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"Telah dilakukan studi penggunaan obat secara rasional, khususnya penggunaan antibiotika pada pasien-pasien infeksi saluran nafas akut dan diare akut di 6 Puskesmas (PKM) di daerah-daerah perkotaan, pinggir kota dan pedusunan di Propinsi Sumatra Selatan. Sampel diambil secara acak sebanyak 15% dan proporsional dengan jumlah pasien berobat jalan di tiap PKM, selama periode 3 bulan (Januari s/d Maret 1997). Karakteristik pasien, diagnosis, dan jumlah serta tipe obat (termasuk obat suntik) dicatat dalam coding sheet” untuk selanjutnya dilakukan analisis. Didapatkan 1781 kasus, dengan jumlah rata-rata obat per resep 2.7; persentase kasus yang diberi suntikan adalah 47%; dan persentase pasien yang mendapat antibiotika adalah 49%. Enam puluh empat persen dari 1277 kasus infeksi saluran nafas atas akut, dan 79% dari 140 kasus diare akut diberi antibiotika. Studi ini menunjukkan bahwa terdapat penggunaan obat yang tidak rasional (berlebihan) yang jelas terlihat pada kasus-kasus infeksi saluran nafas atas akut dan pada kasus-kasus diare akut. (Med J Indones 2004; 14: 44-9)

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Drug utilization study, especially antibiotic usage in therapy of mild acute upper respiratory infections and acute diarrheas has been conducted in six Primary Health Center (PHC) in urban, suburban and rural area in the Province of South Sumatra. We conducted systematic random sampling during which 15% of patients in each PHC were taken. We collected information about drug utilization from medical record of out patient in each PHC for three months period (January to March 1997). We recorded the characteristics of patients, the diagnosis, the number and type of drug (including injection) used. The number of cases studied was 1781, with the average number of drug per prescription being 2.7; the percentage of cases receiving an injection was 43%, and the percentage of cases receiving antibiotic was 48%. Sixty-four percent of 1277 acute respiratory tract infections (common cold), and 79% of 140 cases of acute diarrhea received antibiotic. This study showed that there is overuse or inappropriate use of drugs, especially antibiotic for acute nonspecific diarrhea and mild acute respiratory tract infections. (Med J Indones 2004; 14: 44-9)"

"Resistensi antibiotik merupakan ancaman terbesar di dunia kesehatan. Penyebab resistensi diantaranya yaitu penggunaan antibiotik yang berlebihan dan tidak tepat. Penelitian ini bertujuan mengevaluasi kualitas dan kuantitas penggunaan antibiotik di beberapa Puskesmas Kabupaten Tegal sebelum dan sesudah dilakukan intervensi edukasi. Desain penelitian pre eksperimental (pre - post intervension design) menggunakan data peresepan pasien rawat jalan periode 1 Juni 2018 - 31 Januari 2019 dan Laporan Penggunaan dan Lembar Permintaan Obat (LPLPO) di lima Puskesmas Kabupaten Tegal. Intervensi edukasi diberikan kepada seluruh penulis resep. Kualitas peresepan dinilai dengan membandingkan pemilihan obat, dosis pemberian, frekuensi pemberian dan durasi pemberian antara yang tertulis pada resep dan Panduan Praktik Klinis Fasilitas Kesehatan Primer 2014. Kuantitas penggunaan obat dihitung dalam satuan DDD / 1000 Kunjungan Pasien Rawat Jalan (KPRJ)/ hari. Diperoleh sampel kualitas peresepan sebanyak 1204 resep pada pre intervensi dan 1254 resep pada post intervensi. Ketidaksesuaian dalam durasi terapi memiliki proporsi kejadian yang paling tinggi (56,72%). Secara keseluruhan terjadi penurunan yang bermakna pada ketidaksesuaian peresepan antibiotik dari 98.08% pada pre intervensi menjadi 81.26% post intervensi (p value : 0.012). Faktor yang mempengaruhi peresepan antibiotik diantaranya kualifikasi penulis resep dan pengalaman penulis resep. Kuantitas penggunaan Antibiotik mengalami penurunan dari 14, 960 DDD / 1000 KPRJ/ hari pada pre intervensi menjadi 9, 375 DDD / 1000 KPRJ / hari pada post intervensi. Namun, penurunan bersifat tidak signifikan (p value : 0, 062).

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Antibiotic resistance has posed a serious threat to global health, and one of the reasons for such resistance is the inappropriate use of antibiotics as well as antibiotic overuse. This study aimed to evaluate the quantity and quality of antibiotic use in a number of primary healthcare centers in the District of Tegal prior to and after a health education intervention was provided. This pre-experimental research (pre-post intervention design) employed the outpatient prescribing data over the period of 1 June 2018 through 31 January 2019 and Drug Use Report and Request Form (LPLPO) in five (5) primary healthcare centers in the District of Tegal. A health education intervention was provided for each prescriber. The prescribing quality was assessed by drawing a comparison between the drug selection, dosage of administration, frequency of administration, and duration of administration in the prescriptions and those advised in the Clinical Practice Guidelines for Primary Healthcare Facilities 2014. The quantity of drug use was calculated in a unit of DDD/1000 of Outpatient/day. For the prescribing quality analysis, 1204 prescriptions in the pre-intervention phase and 1254 prescriptions in the post-intervention phase were obtained. Inappropriate duration of administration reached the highest percentage (56.72%). Overall, the inappropriateness of antibiotic prescribing decreased significantly from 98.08% during the pre-intervention phase to 81.26% in the post-intervention phase (p value : 0.012). The contributing factors of antibiotic prescribing included the qualification of prescribers and their experience in prescribing. There was a decrease in the quantity of antibiotic use from 14,960 DDD/1000 of KPRJ/day in pre-intervention to 9,375 DDD/1000 of KPRJ/day in post-intervention. However, the reduction was unsignificant (p value: 0.062)."

"Kontribusi masyarakat dan swasta dalam pembiayaan kesehatan sekitar 70% dan sistem pembayaran untuk tiap pelayanan masih dominan fee for service. Pada era 90-an terjadi perubahan besar dalam sistem pembayaran yang tertuang dalam UU No. 3/1992 tentang Jamsostek dan UU No. 23/1992 tentang Kesehatan yang secara eksplisit menyebutkan sistem pembayaran pra upaya (kapitasi). Sistem pembayaran kapitasi sudah dilakukan oleh PT. Askes, PT Jamsostek, dan beberapa Bapel JPKM dengan bervariasi besaran kapitasi yang dibayarkan Bapel ke PPK.Dalam kondisi krisis ekonomi upaya menjamin pemeliharaan kesehatan keluarga miskin dikembangkan JPKM JPSBK yang pembayaran jasa pelayanan secara kapitasi oleh Pra Bapel kepada Puskesmas dengan premi subsidi dari pemerintah sebesar Rp 9.200,-/KK/tahun. Di era otonomi daerah penduduk miskin menjadi perhatian daerah dalam menanggung pembiayaan kesehatannya dan berdasarkan pengalaman program. JPKM JPSBK akan dihitung berapa besaran kapitasi yang wajar untuk peserta JPKM JPSBK untuk mendapat pelayanan yang bermutu dan tidak merugikan PPK (Puskesmas). Karena PPK maupun penyelenggara asuransi (Pra Bapel) belum menghitung besarnya biaya per kapita.Tujuan penelitian adalah mendapatkan besaran kapitasi yang wajar dari Pra Bapel ke Puskesmas untuk paket pemeliharaan kesehatan dasar JPKM JPSBK di Kotamadya Jakarta Selatan. Data yang digunakan adalah data kunjungan peserta pada tahun 1999 di 74 Puskesmas KecamatanlKelurahan sebagai PPK penyelenggara JPKM JPSBK. Rancangan penelitian survei cross sectional. Variabel babas meliputi jenis pelayanan, karakteristik populasi (jumlah peserta, jenis kelamin, umur), tingkat penggunaan pelayanan (utilization rate) dan biaya per pelayanan menurut Perda. Sedangkan variabel terikat adalah besaran kapitasi.Hasii penelitian menunjukkan bahwa jenis pelayanan yang dimanfaatkan peserta JPKM JPSBK sebagian besar adalah pelayanan rawat jalan tingkat I seperti BP Umum (87,30%), KB (4,87%), BPG (2,54%),KIA (2,34%), dan imunisasi (1,73%). Karakteristik populasi penduduk miskin 69.300 orang (4,10%) dari penduduk di Kotamadya Jakarta Selatan dengan komposisi 51,12% laki-laki, 48,88% perempuan dan sebagian besar ada pada kelompok umur 0-5 tahun, 11-15 tahun, 16-20 tahun. Tingkat penggunaan pelayanan dimanfaatkan oleh kelompok umur 0-5 tahun (27,99%), kelompok umur 6-10 tahun (9,70%) dan kelompok umur > 55 tahun (9,34%).Berdasarkan analisa besaran kapitasi penduduk miskin yang wajar adalah Rp 171,-/orang/bulan atau Rp 2.050,-/orang/tahun. Dengan besaran kapitasi tersebut Puskesmas menerima pembayaran kelebihan dari yang dibayarkan pra Bapel ke PPK (Puskesmas). Perhitungan besaran kapitasi sangat bervariasi tergantung pada jenis pelayanan, karakteristik populasi yang terkait dengan faktor risiko dan tingkat penggunaan pelayanan serta besarnya biaya per pelayanan.

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Fair Capitation Payment of JPKM JPSBK Primary Health Care Package at Health Centers in South Jakarta DistrictThe private sector has been contributing about 70% of health care expenditure in Indonesia. The majority of this financing has been through out of pocket payment that puts high burden to household. During 1990s there had been significant changes in the health care financing system marked by the passage of Social Security Act No. 3192 (UU Jamsostek) and Health Act No 23/92. Both act prescribe capitation payment system as a means to control health care costs. The Health Act promotes the development of JPKM (HMOs), a prepaid health care system. The people in public and private sector have the biggest contribution for health budgeting system. Mostly for the payment system the people are using fee for service or out of pocket In 1990' is big changing for the payment system which is written in Jamsostek Act No. 3/1992 and Health Act No. 23/1992. Those act are starting to introduce the pre paid payment system such as capitation or others.

During the economic crisis starting in the mid 1997. This study was designed to examine whether the capitation payment by a pra bapel in South Jakarta regency was actuarially fair. The data were taken from visit rates during 1999 by those poor households in 74 health centers and from the pra bapel. Demographic characteristics of beneficiaries as well as types of utilization of health services in health centers were then calculated to obtain utilization rates. Calculation of fair capitation payment was made using valid user fees schedule (Tarif Perda) that was valid for the 1999. Simulation of fair capitaion payment was made using age distribution of household members of the poor household listed in the program. This research is Formulated to set up the fair capitation in South Jakarta each house holdlyearlpackage through pra Bapel as during economic crisis, through data analyze in visiting number of participants in 74 health center in 1999 and using cross sectional method. The independent variable enclosed the several of services, population characteristics (number of member, gender, and age) and utilization rate and unit cost for each service based on the rational regulation tariff and dependent variable is capitation payment system.

This research showed that the poor people comprised of 4,10% of the total population in South Jakarta that can be divided into 51,12% male and 48,88% female and grouping such as 0-5 year (27,99%), 6-10 year (9,70%) and > 55 year (9,34%), In term of utilization, 4,10% of members used outpatient services comprised of 87.3% in the general clinics, 4,87% family planning, 2,54% in dental clinic, 2,34% Mother Child Health, and 1,73% utilized immunization services.

Based on the utilization experience the fair capitation rate was Rp 17h-/capita/month or Rp 2,050; /capita/yeaf_ This amount was less than the capitation paid to health centers equal to Rp 191,6/capita/month. Several possible explantion accounted for the difference are: I conclude that the capitation payment to health centers in the JPKM JPSBK was actually too much. However, due to possible underestimate of the data collected, findings from this study should be used cautiously."

"Manajemen Terpadu Balita Sakit (MTBS) adalah suatu pendekatan terintegrasi dalam tatalaksana balita sakit secara menyeluruh. Bidan sebagai salah satu tenaga pelaksana MTBS sangat berperan dalam keberhasilan program MTBS, kinerja bidan dipengaruhi oleh faktor individu, psikologik dan organisasi. Penelitian ini dilakukan untuk menganalisis kinerja bidan dalam pelaksanaan MTBS di puskesmas Kabupaten OKU tahun 2013 dengan menggunakan metode kualitatif dan desain RAP (Rapid Assesment Procedure). Pengumpulan data dilakukan dengan wawancara mendalam kepada informan menggunakan pedoman wawancara. Hasil penelitian menyarankan kepada bidan untuk semakin meningkatkan kinerja dengan mengacu kepada standar baku MTBS.

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Integrated Management of Childhood Illness (IMCI) is an integrated approach to the overall management of childhood illness. Midwives as one of the executive power is very instrumental in the success of IMCI IMCI program, midwives' work is influenced by individual factors, psychological and organizational. This study was conducted to analyze the performance of midwives in IMCI implementation in district health centers in 2013 OKU using qualitative methods and designs RAP (Rapid Assessment Procedure). Data was collected through in-depth interviews using an interview guide to the informant. The results suggest the midwives to further improve the performance with respect to the gold standard IMCI."

"Latar belakang: Puskesmas adalah salah satu bentuk fasilitas pelayanan primer yang memberikan pelayanan kesehatan kepada masyarakat dan perseorangan. Penguatan pelayanan kesehatan primer menjadi fokus utama yang dikembangkan di dunia oleh WHO, dimana negara-negara berkembang didorong untuk melakukan reformasi dalam rangka penguatan pelayanan kesehatan primer. Sesuai dengan Peraturan yang ada puskesmas menjalankan fungsinya dengan lebih mengutamakan upaya promotif dan preventif, untuk mencapai derajat kesehatan yang setinggi-tingginya. Dalam rangka peningkatan mutu pelayanan, puskesmas wajib di akreditasi secara berkala paling sedikit 3 (tiga) tahun sekali. Tujuan akreditasi adalah untuk meningkatkan kinerja dalam memberikan pelayanan kesehatan perorangan dan masyarakat. Tujuan : Penelitian ini bertujuan untuk mengetahui kesiapan puskesmas untuk penilaian akreditasi dengan tujuan khusus adalah mengetahui kesiapan puskesmas dari segi administrasi manajemen, kualitas pelayanan UKM dan UKP, kesiapan dari segi ketersediaan SDM kesehatan dan diketahuinya kesiapan puskesmas dari segi pembiayaan kesehatan. Metode : Metode penelitian ini menggunakan metode kualitatif dengan pendekatan studi kasus. Hasil : Hasil penelitian menunjukkan bahwa kesiapan administrasi manajemen, ketersediaan sarana dan prasarana dan SDM kesehatan serta pembiayaan cukup siap untuk mendukung penilaian puskesmas agar mendapat kategori terakreditasi. Kesimpulan : Puskesmas yang diusulkan untuk penilaian akreditasi telah siap untuk dilakukan survei oleh tim survior. Saran : Puskesmas masih harus terus mempertahankan dan meningkatkan kesiapan dengan melakukan penyegaran dan penguatan komitmen serta melakukan kaji banding ke puskesmas yng talah terkareditasi.

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Background: Puskesmas is one form of primary care facilities that provide health services to communities and individuals. Strengthening primary health care becomes the main focus being developed in the world by the WHO, where developing countries are encouraged to implement reforms in order to strengthen primary health care. In accordance with Rule existing health centers to function more priority promotive and preventive efforts, goals to health level as high. In order to improve the quality of services, community health centers regularly accreditation mandatory in at least 3 (three) years. The purpose of accreditation is to improve performance in providing individual and community health services.

Objective: This study aimed determine the readiness of health centers for accreditation with the specific aim was to determine the readiness of puskesmas terms of administrative management, quality of service UKM and UKP, readiness in terms of availability of health human resources and health centers in terms of knowing the readiness of health financing.

Method: This study used a qualitative method with case study approach.

Results: The results showed that the administration's readiness management, availability of infrastructure and health human resources and finance are quite prepared to support the assessment of health centers in order to get accredited category.

Conclusion: The proposed health center for the accreditation assessment has been prepared for a survey conducted by a team survior.

Suggestion: Puskesmas must continue to maintain and enhance the readiness to conduct refresher and strengthening the commitment and conduct a review of an appeal to the clinic accredited."

"Dalam penatalaksanaan diare non spesifik sering terjadi ketidaktepatan pengobatan seperti pemakaian antibiotika. Penelitian yang bertujuan untuk mengetahui pola dan biaya penggunaan antibiotika pada pasien rawat jalan diare non spesifik balita ini dilaksanakan di puskesmas MTBS dan non-MTBS di wilayah Kota Tangerang Selatan tahun 2012.Rerata item obat per resep, persentase pemberian oralit dan persentase resep mengandung antibiotika pada puskesmas MTBS berturut ? turut adalah 3,18 item, 89,53% dan 25,43%. Pada puskesmas non-MTBS adalah 3,33 item, 60,11% dan 62,84%. Pola peresepan berhubungan dengan biaya obat pada kedua puskesmas, sementara faktor penjamin tidak berhubungan. Penatalaksanaan MTBS di puskesmas mendorong rasionalitas penggunaan antibiotika.

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In the management of non-specific diarrhea, frequently found inaccuracy of treatment such as the use of antibiotics. The research aims to determine the patterns and costs of antibiotic used in the toddler outpatient of non-specific diarrhea. It was conducted in IMCI and non-IMCI health centers in South Tangerang City in 2012.The mean drug items per prescription, percentage of ORS and the percentage of prescriptions containing antibiotics in IMCI health centers were 3.18 item, 89.53% and 25.43%. In the non-IMCI health centers the figures were 3.33, 60.11% and 62.84%. Prescribing pattern was associated with the cost of drugs in both health centers, while source of payment was unrelated. IMCI management in health centers encourages rational antibiotics use."

"ABSTRAKFood provider at university is one of places that needs to implement standards of food hygiene and sanitation (FHS). This study aimed to evaluate and analyze practices of food hygiene and sanitation based on Decree of Health Minister No. 1098 of 2003 and best practices in six food providers at University X. This study used mixed method evaluation with sequential explanatory design through two stages. Stage I was in the forms of assessment on six food providers, food handlers and laboratory examination on food and beverage samples as well as on eating utensils. Stage II was in the form of focus group discussion (FGD) to deepen findings at stage I. The results of this study showed that 100 of food providers had not yet met the governments regulation. As much as 67 of eating utensils and 83 of food were contaminated with bacteria. Based on food handler examination results, 100 of food handlers were not yet to get medical checkups and training. FGD results indicated that findings at stage I were associated with a lack of knowledge among food handlers and the absence of special unit to oversee food hygiene and sanitation at campus. In conclusion, six food providers in the study area have not met the regulation."

"Common Cold atau pada umumnya disebut sebagai Batuk Pilek merupakan penyakit yang sering dialami semua orang. Dalam pengobatan suatu penyakit, diperlukan kerasionalan penggunaan obat. Indikator pemantauan Penggunaan Obat Rasional (POR) di sarana pelayanan kesehatan Indonesia dilihat dari persentase peresepan, salah satunya peresepan antibiotik pada diagnosis penyakit ISPA Non- Pneumonia dengan batas toleransi keberterimaan sebesar 20%. Tugas khusus ini berutjuan untuk Mengevaluasi kesesuaian penggunaan antibiotik pada penyakit common cold di Puskesmas Kecamatan Pasar Rebo dengan batas toleransi POR. Metode penelitian yang digunakan yaitu dilakukan dengan desain penelitian cross sectional secara retrospektif. Dari studi ini diketahui pelaksanaan Puskesmas Kecamatan Pasar Rebo dalam peresepan antibiotik terhadap penyakit Common Cold sudah sesuai dengan ketentuan Penggunaan Obat Rasional (POR) karena jumlah peresepannya masih masuk di bawah batas toleransi, yaitu kurang dari 20%.

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Common Cold or commonly referred to as Cold Cough is a disease that is often experienced by everyone. In the treatment of a disease, rational use of drugs is needed. Monitoring indicators for Rational Drug Use in Indonesian health care facilities are seen from the percentage of prescriptions, one of which is the prescription of antibiotics for Non-Pneumonia ISPA with a tolerance limit of 20%. This report aims to evaluate the suitability of the use of antibiotics in common cold diseases at the Pasar Rebo Public Health Center with Rational Drug Use tolerance limits. The research method used was a retrospective cross-sectional study design. From this study it is known that the implementation of the Pasar Rebo Public Health Center in prescribing antibiotics for Common Cold disease is in accordance with the provisions of Rational Drug Use because the number of prescriptions is still below the tolerance limit, which is less than 20%."

"HIV atau Human Immunodeficiency Virus adalah virus golongan RNA yang spesifik menyerang imunitas atau sistem kekebalan tubuh yang kemudian menyebabkan Acquired Immune Deficiency Syndrome (AIDS). Semua orang dengan HIV dapat menghasilkan harapan hidup yang mendekati normal dan menekan pertumbuhan virus HIV jika tetap melakukan pengobatan dan kepatuhan jangka panjang terapi antiretroviral (ARV). Selama pandemi global COVID-19, menjadi semakin penting untuk memastikan ODHA memiliki akses pengobatan ARV melalui Multi-Month Dispensing dan juga menghindari kerumunan di fasilitas kesehatan. Laporan praktik kerja apoteker ini bertujuan untuk Mengetahui gambaran pola peresepan MMD ARV pasien di Puskemas Kecamatan Cengkareng periode Mei 2022 – Agustus 2022. Metodologi penelitian yang digunakan adalah metode pengumpulan data secara retrospektif pasien MMD ARV periode Mei 2022 sampai dengan Oktober 2022. Didapatkan kesimpulan sebagai berikut, Peresepan MMD ARV untuk ODHA di Puskesmas Kecamatan Cengkareng periode Mei hingga Oktober 2022 adalah 738 resep, dengan peresepan terbanyak FDC TLE (55,01%).

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HIV or Human Immunodeficiency Virus is a type of RNA virus that specifically attacks the immune system which then causes Acquired Immune Deficiency Syndrome (AIDS). All people with HIV can have a near normal life expectancy and suppress the growth of the HIV virus if they are on medication and long-term adherence to antiretroviral therapy (ARV). During the global COVID-19 pandemic, it has become increasingly important to ensure that people living with HIV have access to ARV treatment through Multi-Month Dispensing and also to avoid crowds in health facilities. This pharmacist work practice report aims to describe the pattern of prescribing MMD ARV in patients at the Cengkareng District Public Health Center for the period May 2022 – August 2022. The research methodology used was a retrospective data collection method for MMD ARV patients for the period May 2022 to October 2022. The following conclusions were drawn, MMD ARV prescriptions for PLWHA at the Cengkareng District Health Center from May to October 2022 were 738 prescriptions, with the most prescriptions being FDC TLE (55.01%)."