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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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GAMBARAN KINERJA RUMAH SAKIT SEBELUM DAN SESUDAH ERA JAMINAN KESEHATAN NASIONAL (JKN) Wiwik Lestari; Laksono Trisnantoro; Ni Luh Putu Eka Putri Andayani
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: Changes in the Hospital (RS) business environment have occurred significantly since JKN was introduced by BPJS Kesehatan. In this era, hospital managers are confused about the following changes and hospital performance is declining. Objective: This study measures the service and financial performance before and after the JKN era. Methods: Descriptive research design with quantitative methods at RSKIA SADEWA. The data used are secondary data from medical record data, hospital service data and financial statements (2011-2019) Results: After the implementation of the JKN program, there was an increase in the number of patient visits by 35.23% for outpatients and 36.43% for inpatients. The percentage of inpatients who used health insurance before the JKN era was only around 3%, and after the JKN era the number increased sharply to 73%. BOR increased by 1.83%. The SC rate decreased by 0.83%. Of all general patients with Caesarean Sectio in RSKIA SADEWA, an average of 54.75% were BPJS participants, but aborted their BPJS rights. The average hospital revenue increased by 93.72%, operating costs decreased 5.78%, HR costs increased 1.52% and net profit increased 4.26%. The proportion of hospital revenue obtained from BPJS patients on average is 26.38% of the total hospital revenue. The average ROA after JKN era increased 5,96%. The average financial quick ratio increased by 443%. The average financial solvency decreased by 0.03. The average CRR increased by 7%. Conclusion: After the JKN era, there was an increase in the number of outpatient and inpatient visits. BOR increases, and SC rate decreases. Financial performance is measured by indicators of ROA, Quick Ratio, solvency and CRR. All indicators show an improvement, and there is no change in the environment after implementing the JKN program. Strict evaluation is needed to maintain and improve the achieved performance.

PEMETAAN SISTEM INFORMASI BERDASARKAN SUMBER DAN KEBUTUHAN UNTUK PEMBUATAN KEPUTUSAN DI DINAS KESEHATAN Al Wafi Rahmaputri Ardianingrum; Lutfan Lazuardi
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: Ngawi Regent Regulation Number 39 of 2008 concerning Duties, Functions, and Authorities of the Ngawi Regency Office, the function is to formulate technical policies in the health sector. According to Government Regulation Number 36 of 2014 concerning Health Information Systems, it is written that every health facility is required to record and report. Therefore, research required mapping information systems based on sources and availability for decision making at the Ngawi District Health Office. Objective: To identify the information systems and decisions made by the Ngawi District Health Office. Methods: This research is a type of qualitative descriptive research that uses a case study design. The research subjects are stakeholders who understand and are responsible for health programs and policymakers within the Ngawi District Health Office. Data analysis used thematic analysis. Results: The Ngawi District Health Office uses 31 active applications for daily activities. The infrastructure used to support minimal activities is laptops, applications, and internet networks. Data collection starts with the primary health care, health office, and health ministry. The decisions contained in the Ngawi District Health Office are programmed and non-programmed decisions. In 2020, non-programmed decisions were decisions related to the Covid-19 pandemic. Information system mapping has been carried out with an overview of the applications used by each sector in the health office and the data sources used. Conclusion: The Ngawi District Health Office has 31 active applications. The six applications have been integrated, 18 have not been integrated, and 12 applications can be integrated without having to enter the same data twice. There is no standard operating procedure in the public health department at the health office.

SUPERVISI VIRTUAL PROGRAM PENGENDALIAN TUBERKULOSIS PARU ERA PANDEMI COVID-19 DI KABUPATEN OKU TIMUR Siti Patria Hutami; Yodi Mahendrahata; Diah Ayu Puspandari
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: COVID-19 requires all parties to adapt to an unprecedented situation. Meanwhile, the implementation of the Pulmonary TB Control Program activities must continue to support the success of the Pulmonary TB Control Program in East OKU Regency. Coaching which is usually done face-to-face but is now very difficult to do because the COVID-19 has not subsided. Modern technology that reaches all aspects of life, including supervision activities. Objective: To describe the virtual supervision mechanism carried out by the Regional Health Department to the primary health care during the Covid-19 pandemic in the Pulmonary TB Control Program in East OKU Regency. Methods: A descriptive case study approach through a single case holistic design. Qualitative information was obtained through in depth interviews and documentation studies on April-Mei 2021. The research subjects were taken by the purposive sampling method. The subjects were 16 people. Results: The implementation of virtual-based supervision activities was carried out via WhatsApp and telephone from the Regional Health Department to the primary healthcare. Virtual supervision made it easier to access communication between the Health District Office and the TB Program Manager at the puskesmas because there are no restrictions on funds, distance and time. The Health District Office were able to monitor MSS achievements through the SITB report and monitor the availability of drug stocks virtually through coordination with the TB Program Manager at the puskesmas. However, the Health District Office was unable to monitor the use of logistics and reports related to slide numbering at the puskesmas in addition to the limited guidance provided during the COVID-19 pandemic. Conclusion: Social media is used as a means of exchanging data and information. Virtual monitoring of activities and coaching has not been carried out optimally. Coaching needs to be done virtually to improve the ability and skills of a TB Programmer in terms of recording and reporting TB programs during the pandemic of COVID-19.

PENERIMAAN PEMANGKU KEPENTINGAN KABUPATEN DALAM PENGEMBANGAN PELAYANAN TERPADU PRA-KONSEPSI Matsna Haniifah; BJ Istiti Kandarina; Retna Siwi Padmawati
Journal of Health Service Management Vol 24 No 04 (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: Stunting prevention can be accomplished in prewedding services for prospective brides based on the latest regulations regarding the acceleration of stunting reduction. Sleman Regency, as one of the focus locations for the intervention of stunting, has institutions that are involved in the service of prospective brides, i.e. institutions in the field of health, religion, and family planning. This new policy is a challenge because the existing programs in these institutions have not utmostly directed the prevention of stunting. There is a suggestion from the academic side to develop pre-conception integrated services causes be necessary to explore the early acceptance of Sleman Regency stakeholders. Objective: This study aimed to explore the potential in Sleman Regency to develop the pre-conception integrated services, including the early acceptance of stakeholders. Methods: A qualitative approach with a descriptive-exploratory design is used in this study by determining subject by purposive sampling. Research was conducted in Sleman and Mlati Sub-district. Data collection using in-depth interviews, focus group discussions, observation and document studies using the framework analysis method as a technique in analyzing the data. Results: There are various things behind aspects of stakeholder acceptance, i.e. capacity in the aspect of affective attitudes, the aspect of supportive needs of each stakeholder group, various things that affect the financing aspect, aspects of effectiveness perceived by stakeholders, aspects of stakeholder confidence in participating, and aspects of suitability of the proposed concept with stunting reduction. Conclusion: Stakeholders give a positive response and confidence to participate in pre-conception integrated service. In the future, local governments need to provide policy support to implement pre-conception integrated services as commitment to preventing stunting from upstream. In addition, stakeholders can maximize potential so that pre-conception integrated services can be a solution in improving health status of community.

HAMBATAN PEMANGKU KEBIJAKAN DALAM MENGGUNAKAN DATA RUTIN KESEHATAN IBU DAN ANAK UNTUK PERENCANAAN DAN PENGANGGARAN Brian Sahar Afifah; Lutfan Lazuardi; Tiara Marthias
Journal of Health Service Management Vol 24 No 04 (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: In Indonesia, policy stakeholders’ use of routine health data is still limited because the data are incomplete, not of good quality, and timeliness is still constrained. In MCH (Maternal and Child Health), the use of routine data contributes to the quality of services, MMR (Maternal Mortality Rate) and IMR (Infant Mortality Rate), including in the Special Region of Yogyakarta (DIY). The current pandemic situation has a negative impact on the availability of routine data and the achievements of the MCH program. Thus, it is essential to understand the factors that influence the use of routine data to improve the MCH program during the pandemic. Objective: This study aimed to explore the use of MCH data in the planning and budgeting process for MCH programs and the fac tors that need to be improved in the utilization of MCH data in DIY Province during the COVID-19 pandemic. Methods: This research is descriptive qualitative research that explores barriers to policy stakeholders’ used data in the planning and budgeting process of the MCH program. Research is located in two regencies, Sleman and Gunung Kidul Regencies, DIY Province. Determination of subjects by purposive sampling method, with criteria for stakeholders involved in the planning and budgeting process for the MCH program at the primary health care and health offices. Data analysis using content analysis techniques. Results: The study results found obstacles to using routine MCH data by policymakers, such as low quality of MCH data, Human Resources (HR) quality, an unintegrated MCH information system, internet network, and political interests. In addition, researchers also found lower quality of MCH data during the pandemic. Conclusion: The government needs to increase the use of data in planning and budgeting by using an integrated and simple electronic-based information system to meet MCH information needs. Furthermore, the government needs to make regulations on the integration of MCH information and special SOPs for MCH, improve the quality of human resources for users of information systems, increase HR motivation in respecting MCH information, and need to review PMK policy No. 7 regarding the preparation of MCH planning and budget regarding the timeline for submitting plans. and program budgets.

KUNJUNGAN RUMAH SEBAGAI STRATEGI PENINGKATAN PELAYANAN KESEHATAN UNTUK KELUARGA RAWAN DI KOTA MATARAM (WILAYAH KERJA PUSKESMAS KARANG PULE) Yatik Krisliani; Mubasysyir Hasanbasri
Journal of Health Service Management Vol 24 No 04 (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 Government of Indonesia has adopted the Healthy Indonesia Program with a Family Approach (PIS-PK) as a strategic step to assist home visit services for vulnerable populations. Current PIS-PK research or home visits relate to how home visits result in mapping of health conditions. Mataram city is included in the vulnerable category. For this reason, a strategy is needed to address vulnerable communities in the city of Mataram by conducting a home visit program. Objective: To examine the home visit program for vulnerable or vulnerable communities within the puskesmas area and how such home visits will strengthen the improvement of these health services. Methods: The research method used a qualitative descriptive approach with data collection using interview guidelines and data analysis using descriptive analytic. The subjects in this study were nurses or midwives who had done home visits, heads of puskesmas, heads of home visit programs and people who received home visit services. Results: Home visits were carried out to all families in the working area of the Karang Pule Health Center, both to families with health problems and those without health problems. This caused a lack of focus for health workers in providing home visit services to vulnerable families because they do not prioritize which families to visit. Antenatal care services for pregnant women were not carried out during home visits. In addition to home visits, services for pregnant women are carried out by telephone with a process through cadres to be informed to the puskesmas midwife. The services provided during home visits are health education, education and care for families who have health problems. Conclusion: Home visit service to all families in each region is an ineffective program because home visits should be aimed at prioritized families, specifically families who are vulnerable, both in terms of health and vulnerable in the use of health service facilities.

MANAJEMEN PERSEDIAAN OBAT DENGAN PENDEKATAN PERIODIC REVIEW SYSTEM Rukmono Siswishanto; Erna Kristin; Irwan Endrayanto Aluicius
Journal of Health Service Management Vol 24 No 04 (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: Continuity of drug availability in hospitals with no excessive supplies is still a problem. The range of inaccuracies in the plan for drug needs can be wasteful in procurement costs and affect the continuity of health services. Hospitals need to improve historical processing data on drug absorption to optimize drug demand planning. Objective: The research aimed to simulates optimizing the planning and control of drug inventory using the periodic review system. Methods: Case study research to plan drug needs, using daily drug uptake data longitudinally (2014-2017). The obtained formulas are used to perform simulations by comparing drug supplies based on existing methods with optimization methods on accurate uptake data in 2018. Interviews In-depth research is carried out on informants selected based on the relationship with system. Data analysis was performed using the t-test statistical test and qualitative data were analyzed using open coding. Results: An assessment of 10 types of drugs, each of 5 drugs has carried out in the fast moving and slow-moving groups. Eight out of the ten drugs reviewed, there were significant differences in drug supply between the existing method and the periodic review system method. The price of drug supplies during 2018 is Rp.13,315,337,556, while the existing method is Rp. 16,481,465,208. There were 25 cases of drug shortages worth Rp. 655,282,174 in the periodic review system method that is lower than the existing method, which is 31 instances of drug shortages worth Rp.756,743,295. Conclusion: The periodic review system method has advantages compared to existing methods in terms of fewer inventories and cost needs, and the occurrence of fewer drugs shortages and the budget to finance the drug shortages rates. Thus periodic review system method has the potential to improve the planning of drug needs in hospitals.

GAMBARAN KESIAPSIAGAAN, RESPON, DAN PEMULIHAN PADA LEVEL KABUPATEN DALAM PENGENDALIAN PANDEMI COVID-19 Luqman Hakim; Laksono Trisnantoro; Ni Luh Putu Eka Putri Andayani
Journal of Health Service Management Vol 24 No 04 (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: WHO has designated COVID-19 as a World Public Health Emergency. Success of the district level in handling COVID-19 is determined by the efforts made in these 3 phases: preparedness, response, and recovery. Sleman which has an urban character has its own vulnerabilitie and resources in the COVID-19 pandemic situation. Objective: This study aimed to obtain an overview of the preparedness, response, and recovery in controlling COVID-19. Methods: Qualitative research with a case study design in Sleman using the WHO Practical Actions in Cities to Strength Preparedness Checklist for the COVID-19 Pandemic and Beyond. The research subjects are informants who play a role in Task Force. Data were collected by means of documentation studies, observation, and in-depth interviews. Data validation was done by triangulation of sources and research data. Results: Expert academics and communities are less involved. At the beginning of the pandemic, risk communication was less than optimal to form stakeholder awareness in the government and the community, resulting in poor public compliance with health protocols and public health measures. Mobility restrictions follow national directives. However, compliance monitoring and enforcement of violations are weak. Testing and tracing capacity is still far below the standard. The strategy to increase the capacity of COVID-19 beds in hospitals does not anticipate a surge in cases, and the formation of village shelters has not been maximized. Conclusion: Planning and coordination require improvement by taking into account existing vulnerabilities and involving all resources in the community. Risk communication strategies need to be strengthened according to changing situations and tailored to specific targets using effective media. The government needs to make adjustments to public health measures carefully, taking into account the epidemiological situation, the capacity of the health system, and the socioeconomic conditions of the community.

PERSIAPAN PELAKSANAAN REAKREDITASI DI 4 PUSKESMAS KOTA YOGYAKARTA Eka Putri Rahayu; Laksono Trisnantoro; Hanevi Djasri
Journal of Health Service Management Vol 23 No 01 (2020)
Publisher : Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Background: Accreditation is conducted to improve the quality in health service. For continuous quality improvement, we need to re-measure quality standards through re-accreditation. In 2019, several primary health care in Yogyakarta city will face re-accreditation. In order to do that, preparation is needed. Preparation for the implementation of primary health care must be planned as well as possible to gain optimal results. Objective: To analyze preparation for the implementation of primary health care re-accreditation in Yogyakarta city Methods: Descriptive research using a qualitative approach design. There were 18 participants selected by purposive sampling technique. Data collection was carried out by in-depth interview, focus group discussion (FGD) and assessment checklist. Results: For Puskesmas Kotagede I, preparation for the implemen tation of primary health care re-accreditation is good but lacking in Man and Do variable. Preparation for the implementation of primary health care re-accreditation are good for both Puskesmas Mergangsan and Gondokusuman I but lack in Do variable. For Puskesmas Tegalrejo, preparation for the implementation of primary health care re-accreditation is good but lacking in Money and Man variable. Conclusion: Primary health care and the Ministry of Health have been preparing for re-accreditation process well even though several scheduled activities have been postponed due to clashes with other assignments.

PENGARUH METODE MANAJEMEN STRES DENGAN INTERVENSI TERAPI MUSIK TERHADAP TINGKAT KECEMASAN ANAK PADA TINDAKAN EKSTRAKSI GIGI Faridha Hanum; Andreasta Meliala; Rina K. Kusumaratna
Journal of Health Service Management Vol 23 No 01 (2020)
Publisher : Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Background: Anxiety is a common problem and challenge in dentistry. Some patient experience extreme anxiety leads to avoiding dental assessment and treatment. Anxieties in children patient are generally not knowing and fear of dental assessment and treatment. Dental anxiety is managed with non-pharmacology such as music therapy distraction method. Objective: To measure anxiety level on children before and after tooth extraction, with and without using music therapy intervention. To measure parent satisfaction before and after stress management interventions using music therapy Methods: This quasi-experimental research used pre-test posttest non-equivalent control group design approach throughout April The total of research subject were 48 respondent. The respondents included paediatric patients with age group of 810 years old at Klinik Utama Bona Medika, Kota Cilegon. Subjects are categorized to intervention and control group. The assessment of patient anxiety level using psychological parameter based on Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) questioner and physiological using pulse. The research result data is tested using paired t-test to identify the mean score different of anxiety between intervention and control group. Results: The result of paired t-test data shows there is significant different in anxiety between intervention and control group with p=0,000 (p<0,05) value. Conclusion: Music therapy as stress management method lowers the anxiety in children during tooth extraction.

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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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