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Jurnal Manajemen Pelayanan Kesehatan
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Articles 18 Documents
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PENINGKATAN KUALITAS PELAYANAN TUBERKULOSIS DI RUMAH SAKIT DI INDONESIA: PEKERJAAN YANG BELUM SELESAI Probandari, Ari
Jurnal Manajemen Pelayanan Kesehatan Vol 16, No 01 (2013)
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MOTIVASI DOKTER DALAM PENULISAN RESEP DI RUMAH SAKIT RISA SENTRA MEDIKA, MATARAM Dumilah Ayuningtyas, Emma Aprilia
Jurnal Manajemen Pelayanan Kesehatan Vol 16, No 01 (2013)
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Backgroud: Selection process and selection of drugs shouldbe done rationally and follow the guidelines by the World HealthOrganization. However, 70% of prescriptions at Risa HospitalMedical Center.Aim:This study aims to explore physician motivation in writingprescription.Methods: The research was conducted with a qualitativeapproach. Primary data obtained f rom interviews andobservations and were equipped with a document review asa from of triangulation.Result: Motivation of physicians in prescribing was influencedby many factors, such as, the diagnosis of diseases, financialcondition of the patient, and rewards from the pharmaceuticalindustry. Remuneration from pharmaceutical industry provideda strong influence on physician in writing prescription.Conclusion: External rewards from pharmaceutical industryis the most inf luential factor. Increasing rewards andpunishments are needed to improve motivation of physician inwriting prescription according to drug formulary.Keywords: motivation, formulary, prescription, physician.
MINAT PENGGUNAAN PERANGKAT LUNAK PENGHITUNGAN BIAYA STANDAR PELAYANAN MINIMAL KABUPATEN/KOTA Ali Ghufron Mukti, Firdaus Hafidz
Jurnal Manajemen Pelayanan Kesehatan Vol 16, No 01 (2013)
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Background: The Indonesian Ministry of Health developed adistrict essential health package (EHP) costing software in2009. However, this has not yet been utilized due to poordissemination. It is necessary to conduct a study evaluatingthe opinion of health professionals towards intention to usethis software and ensure its usefulnessAim: This paper aims to assess user acceptance of districtEHP costing software by integrating Technology AcceptanceModel (TAM) and End User Computing (EUC) satisfaction.Method: A descriptive study was used. A total of 139respondents were involved in this study. They were policymakers and budget analysts of EHP in district health offices,and also primary health care workers and district hospitalworkers in all districts of Yogyakarta. Data were collected toassess the perceived usefulness, ease of use, content, format,accuracy, timeliness, attitude toward use and behavioralintention to use. Path diagram analysis was conducted.Result: The study showed that the respondents have theintention to use the EHP software. Usefulness and satisfactionhad the greatest positive influence on higher intention to useEHP costing software and were found to be statisticallysignificant, (0.29 and 0.22 respectively). Both the usefulnessand ease of use had positive influence on attitudes, (0.45 and0.23 respectively). Ease of use, content, accuracy andtimeliness gave a positive effect to satisfaction.Conclusion: Intention to use the EHP costing software wasmostly driven by perceived usefulness and satisfaction.Adequate human resources and hardware need to be in placefor its implementation.Keywords: essential health package, costing software,intention to use
ANALISIS BIAYA JAMINAN KESEHATAN MASYARAKAT DAN ASURANSI KESEHATAN PADA PASIEN STROKE NON-HEMORAGIK DI RUMAH SAKIT UMUM DAERAH KABUPATEN SLEMAN Iwan Dwiprahasto, Manna
Jurnal Manajemen Pelayanan Kesehatan Vol 16, No 01 (2013)
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Background: Non-hemorrhagic stroke causes many deaths.Its treatment requires long-term care, resulting in very highcost. Controlinging costs and quality are very important in maintainingsustainability, however, in reality there are cost sharingby patients and hospitals outside the insurance coverage.Aim: This study aims to identify the difference in cost thatmust be shared to the patient and the hospital for inpatientnon-hemorrhagic stroke of the Jamkesmas and Askes patientsin Sleman Hospital.Method: This study used a cross ssectional design. Datawere retrieved retrospectively with a primary diagnosis ofnon-hemorrhagic stroke hospitalizations for patients admittedto the hospital during the period of January 2011 to May 2012.Data were analyzed using univariate, bivariate correlation,and multivariate.Result: The average cost of inpatient care non-hemorrhagicstroke Jamkesmas patients was Rp3.541.021,00 +Rp2.609.488,00 and for Askes patients Rp4.678.509,00 +3.257.816,00. The average cost sharing in Askes patients isRp.1.851.536,00 + 1.968.757,00 and Jamkesmas isRp405.976,00 +Rp2.303.903,00. Percentage the greatest costcomponent in Askes patients is drugs (47%) and accomodation(44%), while in Jamkesmas is drug (52%) and accommodation(36%). Components of the cost sharing in Askes patients wasdrug (87%). The difference in the cost of hospital rates wasgreater than INA-CBGs respectively Rp3.541.021,00 +Rp2.609.488,00 and Rp3.135.045,00 + Rp727.710,00.Conclusion: The proportion of costs covered by the insuranceand shared by patient/hospital is 87:13 for Jamkesmaspatient, 55:45 for Askes patients (January 2011-May 2011),and 59:41 for the Askes patients (June 2011-May 2012). Theproportion of cost sharing of inpatient care non-hemorrhagicstroke by Askes patients outside the program is greater thanthe proportion of costs sharing by the hospital on Jamkesmasprogram.Keywords: cost sharing, Askes costs, Jamkesmas costs,non-hemorrhagic stroke patient
RESPON PEMIMPIN RUMAH SAKIT TERHADAP PENERAPAN AKREDITASI RUMAH SAKIT KARS VERSI 2012 Viera Wardhani, Euis Komala Restiawati, Achmad Rudijanto
Jurnal Manajemen Pelayanan Kesehatan Vol 16, No 01 (2013)
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Background: The role of hospital leader is key for thesuccessful implementation of KARS version 2012 accreditationwhich puts patient safety as the focus of hospital management.Aim: This study aimed to explore the understanding andresponses of hospital leades toward hospital accreditation2012.Method: This was a qualitative research design using casestudy. Data were gathered through 1) semi structuralquestionnaire interview of Hospital Director, Nursing Chief andCoordinator of Care Services (3 informants); 2). directobservation at medical services activities, patient transfer,Medical Support Services, patient’s identity writing and patientsidentification on treatment; and 3) data obtained from minutesof meeting, Standard Operational Procedure, policy, patient’sdocument related with standard implementation of hospitalaccreditation.Result: Accreditation preparation at this hospital used a topdown approach with limited dissemination. Director’sunderstanding limited to the purposes, scoring method andassessed chapter, meanwhile the Nursing Chief only mentionedthe quality improvement purposes and care, and Coordinatorof care stated quality improvement accreditation. The leaderhas not built a structured planned for overall hospital activity,but only reactive responses. In the service level there is onlya minor change found. For example writing patient identitydiffers in each unit, hand washing practice has no properstandard operational procedure, and hand washing facilitywas not available in every patient bed.Conclusion: There is a gap of understanding and responseson accreditation due to unstructured preparation. Responseswere only on hand washing aspect and personal identity.There is still no written policy on implementation of KARS 2012accreditation.Keywords: accreditation, hospital leader, understanding andresponses, KARS 2012 accreditation
BIAYA PELAYANAN HEMODIALISIS PESERTA ASURANSI KESEHATAN MENURUT PERSPEKTIF PASIEN DI RUMAH SAKIT UMUM DAERAH TIPE B, PROVINSI BALI Adi Utarini, G.N Catur Wiguna Riris A. Ahmad
Jurnal Manajemen Pelayanan Kesehatan Vol 16, No 01 (2013)
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Background: Chronic Kidney Disease has become a largeburden of public healthcare in many countries. Incidence andprevalence of patients requiring hemodialysis has increasedcontinuosly and hemodialysis is also high cost. Since healthinsurance takes a bigger role in financing health care, theperspective of insurance and patient are needed to beleaderstood.Aim: The aims of this study were to describe cost ofhemodialysis covered by Askes and out of pocket, and toidentify factors related to hemodialysis costs.Method: Cross sectional study was carried out. Subjectswere 51 Askes patients receiving hemodialysis treatment intype B public hospital Bali Province. A quesionaire was used tocollect data. Descriptive statistic analysis was carried out todescribe the dependent and independentvariables, followedby a linear regression to identify corelation among dependentand independent variables.Result: Average cost of hemodialysis in Askes patient wasRp62.543.379,08 per person per year. Average costs ofhemodialysis covered by PT. Askes and out of pocket wereRp56.501.237,90 and Rp6.042.141,18 respectively. Distancesfrom patient’s house to hospital was significant to predict 11,1%of hemodialysis cost from out of pocket. Frequency ofhemodialysis was significant to predict 12,4% of hemodialysiscost covered by Askes.Conclusion: Distances from patient’s home to the hospital isrelated to out of pocket cost, while frequency of hemodialysisis related to hemodialysis cost covered by Askes.Keywords: cost of hemodialysis, insurance cost, out of pocket,patient perspective
KOORDINASI PELAYANAN KESEHATAN PENGUNGSI BENCANA GUNUNG MERAPI Yodi Mahendradhata, Enik Listyaningsih Fransiska Meyanti Sitorus
Jurnal Manajemen Pelayanan Kesehatan Vol 16, No 01 (2013)
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Background: The eruption of Mount Merapi in Yogyakartahas caused dangerous impact to the people’s health. It is importantto provide a good health care services during emergencyresponse. Maguwoharjo is a shelter with the largestnumber of refugees, but health care staff are not well distributed.The coordination on health care service is important toovercome the health problems during emergency response.Aim: To describe effetiveness of coordination of care providedfor the refugees.Methods: This was a qualitative study using in-depth interviewsmethod to collect data. The informants were representativesfrom Yogyakarta provincial health office, Sleman districthealth office, primary health care center of Depok, NonGovernment Office/NGO, and former refugees. To ensure thevalidity of data, triangulation was carried out.Results: The coordination of health care service to refugeesis studied from its communication and organization. The communicationwas done by regular meetings in the morning andin the afternoon involving shelter’s coordinator, volunteer’scoordinator, and representative from both provincial and districthealth office. Not only by the regular meeting, but also byusing SMS gateway and skype (internet-based). There wasalso a hierarchial structure to organize all health care staffand their responsibilities during emergency response. Untilend of the evacuation, there was no outbreaks, incidence ofdisease was decreased, and infectious diseases were controlled.However, health care personels and adequate facilitieswere lacking, and standard operating procedure to providegood health services to refugees was not available.Conclusion: The coordination of health services for refugeesduring the emergency was effective but still needs toimprove information and use of SOP.Keywords: effectiveness, coordination, health care, refugees
FAKTOR-FAKTOR YANG MEMPENGARUHI RUJUKAN BALIK PASIEN PENDERITA DIABETES MELLITUS TIPE 2 PESERTA ASURANSI KESEHATAN SOSIAL DARI RUMAH SAKIT KE DOKTER KELUARGA Julita Hendrartini, Asri Wulandari Gatot Subroto
Jurnal Manajemen Pelayanan Kesehatan Vol 16, No 01 (2013)
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Background: Increased number of Askes insurance memberswith type 2 diabetes mellitus (DM) may have an impact of costof health care. Since 2010, PT Askes (Persero) implementedthe Chronic Disease Management Programme (Prolanis),especially for type 2 DM disease. However, back referral frominternal medicine specialist to primary care physician was notwell implemented.Aim: This study aims to identify perceptions of internal medicinespecialist and patients affecting implementation of back referralfor patients with type 2 DM from the hospital to primary carephysician.Method: A qualitative study was employed, using in-depthinterviews, observation and focus group discussions. In-depthinterviews were conducted with eight internal medicinespesialists in three hospitals in Kudus district and two primarycare physicians. Focus group discussions were conductedwith four groups of patients with type 2 DM, and observationwas made to describe the working environment at the hospital.Result: This study found that implementation of back referralswere influenced by physicians’ workload at the hospital,perceived competence of primary care physician, lack ofcommunication and coordination between the specialists andprimary care physicians, as well as patient demands towardspecialist doctor. Patients felt that access to a specialist doctorwas limited due to referrals made by the primary physicians.Conclusion: Both the internal medicine specialists and patientsfactors affect poor implementation of back referrals, despitetheir perceived understanding of the importance.Keywords: back referral, Askes insurance members, type 2diabetes mellitus, qualitative study
BIAYA SATUAN POLIKLINIK IBU DAN ANAK SEBAGAI USULAN PENETAPAN SUBSIDI DI RUMAH SAKIT IBU DAN ANAK Julita Hendrartini, Devi Purnama Sari M. Arifa’i
Jurnal Manajemen Pelayanan Kesehatan Vol 16, No 01 (2013)
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Background: Funding is a very important aspect to improvequality of services and sustainability. The calculation per unitof service at the hospital is required to determine the amountof subsidy from the government.Aim: To calculate of unit cost and operating cost subsidiesand to explore stakeholder opinions toward the calculation inmaternal and child hospital, Government of Aceh.Method: The study used a descriptive case study design.Data processing referred to the calculation of unit cost byusing Activity Based Costing (ABC) through two steps of directtracing and driver tracing.Results: The average cost of direct cost is Rp13.616,00. andthe driver cost is Rp2.421,00 and the unit cost is Rp20.046,00.The highest unit cost is Rp38.343,00 for implant removalservice. The total subsidy required by this hospital in 2012amounted to Rp1.019.946.211,00.Conclusion: Costs produced per unit of service are greaterthan tariff. Stakeholders strongly support the calculation ofunit costs and will use the information for proposing subsidyto the Government of Aceh.Keywords: unit cost, activity based costing, subsidies
PENINGKATAN KUALITAS PELAYANAN TUBERKULOSIS DI RUMAH SAKIT DI INDONESIA: PEKERJAAN YANG BELUM SELESAI Probandari, Ari
Jurnal Manajemen Pelayanan Kesehatan Vol 16, No 01 (2013)
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