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Jurnal Manajemen Kesehatan Indonesia

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Published by Universitas Diponegoro

ISSN : 23033622 EISSN : 25487213. DOI : -

Core Subject : Health, Science,

Decision Sciences, Operations Research & Management Health Professions

Arjuna Subject : -

Articles 10 Documents

Search results for , issue "Vol 4, No 2 (2016): Agustus 2016" : 10 Documents clear

Analisis Implementasi Sosialisasi Pemberian Asi Eksklusif Oleh Bidan Praktek Swasta (BPS) Di Kabupaten Bengkulu Selatan Lela Hartini; Martha Irene Kartasurya; Susi Herawati
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 2 (2016): Agustus 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Profile of South Bengkulu district health office 2008 – 2009 did not include data on exclusive breastfeeding coverage. Private practice midwives (BPS) did not have standard operating procedure (SOP) in providing obstetric service. One of midwives duties was to provide exclusive breastfeeding socialization to pregnant women, childbearing mothers and community. The objective of this study was to analyze the implementation of exclusive breastfeeding socialization by BPS in South Bengkulu district. This study applied qualitative method and using in-depth interview as data collection technique. The main informant was 3 private practice midwives in the city area and 2 private practice midwives in the rural area. Triangulation was done to 5 head of puskesmas, chief of nutritional unit and head of Indonesian Midwifery Association (IBI). Focus group discussion was conducted to 3 mothers and 3 people in the community (family member of the patient) in each selected BPS. Results of the study showed that implementation of exclusive breastfeeding socialization variable was still limited to individual education and no education materials were provided. There was no communication among head of puskesmas, head of district health office and head of IBI towards BPS. BPS facilities were still insufficient to support the success of exclusive breastfeeding. Disposition had not supported exclusive breastfeeding coverage improvement. In the bureaucracy structure variable, there was no reporting format from BPS to puskesmas on exclusive breastfeeding socialization implementation in South Bengkulu district. It was suggested to district health office to formulate regulation policy in the form of decree regarding exclusive breastfeeding and to forbid collaboration between BPS and infant formula companies. Head of puskesmas had to do supervision and monitoring to BPS. Private practice midwives were expected to improve the frequency of exclusive breastfeeding socialization and to avoid collaboration with infant formula companies.

Pengembangan Sistem Pendukung Keputusan Untuk Mendukung Penegakkan Diagnosa TB Dots Di Rumah Sakit Aisyiyah Muntilan Susanti Susanti; Mateus Sakundarno Adi; Atik Mawarni
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 2 (2016): Agustus 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jmki.4.2.2016.123-128

Tuberculosis (TB) disease intervention is a national program and being a target of MDGs. Therefore, a government determined minimum service standards of a hospital that had to be implemented in all health service units and hospitals in Indonesia. A strategy of DOTS at Aisyiyah Hospital in Muntilan had been available particularly in terms of case finding. Notwithstanding, a process of patient diagnosis had not been implemented in accordance with a standard of human resource. Number of medical officers at a TB DOTS unit was not sufficient. In addition, quality of information like completeness, accurateness in diagnosis, and timeliness in reporting TB cases had not achieved a target. The aim of this study was to develop decision support system of TB as an effort to systematically diagnose and manage data of TB based on the standard. This was qualitative-quantitative research. A qualitative method was used to identify each step of information system development. Meanwhile, a quantitative method was used to assess quality of information between before and after developing information system using pre-experimental design (the one group pre and posttest design). Qualitative data were collected by conducting indepth interview, whereas quantitative data were collected using checklist. Data were analysed using T test. Research object was decision support system before and after applying at TB unit at Aisyiyah Hospital in Muntilan. Research subjects consisted of four TB officers as main informants. Informants for triangulation purpose consisted of head of SIMRS and head of medical services. The results of T test showed that variables of completeness, accurateness, and preciseness after developing the decision support system were better than that of before developing the system (p-value = 0.000). As suggestions, head of SIMRS needs to conduct further development of decision support system of TB in another unit particularly in inpatient unit. The decision support system needs to be evaluated and adjusted with the standard.

Upaya Pencegahan Perbedaan Diagnosis Klinis Dan Diagnosis Asuransi Dengan Diberlakukan Program Jaminan Kesehatan Nasional (JKN) Dalam Pelayanan Bpjs Kesehatan Studi Di Rsud Kota Semarang Faik Agiwahyuanto; Sudiro Sudiro; Inge Hartini
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 2 (2016): Agustus 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Percentage of clinical and insurance diagnosis differences at Semarang City Public Hospital tended to increase. If this condition remained, it would lead to upcoding (fraud). The aim of this study was to explain a process of clinical and insurance diagnosis at a hospital in the implementation of Healthcare and Social Security Agency (Health BPJS). This was a qualitative study. Main informants consisted of doctors at an emergency room, surgeons, and internists. Informants for triangulation purpose consisted of a Hospital Director, a hospital verifier, and a head of Medical Record Unit. Data were analysed using content analysis.The results of this research showed that there were any differences in clinical and insurance diagnosis at Semarang City Public Hospital. The cause of these differences was due to differences in diagnosis and medical treatment between medical service standard of doctors at the hospital and a standard of INA-CBGs. To prevent the differences of clinical and insurance diagnosis, the Semarang City Public Hospital had formed an internal verifier team of the hospital and a Clinical Micro System team. A medical committee had a role to minimise the occurrence of upcoding by multiplying kinds of Clinical Pathway as a reference for doctors in diagnosing and determining kinds of treatments for patients.The differences of clinical and insurance diagnosis must be equated to prevent the occurrence of upcoding and disadvantage of the hospital. Efforts to prevent these differences are by adding officers, training coding, making and multiplying algorithm of clinical pathway, forming a team of Clinical Micro System, and monitoring and evaluating medical services.

Evaluasi Sistem Informasi Manajemen Puskesmas Guna Mendukung Penerapan Sikda Generik Menggunakan Metode Hot Fit Di Kabupaten Purworejo Viera Juniver Thenu; Eko Sediyono; Cahya Tri Purnami
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 2 (2016): Agustus 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Purworejo District Health Office (DHO) has developed Health Center Management Information System (HCMIS) to provide quick, precise, and accurate information for supporting the process of decision making and the policy of services at Health Center. However, there was still any empty forms and did not use the system. To standardize Health Information System, Ministry of Health has released a concept of Generic SIKDA. Therefore, the system applied by Purworejo DHO needs to be evaluated using the method of HOT fit. This was qualitative research using indepth interview and direct observation. Main informants were nine data operators and informants for triangulation purpose was six persons from health centers and five persons from DHO. Furthermore, data were analyzed using content analysis. The result of this research revealed that the application of HCMIS at Purworejo DHO was equal to Generic SIKDA. The system had been applied routinely but there was no a guidance book and training. Number of human resources was sufficient. However, there needed to make an implementer team of Health Information System in accordance with competency. There was no routine monitoring and current budget was not sufficient to maintain hardware to support the system. Quality of the system used was good, easy to use, and available of menu to communicate data. Unfortunately, quality of resulted information had still been inaccurate and incomplete because it did not cover data of services at Subsidiary Health Centers (SHC) and Village Health Posts (VHP). The lateness of services was related to a funding procedure. HCMIS at Purworejo DHO was equal to Generic SIKDA but it had not been used to make a decision. As a suggestion, DHO needs to conduct training, monitor, and provide hardware and a network. Meanwhile, Health Centers needs to make a commitment for applying the HCMIS maximally by SHC and VHP.

Pengaruh Kualitas Jasa Dan Nilai Pelanggan Terhadap Minat Kunjungan Ulang Melalui Kepuasan Pasien Di Poli Umum Di RSISA Semarang Retno Kusniati; Naili Farida; Sudiro Sudiro
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 2 (2016): Agustus 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Patient’s satisfaction is one of the indicators in assessing a service quality at a hospital. Fluctuations in number of total visit of patients and declining trend of old patient visit number at a general polyclinic at Sultan Agung Islam Hospital (SAIH) in Semarang during the period of 2010-2013 indicated that there were any problems at the polyclinic. The aim of this study was to comprehensively analyse a service quality and customer value that influenced towards willingness to revisit through patient’s satisfaction at outpatient/general polyclinic at SAIH in Semarang.This was an explanatory study using cross-sectional approach and an analytic method. Population was all patients at outpatient unit/general polyclinic at SAIH in Semarang who had visited the polyclinic at least two times. As many as 125 respondents were selected as samples using a method of purposive sampling. Data were collected using a structured questionnaire and measured using Likert scales of 1-5 and analysed using SEM performed by software of Smart PLS 2.0. The results of this research showed that the service quality and the customer value positively significantly influenced patient’s satisfaction. In addition, the patient’s satisfaction positively significantly influenced willingness to revisit. The patient’s satisfaction could be explained by the service quality and the customer value equal to 45.3%. Meanwhile, willingness to revisit could be explained by the service quality, the customer value, and the patient’s satisfaction equal to 45.0%. Overall, the service quality and the customer value at the general polyclinic of SAIH in Semarang are good. Notwithstanding, there still needs improvement in timeliness of service, availability of accurate service information, consistent and polite officers, greetings, and smiling to patients in order to improve patient’s satisfaction and to increase willingness to revisit at the general polyclinic of SAIH in Semarang.

Faktor-Faktor Yang Mempengaruhi Motivasi Bidan Pelaksana Dalam Pelayanan Ibu Nifas Di Wilayah Kabupaten Blora Epi Saptaningrum; Sutopo Patria Jati; Anneke Suparwati
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 2 (2016): Agustus 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Maternal Mortality Rate mostly occurred during postnatal period. Midwives played an important role and had responsibility in providing maternal services. Postnatal services in Blora District had not been optimally implemented. This condition was influenced by motivation of midwives in providing postnatal services. Five of seven midwives said that they were lazy to provide postnatal services particularly in visiting maternal. Motivation was influenced by intrinsic and extrinsic factors. Therefore, factors influencing motivation of midwives in providing maternal services needed to be investigated. This was a quantitative-analytic study using cross sectional approach. Data were collected using a questionnaire. Number of population was 359 midwives in Blora District. Number of samples were 76 respondents calculated using minimal sample size. A validity test used pearson product moment whereas alpha Cronbach test was used to analyse reliability. Data were analysed using methods of univariate (Kolmogorov-Smirnov test), bivariate (Chi-Square test), and multivariate (logistic regression test). The results of this research showed that factors of perception of administration and policy (p=0.043; C=0.227), perception of supervision (p=0.001; C=0.346), perception of work (p=0.000; C=0.503) and perception of environmental condition (p=0.001; C=0.350) statistically significantly related to motivation of midwives. Perception of work was the most influenced factor of motivation (p=0.000; Exp(B)=11.655). As suggestions, other researchers need to investigate the factor of perception of work. District Health Office needs to evaluate main and additional tasks and to consider increasing incentive for activities of maternal services. Indonesian Midwives Association of Blora needs to guide and to improve motivation of midwives in providing maternal services. Health Centres (Coordinator Midwives) need to involve midwives in improving perception of work (maternal services) by conducting training.

Analisis Implementasi Program Perawatan Metode Kanguru (PMK) Dan Partisipasi Pasien Pada Pelayanan Kesehatan Bayi Berat Lahir Rendah (BBLR) (Studi pada Pasien di Rumah Sakit Mardi Rahayu Kudus) Nur Sri Atik; Sri Achadi Nugraheni; Kusyogo Cahyo
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 2 (2016): Agustus 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Kangaroo Mother Care (KMC) varies in each hospital. This condition can be viewed from the aspects of types of services, competency of human resource, facilities, and means. Implementation is a crucial step in the process of policy. Readiness and participation of parents will support the success of the KMC implementation. A role of family such as attitude, behaviour, and family participation is as a desire to protect a family member who is sick. This research aimed to identify the implementation process of factors of communication, disposition/attitude, resource, bureaucratic structure, and participation of patients and their families in KMC at Mardi Rahayu Hospital. This was qualitative research using in-depth interview and direct observation. Main informants encompassed 4 mothers who had Low Birth Weight (LBW) Babies. Meanwhile, informants for triangulation purpose encompassed 3 trained midwives, 3 trained nurses, and 3 trained paediatricians, nursing manager, and director of medical services. Furthermore, data were analyzed using thematic analysis in which data as the result of in-depth interview were analyzed in accordance with a theme. The implementation of KMC had not been done optimally. Regarding communication, there was no socialization of the program. Therefore, information of the KMC program was unclear, inconsistent. Regarding attitude/disposition of the program implementer, there was not only lack of support from all implementers in implementing the program but also lack of commitment. Regarding resource, there was lack of trained health workers, lack of facilities, and no sustainable fund for the program. Regarding bureaucratic structure, Standard Operating Procedure was needed to be revised and no clear job-sharing in KMC. Mothers had not participated in making decision, implementing, taking benefits, and evaluating yet. This was due to lack of information. As suggestions, the hospital needs to improve socialization of the program, provide implementation guidelines, and implement KMC followed by monitoring and supervising. In addition, the hospital needs to improve communication, information, education (CIE) for mother/family and provide opportunity for clients to implement KMC at the hospital before going home.

Faktor-Faktor Yang Berhubungan Dengan Kinerja Bidan Desa Sebagai Fasilitator Dalam Kegiatan Tabulin Dan Dasolin Di Kabupaten Sumenep Fitriah Fitriah; Ani Margawati; Atik Mawarni
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 2 (2016): Agustus 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

One of the efforts to decrease maternal mortality rate (MMR) was an implementation of a delivery planning and complication prevention program (P4K) in activities of delivery mother’s saving and social fund for delivery conducted by village midwives. The aim of this study was to analyse factors relating to performance of a village midwife as a facilitator in the activities of delivery mother’s saving and social fund for delivery on the P4K in District of Sumenep in 2014.This was an analytic-observational study using a cross-sectional approach. Independent variables consisted of age, marital status, education, knowledge, experience, motivation, and supervision and a dependent variable was performance of village midwives. Number of samples were 90 village midwives working at 30 health centres. Data collection used a structured questionnaire that had been performed tests of validity and reliability. Furthermore, data were analysed using methods of bivariate (Chi-Square test) and multivariate (Logistic Regression test). The results of this research showed that respondents had low performance (30%), young age (31.1%), not married (24.4%), low education (42.2%), low knowledge (35.6%), low experience (77.8%), low motivation (26.7%), and low supervision (24.4%) in managing the activities of delivery mother’s saving and social fund for delivery at their work areas. Variables of knowledge (p=0.019) and supervision (p=0.037) statistically significantly related to the performance of village midwives. These two variables jointly influenced the performance of village midwives with p values= 0.07 and 0.013 respectively. District Health Office, Health Centre, and Indonesian Midwives Association need to conduct training, workshop, or socialisation to village midwives regarding the P4K particularly the activities of delivery mother’s saving and social fund for delivery.

Kebutuhan Perawat Puskesmas Berbasis Analisis Beban Kerja Harisa Laraswatie; Tjahjono Kuntjoro; Sutopo Patria Jati
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 2 (2016): Agustus 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

A nurse’s necessity at a health centre viewed from workload analysis is required to identify a nurse’s necessities adjusted with service standards and real condition at a health centre. This requirement is in accordance with the change of an outpatient health centre status to be an inpatient health centre in which infrastructure and human resource need to be improved. This was a qualitative study using case study approach started from data collection, FGD, NGT, work sampling, to indepth interview with stakeholders who had experiences in calculating an employee’s necessities based on ABK and nurse representative. Furthermore, data were analysed using a form to calculate an employee’s necessities obtained from BKN. The results of calculation of a nurse’s necessities showed that number of nurses required for an inpatient unit were nine persons consisted of five skilled nurses and four expert nurses. This number was equal to nine beds that were required (1:1). On the other hand, number of nurses required for an outpatient unit including BP, UKM, and Pustu were 26 persons (16 skilled nurses and 10 expert nurses) or 1 nurse served 1,458 people or 456 families. Rembang 2 Health Centre needs to fulfil a nurse’s necessities by considering innovation of nursing services to reduce burden of human resource. A nursing committee needs to be formed by District Health Office as an institution that is responsible to supervise functional positions. Standards of nursing diagnosis and an information system of nursing care services need to be determined in order to describe an autonomy level of individual, family, group, and community in District of Rembang in terms of self-care. In addition, academics need to conduct further research regarding workload of other functional positions in health in order to achieve goals of national health development.

Analisis Kebijakan Donor Darah Dan Implementasi Program Rekrutmen Donor Di Unit Donor Darah (UDD PMI) Kota Pontianak Ria Risti Komala Dewi; Martha Irene Kartasurya; Atik Mawarni
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 2 (2016): Agustus 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

The availability of blood in Blood Donor Unit of Indonesian Red Cross (BDU-IRC) cannot fulfil the necessity of blood in Pontianak City for every year. Until the year 2014, there was only 37.3% of the total blood demand that could be provided. The aim of this study was to analyse problems of resource, attitude and commitment, a bureaucracy structure, communication, and social condition in implementing the blood donor recruitment program in BDU-IRC in Pontianak City.This was an observational study using a descriptive-qualitative design. Data were collected using methods of indepth interview, Focus Group Discussion, and observation. Main informants consisted of five P2D2S officers (a head of department and four staffs of P2D2S). Informants for triangulation purpose were 22 persons consisted of two decision makers, (a head of BDU and a deputy head of IRC), five coordinators of KDD, five persons of DDS, five persons of DDP, five citizen of Pontianak City. Data were analysed using content analysis.The results of this research showed that resource was quantitatively sufficient but it was qualitatively insufficient, particularly willingness of the officers in implementing their duties. Amount of budget was limited. There were a poor attitude and lack of commitment of the officers due to lack of willingness and low motivation to implement their duties in accordance with available regulations and goals. Not all the implementation was referred to Standard Operating Procedure released by the main office of IRC because the officers assumed that they had understood the ways to recruit blood donor. Communication was unclear and inconsistent. Support from blood donor groups was not optimal due to lack of attention and support from the program implementer such as supervising, providing rewards, and providing a supporting facility. In conclusion, the implementation of the blood donor recruitment program have not been well implemented. BDU-IRC needs to improve a competency of the officers by conducting training for untrained officers. The unit also needs to conduct a meeting to arrange a work program and a budget allocation annually. In addition, a community needs to be proactively asked to provide their blood to the IRC.

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