang District, East Java.Subjects and Method: This was a qualitative study (descriptive non-doctrinal legal research) conducted in Wonorejo, Malang, East Java. Nine informants consisting of psychiatrist, general doctor, nurse, caregiver, social worker, public health officer, and village leader was selected for this study by purposive sampling. Data collected by interview, observation and documentary review. Data were analyzed by data reduction, presentation, and verification. Results: Integration of human resources is needed as a driver of the legal structure and there was urgency to add more resources (human, technology, fund). The constraint of this program is the limited number of workers (doctor, nurse, social worker) and limited distribution and kind of psychiatric drugs. Communication as a modality of legal substance has done well between social worker, caregiver, public health services, mental health hospital dan village). Community acceptance be legal culture was completely done by various educational programs, advocacy, and socialization. There was good coordination and acceptance between internal and external legal culture. The legal system has done well and leads to optimal community mental services.Conclusion: Analyzing of legal system working in community mental health services from structure, substance and legal culture in Wonorejo, Malang District, East Java has shown integration, effectiveness and acceptance from their community. Implication of this study that are needed policies to increase resources and fulfill of psychiatric drug distribution that was need by the patient.Keywords: community, mental health, legal systemCorrespondence:Zuhrotun Ulya. Masters Program in Law, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: psychiatry.law12@gmail.com. Mobile: 082232839048.Journal of Health Policy and Management (2018), 3(2): 108-113https://doi.org/10.26911/thejhpm.2018.03.02.07
The Associations of Ward Head Direction and Incentive with Nurse Performance at Arun LNG Hospital, Lhokseumawe, Aceh Irwadi, Irwadi; Zulfendri, Zulfendri; Aulia, Destanul
Journal of Health Policy and Management Vol 3, No 2 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: The current transformation in the hospital care industry demands greater coordination of care across providers and across settings so as to improve quality care, improve outcomes, and reduce spending. Nurses contribute to the transformative changes by being a fully contributing member of the inter-professional team. It requires an enhanced set of knowledge, skills, attitudes, and performance among nurses around wellness and population care with a renewed focus on patient-centered care, care coordination, data analytics, and quality improvement. This study aimed to analyze the associations of ward head direction and incentive with nurse performance at Arun LNG Hospital, Lhokseumawe, Aceh.Subjects and Method: This was a cross-sectional study carried out at Arun LNG Hospital, Lhokseumawe, Aceh. A sample of 74 nurses was selected for this study by exhaustive sampling. The dependent variable was nurse performance. The independent variables were ward head direction and incentive. The data were collected by questionnaire and analyzed by a multiple logistic regression.Results: Nurse performance improved with high motivation (OR= 11.12; 95% CI= 2.66 to 46.49; p= 0.001), explicit ward head direction (OR= 4.37; 95% CI= 1.05 to 18.17; p= 0.043), and existence of incentive (OR= 5.84; 95% CI= 1.30 to 26.17; p= 0.021).Conclusion: Improved nurse performance is associated with explicit ward head direction and existence of incentive.Keywords: nurse performance, ward head direction, incentiveCorrespondence: Irwadi. Masters program in Public Health, Universitas Sumatera Utara, Medan, North Sumatera. Email: wadieadi655@gmail.com. Mobile: 08126922595.Journal of Health Policy and Management (2018), 3(2): 114-117https://doi.org/10.26911/thejhpm.2018.03.02.08
Contextual Factor Affecting Health Quality among Female Prisoners in Semarang Hidayati, Alvy Nur; Joebagyo, Hermanu; Murti, Bhisma
Journal of Health Policy and Management Vol 4, No 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Health law number 36 of 2009 article 4 states that everyone has the right to be healthy. The right applies to all people, including the prisoners even though they have broken the law. This study aimed to describe the quality of health of female prisoners in obtaining health services during detention in Semarang's female prison.Subjects and Method: This was a qualitative study with a single fixed case study research strategy. The study was conducted in November 2018. The key informants were 4 female prisoners, 1 health policlinic doctor, and 1 head of a correctional institution.Results: There was a polyclinic unit that provided health services. Prisoners were not sure that health services are often given drugs that do not provide benefits optimally. Health personnel are always prepared to provide health services outside of working hours even though the number of health personnel is limited. Referral is done by conducting a basic examination to obtain an initial diagnosis to determine the next action, referral is done with the permission of members of the correctional observer team (TPP) and the head of the prison then referral can be done at facilities that have collaborated and have MOUs with prison so that prisoners do not pay for treatment. The availability of food and beverages consumed is provided in sufficient quantities. The availability of sports facilities to support health, as well as maintaining personal hygiene of prisoners is carried out by bathing, washing clothes, cleaning beds, and disposing of sanitary napkins in the places provided.Conclusion: The lack of health personnel causes sub-optimal health services. The lack of effectiveness of the drugs causes convictions of prisoners with health services provided in prisons.Keywords: quality of health, female prisonersCorrespondence: Alvy Nur Hidayati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami No. 36 A, Surakarta, Central Java. Email: alvynurhidayati@gmail.com. Mobile: 081328353336Journal of Health Policy and Management (2019), 4(1): 1-12https://doi.org/10.26911/thejhpm.2019.04.01.01
Criminal Legal Accountability on Medical Privacy Violations Ridwan, Ridwan; Isharyanto, Isharyanto; Purwadi, Hari
Journal of Health Policy and Management Vol 4, No 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: The secret of medicine or medical secrets is the right of the patient, this secret is a moral obligation based on the norms of decency originating from Hippocratic oaths, maintaining the secret of medicine is the duty of doctors to carry out their duties and practices. This provision is regulated in Article 48 of Law Number 29 of 2004 concerning Medical Practice, if this secret is leaked it can be held liable for violators. The purpose of this study was to solve legal issues and at the same time provide a prescription regarding the need for legal sources in the form of primary legal materials and secondary legal materials.Subjects and Method: This was a systematic review with normative juridical methods to solve legal issues.Results: Legal liability for medical secrets in health service facilities can be applied to the Criminal Code (KUHP). Disputes that occur regarding doctors or health personnel are resolved through professional organizations. Doctors through the Indonesian Doctors Discipline Honorary Council (MKDKI) but MKDKI did not have the authority to examine Criminal cases. Violations of medical secrets or job secrets, legal liability is not regulated or not based on legislation in force in the health sector, but the legal liability of violations of medical secrets comes from the general Criminal Code (KUHP).Conclusion: The secret of medicine is the autonomy right of patients. Maintaining the secret of medicine is the duty of doctors to health service facilities, the secret of medicine is not absolute and can be opened in certain circumstances, but this secret can be opened in accordance with the provisions of legislation. If the secret is leaked, violators can be asked for legal responsibility, especially Article 322 of the Criminal Code.Keywords: Medical Secrets, Criminal Legal Accountability, Health Services.Correspondence: Ridwan. Masters Program in Law, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta, Central Java 57126. Email: ridwanozil16@yahoo.com. Mobile: +6281237553434Journal of Health Policy and Management (2019), 4(1): 67-75https://doi.org/10.26911/thejhpm.2019.04.01.08
Association between Doctor’s Motivation, Age, and Leadership on Patient’s Satisfaction: A Path Analysis Evidence Aryoseto, Lukman; Tamtomo, Didik; Murti, Bhisma
Journal of Health Policy and Management Vol 4, No 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Quality health care needs are increasing. The service quality of one public health center and another does not have the same standard yet. One of the factors that influence the assessment of service quality is patient satisfaction. Several factors can influence patient satisfaction, especially from the doctor's side. This study aims to determine the effect of physician motivation, the age of the doctor, and the head of the health center on physician job satisfaction and patient satisfaction.Method: This was an analytic observational study with a cross-sectional design. The study was conducted at community health centers in Karanganyar and Surakarta, Central Java, in August 2018. A total of 25 doctors and 225 patients were selected using proportional random sampling. The dependent variable in this study is patient satisfaction. The independent variables in this study were the doctor's motivation, doctor's work satisfaction, doctor’s age, and the head of the health center. Data were obtained using questionnaires and analyzed using path analysis.Results: Patient satisfaction was directly increased by by the doctor's work satisfaction (b = 0.10; SE= 0.02; p<0.001) but decreased by doctor’s age (b= -0.82; SE= 0.02; p<0.001). Patient satisfaction was indirectly affected by doctors' motivation and head of community health center.Conclusions: Patient satisfaction is directly increased by the doctor's work satisfaction but decreases by doctor’s age. Patient satisfaction is indirectly affected by doctors' motivation and head of community health center.Keywords: patient satisfaction, doctor’s motivation, leadership, community health centerCorrespondence: Lukman Aryoseto. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: lukmanaryoseto@gmail.com.Journal of Health Policy and Management 4(1): 31-38https://doi.org/10.26911/thejhpm.2019.04.01.04
The Urgency of Law Enforcement of Illegal Medicine Distributions in Indonesia Yuliani, Evelina; Novianto, Widodo T.; Purwadi, Hari
Journal of Health Policy and Management Vol 4, No 2 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Medicine plays an important role and is an irreplaceable component in health. World Health Organization (WHO) statistics in 2015 stated that illegal medicine distributions in Indonesia are not less than 3 trillion rupiahs per year or 10 percent of all existing medicine distributions. These findings indicate that law enforcement against criminal acts of illegal medicines distribution is still not adequate. The distribution of illegal medicines including counterfeit medicines is a serious threat to the health of all Indonesian people. This study aimed to analyze the urgency of law enforcement of illegal medicine distribution in Indonesia.Subjects and Method: This was a qualitative study (descriptive non-doctrinal legal research) conducted in Sragen, Central Java. Five informants consist of the head of Loka BPOM Surakarta, the head of Sragendistric health office, a hospital director, a pharmacist in a community health center, and a pharmacy owner. Data collected by interview, observation, and documentary review. Data were analyzed by data reduction, presentation, and verification.Results: The investigations of the distribution of illegal medicines are carried out by PPNS from BPOM and accompanied by the police as supervisory coordinators. BPOM has a mapping of facilities and cases, as well as information from the community. If there is sufficient evidence, BPOM applies administrative sanctions, and if there is a criminal sanction, it will continue to other law enforcement officers. The regulations in the field of medicine are adequate, starting from Law number 36 of 2009 concerning Health, government regulations, the minister of health regulations, and BPOM regulations. The distribution of illegal medicines still occurs because there are demands from community and online medicine sales that have not been regulated by the government.Conclusion: Based on Lawrence M. Friedman’s theory, a legal substance, legal structure, and legal culture are a unity in carrying out law enforcement efforts, meaning that no matter how good a law is if it is not accompanied by a good implementing structure and a supportive culture it will be difficult to enforce the law. The society’s trust in the law enforcement officers in Indonesia that considered low should be restored with some improvement in structural and substantial aspects of law along with the presence of legal culture.Keywords: medicine, pharmacy, distribution, illegalCorrespondence: Evelina Yuliani. Masters Program in Law, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: eyuliani12@gmail.com. Mobile: 0811285066.Journal of Health Policy and Management (2019), 4(2): 76-85https://doi.org/10.26911/thejhpm.2019.04.02.01

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