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Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management)

JMPK
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Published by Universitas Gadjah Mada

ISSN : 14106515 EISSN : 28286774 DOI : https://doi.org/10.22146/jmpk.v25i03.5186

Core Subject : Health,

Health Professions Public Health

Misi JMPK adalah menerbitkan, menyebarluaskan dan mendiskusikan berbagai tulisan ilmiah mengenai manajemen pelayanan kesehatan yang membantu manajer pelayanan kesehatan, peneliti, dan praktisi agar lebih efektif. Jurnal ini ditujukan sebagai media komunikasi bagi kalangan yang mempunyai perhatian terhadap ilmu manajemen pelayanan kesehatan antara lain para manajer, pengambil kebijakan manajerial di organisasi-organisasi pelayanan kesehatan seperti rumah sakit, dinas kesehatan, Kementerian Kesehatan, pusat-pusat pelayanan kesehatan masyarakat, BKKBN, pengelola industri obat, dan asuransi kesehatan, serta institusi pendidikan penelitian.

Arjuna Subject : Kedokteran - Kesehatan Masyarakat, Kesehatan Lingkungan dan Pekerjaan

Articles 131 Documents

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PENDEKATAN DINAS KESEHATAN DALAM PEMBERIAN PELAYANAN KESEHATAN DASAR MATERNAL PADA KOMUNITAS ADAT TERPENCIL SUKU ANAK DALAM DI KABUPATEN MERANGIN Lailatul Khoiriyah; Retna Siwi Padmawati
Journal of Health Service Management Vol 24 No 01 (2021)
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: Based on previous research in Sarolangun District which stated that mothers of Anak Dalam tribes do not want to come to give birth at the Health Service center provided by the government. Meanwhile in Merangin District, there were mothers of AnakDalam tribes who want to do ANC and gave birth to available health services.Objective: To explore the approach taken by the Merangin District Health Office in providing basic maternal health services tothe remote indigenous communities of the Anak Dalam tribe in the Merangin District area.Methods: This research was qualitative research with a single embedded case study design. The respondents were mothers,tumenggung (chief of tribe), health workers, holders of maternal health programs at the health department and the Head of HealthDistrict Office.Results: Maternal health services in Kabupaten Merangin included 14 services that cover the entire community including Anak Dalamtribe. Service delivery efforts were provided with a cultural approach and teamwork. The strategy of providing maternal health servicesto the Anak Dalam tribe was carried out with innovations in health care facilities thus the Anak Dalam tribe community begun to minglewith the community, understand maternal health, and finally accept maternal health services provided by health care facilities. Itwas also inseparable from cross-sectoral support in providing counselling and outreach about healthy life style of the Anak Dalam triberesidents. Therefore, the impact was Anak Dalam tribe begun to understand the importance and need to utilize health care facilitiesprovided by the government.Conclusion: The approach was carried out with cross-sectoral collaboration and initiation of innovation in health service facilities.Evaluation of the approach to providing health services can be viewed from the aspect of mistrust in health services and the acceptance of providing maternal health services to the Anak Dalam tribe.

ANALISIS PENGHITUNGAN BIAYA SATUAN (UNIT COST) TINDAKAN POLI GIGI KLINIK PRATAMA X MENGGUNAKAN METODE TIME DRIVEN ACTIVITY BASED COSTING Erfandi Ahmad; Diah Ayu Puspandari; Anastasia Susty Ambarriani
Journal of Health Service Management Vol 24 No 01 (2021)
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 high demand for dental and oral care in the community has led to an increase in Dental Poly visits to the PratamaX clinic. Determining the unit cost of polydental procedures is an important factor in clinic financing and increasing clinic revenue.Until now, the clinic owner has never evaluated the cost of dental poly surgery correctly and has not referred to the cost analysis ofthe service unit.Objective: To analyse the unit cost per Dental Poly procedure at Pratama X Clinic by using the Time Driven Activity Based Costing(TDABC) method.Methods: Descriptive observational study, using primary and secondary data from the clinic with the aim of obtaining a unit costcalculation of dental poly procedures. The design of this research was cross sectional and the type of data used was quantitative data.The results of the calculation and cost analysis to determine the unit costs of dental poly procedures in the form of tartar cleaning, dentalfillings with composite resin materials, tooth extraction and dental braces treatment (fixed orthodontics) by tracing costs related to thecost center of the procedure and other parts. that supports action. Results: Based on the unit cost calculation per procedure at thedental clinic, the Time Driven Activity Based Costing cost system imposed indirect costs in calculating unit costs at the Pratama XClinic. Because the Pratama X Clinic did not accurately classify direct and indirect costs, Pratama X Clinic was not accurate in allocating the costs, number and working hours of ineffective PratamaX Clinic employees.Conclusion: According to the data obtained, the application of Time Driven Activity Based Costing resulted in higher levels of dental care compared to the Pratama X Clinic, except for dental fillingswith small composite resin and dental orthodontics.

INTERVENSI PENINGKATAN MUTU PELAPORAN INDIKATOR KINERJA PENGGUNAAN OBAT RASIONAL (POR) DI KABUPATEN KARAWANG Yusrianti; Erna Kristin
Journal of Health Service Management Vol 24 No 01 (2021)
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: Rational use of drugs plays a role in reducing morbidity and mortality in the community associated with the treatment of disease. Acute respiratory infections (ARI), diarrhea, and myalgia are diseases that are still commonly found and treated in primary health centers, so far the three diagnoses are considered potential for irrational treatment. Data from existing reports can actually be used to identify the rationality of rational drug use, but until now the quality of report data is still poor. Therefore, how interventions can improve the quality of reporting the performance indicators of rational drug use in the Karawang District. Objective: To improve the quality of reporting on performance indicators of rational drug use (POR) in Karawang District. Methods: This study used a Quasi-Experimental research design with one- group pretest-posttest design, without a comparison group (control), in Karawang District in January - March 2020. Twenty officers reporting rational drug use in primary health centers were selected by purposive sampling. Results: Training interventions can improve the quality of reporting the performance indicators of rational drug use from the results of increased pretest after the training intervention (posttest) namely; report preparation process 25% to 80%, report completeness from 45% to 95%, timeliness from 15% to 75%, report compliance with technical instructions from 0% to 75%. Conclusion: Providing interventions in the form of explanations of technical guidelines for rational drug use and training has been proven to improve the quality of reporting on performance indicators of rational drug use.

PEMETAAN DIMENSI KUALITAS PELAYANAN KESEHATAN HEWAN DARI PERSPEKTIF PENYEDIA DAN PENERIMA PELAYANAN MEDIS VETERINER Alan Chandrasaputra; Adi Utarini; Ida Tjahajati
Journal of Health Service Management Vol 24 No 01 (2021)
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 increasing demand for veterinary medical service quality from community has been increasing as seen on the raising of lawsuit for veterinary services since 2008. The description of veterinary healthcare service quality in Indonesia was still unclear which part of quality dimension play the role to describe quality in veterinary healthcare service, especially in clinical area. Objective: This study aimed to determine the dimensions that influence the quality of veterinary medical services from the perspective and expectations of clients and providers. Methods: Qualitative Explorative as research design. Data Collection was done by 17 In-Depth Interview with 14 service providers and 3 service clients with addition 1 panel interview with 4 cat owner from cat lovers community and 1 panel interview with 2 dog owner. All respondent must have experienced with providing/receiving veterinary healthcare service. Interview Data then transcribed followed with Coding, Categorizing, and being made into Themes with Atlas.ti application which Themes become the fundamental of Quality Dimension of Veterinary Healthcare service. Results: The interview produced 20 transcripts that were coded subcategory categories-themes. The results of the categories obtained have the capacity as a dimension of the quality of veterinary medical services in the form of: managerial services; internal provider communication; professionalism of the provider; service competency, communication skills; client education, honesty and transparency; service security; service facilities; the dynamics of the world of service; service outputs and outcomes; and client assurance. Conclusion: The category becomes the dimension of service quality in D.I. Yogyakarta contains 11 service quality dimensions which are divided into 3 themes. The theme is the value of service; communication and interaction between service providers and clients; and clients demands. This theme affects the veterinary medical services especially in the D.I area. Yogyakarta.

EVALUASI PERESEPAN ELEKTRONIK DI DEPARTEMEN ILMU KESEHATAN ANAK Dyah Anggraini; Andreasta Meliala; Iwan Dwiprahasto
Journal of Health Service Management Vol 24 No 02 (2021)
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: Hospitals can prevent errors in medical actions or pharmaceutical services to patients called medication errors. One of the incidences of medication errors that are still high in Indonesia is the prescribing phase. So, currently, many hospitals have replaced manual prescription writing with electronic prescribing systems, including at Dr. Hospital. Cipto Mangunkusumo (RSCM). However, prescribing errors are still often found, especially in pediatric patients’ prescriptions. Objective: To evaluate the implementation of electronic prescribing and measure the results of personnel interventions on electronic prescribing in pediatric patients. Methods: Experimental with a quasi-experimental design, the one group pretest-posttest design. The research was conducted from December 2019 to January 2020 in pediatrics. The research subjects were 100 doctors participating in the Specialist Medical Education Program (PPDS). Training subjects carried out the intervention to write electronic prescriptions and provide feedback in the form of personal letters. Reassessment of the incidence of prescribing errors was carried out after four weeks. Results: The incidence of prescribing errors decreased after the intervention. (p = 0.05). The most types of prescription errors are the wrong dosage, strength, frequency. Prescribing errors in perinatology ward, pediatric inpatient ward and polyclinics decreased after intervention, while prescribing errors in the emergency room remained. There is a significant relationship between the provision of intervention with the level of education (p = 0.001). PPDS mid-level doctors make more prescribing errors in almost all types of errors and workplaces than junior and senior PPDS doctors. The results of the calculation of prescribing error pre and post intervention shows that giving an intervention can reduce the risk of prescription errors by up to 37%. Conclusion: Personnel intervention in education and providing feedback plays a role in reducing the incidence of prescribing errors. Education and providing feedback should be done regularly. In addition, it is necessary to add an electronic prescription support system to support the reduction of prescribing errors.

EVALUASI IMPLEMENTASI KEBIJAKAN TATA KELOLA KEPESERTAAN PBI DAERAH JAMINAN KESEHATAN NASIONAL DI KABUPATEN KAYONG UTARA DAN KABUPATEN KETAPANG PROVINSI KALIMANTAN BARAT Dedet Triwahyudi; Firdaus Hafidz As Shidieq; Laksono Trisnantoro
Journal of Health Service Management Vol 24 No 02 (2021)
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 management of the Regional Health Insurance was merged into BPJS Health after the implementation of the 2014 National Health Insurance program. Kayong Utara Regency and Ketapang Regency are part of the Regency that combines regional health insurance participation into BPJS Health. The implementation of regional PBI governance needs to be supported by adequate regulations, a strong stakeholder vision, communication between stakeholders that is in line with the policies of regional leaders. Objective: The general objective of this research was to explore the ability of stakeholders in implementing the governance of PBI participation in the National Health Insurance Region. Methods: This study used a realist evaluation approach with a descriptive case study design. The study used purposive sampling, the research subjects were 24 people. Data was collected by means of in-depth interviews and document review. Results: The implementation of the JKN Program is a strategic policy. North Kayong Regency insures the rich and the poor at BPJS Health, while Ketapang Regency only insures the poor or the poor. Based on the Context, Mechanism, and Outcome hypothesis, the management of PBI participants responded differently in the two districts. In the implementation of non-comprehensive regulatory influences, the Regional PBI Management had not been good in the two districts, a strategic vision that was not accompanied by a strategic plan and partial communication (mechanism) contributes to the results or in ensuring health insurance for the poor (outcomes). Conclusion: The government of Kayong Utara and Kabupaten Ketapang have a strong commitment to managing health insurance for the poor. The implementation of the Regional PBI in the two districts faces challenges in the form of regulations that are not yet comprehensive. Comprehensive regulations, clear targets, and cross-structure coordination are needed in the management of Regional PBI in North Kayong Regency and Ketapang Regency so that it can be carried out properly.

RESPONS TINDAK LANJUT REKOMENDASI AUDIT MATERNAL DI KABUPATEN BREBES DAN KABUPATEN BANYUMAS Dessyana Iriani; Eugenius Phyowai Ganap; Dwi Handono Sulistyo
Journal of Health Service Management Vol 24 No 02 (2021)
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 number of cases of maternal deaths in several districts is still high and has increased as in Brebes and Banyumas districts. The Maternal Perinatal Audit Policy in the District / City as an effort to reduce the number of maternal deaths is felt to be unsuccessful. In addition, the extent to which policy makers and implementers respond to or follow up on the results of maternal audit recommendations is still a big question. Objective: To explore the responses and factors that influence the implementation of follow-up maternal audits recommendations in Brebes and Banyumas Districts. Methods: This study used a qualitative design with a case study research design. Data collection techniques through document review, in-depth interviews and focus group discussions with a total of 14 informants. Results: The immediate response to the follow-up to the maternal audit in Brebes Regency was adequate and in Banyumas District good. Planned responses in both districts were not analyzed in this study because terms of reference for activities is not reviewed. Based on the characteristics of the problems the Brebes Regency is difficult to control because there are still many problems in the field and Banyumas Regency is easy to control. Based on the Policy Characteristics of the two districts included in the good category and based on the environment the Brebes Regency has not supported and the Banyumas Regency environment supports the implementation of the follow-up to the maternal audit recommendations. Conclusion: The response of the regencies is very dependent on leadership to make decisions immediately. The immediate response to the follow-up of the maternal audit in Brebes Regency was sufficient and in Banyumas District was good. It is recommended that the District Health Offices need to make a follow-up SOP on recommendations to the implementation of monitoring and evaluation by adding a reward and punishment system and Brebes Regency should accelerate the process of adding PONEK Hospitals and pay more attention to the principles of response in MDSR.

STRATEGI PENGEMBANGAN BALAI PENELITIAN DAN PENGEMBANGAN KESEHATAN BANJARNEGARA Agung Puja Kesuma; Laksono Trisnantoro; Yodi Mahendrahata
Journal of Health Service Management Vol 24 No 02 (2021)
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: Based on Permenkes No. 65 the year 2017, the Banjarnegara Health Research and Development (R&D) Unit is one oft he units under the NIHRD Ministry of Health, which has the task of conducting research and development of health with the advantage of leptospirosis control. The working area includes four provinces: DI Yogyakarta, DKI Jakarta, West Kalimantan, and South Sulawesi. In addition to conducting excellent research, Banjarnegara Health R&D Unit also has to do health research based on program needs in the target area. The Banjarnegara Health R&D Unit needs to understand its strengths, weaknesses, opportunities, and challenges through the identification of internal and external environments that can be using as a basis for developing strategic planning for organizational development. Objective: Formulate alternative strategies for the development of The Banjarnegara Health R&D Unit. Methods: Research A descriptive case study by using a holistic single case design plan. Variable research is the internal and external factor of Banjarnegara Health R&D Unit, development issues, and the strategies of develepment. Data obtained through in-depth interviews with the related informants, observation, and study of documents. Results: Internal environmental analysis to see the strengths and weaknesses of the Banjarnegara Health R&D Unit. Based on the results of internal environmental analysis, the Banjarnegara Health R&D Unit has considerable strength in terms of organizational as pects, HR experience, a budget that continues to increase every year, and infrastructure. External environmental analysis opportunities that can be utilized by the Banjarnegara Health R&D Unit are excellent stakeholder support, opportunities to collaborate with various institutions, sources of research funding, availability of information technology, and regulations that support the research climate. While the threats identified, require large budgets to keep abreast of medical or laboratory equipment technology, the development of potential epidemic diseases, limited recruitment of human resources and the potential to reduce PNBP. Conclusion: Strategies that can be used Banjarnegara Health R&D Unit for development are the development of services and products according to the needs of the stakeholders, the development of cooperation with strategic stakeholders, and the development of organizations with public service agency financial management patterns.

DAMPAK IMPLEMENTASI APLIKASI PENDAFTARAN DARING PELAYANAN RAWAT JALAN RUMAH SAKIT Yohana Denyka Kurniawati; Hanevi Djasri; Adi Utarini
Journal of Health Service Management Vol 24 No 02 (2021)
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: Outpatients at the polyclinic of Dr. Oen Solo Baru Hospital complained to the hospital regarding the waiting time from registration to the specialist clinic. Meanwhile, the policy of a tiered referral system also causes an accumulation of patients. Hospitals have been trying to increase the speed of outpatient services by implementing an online registration application since July 2010. Still, there has never been an evaluation of the implementation of the application. Objective: To assess the impact of using the online registration application on waiting time for outpatients and to identify the constraints in implementing the online registration application and the possibility of developing this application in the future. Methods: A mixed-method with explanatory sequential design. A quantitative approach to measure the difference in waiting time of outpatients before and after implementing the online registration application and the patient’s experience of using the application. Qualitative method to explore application implementation constraints and management’s strategy for application development. Results: There is a difference in outpatient waiting time before and after implementing the online registration application. Before the online registration application, the average waiting time is 1.97 + 0.92 hours. After implementation, 1.49 +1.06 hours for patients who register manually (there is an acceleration of 24.4%) and 1.69 +0.93 hours for patients who use the application (there is an acceleration of 18.8%). Some of the obstacles found were application utilization which was still stagnant, patient problems related to gadgets, and a penalty and blocklist system. The strategy that will be taken by hospital management is to increase the use and development of applications, namely increasing promotions, increasing service ac cess, developing towards e-payments, and commercial benefits. Conclusion: The online registration application can significantly reduce the waiting time for outpatients and meet user expectations. However, the number of users is still stagnant, and there are still obstacles that prevent patients from switching to using the application. Efforts need to increase the number of users and develop online registration applications.

NURSE ENGAGEMENT DI RSU APRILLIA CILACAP Bhintani Embriana; Andreasta Meliala; Widyawati
Journal of Health Service Management Vol 24 No 03 (2021)
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 success of the hospital industry, especially health services, depends on the participation of nurses in providing quality services to patients. In improving the quality of nurse services, hospital management must maximize nurses’ effectiveness, productivity, and innovation by encouraging positive attitudes in work by increasing nurse engagement. At RSU Aprillia Cilacap, the role of nurses is needed, which is shown through vigor, dedication and absorption. Objective: This study measured the relationship between the variables of nurse engagement with the performance of nurses in inpatient installations. Methods: Analytical descriptive quantitative research with cross sectional research design and research sample was 40 nurses. The study measuring instrument is a questionnaire. The sampling technique used was a survey technique carried out by distributing questionnaires with a Likert Scale, involving the entire research sample. Data analysis used cross-tabulation of respondent characteristics on nurse engagement and nurse performance and bivariate analysis using the Chi-Square test (x2 ). Results: There is no correlation between vigor and nurse performance (significance value (p) = 0.061 > 0.05), no correlation between dedication and nurse performance (significance value (p)= 0.291 > 0.05), and there is a correlation between absorption and nurse performance (value of significance). significancy (p) = 0.029 < 0.05). Conclusion: The majority of nurses are at the level of engagement and nurse performance in the medium category. Thus, the manage ment needs to increase the engagement and performance of nurses by implementing nurse engagement with a work contract or MOU for new employees who have completed orientation and old employees who have been appointed as employees. Management needs to do retention so that potential nurses remain obedient and contribute generously to the hospital. The nurse recruitment process requires re-evaluation to obtain quality human resources and have values following the hospital’s vision, mission and goals.

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Editorial Address Jl. Farmako Sekip Utara, Yogyakarta, Indonesia 55281 Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada

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Lutfan Lazuardi

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Jl. Farmako Sekip Utara, Yogyakarta, Indonesia 55281 Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada

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