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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 7 Documents
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Search results for , issue "Vol. 4, No. 1" : 7 Documents clear
Makanan Etnik Minahasa dan Kejadian Penyakit Jantung Koroner Kandou, Grace Debbie
Kesmas Vol. 4, No. 1
Publisher : UI Scholars Hub

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Abstract

Penyakit jantung koroner yang menjadi kausa utama kematian di seluruh dunia merupakan masalah kesehatan masyarakat yang penting di seluruh dunia, termasuk Indonesia dan Sulawesi Utara. Kebiasaan makan yang dipengaruhi oleh faktor budaya, adat istiadat, agama dan kepercayaan berperan penting dalam proses kejadian penyakit. Penelitian ini bertujuan mengetahui pengaruh kebiasaan makan etnik Minahasa terhadap kejadian penyakit jantung koroner. Penelitian di RSU Prof. Dr. R.D. Kandou ini menggunakan disain studi kasus kontrol dengan ukuran sampel 128 kasus dan 128 kontrol. Data frekuensi makan dikumpulkan dengan Food Frequency Quationnaire (FFQ). Makanan etnik Minahasa ditentukan berdasarkan 41 jenis makanan yang dikompositkan. Asam lemak jenuh pada setiap jenis makanan etnik Minahasa umumnya mengandung ALJ dengan kisaran kadar 0,01-10,46% food per 100 gram. Pengkomsumsi makanan Mihahasa dengan frekuensi makan ≥ 2 kali/ bulan berisiko PJK 4,43 kali lebih besar daripada pengkonsumsi ≤ 1 kali/ bulan setelah dikontrol dengan variabel daging babi hutan(OR=4,3 95%CI:1,66-11,05), kotey(OR=7,15 95%CI: 1,70-30,08), merokok (OR=2,76 95% CI: 1,36-5,61), usia(OR=1,96 95%CI: 1,36-2,83), jenis kelamin(OR=2,86 95%CI: 1,41-5,78) dan hipertensi (OR=5,86 95%CI: 2,94-11,66). Kebiasaan makan dengan frekuensi sering berisiko 5,4 kali lebih besar untuk terkena PJK daripada yang mempunyai kebiasaan makan jarang setelah dikontrol variabel jenis kelamin, riwayat keluarga PJK dan diabetes. Coronary Heart Disease (CHD) is the leading cause of disability and mortality in the world, including Indonesia and North Sulawesi province. There are many factors that has contribution to the development of CHD. Food habit that influenced by culture and religion is known as a risk factor. The objective of this study is to know the effect of food habit and food variety of Minahasan to the risk of CHD. The methodology used in this research was case control, with respondents drawn from the Prof. Dr. R.D. Kandou General Hospital, Manado, North Sulawesi province. The samples were consisted of 128 cases of CHD and 128 controls of noncoronary heart diseases. Eating frequencies were collected through a Food Frequency Questionnaire (FFQ). Those who were eating “ babi putar ” (roasted pork) more than twice a month had potentially 4.43 times to develop CHD compare to those who were eating less than once a month controlled by consumption of “ babi hutan ” (wild boar) (OR=4,3 95% CI: 1,66-11,05), “ kotey/sa’ut ” (OR=7,15 95% CI: 1,70-30,08), smoking (OR=2,76 95% CI: 1,36-5,61), age (OR=1,96 95% CI: 1,36-2,83), gender (OR=2,86 95% CI: 1,41-5,78) and hypertension (OR=5,86 95% CI: 2,94-11,66). Those with food habit which include higher frequency of consumption of composite of “high risk” 41 Minahasan food items has 5.4 times higher risk to develop CHD compared to those who has lower frequency, after controlled by gender, family history of CHD and Diabetes Mellitus.
Pengaruh Kemiskinan Keluarga pada Kejadian Pneumonia Balita di Indonesia Machmud, Rizanda
Kesmas Vol. 4, No. 1
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Pneumonia merupakan penyakit infeksi saluran pernapasan akut yang menjadi kausa utama kematian balita. Di Indonesia, pada akhir tahun 2000, angka kematian balita akibat pneumonia diperkirakan 4,9/1000 balita. Faktor sosio-ekonomi berkontribusi besar terhadap penyakit saluran pernapasan. Tujuan penelitian ini adalah mengetahui faktor sosio-ekonomi yang paling berpengaruh terhadap pneumonia pada balita. Penelitian dengan dengan disain krosseksional ini menggunakan sumber data sekunder Benefit Evaluation Study (BES) II oleh Pusat Penelitian Kesehatan Universitas Indonesia bekerja sama dengan Proyek Intensifikasi Pemberantasan Penyakit Menular, Departemen Kesehatan. Sampel diambil berdasarkan multilevel statistical frameworkdari 7.170 ba-lita pada 10.900 rumah tangga di 27 kabupaten di tujuh provinsi. Metode analisis yang digunakan adalah multilevel logistic regression. Penelitian ini memperlihatkan bahwa sosio-ekonomi rumah tangga berperan secara bermakna terhadap kejadian pneumonia balita. Rumah tangga miskin berisiko lebih besar untuk terkena pneumonia. Pada keluarga miskin, risiko pneumonia yang lebih besar disebabkan oleh faktor kontekstual lingkungan yang buruk berupa pencemaran di dalam rumah yang dikontrol faktor komposisi status gizi (95% CI OR 4.05- 4.78). Kebijakan intervensi program P2ISPA disarankan lebih mengutamakan intervensi pada faktor kontekstual lingkungan buruk pencemaran dalam rumah tangga miskin. Pneumonia is an acute respiratory tract infection disease that becomes a major cause of death among under five years old children. In Indonesia, in 2000, pneumonia specific cause of death rate among under five children is predicted to be 4.9/ 1000. The socio-economic factor has significant contribution to respiratory tract infection. The objective of this study is to know the socioeconomic factor that affect pneumonia among under five children. The study uses cross sectional study design using secondary data of Benefit Evaluation Study (BES) II conducted by Centre for Health Research, University of Indonesia in collaboration with Intensification of Infectious Diseases Eradication Project, MOH-RI. The study sample is selected based on multilevel statistical framework from 7170 under five children in 10900 households within 27 districts in seven provinces. Analysis method used in this study is multilevel logistic regression. This study shows that the low level of socioeconomic status affect significantly the pneumonia occurrence among under five children. The risk of pneumonia among lower socioeconomic household is higher than that of the high socioeconomic household. It was found that the association was found for poor environmental factor including in-house hygienic condition after controlled by nutritional status. The pneumonia occurrence among under five children is more influenced by environmental factors than individual factors (compositional effect). It is suggested to prioritize intervention on environmental factors to eradicate respiratory tract infection.
Masyarakat Depok Memilih Fogging yang Tidak Dimengerti Krianto, Tri
Kesmas Vol. 4, No. 1
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Sampai kini, demam berdarah dengue masih menjadi masalah kesehatan yang utama di Kota Depok. Hal tersebut terlihat pada jumlah kasus yang terus meningkat dan semua kelurahan sudah berkembang menjadi daerah endemis demam berdarah dengue yang dapat dicegah dengan mengendalikan vektor. Upaya pembersihan sarang nyamuk PSN 3M Plus adalah teknologi yang disarankan untuk mengendalikan kejadian demam berdarah dengue, tetapi belum mendapat dukungan pelaksanaan dari masyarakat. Studi ini bertujuan untuk menggali informasi tentang pengetahuan, sikap dan praktek masyarakat dalam pengendalian vektor demam berdarah dengue di Kota Depok. Hasil studi menunjukkan bahwa pengetahuan dan partisipasi masyarakat dalam pengendalian vektor DBD masih rendah, dan lingkungan sosial berpengaruh sangat dominan terhadap keputusan masyarakat. Until now, dengue hemorrhaegic fever (DHF) is the major health problem in Depok City, number of cases was increasing, and nowadays all sub-district have DHF endemic areas. DHF can be prevented by vector control. PSN 3M Plus is the recommended technology, but the community has not been implemented it yet. This study aims to explore information about knowledge, attitude and practice in dengue control among the communities. Results of this study indicated that knowledge and community participation dengue vector control were still low, and social environment factor was the dominant factor influencing community decision.
Penilaian Kualitas Pelayanan Puskesmas dengan Model Donabedian: Studi Kasus Puskesmas di Kota Depok Ayubi, Dian
Kesmas Vol. 4, No. 1
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Perkembangan struktur sosio-demografi penduduk dan infrastruktur Kota Depok yang pesat berpengaruh terhadap masalah kesehatan yang semakin kompleks. Pada era desentralisasi, Dinas Kesehatan Pemerintah Kota Depok dituntut memberikan pelayanan kesehatan masyarakat yang berkualitas antara lain melalui pelayanan kesehatan tingkat primer di puskesmas. Penelitian ini bertujuan menganalisis mutu pelayanan puskesmas dan hubungan struktur dan proses terhadap hasil pelayanan puskesmas, kepuasan pelanggan. Survey di rumah responden dilakukan pada bulan Maret 2004, dalam wilayah kerja enam puskesmas kecamatan di Kota Depok. Populasi adalah semua penduduk yang bermukim di wilayah kerja Puskesmas Kecamatan se-Kota Depok. Sampel adalah 300 rumah tangga yang tersebar di setiap kelurahan wilayah kerja masing-masing puskesmas kecamatan dengan responden ibu rumah tangga. Analisis dilakukan dengan pendekatan Structure, Process dan Outcome berdasarkan penilaian pasien. Penelitian ini menemukan nilai median atribut mutu struktur, proses dan kepuasan pelanggan adalah 75; 71,4 dan 75,0. Variasi pada dimensi struktur lebih lebar daripada dimensi proses. Secara bersama-sama, ada hubungan statistik yang bermakna antara struktur dan proses terhadap hasil di puskesmas kecamatan di Kota Depok. Aspek atribut struktur pelayanan puskesmas yang dinilai pelanggan perlu perbaikan adalah kelengkapan sarana, sedangkan untuk atribut proses adalah waktu tunggu pendaftaran. Rapid growth of sociodemographic and infrastructure in Depok City has influenced the complexity of health problems. In the decentralization era, one of community health center function is to provide quality primary health care. The aim of this study is to assess quality of health services that was provided by sub-district community health center based on Donabedian Model (Stucture Process Outcome). Survey was conducted in six sub-district community health centers. Data were collected using questionnaires. Respondents were interviewed in their home during March 2004. Samples covered 300 households in six areas. Median of stucture, process and outcome atributes of health services is 75, 71.4 and 75.0. Variation of stucture attribute is wider than process attribute. This study found there is a statistically significant correlation between structure and process attributes to outcome (patient satisfaction) of community health center services. In the structure attribute, equipment or facility aspect of community health center is needed to be improved while for process attribute, it is the aspect of waiting time in admission.
Kinerja Bidan di Desa dalam Program Jaminan Pemeliharaan Kesehatan Masyarakat Miskin Husna, Arfah; Besral, Besral
Kesmas Vol. 4, No. 1
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Cakupan pelayanan kebidanan program Jaminan Pelayanan Kesehatan Masyarakat Miskin (JPKMM) di Kabupaten Aceh Selatan tahun 2006 yang belum mencapai target mengindikasikan kinerja bidan di desa dalam pelayanan kebidanan program JPKMM masih rendah. Penelitian ini bertujuan mengetahui kinerja bidan desa dan faktor-faktor yang berhubungan. Kinerja bidan desa diukur dengan melihat cakupan pelayanan kebidanan program JPKMM meliputi cakupan pemeriksaan kehamilan minimal 4 kali dan cakupan pertolongan persalinan. Disain penelitian yang digunakan adalah cross sectional dengan populasi seluruh bidan desa yang bertugas di Kabupaten Aceh Selatan tahun 2007. Sampel adalah bidan desa yang sudah bertugas minimal setahun yang berjumlah 104 orang. Disimpulkan bahwa sebagian besar kinerja bidan desa masih rendah (56%). Faktor-faktor yang berhubungan dengan kinerja bidan desa adalah: tidak adanya pesaing, adanya pembinaan, pengetahuan dan motivasi. Faktor-faktor yang tidak berhubungan dengan kinerja bidan desa adalah umur, status pernikahan, status kepegawaian (PNS/PTT), domisili, jumlah desa, sikap, imbalan, kemampuan dan pendidikan. Disarankan kepada Dinas Kesehatan untuk memberikan pembinaan yang lebih intensif kepada bidan desa dan memberikan penghargaan untuk meningkatkan motivasinya. Disarankan kepada bidan di desa untuk terus-menerus melakukan peningkatan pelayanan kepada pasien dan selalu menerapkan prinsip 3S (salam, senyum dan sopan) serta proaktif mendatangi pasien ke rumahnya untuk memberikan pelayanan kebidanan ataupun memelihara hubungan sosial yang baik. This research aimed to find out the performance of village midwife and its determinant factors. The performance of midwifery service within the Jaminan Pemeliharaan Kesehatan Masyarakat Miskin (JPKMM) program was measured by the coverage of antenatal care and coverage of trained birth attendance. The design of this study is cross sectional and data was analyzed using univariate, bivarite, and multivariate logistic regression. The population was all village midwives (137 persons) in Aceh Selatan District in the year 2007. The sample was village midwife who has at least one year work experience in a certain village and it consists of 104 persons. The result shows that the performance of village midwife is still low (56%). Multivariate logistic regression analysis confirmed that the dominant factor related to good performance were no competitor, good supervision, knowledge and motivation. Factors which not associated with performance were age, marital status, employee status, domicile, number of village to be covered, attitude, reward, and education. We recommend that the District Health Office must supervise intensively and giving more reward to improve work motivation. The village midwife should improve their quality of services and implement the 3S principle ( salam, senyum and sopan) and conducting home visit to provide maternal health services and to maintain good social relationship with the community.
Kepuasan Pasien dan Kunjungan Rumah Sakit Hafizurrachman, Hafizurrachman
Kesmas Vol. 4, No. 1
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Kepuasan pasien ternyata tidak selalu meningkatkan kunjungan pasien di fasilitas pelayanan kesehatan. Penelitian ini bertujuan mengetahui hubungan kepuasan pasien dengan jumlah kunjungan di rumah sakit. Penelitian ini menggunakan data primer survei pelayanan di rawat jalan dan rawat inap selama 9 periode pengukuran pada 2007 – 2009 dan data sekunder kunjungan rumah sakit pada periode yang sama, jumlah sampel adalah 125 pasien per periode yang diambil dengan metoda stratified random sampling. Analisis dilakukan secara analisis time series dengan metode tren kuadrat terkecil (Least Square Method ), analisis regresi sederhana dan analisis uji perbedaan tiga atau lebih rata-rata (Uji-Kruskal Wallis). Penelitian ini memperlihatkan tingkat kepuasan pasien berpengaruh terhadap variasi jumlah kunjungan dengan nilai nol pada rawat jalan dan sangat kecil pada rawat inap. Pada rawat jalan tingkat kepuasan pasien tidak berbeda untuk setiap periode, tetapi pada rawat inap berbeda. Terlihat perbedaan tingkat kepuasan pasien rawat jalan dan di rawat inap, tetapi secara statistik diketahui tidak terlihat perbedaan tingkat kepuasan antara jumlah kunjungan pasien rawat jalan dan rawat inap pada setiap periode pengukuran di suatu rumah sakit swasta di Tangerang tersebut. To improve services in order to increase patient satisfaction, does not necessarily means to cease the search for innovative effort to improve the quality of health service hospital. One way to know the value of customers is through customer satisfaction surveys. Based on the customer satisfaction survey it can be known what is the indicators of customer satisfaction and customer expectations, which in turn may increase the expected visit. The purpose of this re-search is to know the level of patient satisfaction in a private hospital in Tangerang in 2007 until 2009. Survey research design is used to find the differences between the level of satisfaction in out-patient and inpatient services during the 9 period of measurement in 2007-2009, and the secondary data of hospital visit in the same period. Number of sample is 125 patients per period taken with a stratified random sampling. Analysis done in time series analysis methods with the smallest quadratic trends (Least Square Method), simple regression analysis and Kruskal-Wallis test. The result is that the patient satisfaction level affect the number of visits for both types of patient. Among the out-patient, there is no difference found in the level of patient satisfaction among different periods, while the situation is contrary among the inpatient at a private hospital in Tangerang 2007-2009.
Indonesia Diagnosis Related Groups Rivany, Ronnie
Kesmas Vol. 4, No. 1
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Di Amerika dan Australia, Kelompok Diagnosis Terkait (Diagnosis Related Group’s ) (DRGs) adalah suatu cara mengidentifikasi dan mengelompokkan pasien yang mempunyai kebutuhan dan sumber yang sama dirumah sakit berdasarkan alur perjalanan klinis (Clinical Pathway ). Penyakit yang mempunyai co morbidity atau co mortality, disebut Casemixdan mempunyai kode yang memperlihatkan derajat keparahan kelompok penyakit sehingga secara linear akan mempengaruhi besaran biaya perawatan. Dengan demikian, pembayaran perawatan di rumah sakit akan dilakukan berdasarkan “kesembuhan“ (cost of treatment per diagnosis), dan bukan berdasarkan penggunaan pelayanan medis dan non medis (fee for services). Di Indonesia sampai kini belum ada model perhitungan biaya untuk pembayaran perawatan mulai pasien masuk sampai sembuh dan keluar rumah sakit berdasarkan diagnosis (cost of treatment per diagnosis). Pola pembiayaan yang digunakan di rumah sakit masih didasarkan pada fee for services. Dalam bentuk tesis, konsep Indonesia – DRG/ INA –DRG kami kembangkan di Fakultas Kesehatan Masyarakat Universitas Indonesia, mengacu pada Australian DRG. In America, and Australian, Diagnosis Related Groups, known as DRGs is a method to identify and classify inpatients that have the same resources within hospitals based on Clinical Pathway. It has numbering/coding system used like a menu for determining the cost. The co morbidity and/or co mortality of a di-sease is called the Casemix, where it has numbering/coding that shows the degree of severity, which the cost linearly increased. Therefore the financing is based on the in-patients’ ”recovery” (cost of treatment per diagnosis), and not based on the utility of the medical and non medical treatments (fee for services). One of the issues arise in Indonesia’s health financing system is that it does not have the costing model for health care financing, for inpatients from ad-mission to discharge (cost of treatment per diagnosis). Therefore the financing system used is based on fee for services. Using Australian DRG as reference, the concept of Indonesia–DRG / INA–DRG is developed by the researcher with Graduate Students in the Public Health and Hospital Administration Program, Postgraduate Studies Faculty of Public Health University of Indonesia, in Thesis.

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