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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 373 Documents

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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.

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.

Pengembangan Instrumen RDQA Untuk Surveilans Epidemiologi DBD Di Dinas Kesehatan Kota Tarakan Haikal Haikal; Martini Martini; Eko Sediyono
Jurnal Manajemen Kesehatan Indonesia Vol 7, No 1 (2019): April 2019
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

In 2016 from 7 Puskesmas in Tarakan City, 4 (four) Puskesmas (58%) sent their reports above the 5th of each month. There is still a mismatch of the number of source data with the results of recapitulation such as the number of DHF cases in Tarakan DHO with the number of DHF cases in the Ministry of Health Republic of Indonesia SKDR as well as the incompatibility of the reporting format by recording surveillance staff. The purpose of this study was to develop a Routine Data Quality Assessment (RDQA) instrument for DHF Epidemiological Surveillance in Tarakan City Health Office. The type of research used is Research and Development. The total subjects of the study were 9 people with details of 7 data management officers in the Puskesmas in the Tarakan DKK working area and 1 person in charge of the DHF Program in Tarakan DKK. The steps in this study, namely: (1) Potential and problems, (2) Data Collection (3) Product Design (4) Design Validation (5) Design Revision (6) Product Trial (7) Product Revision (8) Trial Use. The results of this study are that data quality assessment instruments have been developed according to RDQA and routine data quality assessments by the Ministry of Health with R & D research methods modified with eight indicators namely timeliness, data availability, data completeness, monitoring and evaluation unit capabilities, reporting indicators and guidelines, data collection and reporting format, data management process, linkages with the national reporting system and the use of data for decision making. The results of the assessment of the instruments developed, namely the aspect of content feasibility has an average value of 81%, the feasibility aspect of presentation is 78% and language assessment aspects 81%. Based on the results of the assessment of the three aspects assessed in the development of the RDQA instrument, a good conclusion is reached, but there are general recommendations given both by the Chair of the DHF Program in the DHO and the Epidemiological Surveillance Data Management Officer in DHO and Puskesmas, namely the use of modules and manuals RDQA instrument.

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.

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.

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.

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 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.

Penilaian Usability Sistem Gasurkes “Go Bumil” untuk Pencarian Ibu Hamil di Wilayah Kota Semarang Undari Nurkalis; Kusworo Adi; Farid Agushybana
Jurnal Manajemen Kesehatan Indonesia Vol 7, No 1 (2019): April 2019
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

The Gasurkes System "Go Bumil" is an application system developed to improve the search performance of pregnant women by village level maternal and child health surveillance officers in the Semarang City area. Usability evaluation on the "Go Bumil" application system needs to be done to find out the usefulness of the application system for users.This type of research uses a pre-experimental design in a single group. Data collection used the PSSUQ questionnaire (Post Study System Usability Questionnaire). The research subjects were 12 respondents from urban KIA gasurkes, 104 respondents to pregnant women and postpartum mothers. The object of research is the "Go Pregnancy" application. Data processing methods use descriptive analysis using a weighted average.The results of the usability evaluation of the "Go Bumil" application with respondents to KIA gaskes, pregnant and postpartum mothers as a whole were satisfied with the application system developed. The overall results of the overall assessment on kelurahan gas, pregnant women and postpartum mothers in the category of system usefulness = 6.02 (range values 6.00 - 6.99 state respondents agree), information quality = 5.99 (range of values 5, 00 - 5.99 states the respondent somewhat agrees), interface quality = 5.99 (range values 5,00 - 5,99 state respondents somewhat agree) and overall satisfaction = 6.01 (range values 6,00 - 6,99 state respondent agreed). Based on the evaluation of the system usefulness, information quality, interface quality and overall satisfaction categories, it can be concluded that the respondents were satisfied with the "Go Bumil" application.

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.

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