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"Dalam rangka meningkatkan mutu pelayanan kesehatan masyarakat perlu didukung oleh jenis tenaga yang tersedia, obat, alat kesehatan dan sarana penunjang lainnya, proses pemberian pelayanan, dan kompensasi yang diterima serta harapan masyarakat pengguna. Selanjutnya proses pemberian pelayanan ditingkatkan melalui peningkatan mutu dan profesionalisme sumber daya kesehatan. Pada tahun 1992 Departemen Kesehatan telah mengeluarkan buku Pedoman Pengobatan Dasar di Puskesmas yang memuat uraian tentang standard terapi yang harus diperhatikan dan dilaksanakan oleh seluruh dokter Puskesmas dalam melaksanakan pelayanan pengobatan.Dari hasil survey pendahuluan diketahui hampi 80 % dokter Puskesmas tidak mematuhi pedoman pengobatan. Berdasarkan hal tersebut dilakukan penelitian sejak bulan September sampai bulan Oktober 2002, dengan pendekatan kuantitatif secara pengamatan (observasional) dengan dasar potong lintang (cross sectional) yang menggunakan sampel total populasi sebanyak 44 orang dokter Puskesmas di kota Jambi, dengan tujuan mengetahui gambaran kepatuhan, faktor-faktor yang berhubungan dengan kepatuhan dokter Puskesmas terhadap penerapan pedoman pengobatan dalam penggunaan antibiotika.Hasil penelitian menunjukkan bahwa 25 dokter Puskesmas (56,8 %) kurang patuh, sedangkan sisanya 19 dokter Puskesmas (43,2 %) patuh. Dari hasil uji Chi Square diketahui bahwa sikap dan persepsi dokter Puskesmas, supervisi dan ketersediaan obat di Puskesmas berhubungan bermakna dengan kepatuhan dokter Puskesmas terhadap penerapan pedoman pengobatan dalam penggunaan antibiotika. Dokter Puskesmas yang mempunyai sikap negatif tehadap pedoman pengobatan akan berpeluang kurang patuh 4,4 kali dari yang mempunyai sikap positif dan dokter Puskesmas yang memiliki persepsi kurang kondusif terhadap pedoman pengobatan akan berpeluang kurang patuh 7,2 kali dari yang memiliki persepsi kondusif. Supervisi yang kurang baik oleh atasan akan berpeluang dokter Puskesmas kurang patuh 8,6 kali dari supervisi atasan yang baik, sedangkan dokter Puskesmas yang memiliki ketersediaan obat tidak cukup akan berpeluang kurang patuh 20,5 kali dari yang memiliki ketersediaan obat cukup.Berdasarkan hasil tersebut terdapat beberapa saran untuk dinas kesehatan kota Jambi menyusun pedoman pengobatan yang bersifat lokal yang melibatkan seluruh dokter Puskesmas dengan melakukan penyesuaian Pedoman Pengobatan dari Departemen Kesehatan, mengkomunikasikan dan mensosialisasikan penggunaan pedoman pengobatan, melaksanakan lokakarya dengan tujuan tergalangnya kerja sama antar tenaga kesehatan, menyusun perencanaan obat menggunakan metoda morbiditas akan menghasilkan jumlah obat mendekati kebutuhan riil untuk masing-masing penyakit pada populasi, serta meningkatkan peran dinas kesehatan kota melakukan supervisi. Untuk dinas kesehatan propinsi Jambi perlu melakukan bimbingan teknis secara periodik tentang penggunaan dan pengelolaan obat di puskesmas, serta peran dokter Puskesmas menulis resep sesuai dengan standard terapi yang ada dan mengikuti kaedah penulisan resep yang lengkap. Saran untuk peneliti lain melakukan penelitian tentang dampak kemungkinan terjadinya resistensi kuman terhadap antibiotika Ampisilin, Arnoksisilin dan Tetrasiklin akibat pemberian yang tidak sesuai dalam interval waktu dan lama pemberian.

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Analysis Of Health Center Staff's Compliance On Therapy Guidelines In Antibiotics Use In The Municipality Of Jambi, 2002In order to maintain the quality of public health service, available human resource, medicines, medical equipments, other supporting facilities, health delivery process, received compensation, and community, as user should be provided. Then, the health delivery process can be enhanced through quality improvement and professional health resources. In 1992 the Ministry of Health had published Primary Therapy Guidelines for Health Center that contains the explanation about standard of therapy that should be noticed and be conducted by all health staff in delivering therapy.From the preliminary survey, it was found that almost 80% of the health center staff (doctors) did not adhere to the therapy guidelines. Based on that matter, the study about the health center staff's compliance was conducted from September to October 2002. The study employed an observational quantitative approach as with cross sectional method and covered a sample of 44 doctors who work at health center in the Municipality of Jambi. The objective of this study was to find the description of compliance and factors related to the health center staff's compliance on application of therapy guidelines in antibiotics use.The study found out that 56.8% of the health center staff did not comply on the therapy guidelines and the rest (43.2%) complied on the therapy guidelines. A Chi square test showed that attitude and perception of health center staff, supervision, and drug supply related to the staffs compliance significantly. The staff who had negative attitude to the therapy guidelines was risky to have not quite compliance about 4.4 times of the staff who had positive attitude. The staff whose the lack of good perception was risky 7.2 times lower to have compliance than the staff whose good perception on the therapy guidelines. The staff who did not get good enough supervision from the higher manager gave a risk 8.6 times lower compliance than the staff who did get good supervision. Meanwhile, inadequate drug supply in the health center had risk about 20.5 times to not quite comply on the therapy guidelines.According to the result above, it is recommended to the Health Office in the Municipality of Jambi to make a local therapy guidelines which involves all doctors in the health center by conducting the adjustment of therapy guidelines that published by the Ministry of Health and also to make drug planning by using morbidity method which will result the quantity of medicine that is close to the real need for each disease in population, and to maintain the Health Office roles to do supervision as well. Recommendation for the Jambi Province Health Office, it is necessary to conduct technical assistance periodically about using and managing medicines/drug in the health center, and to maintain doctor roles to write the prescription appropriately with the principle of prescription writing. It is recommended to other researchers to conduct the study about the possible impact of bacterial resistance against antibiotics such as amphycillin, amoxycillin, and tetracyclin, caused by inappropriate time interval and time during period therapy delivery."

"ABSTRACTDalam ilmu kedokteran, demi tercapai keselamatan pasien maka tindakan medis harus sesuai dengan evidence based medicine (EBM) berdasarkan uji klinik. Namun, kerap kali tenaga medis menerapkan tindakan medis tanpa uji klinik. Penelitian ini bertujuan untuk membahas mengenai pengaturan dan penerapan uji klinik terhadap tindakan medis, serta pertanggungjawaban hukum tenaga medis yang melakukan tindakan medis tanpa uji klinik ditinjau dari hukum kesehatan Indonesia. Penelitian ini menggunankan metode penelitian yuridis-normatif, dimana menitikberatkan pada studi kepustakaan sebagai data utamanya serta wawacara dan studi dokumen yang berfungsi untuk melengkapi serta menunjang data kepustakaan. Hasil penelitian ini bersifat deskriptif analitis. Dalam hukum positif Indonesia, belum ada pengaturan mengenai penerapan uji klinik terhadap tindakan medis secara khusus. Adapun pedoman penerapan uji klinik terhadap tindakan medis ialah International Conference on Harmonization-Good Clinical Practice (ICH-GCP) yang tidak memiliki kekuatan hukum. Tenaga medis yang melakukan tindakan medis tanpa uji klinik, maka ia telah melakukan pelanggaran disiplin karena tidak bertindak sesuai standar profesi kedokteran, pengetahuan, pengalaman, dan  kualifikasinya. Sehingga, diperlukan pengaturan secara khusus mengenai uji klinik terhadap tindakan medis serta diperlukan perubahan atas sifat Majelis Kehormatan Disiplin Kedokteran Indonesia yang sebelumnya bersifat pasif menjadi aktif agar dapat mengusut penerapan tindakan medis tanpa uji klinik sebagai pelanggaran disiplin, meskipun tidak ada pengaduan sebelumnya.

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ABSTRACTIn medical science, in order to achieve patient safety, medical treatment must be in accordance with evidence based medicine (EBM) based on clinical trials. However, often medical personnel apply medical treatment without clinical trials. This study aims to discuss the regulation and application of clinical trials on medical treatment, as well as the legal responsibility of medical personnel who carry out medical treatment without clinical trials in terms of Indonesian health law. This study uses a juridical-normative research method, which focuses on the study of literature as the main data as well as interviews and document studies that serve to supplement and support library data. The results of this study are descriptive analytical. In Indonesian positive law, there are no regulations regarding the application of clinical trials to medical treatment specifically. The guidelines for the implementation of clinical trials on medical measures are the International Conference on Harmonization-Good Clinical Practice (ICH-GCP) which has no legal force. Medical personnel who carry out medical actions without clinical trials, they have committed disciplinary violations because they do not act according to medical professional standards, knowledge, experience, and qualifications. Thus, special regulation are needed regarding clinical trials of medical treatments and changes the trait of the Indonesian Medical Disciplinary Board (MKDKI) are needed from passive to active, in order to be able to investigate the application of medical treatment without clinical trials as disciplinary violations, even though there were no previous complaints."

"Tugas akhir ini membahas tentang karakteristik Ritual Tatung sebagai Pengobatan di Singkawang. Singkawang merupakan salah satu kotamadya atau pemerintahan kota di Kalimantan Barat. Penduduk Kota Singkawang terdiri dari berbagai etnis suku bangsa seperti Tionghoa, Dayak, Melayu (Tidayu) dan lain-lain. Ketiga suku tersebut saling bersaudara, rukun dan tentram. Penduduk keturunan Tionghoa di Singkawang mempercayai Ritual Tatung dapat mengobati berbagai penyakit. Terdapat banyak hal menarik yang menjadi karakteristik Ritual Tatung sebagai alternatif pengobatan di Singkawang. Hal-hal seperti dewa-dewi, ritual, dan bahkan mitos-mitos yang terkait dengan Ritual Tatung menyebabkan Ritual Tatung memiliki karakteristiknya sendiri. Tugas akhir ini berusaha menjelaskan karakteristik dan unsur-unsur yang terdapat di dalam Ritual Tatung. Metode penelitian yang digunakan adalah metode kualitatif. Dalam penelitian ini terdapat fungsi sosial-budaya Ritual Tatung pada masyarakat keturunan Tionghoa di Singkawang yang masih percaya dengan Shamanisme. Hasil dari penelitian ini menunjukkan bahwa terdapat hubungan antara dewa atau dewi dalam Ritual Tatung. Ritual Tatung sebagai pengobatan memberikan dampak yang cukup besar pada masyarakat keturunan Tionghoa di Singkawang baik secara religi maupun sosial budaya.

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This final project discusses the characteristics of the Tatung Ritual as Medical Treatment in Singkawang. Singkawang is a municipality or city in West Kalimantan. The inhabitants of the Singkawang city consists of various ethnic groups such as Chinese, Dayak, Malay (Tidayu) and others. The three tribes are living in brotherhood, harmony and peace. People of Chinese descent in Singkawang believes that the Tatung Ritual can treat various diseases. There are many interesting things that characterizes the Tatung Ritual as an alternative treatment in Singkawang. Things like gods, rituals, and even myths that are related to the Tatung Ritual cause the Tatung Ritual to have its own characteristics. This final project tries to explain the characteristics and elements contained in the Tatung Ritual. The research method used is a qualitative method. In this study, there is a socio-cultural function of the Tatung Ritual of Chinese descent in Singkawang who still believes in Shamanism. The results of this study indicates that there is a relationship between gods or goddesses in the Tatung Ritual. The Tatung ritual as a treatment has a significant impact on the Chinese people in Singkawang both religiously and socio-culturally."

"Peluncuran Kartu Jakarta Sehat (KJS) pada November 2012, sebagai pilot project ke enam kelurahan yang kemudian didistribukan ke seluruh wilayah DKI Jakarta, mengakibatkan lonjakan kunjungan pasien di banyak fasilitas kesehatan, terutama di RSUD DKI Jakarta. Program KJS memberikan kemudahan bagi warga DKI untuk berobat secara gratis, baik untuk perawatan di Instansi Gawat Darurat (IGD), rawat inap maupun rawat jalan. Keuntungan tersebut tak heran menyebabkan persoalan seperti pasien harus mengantre lama di loket pendaftaran, ruang pemeriksaan (poli rawat jalan) maupun ruang pengambilan obat (apotek). Tak hanya itu, tidak sedikit pasien harus sulit mendapatkan kamar rawat inap sehingga harus bertahan di IGD. Distribusi KJS pun menimbulkan pertanyaan apakah KJS memang diberikan kepada warga miskin/rentan miskin? Sebab, tidak sedikit warga kaya, tingkat penghasilan gaji relatif tinggi ataupun memiliki aset kekayaan lain, yang mendapatkan KJS tersebut. Tak hanya itu, beberapa warga yang telah memiliki jaminan kesehatan lain, seperti Askes atau asuransi swasta juga menggunakan KJS tersebut dengan alasan gratis. Penelitian ini bertujuan untuk mengevaluasi program KJS yakni berupaya untuk menganalisis kesesuaian target penerima KJS yang berobat ke RSUD DKI Jakarta, menganalisis penilaian pasien KJS terkait pelayanan KJS di RSUD DKI Jakarta serta mengetahui faktor-faktor apa yang dapat berhubungan dengan penilaian pasien tersebut, seperti usia, jenis kelamin, pendidikan, penghasilan gaji responden dan kepemilikan aset responden. Peneliti melakukan penelitian di tujuh RSUD DKI Jakarta selama Mei 2014 hingga Februari 2015. Peneliti mencatat, sebanyak 6,00% menilai pelayanan KJS buruk (tidak baik), sebanyak 71,75% responden menilai pelayanan KJS kurang baik, sebanyak 20,75% menilai pelayanan KJS sudah baik dan hanya 1,50% menilai pelayanan KJS baik sekali Penilaian mencatat, faktor usia, pendidikan, jenis kelamin signifikan berkorelasi terhadap penilaian responden tersebut, sedangkan penghasilan gaji responden tidak signifikan berkorelasi.

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The launch of Jakarta Health Card (Kartu Jakarta Sehat/KJS) in November 2012, as a pilot project of six villages later distributed to all areas of Jakarta, gives impact to patients visit in many health facilities, especially in District General Hospital of DKI Jakarta. KJS program ease Jakarta citizens to get free medication treatment in Emergency Room (ER), inpatient and outpatient. Patients do not have to queue in making registration at Poly Clinic and also Pharmacy. Patients sometimes face difficulties in getting room hospital therefore patients have to wait in Emergency Room (ER). A question raises whether KJS Distribution appropriately received by poor patient/vulnerable poor? Some rich patients, with relatively high income and having other property assets, also received KJS. Not only that, some patients who already have other health insurance, such as ASKES or private insurance also use the pretext of KJS free. This study aimed to evaluate the program KJS which seeks to analyze the suitability of the target beneficiaries of KJS, to analyze patient assessment KJS related services KJS in RSUD DKI Jakarta and to know what factors that can correlate the assessment of the patient, such as age, sex, education, income and asset ownership respondents. Researchers conducted a study in seven of District General Hospital (RSUD/RSKD) of DKI Jakarta during May 2014 to February 2015. The researchers noted, as much as 6.00% rate assess the service KJS bad, as many as 71.75% of respondents rate assess the service KJS is not good, as much as 20.75% assess KJS service is good and only 1.50% rate assess this excellent service KJS such assessment may be influenced by factors such as age, sex, education and income respondents. From these factors, age, sex, education are significantly correlated but income respondent is not significantly correlated."