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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 3 (2016): Desember 2016" : 10 Documents clear

Cost Of Treatment Tonsilektomi Di Instalasi Bedah Sentral Rsud Kajen Kabupaten Pekalongan Tahun 2015 Imam Prasetyo; Sudiro Sudiro; Chriswardani Suryawati
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 3 (2016): Desember 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Tariff of services at Kajen Public Hospital charged on general patients was calculated based on operational costs like cost of medical services, consumables, medicines, treatment class, and rental cost of surgery room. Unfortunately, all components of costs for tonsillectomy treatment had not been included. Determination of the tariff had not calculated indirectly costs. Tariff of tonsillectomy treatment at the Kajen Public Hospital at inpatient room based on a local regulation Number 1 year 2012 was Rp 3,275,000 for class 3 whereas tariff for claim of BPJS at the same class at a regional hospital type C was Rp 1,767,900. In this case, there was any difference between costs that had to be spent for tonsillectomy treatment and claim from BPJS. Each cost must be calculated in accordance with clinical pathway to determine unit cost in order to provide high-quality of services. The aim of this study was to figure out amount of unit cost based on clinical pathway on tonsillectomy diagnosis at the Kajen Public Hospital. This was an observational analytic study by conducting a case study at the Kajen Public Hospital. Clinical pathway was arranged through meeting of a drafting team. A calculation of unit cost was performed using a method of Activity Based Costing (ABC), determination of exceeding cost. The results of clinical pathway arrangement showed that steps of tonsillectomy diagnosis pathway were as follows: admission, diagnostic, therapy, and follow up. Unit cost of tonsillectomy diagnosis based on the ABC calculation was Rp 2,717,662. The results of cost recovery rate calculation demonstrated that CRR among general patients was 121% whereas among BPJS patients was 65%. It means that each general patient of the Kajen Public Hospital obtained surplus as many as 21% otherwise each BPJS patient obtained minus as many as 35%. Arrangement of clinical pathway and implementation of final clinical pathway could be used as quality control of the Kajen Public Hospital. The hospital management needs to trace costs, to monitor, and to evaluate the obedience of clinical pathway.

Analisis Pelaksanaan Program Stabilisasi Bayi Asfiksia Oleh Bidan di Puskesmas Kota Parepare Harima M; Martha Irene Kartasurya; Siti Fatimah
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 3 (2016): Desember 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Infant mortalities in Parepare City in South Sulawesi in 2014 were mostly caused by asphyxia (31%). The places of these mortalities with asphyxia occurred among infants aged less than or equal to 48 hours after birth were at health centres (46%) and at referral units (54%). This problem was due to unoptimal stabilisation program for asphyxia babies. The aim of this study was to analyse the implementation of the stabilisation program of asphyxia babies by midwives at health centres in Parepare City. This was a qualitative study. Main informants consisted of implementer midwives at health centres who had followed training of asphyxia management (10 persons). Informants for triangulation purpose consisted of coordinator midwives, heads of health centres, head of maternal and child health sections at Parepare City Health Office (CHO), and asphyxia babies’ families. Three health centres with the highest asphyxia baby mortality rate in Parepare City were selected. Data were collected by conducting indepth interview and analysed using a method of content analysis. The results of this research showed that the stabilisation program of asphyxia baby by midwives had not implemented two of six components namely components of blood sugar stabilisation and laboratory analysis. These condictions were due to communication aspects like lack of clarity and lack of information consistency about the program. Meanwhile, viewed from the aspect of disposition/attitude, there were lack of midwives’ commitments in implementing the program, lack of trained health officers, no specific budget, lack of facilities, and no mechanism of reporting and Standard Operating Procedure (SOP) for implementing the program. Parepare CHO needs to provide training for implementer midwives about stabilisation of asphyxia baby, to increase socialisation of the program to implementer midwives, and to arrange SOP and a report form.

Pengaruh Pelatihan Kepemimpinan Spiritual Terhadap Peningkatan Kinerja Ketua Tim Keperawatan Rumah Sakit Umum Daerah Kota Semarang Yunita Yudaningsih; Nico L Kana; Untung Sujianto
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 3 (2016): Desember 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Rumah Sakit Umum Daerah Kota Semarang merupakan rumah sakit milik Pemerintah Kota Semarang. Kinerja perawat merupakan bagian integral dalam meningkatkan mutu pelayanan yang diberikan rumah sakit, sehingga kinerja perawat harus selalu ditingkatkan. Tujuan penelitian ini adalah untuk menganalisis pengaruh pelatihan kepemimpinan spiritual terhadap peningkatan kinerja ketua tim keperawatan dalam memberikan pelayanan keperawatan di rumah sakit. Jenis penelitian adalah penelitian kuantitatif meggunakan design pre –post test with control group dengan cara melakukan intervensi, berupa kegiatan pelatihan dengan materi kepemimpinan spiritual pada kelompok eksperimen. Setelah dua bulan pelaksanaan pelatihan, dilakukan pengukuran kinerja ketua tim keperawatan, untuk melihat pengaruh kegiatan pelatihan tentang kepemimpinan spiritual terhadap peningkatan kinerja ketua tim keperawatan pada kelompok eksperimen. Cara pengambilan data kinerja ketua tim dengan menggunakan kuesioner yang diisi oleh perawat pelaksana. Populasi adalah seluruh ketua tim keperawatan dengan total sampling Analisis data menggunakan T test dengan Uji One Sample Kolmogorov-Smirnov Test untuk melihat pengaruh pelatihan terhadap peningkatan kinerja ketua tim keperawatan. Hasil penelitian menunjukkan rerata peningkatan kinerja ketua tim keperawatan pada kelompok ekperimen yang diukur sebelum pelaksanaan pelatihan, dengan nilai sebesar 58,66 dalam katagori kurang. Adapun setelah dilakukan pelatihan kepemimpinan spiritual terjadi peningkatan kinerja ketua tim keperawatan menjadi sebesar 77,04 dalam katagori baik. Dari analisis data mendapatkan dengan nilai mean (-43,422) artinya terjadi kecenderungan peningkatan kinerja ketua tim keperawatan yang cukup bermakna pada kelompok eksperimen, yaitu sebesar 43,422. Nilai tersebut menunjukkan bahwa pelatihan tentang kepemimpinan spiritual berpengaruh terhadap peningkatan kinerja ketua tim keperawatan Rumah Sakit Umum Daerah Kota Semarang.

Analisis Pelaksanaan Program Kemitraan Bidan dan Dukun Ditinjau Dari Aspek Input, Proses dan Output di Wilayah Dinas Kesehatan Kabupaten Fakfak Provinsi Papua Barat Elzina De Fretes; Hardi Warsono; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 3 (2016): Desember 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Number of midwives in Fakfak District in 2012 was 108 persons. Number of Traditional Birth Attendants (TBAs) was 191 persons consisted of 79 (41%) trained TBAs and 112 (59%) untrained TBAs. The TBAs had an important role in delivery process because number of them was higher than number of midwives. Therefore, coverage of delivery process helped by health workers had not achieved the target. This research aimed to analyze the implementation of the partnership program between midwives and TBAs viewed from the aspects of input, process, and output at Fakfak District Health Office. This was qualitative research with descriptive-explorative approach by conducting indepth interview. Subjects were midwives and TBAs who had been partnering. Data were analysed using a content analysis. The input aspect showed that: 1) Implementers, midwives and TBAs only knew partnership in helping delivery; 2) Specific allocation funds for the program was not available. The funds was from Operational Support for Health but it was still not sufficient; 3) Specific means for the program was not available. The current means is from health center and village polyclinic but it is still limited. Furthermore, the process aspect revealed that: 1) Program planning, midwives and TBAs collected data of pregnant women, maternal, postpartum women, and number of TBAs; 2) The implementation was not good because midwives were not available when needed by TBAs and there was difficult to access. Socialization for cross-program (community leaders and religious leaders) and internship for TBAs had not been done yet due to insufficient fund; 3) Recording and reporting especially about partnership activities had not been done yet and only used a form on a Maternal and Child Health report. Regarding the output aspect, as many as 195 (89%) from 219 TBAs had not been partnered. Coverage of K1, K4, and delivery process helped by health workers from 2011 to 2012 decreased gradually. As a suggestion, District Health Office and Health Center need to maintain partnership by recruiting midwives, providing means, allocating fund, socializing to community leaders, and funding TBAs’ daughter or grandchild to study midwifery.

Analisis Hubungan Faktor Internal Dan Eksternal Dengan Kinerja Bidan Desa Dalam Deteksi Dini Dan Penanganan Ibu Hamil Kekurangan Energi Kronik (KEK) di Kabupaten Grobogan Tahun 2015 Rosmala Kurnia Dewi; Sri Achadi Nugraheni; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 3 (2016): Desember 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Chronic Energy Deficiency (CED) is one of the causes of maternal and infant mortality indirectly. Maternal Mortality Rate (MMR) in Grobogan District increased gradually during the period of 2011 – 2012 from 26 cases (114.03/100,000 live births) to 34 cases (151.15/100,000 live births), and decreased sharply to be 22 cases (102.03/100,000 live births) in 2013. Meanwhile, Infant Mortality Rate (IMR) was 194 cases in 2011, rose dramatically in 2012 to be 240 cases, and declined sharply in 2013 to be 166 cases. Low Birthweight Babies (LBWB) was one of the causes of infant mortality because pregnant women suffered from CED during their pregnancies. The aim of this study was to analyse internal and external factors with performance of village midwives in conducting early detection and handling pregnant women with CED. This was an observational-analytic study using cross-sectional approach. Data were collected using structured questionnaires. Population was 243 village midwives at health centres in Grobogan District. As many as 71 village midwives were selected randomly using a technique of stratified random sampling. Data were analysed using analyses of bivariate (chi square test) and multivariate (logistic regression test). The results of this research showed that most of the respondents aged ranging from 20-35 years old (76.1%), had working period less than or equal to 6 years (53.5%), ever handled CED (81.7%). Variables of health facilities (p=0.001), fellow worker support (p=0.016), community support (p=0.001), leader support (p=0.0001) had significant relationship with the performance of village midwives in conducting early detection of pregnant women with CED. Factors jointly influencing the performance were health facilities (p=0.000; Exp(B)=25.395), and leader support (p=0.001; Exp(B)=10.278). As suggestions, health centres and District Health Office need to provide complete health facilities to improve performance of health workers in providing services.

Faktor-Faktor Yang Berhubungan Dengan Pemanfaatan Pelayanan K4 Oleh Ibu Hamil Di Wilayah Kerja Puskesmas Kabupaten Sumba Timur Tahun Kartini Pekabanda; Sutopo Patria Jati; Atik Mawarni
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 3 (2016): Desember 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Pada tahun 2011-2013 terjadi penurunan cakupan K4 di Kabupaten Sumba Timur dan hanya mencapai 44,7%, jauh dari target 85%. Hasil studi pendahuluan menunjukkan bahwa ibu hamil tidak mengetahui manfaat pelayanan K4 dan mempunyai kesulitan dalam akses pelayanan kesehatan. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan pemanfaatan pelayanan K4 oleh ibu hamil. Penelitianobservasional analitik ini menggunakan metode survey dengan desain cross sectional. Subjek penelitian adalah 96 ibu hamil yang dipilih secara multistage random sampling pada tingkat Puskesmas dan Desa. Pengambilan data dilakukan dengan wawancara menggunakan kuesioner terstruktur. Analisis bivariat dengan uji Chi Square dan multivariat dengan regresi logistik. Hasil penelitian menunjukkan 71,8% responden tidak memanfaatkan pelayanan K4, 66,7% pengetahuan kurang, 66,7% persepsi kurang terhadap pelayanan bidan, 52,1% tersedia sarana prasarana, 75,0% sulit untuk mencapai Puskesmas, 56,3% tidak tersedia biaya, 65,6% persepsi terhadap kebutuhan pelayanan K4 masih rendah. Ada hubungan positif antara pengetahuan (p=0,004), persepsi terhadap pelayanan bidan (p=0,004), sarana prasarana (p=0,444), kemudahan mencapai Puskesmas (p=0,001), ketersediaan biaya (p=0,006), persepsi terhadap kebutuhan (p=0,001) dengan pemanfaatan pelayanan K4. Tidak ada hubungan antara ketersediaan sarana prasarana Puskemas dengan pemanfaatan pelayanan K4. Faktor-faktor yang berpengaruh bersama-sama terhadap pemanfaatan pelayanan K4 adalah kemudahan mencapai Puskesmas (Exp-B=4,728, p=0,001) dan persepsi terhadap kebutuhan (Exp-B=4,177 p=0,001). Akses dan persepsi kebutuhan merupakan dua faktor utama dalam pemanfaatan pelayanan K4 di Kabupaten Sumba Timur. Disarankan Dinas Kesehatan untuk membangun Poskesdes di setiap Desa, agar pelayanan K4 lebih dapat dijangkau oleh ibu hamil.

Analisis Pengelolaan Obat Pasien BPJS Di Instalasi Farmasi Rumah Sakit Panti Wilasa Citarum Semarang Devina Eirene Mendrofa; Chriswardani Suryawati
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 3 (2016): Desember 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Bertambah banyaknya pasien BPJS menyebabkan rumah sakit harus mengatur efisiensi pengeluaran untuk pasien BPJS agar keuangan rumah sakit dapat berjalan dengan baik. Pengelolaan obat BPJS di Instalasi Farmasi Rumah Sakit Panti Wilasa Citarum mengalami kendala sehingga perlu dianalisa penyebab permasalahan pengelolaan obat BPJS dan bagaimana kebijakan rumah sakit dalam mengatasi permasalahan pengelolaan obat pasein sehingga penggeluaran biaya pasien BPJS tidak membengkak. Penelitian ini merupakan penelitian kualitatif dengan subjek penelitian 1 direksi, 1 kepala instalasi farmasi, 1 petugas gudang, 1 tim verifikator, dan 4 orang petugas farmasi. Variabel penelitian ini adalah perencanaan obat, pengadaan obat, pendistribusian obat, pengendalian obat dan kebijakan rumah sakit. Analisis data yang digunakan content analysis yaitu pengumpulan data, reduksi data, menyajikan data dan menarik kesimpulan. Hasil penelitian menunjukkan perencanaan obat sesuai dengan formularium rumah sakit dan fornas, perencanaan dan pengadaan berdasarkan ROP, dalam instalasi farmasi tidak membuat RPO (Rencana Pengadaan Obat), dan tidak melakukan pengelolaan persediaan dengan cara VEN-ABC. Obat BPJS memiliki lead time lebih lama dibanding obat reguler, sehingga perhitungan ROP obat BPJS dan reguler harus terpisah. Kepatuhan dokter menulis resep sesuai fornas BPJS belum 100%. Pemberian obat BPJS di rumah sakit panti wilasa citarum sesuai fornas. Direksi menentukan pemberian obat diluar fornas yang diresepkan dokter dengan mempertimbangkan apakah pasien memang membutuhkan obat tersebut dan adanya alternatif obat pengganti lain yang masuk BPJS, dan dengan melihat harga obat.Rumah sakit mengatasi perbedaan harga obat adalah dengan penghematan di bagian lain yaitu dengan mengefisienkan pengobatan, BHP, pemakaian alkes yang lebih murah. Penelitian ini merekomendasikan beberapa saran yaitu bagi rumah sakit agar membuat RKO, melakukan perhitungan analisa VEN-ABC, membuat sistem ROP baru untuk obat BPJS, dan membuat pedoman ketetapan untuk pemberian obat pasien BPJS yang diluar fornas.

Faktor-Faktor Promosi Kenaikan Jabatan, Efektifitas Pembagian Tugas dan Keadilan Pembagian Insentif Yang Mempengaruhi Kepuasan Kerja Terhadap Pegawai Dinas Kesehatan Provinsi Jambi Tahun 2016 Ayu Aztuty Tanjung; Sudiro Sudiro; Sutopo Patria Jati
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 3 (2016): Desember 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

To improve health development in Jambi Province, it needs to be supported by qualified human resource that can improve performance of employees. The decrease in performance might be caused by no work satisfaction among them. One of the problems faced by Health Office of Jambi Province was decreasing a level of work satisfaction among employees from time to time. Promotion, equity in sharing either financial or non-financial incentive, and sharing tasks equally needed to be done in order improve their work satisfaction. The aim of this study was to figure out the influence of promotion, effectiveness in sharing tasks, and equity in sharing incentive towards work satisfaction of employees at the Health Office of Jambi Province. This was an observational study using cross-sectional approach. Number of population was 277 employees of the Health Office of Jambi Province. Meanwhile, number of samples was 74 persons. Data were collected using a questionnaire and analysed quantitatively using methods of univariate, bivariate (a Chi Square test), and multivariate (a Logistic Regression test). The results of this research showed that more than half of the respondents were satisfied (56.8%), had perception of balanced promotion (50%), had good effectiveness in sharing tasks (55.4%), and felt equal in sharing incentive (51.4%). There were any significant relationships between these three variables and work satisfaction of the employees. The results of multivariate analysis demonstrated that variables of promotion (p=0.015) and equity in sharing incentive (p=0.151) jointly influenced work satisfaction of the employees. As suggestions, employees need to pay more attention to the factors of promotion, effectiveness in sharing tasks, and equity in sharing incentive.

Evaluasi Sistem Informasi Kesehatan di Provinsi Jawa Tengah Dalam Rangka Penguatan Sistem Informasi Kesehatan Nasional Endah Sri Lestari; Sutopo Patria Jati; Aris Puji Widodo
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 3 (2016): Desember 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Evaluasi SIK bertujuan untuk memastikan SIK berjalan secara efisien, mampu mengumpulkan informasi yang relevan dan berkualitas sebagai dasar pengambilan keputusan oleh pemangku kebijakan. Hasil penilaian SIK sangat dibutuhkan dalam meningkatkan kinerja SIK.SIK Provinsi Jawa Tengah merupakan sub sistem dari SIKNAS sehingga pengembangan SIK Provinsi Jawa Tengah akan berpengaruh terhadap penguatan SIKNAS. Tujuan dari penelitian ini adalah untuk mengevaluasi SIK di Provinsi Jawa Tengah dalam rangka Penguatan SIKNAS. Penelitian ini merupakan penelitian deskriptif evaluatif dengan pendekatan kuantitatif dan kualitatif. Subyek penelitian adalah 35 petugas SIK DKK dan enam petugas SIK Dinas Kesehatan Provinsi Jawa Tengah. Pengumpulan data kuantitatif melalui pengisian kuesioner, pengumpulan data kualitatif melalui FGD dan wawancara. Analisis data penelitian dilakukan dengan menggunakan perangkat Evaluasi SIK Provinsi yang merupakan modifikasi dari Assessment Tool HMN Versi 4.00. Modifikasi Assessment Tool HMN Versi 4.00 dilakukan dengan cara menghapus item pertanyaan yang tidak relevan dengan SIK di provinsi dan menambahkan item pertanyaan berdasarkan PP no 46/2016 tentang SIK. Hasil evaluasi terhadap tujuh komponen SIK, empat diantaranya dinilai “ada tapi tidak adekuat” yaitu komponen pengelolaan (54,7%), sumber daya (54,2%), sumber data (58%) dan manajemen data (41,3%). Sementara tiga komponen lainnya dinilai “adekuat”, yaitu komponen indikator (74,3%), produk informasi (71,3%) dan diseminasi dan penggunaan informasi (74,5%).Disimpulkan bahwa secara umum SIK Provinsi Jawa Tengah berada dalam kategori “adekuat”. Untuk meningkatkan pengelolaan SIK di Provinsi Jawa Tengah, direkomendasikan untuk membuat suatu standar tata kelola SIK sebagai acuan pengelolaan SIK di Provinsi Jawa Tengah. Evaluation of Health Information System (HIS) aimed at ascertaining the efficient implementation of HIS that could result relevant and high-quality information to be used as a basis of making a decision by a decision maker. The result of HIS assessment was needed to improve the HIS performance. HIS of Central Java Province was a sub-system of National Health Information System (NHIS) in which the development of HIS there would strengthen the NHIS. The aim of this study was to evaluate HIS in Central Java Province in order to strengthen NHIS. This was a descriptive-evaluative study using quantitative-qualitative approach. Research subjects were 35 HIS officers at District Health Office (DHO) and six HIS officers at Central Java Province Health Office. Quantitative data were collected by filling a questionnaire whereas qualitative data were collected by conducting FGD and indepth interview. Data analysis was performed using a software of Province HIS evaluation that was modified from Assessment Tool HMN version 4.00. Modification of Assessment Tool HMN version 4.00 was performed by deleting questions that were irrelevant with HIS at province and adding questions based on government regulation number 46/2016 about HIS. The results of evaluation of seven components of HIS, four of these seven components indicated “available but inadequate”, namely components of management (54.7%), resource (54.2%), data source (58%), and data management (41.3%). In contrast, three of these seven components were “adequate”, namely components of indicator (74.3%), information product (71.3%), and dissemination and use of information (74.5%). To sum up, generally HIS of Central Java Province was categorised as “adequate”. To improve HIS management in Central Java Province, a standard of HIS management needs to be made as a reference to manage HIS in Central Java Province.

Pengembangan Sistem Informasi Pemantauan Alat Kesehatan Untuk Mendukung Penjaminan Mutu Pelayanan Kesehatan Di Balai Kesehatan Indera Masyarakat (BKIM) Provinsi Jawa Tengah Hamdan Syah Alam; Sudiro Sudiro; Cahya Tri Purnami
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 3 (2016): Desember 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

An information system of monitoring health equipment at Balai Kesehatan Indera Masyarakat (BKIM) in Province of Central Java was very simple. The available system had not resulted complete, accurate, and well-timed information in accordance with the needs of management to monitor health equipment in all health service rooms. The aim of this study was to develop an information system of monitoring health equipment to support quality assurance of health services at BKIM in the Province of Central Java. This was a qualitative-quantitative study using Pre-Experimental design with one group pretest-posttest approach. Data were collected using methods of observation and interview. Furthermore, qualitative data were analysed using content analysis whereas quantitative data were presented descriptively using a balanced average value. The result of this study showed that a balanced average value before developing the system was 37.73 and after developing the system was 78.90 with the difference equal to 41.17. There needs commitment and support from the head of BKIM in Central Java Province. Implementation of the developed system needs to be continually monitored. Socialisation and training needs to be conducted for all employees who have main tasks and functions relating to health equipment. In addition, budget for operational costs and system maintenance needs to be allocated.

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