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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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EVALUASI KEBIJAKAN RUMAH TUNGGU KELAHIRAN (RTK) DI KABUPATEN KONAWE PROVINSI SULAWESI TENGGARA TAHUN 2016 Sri Ayu Lestari; Laksono Trisnantoro; Dwi Handono Sulistyo
Journal of Health Service Management Vol 22 No 1 (2019)
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 maternal mortality rate (MMR) in Indonesia prompted the government to issue a Jampersal fund policy. One of the objectives of Jampersal fund is to provide budget for operational activities of Maternity Waiting Home (MWH) Program, a government strategy to facilitate access of pregnant mother to get health service to overcome pregnant, childbirth and childbirth problems as an effort to decrease maternal MMR in Indonesia. Objective: To describe the implementation of MWH policy as an effort to facilitate pregnant women, childbirth, and postpartum to get access to health service in Konawe Regency of Southeast Sulawesi Province. Methods: The study was descriptive using qualitative design with case study approach focusing on developing in-depth description and analysis of cases also studying MWH program. Results: MWH Program in Konawe Regency has been running for one year but there was still one Puskesmas that has not run the MWH program because the location of Puskesmas is far from the citizen’s residence. MWH is not only used by pregnant women who are far from the health facility and have a high risk but also used for all pregnant women who will give birth. MWH already meets the criteria set by the Ministry of Health. The operational cost of the waiting house guarantees all the costs of pregnant and family needs during their stay. The obstacles to MWH programs were disbursement of funds, rejection of pregnant women to the waiting house and difficult road access. Conclusion: MWH Program has been effective because it has been used by all pregnant women who have risk and who will give birth are placed in the waiting house of birth. The barriers that exist during the MWH program runs were disbursement of funds, the rejection of pregnant women into waiting homes and difficult road access.

MANAJEMEN LEAN PADA LAYANAN KEMOTERAPI ANAK RAWAT INAP DI RUMAH SAKIT CIPTO MANGUNKUSUMO Teny Tjitra Sari; Andreasta Meliala; Firman
Journal of Health Service Management Vol 22 No 1 (2019)
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: Cancer in children has high morbidity and mortality. Retinoblastoma is the most common solid tumor in children at the Cipta Mangunkusumo Hospital (RSCM). Chemotherapy is one of the therapeutic modalities, interdisciplinary and many procedures. Lean management continuously reduces waste and improves work flow. Objective: This study used lean management to determine the efficiency of health care in teaching hospital. Methods: Action research was conducted at RSCM. Sampling by purposive sampling that represents the role in the flow of the service process. The observation guide uses cycle time observation sheets, value-added analysis sheets, waiting time and lead time. The waste found is listed in the DOWNTIME matrix. Observations were made on inpatient chemotherapy services for children and then a diagnosis was made using Value Stream Mapping. The Kaizen team consisted of pharmacists, nurses, doctors doing a plan-do-study-action, prepared an intervention plan, and conducted post-intervention observations. The 5S method is used to improve service flow. Results: In this study, patients with retinoblastoma in class III in patient ward included were 7 patients in the pre-intervention group and 16 patients in the postintervention group. Major decreases in lead time happened in the subprocesses of ordering chemotherapy (75%), decision-making of chemotherapy administration (55%) and filling of the resume (41%). Lead time process in chemotherapy administration for retinoblastoma changed from 48 hours, 36 minutes (more than 2 days) to 38 hours, 38 minutes (1.6 days or less than 2 days). The efficiency of the process was measured using value added ratio which showed changes from 33% to 37%. Conclusion: Lean management applied in the process of chemotherapy administration in the inpatient wards increased the efficiency of the process.

PEMANFAATAN PROGRAM JAMINAN KESEHATAN NASIONAL DI PUSKESMAS DAERAH TERPENCIL KABUPATEN SUMBA TIMUR Damaris Pura Tanya; Julita Hendrartini; Dwi Handono Sulistyo
Journal of Health Service Management Vol 22 No 2 (2019)
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: National Health Insurance has been performed since The implementation aims of performing National Health Insurance to facilitate access and utilization of health care. Public Health Center (PHC) as the forefront of health care and has major role to facilitate utilization of health care for members of National health Insurance. Nowadays, utilization of National Health Insurance in PHC has not reached national target amounts 15%. Objective: To explore determinant factors on utilization of national health insurance in remote PHC, East Sumba. Methods: The study type is qualitative with case study design. Variable included access of health care, health resources, medical needs and other factors. Amounts 20 informant involved this study. The informant included patient as members of National health Insurance, provider and head of district health office. Collecting data by indepth interview. Data analysis was conducted systematically by transcript, coding and analysis. Results: The higher utilization of national health insurance when traditional market was opened (market day). Limitation on access affected patient prefer to got services in outside. Limitation of health resources such as, unavailability of medicine and always exhausted, no lighting, and unavailability of water so utilization of PHC by patient was low. Most of patient need medical care in PHC such as need injection and unavailability of medicine so patient sought care out of PHC. Cultural factors still retained by society that diseases just be cured by a shaman. The pregnant women giving birth at home was high due to unavailability of waiting home (Rumah Tunggu) and village regulation has not examined about punishment of birth at home. Conclusion: Utilization of nasional health care in PHC remote area is less than optimal. It is not supported by adequate transportation facilities, the availability of drugs, and cultural changes.

EVALUASI IMPLEMENTASI DANA BOK DI PUSKESMAS WILAYAH KERJA DINAS KESEHATAN KOTA BIMA TAHUN 2015 Aris Iwansyah; Julita Hendrartini; Muhamad Faozi Kurniawan
Journal of Health Service Management Vol 22 No 2 (2019)
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: Health Operational Cost (Bantuan Operasional Kesehatan/BOK) is government aids for local government to accelerating achievement of national priority programs, especially health aspect in Millennium Development Goal’s (MDG), through improvement performances of Public Health Centers (PHC) and the networks. Funding of Health Operational Cost to support PHC on providing promotive and preventive programs to community due to PHC services in district are likely to be directed on curative measures. Funding allocation of Health Operational Cost has been decreasing in Bima from IDR.1.412.500.000 on 2014 became IDR.521.464.000 on 2015. Therefore, evaluation of program implemetation by funding of Health Operational Cost on 2015 in Bima are needed to be examined. Objective: To find out the achievement implemetation of Health Operational Cost program in Public Health Center under District Health Office in Bima at 2015. Methods: The study design was qualitative and quantitative using descriptive case study. Tehnique of sample selection by using purposive sampling. Data analysis was conducted by descriptive qualitative. Results: Decreasing allocation funding of Health Operational Cost affected to planning and implementation of program, while Health Operational Cost became main sources of fund to external program in PHC due to lack of financial support from Regional government budget. Health Operational Cost have not been able to support achievement of Minimas Services Standar in Bima. Many head of PHC still less understanding to technical guide of Health Operational Cost so affected on decision-making of program and lack of monitoring and evaluation by District Health Department. Conclusion: The implementation of BOK program in Bima City is not the best enough especially in supporting SPM target in 2015.

IMPLEMENTASI PERATURAN WALIKOTA NO.41 TAHUN 2015 TENTANG PENCEGAHAN DAN PENANGGULANGAN HIV AIDS DI KOTA SINGKAWANG TAHUN 2016 Yulia Farahdini; Laksono Trisnantoro; Yodi Mahendradhata
Journal of Health Service Management Vol 22 No 2 (2019)
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: Singkawang is a city in West Kalimantan with the second highest number of HIV in West Kalimantan in 2012. To cope with this, then in November 2015, was issued on Mayor Regulation No. 41 Year 2015 on Prevention and Control of HIV AIDS. Objective: To determine the implementation of Singkawang Mayor Regulation No. 41 Year 2015 on Prevention and Control of HIV AIDS in Singkawang. Methods: The study was a descriptive study with a qualitative method by using a single case study design. The way of data collection is done by observation, interview and document study. Analysis techniques used were the analysis of the content (content analysis). Results: In the aspect of the implementation process, in terms of planning, has been carried out properly. However, not all relevant agencies involved in the planning. In terms of acceptability and appropriateness, Mayor Regulation No. 41 Year 2015 has been quite good. However, the constraints of the implementation is the problem of lack of funds and lack of training for agencies outside the health sector. Conclusion: In the Mayor’s efforts to implement Regulation Singkawang Singkawang Goverment expected to develop aspects of equitable funding and training for all agencies to carry out prevention and control of HIV according to Singkawang Mayor Regulation No. 41 2015.

PERBANDINGAN HAMBATAN FINANSIAL PADA SEBELUM DAN SETELAH JAMINAN KESEHATAN DI INDONESIA Putri Listiani; Julita Hendrartini; Dibyo Pramono
Journal of Health Service Management Vol 22 No 2 (2019)
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: Healthcare spending in Indonesia is still dominatedby out-of-pocket (OOP) system (45.1% in 2014). The high number of OOP in Indonesia is feared to cause financial burden tosociety and result in the failure of the financial protection functionof a health system, whereby Indonesia is in a scheme to achieveUniversal Health Coverage through the Universal Health Coverageprogram.Objective: This study aimed to compare the financial burden dueto OOP on before and after JKN and its determinants.Methods: This was a quantitative study that examines secondarydata, including Social Economic National Survey (Susenas) data in2013 and 2015 with cross sectional design. The unit of analysisin this study was households. Analysis conducted in this researchwas univariable, bivariable, and multivariable analysis. Multivariabletest using Logistic Regression Test was conducted to find out therelationship between the financial burden due to OOP with its determinants.Results: There was a decrease in the proportion of householdsexperiencing catastrophic health care expenditure was 0,59% in 2015. Households on before implementation of JKN period tend to face catastrophic health expenditure than households on afterimplementation of JKN period (OR= 2,29). Determinants affectingcatastrophic health expenditure in Indonesia were the number ofhousehold member, educational status of the head of household,the presence of toddler, the presence of elderly in the household,the location of the household residence, the economic status of thehousehold, the ownership of the health insurance, and the utilizationof health services.Conclusion: Utilization of inpatient health care services was themost contributing factor to catastrophic health expenditure. House-holds that use inpatient care had a catastrophic health care spend-ing risk of 26,78 times greater than non-accessed households

ANALISIS PENGGUNAAN DAN BIAYA LANGSUNG OBAT ANTIDIABETIKUM PADA PASIEN RUJUK BALIK DIABETES MELLITUS TIPE 2 DI KLINIK MITRA SEHAT Ade Triana Hapsari; Erna Kristin
Journal of Health Service Management Vol 22 No 2 (2019)
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: An increase in the number of type 2 Diabetes Melli tus (DM) patients at Mitra Sehat Clinic in 2018 as much as 200% compared to 2014. This has resulted in an increase in laboratory and drug claims to BPJS as the insurance agency. Analysis of drug use in patients with type 2 DM provides useful information regarding the management of antidiabetic drug use to determine the direction of management policy in efforts to control quality and costs. Objective: To analyse drug use and direct cost description of antidiabetic drugs at Mitra Sehat clinic using Prescribing Quality Indicator (PQI), for evaluation of the management of the patient referral program (PRB – PROLANIS) Type 2 Diabetes Mellitus. Methods: This study used a cross-sectional method with purposive sampling as a sampling technique. Subject inclusion criteria were PRB-PROLANIS patients with a single diagnosis of type 2 DM at Mitra Sehat Clinic aged 18 – 78 years who had an HbA1C examination, with a sample of 54 respondents. Results: The results of the statistical correlation test showed that there was a relationship between the use of antidiabetic drugs using the four PQI indicators with HbA1C (p value<0.05). There is the effectiveness of using antidiabetic drugs on the first, second, and fourth PQI indicators. Meanwhile, the use of antidiabetic drugs with the third indicator showed ineffectiveness. The use of antidiabetic drugs that has the highest direct cost is the use of the biguanide group, which is 43 respondents as much as Rp. 72,870,020, while the average total direct cost is the most expensive class of insulin. Conclusion: The use of antidiabetic drugs with PQI indicators can reduce HbA1C. Patients who received either insulin alone or insulin in combination did not achieve the target of therapy. The average total direct cost of the most expensive patients is those who use insulin drugs or a combination of insulin with other oral drugs.

MEKANISME KOORDINASI GUGUS TUGAS PERCEPATAN PENANGANAN COVID-19 DALAM PENANGGULANGAN PANDEMI COVID-19 DI KABUPATEN X PROVINSI SUMATERA BARAT Z.A. Prima Putri; Syahirul Alim; Dwi Handono Sulistyo
Journal of Health Service Management Vol 25 No 02 (2022)
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: Coordination is key to the success of disaster management when many parties are involved. However, in carryingout coordination in District X, it is known that there are obstacles, so coordination has not run as it should.Objective: This study aims to explore cross-sectoral coordination (COVID-19 Response Acceleration Task Force) in dealing with theCOVID-19 pandemic in the X Regency. Methods: This is qualitative descriptive research with seven informants from BPBD and X District Health Office. Data was collected through in-depth interviews with transsectional data collection, which only captures the situation at a specific time of the entire longitudinal phase of the disaster, precisely when the COVID-19 Omicron variant developed. Data validation was done by triangulation of sources. Results: The mutual adjustment mechanism has been made by holding meetings to discuss developing issues and compiling. In addition, non-formal communication is also carried out through Whatsapp groups. The direct supervision mechanism carried out by the head of the task force is monitoring and evaluation based on reporting in each implementing field through in-person or online meetings. The process of standardisation mechanism was not carried out because the activities within the task force were deemed to have been integrated with the duties of each regional apparatus institution, so it was sufficient to refer to the guidelines that had been prepared at the central level as a form of standardised activity. Conclusion: The dominant coordination mechanism carried out during the COVID-19 pandemic disaster by the task force in X Regency was mutual adjustment and direct supervision.

PEMODELAN DAN SIMULASI ANTRIAN UNTUK MEMPERBAIKI WAKTU TUNGGU POLIKLINIK VITREORETINA RS MATA “DR.YAP” YOGYAKARTA Anggun Desi Wulandari; Irwan Endrayanto Aluicius; Firman Setya Wardhana
Journal of Health Service Management Vol 25 No 01 (2022)
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpk.v25i01.4771

Background: Queuing problems often occur in the health care industry, such as hospitals. The problem has arisen because many requests access the services, but it is in imbalance with the adequacy of providers. Increased outpatient visits at the vitreoretinal polyclinic at the “Dr. YAP” causes long queues and long waiting times. Meanwhile, waiting time is an essential indicator of service quality in hospitals and affects patient satisfaction. Queueing model and simulation can be one method to identify queuing process problems and find the most optimal queuing scenario. Objectives: Identify the queuing system model at the vitreoretinal polyclinic service at the “Dr. YAP”, analyze the vitreoretinal polyclinic queuing system’s performance measures, and identify the optimal queuing scenario through simulation to improve the total waiting time. Methods: This research was conducted in two stages. The first stage is a quantitative descriptive analysis where the queue performance parameters are calculated. Data collection techniques used in this research are observation to obtain primary data (patient arrival time, service time, and waiting time on each server) and interviews to get supporting data. The second stage is the study of model construction. At this stage, the simulation model is designed to predict changes in patient waiting time for several scenarios using Ms. Excel and JaamSim software. Results: The queuing system model in the vitreoretinal polyclinic is Multi-Channel Multi-Phase, consisting of 3 queue phases with more than 1 server. A total of 338 patients were served, and the patients’ largest distribution for total waiting time was patients who waited for > 2 hours (41.12%) and between 1-2 hours (37.57%). The longest waiting time is for a doctor’s check-up length of 1 hour and 47 minutes. Several queuing scenarios were made from several identified problems. The first scenario, simulating the doctor’s arrival on time, reduces 25% of the total waiting time to 1 hour and 20 minutes. In the second scenario, separating the laser procedure schedule reduces 4% of the waiting time to 1 hour and 43 minutes. By combining scenarios 1 and 2, the third scenario reduced the total waiting time by 29% to 1 hour and 16 minutes. The fourth scenario is carried out through modeling on the JaamSim software by adding one doctor and one nurse, and the result is that there is a decrease in waiting time and the number of patients waiting in queues. Conclusions: Hospitals can take several ways to improve the waiting time. The first is to improve the punctuality of doctor’s practice time. This effort can be made by evaluating the starting hours of a doctor’s practice following the doctor’s feasibility and using an information system that can send automatic messages to the patients regarding the doctor’s practice start time and the patient’s arrival time. The second is the separation of the queue for laser procedures from the polyclinic queue. Laser procedures for reserved patients can be scheduled before the start of practice, after the practice, or on another day. Third, the addition of a Retinal Subspecialist Doctor and nurses at certain hours when there is no retinal schedule. The doctor is a preferably permanent doctor who has first practice license at the “Dr. YAP” Eye Hospital.

PERAN PEMBERDAYAAN MASYARAKAT DAN TENAGA KESEHATAN DALAM MENANGGULANGI MALNUTRISI DI DESA AIR ANYIR KECAMATAN MERAWANG KABUPATEN BANGKA PROVINSI KEPULAUAN BANGKA BELITUNG Syamsinar; Mubasysyir Hasanbasri
Journal of Health Service Management Vol 25 No 02 (2022)
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: Malnutrition is one of the causes of death in children under five years of age and has become one of the most threatening factors for children’s lives and health. Based on the nutritional status of weight and height index in the 2019 Bangka Belitung Islands Province Health Office data in Bangka, there were 0.84% wasting toddlers from 8,980 toddlers measured. In 2020, toddlerswith malnutrition were 0.63% of the 28,062 toddlers that were measured. Data recorded in February 2021 showed that from the 27,501 children under five who were measured and weighed, 1.13% of children were underweight and 0.64% with malnutrition. The Community Health Center (Puskesmas) has run nutrition improvement programs, including providing additional food, promoting healthand health services, nutrition counseling, and being active in the Kampung KB (Family Planning) program.Objectives: To find actors from both the Provincial/District/Village/Health Care Centre (Puskesmas) Governments/Communities who care to resolve malnutrition issues; to find daily activities in society that are obstacles to a healthy living culture; examine the role of community empowerment and health workers as well as the impact of empowerment toward the nutritional status of toddlers (children under five years old) in Air Anyir Village. Methods: A case study with an embedded single case design. Data were collected by in-depth interviews with twelve informants in February 2022 and then analysed by thematic analysis. Results: The informants of this research were 12 informants, namely family planning instructors, health workers as nutrition officers at Baturusa Health Center and Village Midwives, data managers for the nutrition program of the Health Service, community leaders as head of the Kampung KB, village officials fromthe village government, community leaders acting as TP PKK also serves as the head of the RT, community members who work as Posyandu cadres and parents of toddlers who visit the Posyandu. In Kampung KB, there is integrationand convergence in the implementation of empowerment and strengthening of family institutions to improve the quality of human resources, families, and communities. This study proves that the role of community empowerment andhealth workers in Kampung KB affected the nutritional status of the people in Air Anyir Village. The evidence (nutrition data of Baturusa Health Center) showed a decrease in cases of undernourished toddlers in Air Anyir Village.Conclusion: Actors in community empowerment include health cadres, TP PKK, village government, family planning extension workers, and health workers. Through the Kampung KB, the empowerment program in Air Anyir Village is going well. There is a decrease in cases of undernourished children underfive, although there are still bad habits in the community to hinder healthy living culture.

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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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Daerah istimewa yogyakarta

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