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Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Published by Universitas Indonesia
ISSN : 19077505     EISSN : 24600601     DOI : https://doi.org/10.7454/kesmas
Core Subject : Health,
Health Professions Public Health
The focus of Kesmas is on public health as discipline and practices related to preventive and promotive measures to enhance the public health through a scientific approach applying a variety of technique. This focus includes areas and scopes such as Biostatistics, Environmental Public Health, Epidemiology, Health Policy, Health Services Research, Nutrition, Occupational Health and Industrial Hygiene, Public Health, Public Health Education and Promotion, Women Health.
Arjuna Subject : Kedokteran - Epidemilogi
Articles 6 Documents
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Search results for , issue "Vol. 2, No. 3" : 6 Documents clear
Pengaruh Implementasi Quality Management System ISO 9001:2000 terhadap Kinerja Rumah Sakit Duren Sawit Ekowati, Dian
Kesmas Vol. 2, No. 3
Publisher : UI Scholars Hub

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Abstract

Upaya organisasi meningkatkan produksi jasa pelayanan kesehatan melalui implementasi Quality Management System ISO 9001:2000 secara sistematis, menyeluruh dan sinambung seharusnya mampu menampilkan kinerja yang efektif dan efisien. Penelitian ini bertujuan untuk memperoleh gambaran mengenai peran implementasi QMS ISO 9001:2000 terhadap kinerja Rumah Sakit Duren Sawit yang akan diukur melalui pendekatan kerangka strategis Balanced Scorecard serta identifikasi kesenjangan dalam organisasi untuk menganalisis kesiapan implementasi manajemen strategis Balanced Scorecard di Rumah Sakit Duren Sawit. Hasil penelitian menggambarkan bahwa melalui pemahaman dan implementasi yang QMS ISO 9001:2000 konsistensi, Rumah Sakit Duren Sawit mampu menghasilkan kinerja organisasi yang efektif dan efisien. serta berhasil menganalisis kesiapan Rumah Sakit Duren Sawit untuk mengimplementasikan manajemen strategis Balanced Scorecard melalui identifikasi kesenjangan dalam mengumpulkan sumber informasi untuk mengukur indikator-indikator hasil yang merupakan rambu-rambu bagi keberhasilan pencapaian sasaran strategis organisasi. The organization effort to improve health care service production through implementation of Quality Management System ISO 9001:2000 in a systematic, comprehensively and continuously should results in effective and efficient performance. This study objective is to observe the role of Quality Management System ISO 9001:2000 implementation on performance of Duren Sawit Hospital measured by Balance Scorecard strategic frame approach to analyze the readiness of the hospital to implement Balance Scorecard strategic management. The study results show that through understanding and consistent implementation of QMS ISO 9001:2000 Duren Sawit Hospital can produce effective and efficient organization performance. This study also provide analysis on the readiness of Duren Sawit Hospital to implement Balance Scorecard strategic management and identify the gaps of sources of information to measure indicators to achieve organization strategic objectives.
Perlindungan Hak Pasien di RS Kanker Dharmais Jakarta Gunnara, Harvensica
Kesmas Vol. 2, No. 3
Publisher : UI Scholars Hub

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Abstract

Banyaknya kasus “kelalaian atau kesalahan medis” dan pasien yang belum memperoleh haknya dalam pelayanan medis merupakan masalah yang sangat krusial dewasa ini Untuk mengatasi masalah tersebut telah ditetapkan berbagai kebijakan dibidang pelayanan medis dalam rangka memberikan perlindungan pada hak pasien yang antara lain adalah UU Kesehatan dan UU Praktik Kedokteran, dan agar tujuan kebijakan tersebut dapat dicapai perlu adanya peran aktif seluruh pihak. Namun, berbagai kebijakan pelayanan medis dalam rangka perlindungan hak pasien belum sepenuhnya mencapai tujuan yang diharapkan. Tujuan penelitian ini adalah menganalisis kebijakan pelayanan medis dalam rangka perlindungan hak pasien di Rumah Sakit Kanker Dharmais Jakarta. Penelitian ini menggunakan pendekatan kualitatif dengan metode studi kasus. Data diperoleh dari wawancara mendalam dengan 5 orang informan dan telaah dokumen kebijakan. Teknik analisis data yang digunakan dalam penelitian ini adalah analisis isi. Hasil penelitian menunjukkan bahwa: 1) kebijakan pelayanan medis telah mengatur perlindungan hak pasien, 2) kebijakan pelayanan medis sudah mengatur “kelalaian atau kesalahan medis”, tetapi belum secara menyeluruh, 3) tenaga medis belum sepenuhnya melaksanakan kebijakan pelayanan medis, 4) upaya perlindungan hak pasien di rumah sakit sudah dilaksanakan sesuai dengan kebijakan, 5) kebijakan pelayanan medis yang belum dilaksanakan sepenuhnya sehingga tujuan kebijakan belum tercapai. “Kelalaian atau Kesalahan medis” dan pasien belum memperoleh hak pelayanan medis disebabkan. Oleh sebab itu perlu: 1) melakukan audit medis terhadap pelaksanaan kebijakan dan upaya rumah sakit melindungi hak pasien, 2) menyusun kebijakan mikro yang mengatur mengenai “kelalaian atau kesalahan medis” secara menyeluruh. There are many medical negligence or error charges which patients did not accept their rights in medical service. This is a crucial matter which has a large impact. To solve the problem, many policies have been decided many to give protection for patient rights, for example Health Act and Medical Practice Act. In order to achieve the policy goal, all stakeholders should totally participate. However, many polices have not fully achieved the expected goals, and thus the necessity to analyze content, implementation, and result of those policies. This study objective is to analyze medical service policy for patient rights protection in Cancer Hospital of Dharmais Jakarta. This research applies qualitative approach with case study method. Those collected data are sourced from in-depth interview with 5 informants and policy document study. To analyze data in this research using content analyze. These results of study show that: 1) medical service policy has regulated patient rights safety, 2) medical service policy has regulated concerning medical negligence or error, however it has not been completed, 3) medical professional has not been totally implemented medical service policy, 4) hospital efforts in patient rights safety has been implemented following policy, 5) medical service policy which has not been totally implemented and policy content which has not been totally regulated for problem settlement will affect policy goal that have not been achieved. The problems of medical negligence or error and situations where patients have not accepted their rights are caused by medical service policy which is not regulating medical negligence or error in a comprehensive way and medical professional has not been totally implemented medical service policy. There is a necessity to do medical audit for implementation of policy and hospital efforts in protecting patient rights and to formulate micro policy regulating medical negligence or error comprehensively.
Ketahanan Hidup Setahun Pasien Stroke di RS Cipto Mangunkusumo Jakarta Mulyani, Sri
Kesmas Vol. 2, No. 3
Publisher : UI Scholars Hub

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Abstract

Di Indonesia, penyebab utama kematian di rumah sakit adalah stroke. Penelitian ini bertujuan untuk mengetahui ketahanan hidup 1 tahun pasien stroke yang dirawat di RS Cipto Mangunkusumo Jakarta tahun 2003 dan faktor yang mempengaruhinya. Rancangan penelitian ini adalah kohort retrospektif. Sampelnya adalah total populasi, yaitu 275 pasien yang didiagnosa mengalami serangan stroke pertama dan dirawat di RS Cipto Mangunkusumo Jakarta, yang masuk tanggal 1 Januari sampai 31 Desember 2003. Hasil penelitian menunjukkan bahwa probabilitas ketahanan hidup pasien stroke berbeda beda, tergantung pada tipe stroke, ruang rawat, dan penyakit jantung. Masing-masing probabilitas ketahanan hidup setahun pasien stroke adalah sebagai berikut: 63,7% pada pasien tipe stroke stroke iskemik vs. 22,9% pada pasien tipe stroke hemoragik, 70,4% pada pasien di ruang rawat Unit Stroke vs. 36,9% pada pasien di Ruang Neurologi, 37,7% pada pasien stroke dengan penyakit jantung vs. 53,2% pada pasien tidak dengan penyakit jantung. Hasil analisis regresi cox ganda menunjukkan bahwa setelah dikontrol oleh umur, pasien Stroke Hemoragik berisiko untuk meninggal 3 kali lebih besar dibandingkan pasien Stroke Iskemik, pasien stroke yang dirawat di Ruang Neurologi berisiko untuk meninggal 3 kali lebih besar dibandingkan di Ruang Unit Stroke, dan Pasien stroke berpenyakit jantung berisiko untuk meninggal 1.4 kali. In Indonesia, the main cause of death at hospital is stroke. The objective of this study is to know the one year probability of survival rate of stroke patient at Cipto Mangunkusumo Hospital Jakarta and factors influencing the rate. The design of this study is retrospective cohort using the medical record database, subjects were total population, i.e., 375 patients diagnosed as the first stroke attack and lodge at Cipto Mangunkusumo Hospital during first January to thirty first December year 2003. The results of this study shows that the probability of one year survival stroke patients depend on type of stroke, place of take care, and existing of heart disease after controlled for age of patients. The probability of one year survival stroke patients are as follows: 63,7% among ischemic stroke vs. 22,9% among haemorhagic stroke; 70,4% among patients who take care at Stroke Unit vs. 36,9% among patients take care of at Neurology Unit; 37,7% among patients with existing heart disease vs. 53,2% among patients without heart disease. The multiple Cox regression shows that after controlled for age, the haemoraghic stroke have risk to die 3 time higher compare than ischemic stroke, the patients at Neurology Unit have risk to die 3 time higher compare than those at Stroke Unit, and the patients stoke with existing heart disease have risk to die 1.4 time higher.
Determinan Kematian Neonatal Dini di RSUD Dr. Achmad Mochtar Bukittinggi Efriza, Efriza
Kesmas Vol. 2, No. 3
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Abstract

Berdasarkan data SDKI 2002-2003 angka kematian neonatal di Indonesia adalah 20 per 1000 kelahiran hidup. Sebagian besar kematian neonatal terjadi pada saat neonatal dini ketika bayi berumur 0-7 hari. Penelitian ini bertujuan untuk mengetahui berbagai faktor yang mempengaruhi kematian neonatal dini di RSUD Dr. Achmad Mochtar Bukittinggi tahun 2001-2005. Penelitian yang dilakukan pada sumber data sekunder rekam medik ibu dan bayi ini menggunakan disain studi kasus kontrol. Sampel dihitung dengan rumus ukursan sampel minimal kasus kontrol. Kasus. adalah bayi yang lahir hidup dan meninggal pada periode neonatal dini (0-7 hari) dan kontrol adalah bayi yang lahir hidup dan bertahan hidup pada periode neonatal dini. Jumlah kasus (93i) dan kontrol (392) ditentukan dengan rasio 1:4 untuk meningkatkan power penelitian Metoda analisis yang digunakan adalah analisis regresi logistik. Hasil penelitian menunjukkan kejadian kematian neonatal dini dipengaruhi oleh umur kehamilan, nilai apgar 1 menit setelah lahir, nilai apgar 5 menit setelah lahir dan berat lahir setelah dikontrol oleh variabel komplikasi kehamilan atau persalinan, rujukan, kelas perawatan, jenis persalinan, pendidikan ibu dan paritas. Bayi berat lahir sangat rendah (gram) berisiko untuk mati pada periode neonatal dini 59 kali lebih besar daripada bayi berat lahir normal. Sedangkan bayi berat lahir rendah (gram) berisiko mati pada periode neonatal dini 6 kali lebih besar daripada bayi berat lahir normal (³ 2500 gram). Antisipasi kematian neonatal dini perlu penanganan sejak kehamilan (ANC) sampai persalinan. Kerjasama pusat pelayanan dasar dengan pusat pelayanan ditingkat atas, persalinan di rumah sakit didampingi oleh dokter anak, pengkajian alat, tenaga, standar pelayanan dan mengoperasikan NICU (Neonatal Intensif Care Unit). The Indonesia Demographic and Health Survey (SDKI) 2002-2003 reported neonatal death rate in Indonesia of 20 per 1000 live birth. Most of the neonatal death occurred early, that is in the age of infant of 0-7 days. This study aimed at knowing factors influencing early neonatal death in Dr Achmad Mochtar Hospital Bukittinggi in the year 2001-2005. The study used medical records of mother and infant as secondary data source and was designed as a casecontrol study. Cases were infants born alive and died during the early neonatal period (0-7 days), and controls were infants born and stay alive during that period. Number of cases was 93 and control was 392 subjects was calculated on 1:4 ratio to increase the study power. Analysis method used was logistic regression analysis. The results show that early neonatal death was influenced by gestational age, Apgar score 1 minute after birth, Apgar score 5 minute after birth and birth weight after controlled by pregnancy or delivery complication, referral, health care class, type of delivery, mother’s education, and parity variables. Infants with very low birth weight (grams) have 59 times greater risk of early neonatal death compared to those of normal birth weight. While those with low birth weight (grams) have 6 times greater risk compared to normal birth weight infants. To anticipate the occurrence of early neonatal death there is a need to intervene since pregnancy (through ANC) until delivery. There is also a need to foster the collaboration between different levels of health care facilities, delivery assistance by specialist in the hospital level, and to standardize health care process including Neonatal Intensive Care Unit (NICU) implementation.
Analisis Risiko Asupan Oral Pajanan Mangan dalam Air terhadap Kesehatan Masyarakat Ashar, Taufik
Kesmas Vol. 2, No. 3
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Mangan yang secara alami dapat ditemukan di air, tanah, dan udara adalah zat nutrisi esensial bagi manusia dan hewan. Asupan yang tidak mencukupi atau yang berlebihan dapat gangguan kesehatan. Pajanan kronik mangan pada dosis yang tinggi dapat mengakibatkan gangguan pada sistem saraf. Tujuan penelitian ini adalah mengetahui perkiraan risiko kesehatan akibat asupan mangan dari air sumur di wilayah penelitian. Penelitian dengan disain crossectional ini dilakukan terhadap masyarakat di wilayah sekitar TPA Rawakucing yang meliputi masyarakat yang bermukim di dalam kawasan (114 orang), dan di luar kawasan TPA (177 orang). Hasil penelitian menunjukkan rata-rata konsentrasi mangan dalam air sumur di wilayah sekitar TPA Rawakucing (4.3 mg/l; SD=2.8873 mg/l). Berbeda sevara bermakna dengan di luar TPA Rawakucing (0.300 mg/l; SD=0.1888 mg/l). (nilai p<0.05). Rata-rata besaran risiko (RQ) gangguan kesehatan akibat mengkonsumsi air yang mengandung mangan pada masyarakat yang tinggal di TPA Rawakucing (0.2347) dan yang tinggal di luar TPARawakucing (0.2955). Masyarakat yang tinggal di TPA berisiko gangguan kesehatan 8,12 kali lebih bedsar daripada yang tinggal di luar TPA(p<0.05) dengan OR=8.109 (95% CI = 2.668-24.650). Manganese that can be found ubiquitously in the air, soil, and water is an essential nutrient for humans and animals. Inadequate intake or over exposure can cause adverse health effects. Although manganese is an essential nutrient at low doses, chronic exposure to high doses may be harmful. Regardless, the nervous system has been determined to be the primary target organ with neurological effects generally observed. The objective of the study is to assess the health risk of manganese exposure from the well drinking water intake. This study was done in Final Disposal Site Rawakucing area and outside of this area. The number of subjects were 114 who lived inside the site and 177 who lived outside the area, respectively. Study design is cross-sectional with hypotheses testing. The result showed that the average manganese concentration was 4.3 mg/l (SD=2.8873), 0.300 mg/l (SD=0.1888) respectively. The result was significant different statistically (p<0.05) for manganese concentration from two study area. The average RQ showed 0.2347 (SD=0.5095) for RQ in Disposal Site Area and 0.2955 (SD=0.2465) for RQ outside Disposal Site Area. The result was statistically significantly different (p<0.05) for RQ value, with OR=8.109 (95% CI = 2.668-24.650).
Faktor Risiko Tuberculosis Paru di Kabupaten Rejang Lebong Simbolon, Demsa
Kesmas Vol. 2, No. 3
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Di Kabupaten Rejang Lebong, sejak tahun 1995 telah dilaksanakan kegiatan pemberantasan TB Paru dengan strategi DOTS, tetapi penderita baru tetap di temukan dan memperlihatkan trend yang meningkat dari tahun ke tahun. Penelitian ini bertujuan untuk mengetahui faktor risiko yang berhubungan dengan kejadian TB paru BTA (+) di Kabupaten Rejang Lebong. Desain penelitian yang digunakan adalah disain kasus kontrol. Kelompok kasus adalah penderita TB Paru BTA (+) berumur >15 tahun yang berobat pada Oktober 2005 sampai Mei 2006. Kontrol adalah tetangga kasus yang tidak mempunyai tanda-tanda gejala klinis TB paru dengan golongan umur >15 tahun. Jumlah sampel sebanyak 50 kasus dan 50 kontrol dengan teknik stratified Random Sampling. Analisis data menggunakan metode regresi logistik ganda. Hasil penelitian menemukan bahwa faktor risiko kejadian TB Paru jika tidak pernah di imunisasi BCG (OR=2,855, P=0,048), ada sumber kontak (OR=2,263, P=0,046), luas ventilasi rumah kurang dari 10% luas lantai (OR=4,907, P=0,004), tidak ada cahaya matahari masuk ke rumah (OR=5,008, P=0,006), interaksi antara perilaku merokok dengan penghuni rumah padat serta keeratan kontak (OR=14,576, P=0,017). Faktor yang paling dominan adalah interaksi perilaku merokok dan penghuni rumah yang padat. Probabilitas seseorang mengalami TB paru dengan faktor risiko adalah 98%. Since 1995, eradication program of Pulmonary Tuberculosis with strategy of DOTS have been executed in Rejang Lebong District, but new patient remain to occur and showing tendency of increasing from year to year. The objective of this study is to know risk factor related to occurence of Pulmonary Tuberculosis BTA (+) in Rejang Lebong District. This research use case control study with comparison 1:1. Case is patient of Pulmonary Tuberculosis BTA (+) residing in working areas of Puskesmas Curup, Perumnas and Puskesmas Kampung Delima age >15 year, who seek medical treatment within October 2005 to May 2006, with exclusion criteria of not being relapsing TB patient. Control is neighbor of case who don’t have symptom of clinical Pulmonary Tuberculosis of the same age with cases. Research was conducted in May-July 2006 with 50 cases and 50 controls. Data analysis used in this study is multivariate logistic regression. The study has found that risk factor related to occurrence of Pulmonary Tuberculosis is not BCG immunized (OR=2.855, p=0.048), source of infection (OR=2.263, p=0.046), ventilation less than 10% of wide floor (OR=4.907, p=0.004), no sunlight into the house (OR=5.008, p=0.006), interaction between smoking behavior with house density, and closeness of contact (OR=14.576, P=0.017). The most dominant factor is interaction between smoking behavior with house density.

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