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Associations of Perception towards Doctors, Nurses, and Facilities with Perceived Quality and Patient Satisfaction on Inpatient Care at Nabire Hospital Papua Agustina Utii; Bhisma Murti; Yulia Lanti Retno Dewi
Journal of Health Policy and Management Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: The government's efforts to maintain and improve the highest health status with all resources in the health sector, including personnel, funds, facilities, pharmacy, medical devices, and technology, provide quality health care. Community satisfaction as the service receiver is a comparison between the services received and the services expected. This study aimed to examine associations of perception towards doctors, nurses, and facilities with perceived quality and patient satisfaction on inpatient care at Nabire Hospital Papua.Subjects and Method: A cross-sectional study was conducted at Nabire Hospital, Papua, Indonesia, from March to May 2020. A sample of 207 inpatients was selected by stratified random sampling based on the type of inpatient class I, II, and III.Results: Inpatient satisfaction was affected by age <50 years (b= -0.36; 95% CI= -1.63 to 0.91; p=0.579), type of non-BPJS insurance (b= 0.19; 95% CI= -0.80 to 1.19 p= 0.697), length of stay <7 days (b= -2.39; 95%CI= -3.86 to -0.92; p <0.001), patients’ perception towards adequate inpatient facilities (b=3.11; 95%CI=2.13 to 4.07; p <0.001), good quality of inpatient care (b= 2.74; 95% CI= 1.74 to 3.72; p <0.001). The good quality of inpatient care was affected by male sex (b= 0.91; 95% CI= 0.10 to 1.72; p= 0.028), age <50 years (b= -0.24; 95% CI= -1.26 to 0.78; p= 0.644), type of BPJS insurance (b= 0.41; 95% CI= -1.22 to 0.39; p= 0.318), perception towards adequate facilities (b= 1.85; 95% CI= 1.04 to 2.65; p<0.001), good perception towards nurses (b= 2.18; 95%CI= 1.04 to 3.33; p <0.001), and good perception towards doctors (b= 1.68; 95% CI= 0.89 to 2.47; p <0.001). The good perception towards doctors was affected by the education of patients ≥Senior High School (b= 1.16; 95% CI= 0.31 to 1.83; p= 0.005).Conclusion: Inpatient satisfaction is affected by age <50 years, type of non-BPJS insurance, length of stay <7 days, perception towards adequate facilities, and good quality of inpatient care.Keywords: Quality, satisfaction, inpatient, path analysisCorrespondence: Agustina Utii. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: agustinautii1@gmail.com. Mobile: 081240051451.Journal of Health Policy and Management (2020), 05(03): 215-223https://doi.org/10.26911/thejhpm.2020.05.03.07

Factors Correlated with Willingness and Compliance to Pay National Health Insurance Premium in Jember Regency Nazilla Ade Nurlia; Bhisma Murti; Didik Gunawan Tamtomo
Journal of Health Policy and Management Vol. 6 No. 1 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Fulfillment of premium collectivity is related to willingness and compliance to pay BPJS Kesehatan premiums. Increasing participation in the informal sector is not in line with compliance in paying BPJS Health premiums. This study aims to analyze the influence of factors of willingness and compliance to pay premiums for BPJS Kesehatan independent participants in Jember Regency.Subjects and Method: This was a cross sectional study conducted in 31 sub-districts in Jember Regency, East Java, in July-September 2020. Sampling of 200 BPJS Kesehatan Mandiri participants was conducted using random sampling. The dependent variable is willingness to pay and compliance to pay the BPJS Health premium. The independent variables include education, income, willingness to pay, imitation of the referral group and number of family members. Data were collected using a questionnaire. Data were analyzed using multiple linear regression, multiple logistic regression and path analysis with Stata 16.Results: Factors that affect the willingness to pay are education (b= 45531.18; 95% CI= 35335.1 to 55727.26; p <0.001) and (b= 2.13 units; 95% CI= 1.41 to 2.86; p <0.001), income (b= 17469; 95% CI= 7171.90 to 27766.09; p <0.001), and (b= 1.19; 95% CI= 0.46 to 1.92; p <0.001). Compliance to pay is influenced by the willingness to pay factor (b= 4.19; 95% CI = 2.19 to 8.04; p <0.001) and (b= 0.64; 95% CI= 0.02 to 1.27; p= 0.044) with an average willingness to pay Rp 44,792, imitation of the reference group (b= 2.59; 95% CI = 1.39 to 4.85; p= 0.003) and (b = 0.95; 95% CI = 0.33 to 1.58; p= 0.003) and the number of family members (b= 1.90; 95% CI= 1.02 to 3.56; p= 0.044).Conclusion: Willingness to pay premiums is directly affected by education and income. Compliance with premium payments is directly affected by willingness to pay, imitation of the referral group, and the number of family members.Keywords: willingness to pay, paying compliance, social cognitive theoryCorrespondence: Nazilla Ade Nurlia.Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: nazillaade29@gmail.com. Mobile: +6281230004195.Journal of Health Policy and Management (2021), 06(01): 35-47https://doi.org/10.26911/thejhpm.2021.06.01.04

Management of Dual Health Asset Applications Developed by The Ministry of Internal Affairs and Ministry of Health in Hospitals in Boyolali, Central Java, Indonesia Yunita Rusdiyanti; Didik Gunawan Tamtomo; Bhisma Murti
Journal of Health Policy and Management Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: The management of health assets in Hospitals is a complex matter. State-onwed Hospitals use two applications from the Ministry of Internal Affairs developed by the Development Audit Agencynamely Regional Management Information System of Regional Assets (Simda BMD) and the Ministry of Health namely Application of Infrastructure and Medical Devices (ASPAK). This study aims to determine the management of health assets based on the applications of the Ministry of Internal Affairs and the Ministry of Health in three Regional Public Hospitals in Boyolali Regency.Subjects and Method: This was a descriptive-qualitative study using a study case approach. This study was carried out in three Regional Public Hospitals in Boyolali Regency. The main informants were goods treasurer, warehouse section, staff in charge of planning and reporting section, staff in charge of ASPAK, head of medical support, and head of administrative subdivision. The data were collected using in-depth interviews, non-participative observation, and document observation. The data were analyzed using three main steps namely data reduction, data display, and conclusion drawing.Results: The staff in charge of asset management in RSUD Boyolali had a sufficient proficiency in the asset concept and management by using the two applications. However, not all steps were conducted on time andfollowing the guidance.Conclusion: The training is required to improve the capability of the staff in charge of asset management. A system is also required to link the two applications to provide more efficient input system and create inter operability.Keywords: asset managementCorrespondence: Yunita Rusdiyanti. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: y_rusdiyanti@yahoo.com. Mobile: 081-22981365.Journal of Health Policy and Management (2020), 05(03): 189-196https://doi.org/10.26911/thejhpm.2020.05.03.04.

The Effect of Family Development Session through Family Hope Program on Visit to Integrated Healthcare Center and Child Nutritional Status: A Multilevel Evidence Nisaus Zakiyah; Endang Sutisna Sulaeman; Eti Poncorini Pamungkasari
Journal of Health Policy and Management Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: The Family Development Session through the Family Hope Program (FHP) uses the nutritional status of toddlers as an indicator of the quality of life that reflects the welfare of the community. This study aimed to analyze the effect of the Family Development Session (FDS) through the Family Hope Program on the child nutritional status.Subjects and Method: This was an analytic observational study with a retrospective cohort design. This study was conducted in Ponorogo, East Java, from December to February 2020. A sample of 200 children was selected by simple random sampling. The dependent variable was child nutritional status. The independent variables were FDS (FHP), maternal education, family income, social support, maternal knowledge, self-efficacy, complementary food, integrated community health center. The data were collected by questionnaire and analyzed by a multiple multilevel logistic regression.Results: Child nutritional status was positively associated with FDS (b= 1.24; 95% CI= 0.26 to 2.22; p= 0.014), high maternal education (b= 1.18; 95% CI= 0.16 to 2.19; p= 0.023), family income (b= 1.11; 95% CI= 0.11 to 2.11; p= 0.030), social support (b= 1.57; 95% CI= 0.46 to 2.67; p= 0.006), maternal knowledge (b= 1.24; 95% CI= 0.26 to 2.23; p=0.013), self efficacy (b= 1.38; 95% CI= 0.32 to 2.44; p= 0.011), complementary feeding (b= 1.35; 95% CI= 0.33 to 2.37; p= 0.010), and regular visit to integrated community health center (b=1.42; 95% CI= 0.28 to 2.56; p=0.015). Integrated health center had strong contextual effects on the child nutritional status with intra-class correlation (ICC) = 33.97%.Conclusion: Child nutritional status is positively associated with FDS, high maternal education, family income, social support, maternal knowledge, self efficacy, complementary feeding, and regular visit to integrated community health center. Integrated health center has strong contextual effects on the child nutritional status.Keywords: child nutritional status, integrated healthcare centerCorrespondence: Nisaus Zakiyah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email:nizakiyaah@gmail.com. Mobile: +6285235948995.Journal of Health Policy and Management (2020), 05(03): 224-234https://doi.org/10.26911/thejhpm.2020.05.03.08

Effectiveness of Telemedicine on Patient Satisfaction: Meta Analysis Sri Umiati; Bhisma Murti; Rita Benya Adriani
Journal of Health Policy and Management Vol. 6 No. 1 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Patient satisfaction is one indicator in the success of a treatment in the health sector. There are several ways to make this happen, including by simplifying the process of consultation, treatment and medication. Effectiveness in health services is very important. Telemedicine is a way offered to increase effectiveness in health services.Subjects and Method: Meta analysis was performed with PICO as follows: The population in this study were patients. Health service intervention is in the form of telemedicine. Comparison in the form of Non Telemedicine/ visit services. Outcome in the form of patient satisfaction. The meta-analysis study was applied to this study with electronic data sources: Clinical Key, Google Scholar, MEDLINE/PubMed, Science Direct, Scopus. The article used is a full-text article with a randomized control trial (RCT) study design. There were 8 articles used in this study with a sample size of 2123 people who were divided into two groups (1113 people in the telemedicine group and 1010 people in the control/ non telemedicine group). Articles were analyzed using the Review Manager 5.3 application. The results of this study aim to determine the Standardized Mean Difference (SMD) and the heterogeneity of the research sample.Results: There is high heterogeneity between one experiment and another (I2= 81%; P <0.0001) so that the Random Effect Model (REM) is used. The application of Telemedicine was able to increase patient satisfaction with Standardized Mean Different (SMD) of 0.41 compared to the control/ non-telemedicine group (SMD 0.41; 95% CI= 0.19 to -0.62; p= 0.0002).Conclusion: Providing telemedicine services was able to increase patient satisfaction with Standardized Mean Different (SMD) of 0.41 compared to non-telemedicine.Keywords: Telemedicine, patient satisfactionCorrespondence: Sri Umiati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami No. 36 A, Surakarta 57126, Ccentral Java. Email: umi2374@gmail.com. Mobile: +6287834961974.Journal of Health Policy and Management (2021), 06(01): 48-56https://doi.org/10.26911/thejhpm.2021.06.01.05

Nurse Professionalism in Law Perspective: Risk Management of Occupational Health and Safety in the Hospital Dewi Arradini
Journal of Health Policy and Management Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Law number 38/2014 on nursing requires nurses to provide professional services. Unprofessional nurse increases health and safety risk of themselves. This study aimed to describe nursing professionalism in occupational health and safety risk management at PKU Muhammadiyah Hospital, Karanganyar, Central Java.Subjects and Method: This was a descriptive qualitative. The study was conducted at PKU Muhammadiyah hospital, Karanganyar, Central Java, from December 2018 to February 2019. There were 6 key informants selected for this study, including (1) Infection prevention and control committee, (2) Head of hospital health promotion, (3) Head division of access to hospitals and continuity of service, (4) Head of patient and family rights, (5) Head division of nursing, and (6) Head division of occupational health and safety. A sample of 50 nurses from 7 wards was selected to measure their attitude toward risk management of occupational health and safety. The study sample was selected randomly. Patients were included to describe the quality of health service from their perspective. The data were collected by structured interview and analyzed by triangulation.Results: Nursing professionalism in occupational health and safety risk management at PKU Muhammadiyah Hospital was good. In order to maintain and improve nursing professionalism, internal hospital training and regular coordination meeting were conducted, involving ward nurses and heads, and nursing committee. Occupational health and safety risks were minimal. Near-miss and accident cases were recorded and followed up for future preventive purpose.Conclusion: Nursing professionalism in occupational health and safety risk management at PKU Muhammadiyah Hospital is good. Some preventive measures had been taken to minimize occupational health and safety risk.Keywords: nursing, professionalism, risk managementCorrespondence: Dewi Arradini. School of Health Sciences Mitra Husada. Jl. Achamad Yani 167, Papahan, Tasikmadu, Karanganyar, Surakarta, Central Java. Email: dewiarra29@gmail.com. Mobile: 08994194149.Journal of Health Policy and Management (2020), 05(03): 174-179https://doi.org/10.26911/thejhpm.2020.05.03.02

Determinants of Job Performance among Medical Rehabilitation Health Personnel at Dr. Moewardi Hospital, Surakarta, Central Java: A Path Analysis Evidence Sisybania Sisybania; Mahendra Wijaya; Bhisma Murti
Journal of Health Policy and Management Vol. 6 No. 1 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: The quality of a health institution is determined by human resources (HR) and the quality of staff services. The quality of health human resources is measured by employee performance and productivity especially services that are directly related to patients, such as the Department of Medical Rehabilitation. This study aimed to analyze the psychosocial economic determinants of the performance of medical rehabilitation health personnel.Subjects and Method: This study used a cross-sectional method. This study was conducted from May 2020 to June 2020. The sample was selected by exhaustive sampling by 200 medical rehabilitation health personnel at Dr. Moewardi, Surakarta. The dependent variable was performance. The independent variables were motivation, skill, work atmosphere, facilities and infrastructure, work experience, training, education, leadership style, incentive, reinforcement, vicarious learning, and observational learning. The data were collected using questionnaires and analyzed using path analysis with STATA version 13.Results: Medical rehabilitation health personnel had a likelihood of performing well with participative leaders (b=2.24; 95%CI=0.09 to 1.44; p=0.025), sufficient incentives (b=3.19; 95%CI=0.42 to 1.76; p<0.001), high motivation (b=3.38; 95%CI=0.51 to 1.93; p<0.001), by attenting training and education for medical rehabilitation (b=1.86; 95%CI=-0.03 to 1.27; p=0.064), good reinforcement (b=1.72; 95%CI=- 0.09 to 1.42; p=0.086), training and education through incentives (b=1.86; 95%CI=- 0.02 to 1.11; p=0.062), conducive work atmosphere through motivation (b=2.49; 95%CI=0.16 to 1.42; p=0.013).Conclusion: The performance of medical rehabilitation health personnel is affected by leadership style, incentives, motivation, training and education, work atmosphere, and reinforcement.Keywords: social cognitive, performance, path analysisCorrespondence: Sisybania, Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami No.36 A, Surakarta, Indonesia. Email: sisybania@gmail.com. Mobile: +6289676804589Journal of Health Policy and Management (2021), 01(01): 01-12https://doi.org/10.26911/thejhpm.2021.06.01.01.

The Effectiveness of Health Management-Assisted Technology on Glycated Hemoglobin Levels in Patients with Type 2 Diabetes Mellitus: Meta-Analysis Fajar Novianto; Atika Mima Amalin; Anggun Fitri Handayani; Anggraini Ambarsari; Diana Ode; Alfi Makrifatul Azizah; Ayu Trisni Pamilih; Annisa Fitriana Damalita; Fathiyyatu Assa'diy Firda; Ahmad Syauqi Mubarok
Journal of Health Policy and Management Vol. 6 No. 2 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Given the number of patients failing to achieve control of Diabetes Mellitus (DM), it causes an increase in the incidence of DM complications. Along with the rapid development of technology in this era, this study aimed to prove the effectiveness of technology-based health management compared to usual treatment for levels glycated hemoglobin (HbA1c) in type 2 diabetes mellitus patients.Subjects and Method: This was a meta-analysis using a randomized controlled trial. Articles were obtained from PubMed, Google Scholar, and ResearchGate databases. The articles used in this study were those published from 2012-2021. The search article was carried out by considering the eligibility of the criteria determined using the PICO model. Population: type 2 DM patients (HbA1c>7%), Intervention: health management-assisted technology, Comparison: usual care Outcome: HbA1c levels. There were 10 articles used with a sample size of 1693 people who were divided into two groups (845 people in the health management-assisted technology group and 848 people in the group usual care). Articles were analyzed using Review Manager 5.3 Application to determine the Standard Mean Difference (SMD) and heterogeneity of the study sample.Results: From 10 articles that were processed using RevMan 5.3, significant results were obtained, this is indicated by the overall effect (diamond) which does not touch the vertical line H0 (d= 0) and can also be seen from the 95% CI range of -0.62 to -0.13 which shows significant because it does not pass the number 0 (SMD= -0.37; 95% CI= -0.62 to -0.13; p= 0.003). The heterogeneity of the research data shows I2 = 82% so that the distribution of the data is very heterogeneous (random effects model).Conclusion: Using technology to help health management of patients with type 2 diabetes mellitus can reduce HbA1c levels compared to usual care.Keywords: Health management, technology, diabetes mellitus, HbA1cCorrespondence: Fajar Novianto. Center for Research and Development of Medicinal Plants and Traditional Medicine, National Institute of Health of Health, Jl. Raya Lawu No. 11 Karanganyar, Central Java. Email: dr.fajarnovianto@gmail.com.Journal of Health Policy and Management (2021), 06(02): 81-93https://doi.org/10.26911/thejhpm.2021.06.02.01

Association between Gender and Anxiety among Covid-19 Patients: A Meta-Analysis Zuraida Zulkarnain; Arum Nuryati; Desif Upix; Adilla Misi; Andi Siswanto; Atik Handariati; Alfiana Nur Nur Rohmani; Saryanto Saryanto; Zadia Dara
Journal of Health Policy and Management Vol. 6 No. 2 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: The COVID-19 outbreak rapidly spread worldwide, with a significant number of cases and deaths causing anxiety, especially among the sufferers. Biologically, males and females show different psychological responses to the events at hand. This study aimed to examine the association between gender and anxiety among COVID-19 patients.Subjects and Method: This study was a meta-analysis. The articles were obtained from databases PubMed and Scopus using keywords "Anxiety" OR "anxiety disorder" AND "COVID-19 Patients" OR "Patients with COVID-19" OR "Hospitalized" AND "Risk factors" OR "determinants" OR "Gender" OR "Factors associated". The articles included in this study were full-text with a cross-sectional design, discuss-ed the association between gender and anxiety among COVID-19 patients, published in English, studies located in Asia. The final results were presented in Adjust Odds Ratio (aOR) or Standardized Mean Difference (SMD). Data analysis was performed using Revman 5.3 software, with generic inverse variance data type for categorical outcome group (CtOG) articles and continuous data type for continue outcome group (CnOG).Results: 9 articles were analyzed, including 4 articles CtOG and 5 articles CnOG. The forest plot of both categorical and continue outcomes showed consistent result that among COVID-19 patients who hospitalized with mild to severe symptoms. Female patients significantly had higher anxiety event (aOR= 2.19; 95% CI= 1.60 to 2.99; p<0.001; I2= 0% and SMD= 0.35; 95% CI= 0.21 to 0.49; p<0.001; I2= 12%).Conclusion: Among COVID-19 patients, the female gender has a significantly higher risk of suffering from anxiety than the male gender.Keywords: anxiety, COVID-19Correspondence: Zuraida Zulkarnain. Research and Development Center of Traditional Medicinal and Medicinal Plants, Karanganyar, Central Java. Mobile: 081393933862. e-mail: zuraida.zu@gmail.com.Journal of Health Policy and Management (2021), 06(02): 94-106https://doi.org/10.26911/thejhpm.2021.06.02.02

Determinants of Health Care Renunciation among Women in Ivory Coast: Case of the District of Abobo Anonkoi-3 JÃ©rÃ´me Kouame; Julie-Ghislaine Sackou-Kouakou; Marie-Laure Tiade; RÃ©gine Attia-Konan; Madikiny Coulibaly; AÃ¯ssata Dagnogo; Kouame Koffi; Mariette Gokpeya; Simone Malik; AngÃ¨le Desquith; Agbaya Oga; Kouakou Luc; Kouadio Kouadio
Journal of Health Policy and Management Vol. 6 No. 2 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Health care renunciation aims to identify unmet care needs that a health condition would have justified. This behavior appears to be more common in women than in men. The objective of this work was to analyze the determinants of the health care renunciation among women in the city of Abidjan.Subjects and Method: We carried out a cross-sectional study from March to May 2019 in Anonkoi-3, a peri-urban district of the municipality of Abobo, in the north of the city of Abidjan. Questionnaires served to collect informations. Bivariate analyzes and a multiple logistic regression were used to measure the association between the different types of renunciation and the characteristics of women. Dependant variable was healthcare renunciation. Independent variables were socio-demographic, economic, health status characteristics and reasons for renouncing to health care.Results: The population sample consisted of 423 women (with mean age= 32; SD= 12 years). The renunciation on consultations with the general practitioner concerned, 72.34% of women. Regarding consultation with the specialist, the ophthalmologist (25.05%), the dentist (21.99%), and the gynecologist (14.89%) were those mostly renounced by the women. After consultation, 31.2% of them renounced to pursuing other treatment. They most often renounced to buying drugs from conventional medicine (19.62%) and preferred to use street drugs and traditional drugs (87.71%). All things being equal, women aged 28 to 38 (OR= 2.45; 95% CI= 1.31 to 4.68; p= 0.013), artisans and traders (OR= 3.22; 95% CI= 1.48 to 7.38; p= 0.004) and those in trade learning (OR= 2.42; 95% CI= 1.12 to 5.49; p= 0.028) significantly renouncing more on health care.Conclusion: In addition to financial reasons, the renunciation on health care can be explained by individual and social behaviors specific to individuals.Keywords: women, healthcare renunciation, precariousness, social inequalities, ivory coastCorrespondence: Jérôme Kouame, Faculty of Pharmaceutical and Biological Sciences, Department of Public Health, Hydrology and Toxicology, University Félix Houphouët Boigny, BPV 34 Abidjan 01, Ivory Coast. Email: jerome.kouamejj@gmail.com. Mobile: 0022565237900.Journal of Health Policy and Management (2021), 06(02): 116-129https://doi.org/10.26911/thejhpm.2021.06.02.04

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