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"Pembiayaan kesehatan. cenderung meningkat sejalan dengan meningkatnya jumlah penduduk dan makin besarnya masalah kesehatan baik secara kuantitatif maupun secara kualitatif, perkembangan tehnologi kesehatan yang semakin canggih serta meningkatnya demand masyarakat terhadap pelayanan kesehatan yang bermutu.Bapel Garuda Sentra Medika yang merupakan pengelola Jaminan Pemeliharaan Kesehatan Pegawai PT. Garuda, juga mengalami peningkatan biaya kesehatan yang cukup drastis yaitu pada periode tahun 2001- 2003. Hal tersebut disebabkan oleh belum adanya sistem kendali biaya yang Baku yang diberlakukan dalam rangka menekan tingginya biaya kesehatan yang timbul.Salah satu upaya yang dapat dilakukan oleh Bapel GSM untuk mengendalikan biaya kesehatan, adalah dengan melakukan utilisasi review secara rutin pada setiap PPK yang bekerja sama dengan Bapel GSM. Oleh karena itu, penelitian ini bertujuan untuk mengetahui gambaran utilisasi pelayanan kesehatan rawat jalan tingkat pertama pada peserta Garuda di PPK Garuda Sentra Medika Kemayoran dan PPK Meta Medika di Tangerang.Penelitian ini merupakan penelitian survei operasional dengan menggunakan pendekatan kuantitatif serta pengkajian terhadap sistem yang telah berjalan dengan cara pengamatan proses.Hasil penelitian yang didapat terlihat rata-rata biaya obat per lembar resep serta rata rata biaya obat per R/ pada PPK Meta Medika 3 kali lebih tinggi dari pada rata rata biaya di PPK Garuda Sentra Medika.Untuk itu peneliti menyarankan agar Bapel Garuda Sentra Medika dapat segera melakukan upaya kendali biaya salah satunya yaitu dengan melakukan utilisasi review secara berkala pada tiap-tiap PPK yang bekerja sama dengan Bapel Garuda Sentra Medika.Daftar Pustaka: 22 (1977-2003)

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Utilization Review of Primary Care for Garuda Health Care Security Member at Its Health Providers in Garuda Sentra Medika Kemayoran and Meta Medika Tangerang Year 2003Health financing tends to increase in line with the increasing of population and the magnitude of health problem both quantitative and qualitative, the sophisticated health technology progressively, and also the increasing of society demand for health care quality.

The plan of Garuda Sentra Medika is an organizer of health care security for employee of PT Garuda, also had the increasing on health expense drastically at period of year 2001-2003. It was caused the lack of standardized cost containment system that applied in order to depress the high of health cost.

One of the efforts that can be to be conducted by the plan of Garuda Sentra Medika to control the health cost is by conducting utilization review routinely in each health care provider that collaborate with The Plan of Garuda Sentra Medika. For that reason, this study aimed to assess the utilization of primary health care of Garuda Health Care Security Member at Provider of Garuda Sentra Medika in Kemayoran and Provider of Meta Medika in Tangerang.

This study was an operational survey research using quantitative approach and existed system review by doing the observation of process.

The study resulted that the average of drug expense per prescription sheet and also the expense of drug per prescription at Meta Medika was 3 times higher than the average of such expense at Garuda Sentra Medika.

It was suggested that The Plan Garuda Sentra Medilca should immediately conduct the cost containment periodically especially utilization review in every health care provider that collaborates with The Plan Garuda Sentra Medika.

References: 22 (1977-2003)"

"This book is devoted to understanding the impact of respiratory diseases in older patients. It includes reviews of physiology of the aging lung, allergy and immunology of the aging, as well as sleep changes over the life cycle. There are also comprehensive reviews on specific disease topics including chronic obstructive lung disease, lung cancer, atypical mycobacteria, interstitial lung disease, pulmonary hypertension, pulmonary embolism, obstructive sleep apnea, sleep disorders in older patients. Two chapters focus on unique issues in older patients; HIV and lung transplant. Included also are important chapters on assessing functional and cognitive status and end-of-life issues in older patients with lung disease. In addition to outlining the current state of knowledge, each chapter focuses on special considerations when caring for older patients. "

"The updated second edition of Cutaneous manifestations of infection in the immunocompromised host is an invaluable reference for physicians and ancillary medical professionals involved in the care of patients with impaired immune systems due to cancer, chemotherapy, systemic steroids and other immunosuppressive drugs, HIV/AIDS or organ transplantation. This volume will help you recognize skin lesions and diagnose their infectious cause. Textbook features include, over 350 color images demonstrating pathognomonic, atypical, rare and routine skin lesions. Tables for differential diagnosis of different skin lesions in the immunocompromised host. Complete coverage of infectious pathogens with the patterns of infection and the likely causes in different clinical settings (HIV/AIDS versus solid organ transplantation versus neutropenia post-chemotherapy versus bone marrow recovery post hematopoietic stem cell transplantation. New chapter discussing the role of viruses causing malignancies with cutaneous signs in the immunocompromised patient. "

"In Essentials of sleep medicine : an approach for clinical pulmonology, a concise, evidence-based review of sleep medicine for the pulmonologist is presented. Providing a focused, scientific basis for the effects of sleep on human physiology, especially cardiac and respiratory physiology, chapters also outline a differential diagnosis for common sleep complaints and an evidence-based approach to diagnosis and management. This includes a review of the current standards of practice and of emerging technology and unresolved issues awaiting further research. Each chapter includes a summary of current research and outlines future research directions and issues. In all, Essentials of sleep medicine : an approach for clinical pulmonology provides a clear diagnostic and management program for all the different sleep disorders, with a major focus on respiratory disorders of sleep, and includes key points and summaries. n-depth review of sleep medicine."

"Drug abuse and addiction in medical illness : causes, consequences, and treatment is a major contribution to the literature, a gold standard title offering a comprehensive range of topics for those who care for patients with addiction, conduct research in this area, or simply have an interest in the field. Offering state-of-the-art information for all those working with drug abusing or addicted patients, or for those interested in this topic from other research perspectives, the volume is a first of its kind book, rich, comprehensive, yet focused, addressing the needs of the very active theoretical, basic, and clinical research in the field. Comprised of 46 chapters organized in four sections and developed by the leading international experts, this book covers virtually every core, as well as contemporary, topic on addiction, from the established theories to the most modern research and development in the field. Enhancing the educational value of the volume, every chapter includes an abstract and two boxes summarizing learning objectives and directions for future research. "

"The first section of Functional respiratory disorders : when respiratory symptoms do not respond to pulmonary treatment will help clinicians recognize functional respiratory symptoms that can arise as a result of both organic and psychological causes. The second section of this book provides detailed discussions of such disorders, links to video examples of laryngoscopic evaluation of patients with vocal cord issues, case studies and quizzes. Examples and exercises that should strengthen the clinician’s confidence in identifying and treating these functional conditions are also provided. Finally, the third section of the book will help the clinician differentiate the patients for whom referral to a mental health provider is mandatory from those for whom other approaches may be useful. For the latter group, the book teaches clinicians to empower themselves by learning how to incorporate various therapies for functional disorders into their practice, including biofeedback, breathing techniques, basic cognitive behavioral therapy techniques, and hypnosis. Links are provided to instructive video examples of biofeedback, hypnosis, and speech therapy. Practical strategies for obtaining training in these modalities are provided in the appendix. "

"In keeping with the growing emphasis on psychiatry in the medical school curriculum, problem-based learning (PBL) offers students a unique patient-centred, multidisciplinary approach to study and the synthesis of knowledge.The new 2nd edition of Problem-Based Behavioral Science and Psychiatry integrates DSM-5 updates and diagnostic criteria, and is fully consistent with PBL models and methods. Building on the strengths of the popular and widely downloaded 1st edition, the 2nd edition is a clinically robust resource for both the medical and the behavioral science student. Over 40 contributors, many themselves graduates of PBL medical schools, apply problem-based learning methods to specific psychiatric disorders, general clinical issues, and bedrock physician skills such as the intake interview and treatment planning.The book’s fictional case vignettes illustrated typical patient scenarios, providing real-world context for content areas, and accompanying case diagrams show the relationships between patient behaviour and underlying neurobiological structures. Each student-friendly section ends with helpful review questions."

"Gangguan jiwa sering tidak mendapat pengobatan yang seharusnya. Dokter pada pelayanan primer merupakan kontak awal bagi pasien gangguan jiwa. Pada saat ini belum ada instrumen untuk menilai pengetahuan, sikap dan perilaku dokter Puskesmas terhadap gangguan jiwa sehingga perlu dibuat suatu instrumen dan menilai validitas serta reliabilitasnya.Sembilan puluh tujuh dokter umum yang bertugas di Puskesmas di DKI Jakarta, disertakan dalam penelitian dengan purposive sampling. Kuesioner terdiri dari sepuluh pertanyaan tentang perilaku, sepuluh pertanyaan tentang sikap dan dua puluh pertanyaan tentang pengetahuan terhadap gangguan jiwa. Hasil penghitungan denganCrohnbach?s Alpha menunjukkan instrumen ini belum memiliki construct validitydan reliabilitasyang baik (< 0,7). Di samping itu, terdapat korelasi antarbutiryang kurangkuat pada beberapa pertanyaan. Reliabilitas konsistensi internal masih belum dapat menunjukkan hasil yang baik, beberapa pertanyaan dapat memperbaiki nilai Crohnbach?s Alpha if item deleted secara signifikan.Instrumen pengetahuan, sikap dan perilaku dokter Puskesmas terhadap gangguan jiwa ini masih belum terbukti validitas dan reliabilitasnya, masih butuh penelitian lebih lanjut untuk mengembangkan instrumen ini.

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Mental disorders are often go untreated. Primary care phyisician is the initial contact to people with mental disorders. Currently, there are no instruments which can evaluate knowledge, attitude and behavior of primary care physician towards mental disorders. It is important to make such an instrument and to test its validity and realibility.Ninety seven primary care physicians who work at the Puskesmas in DKI Jakarta were involved. Purposive sampling was used in this study. Questionnaire consist of ten questions about behavior, tenquestions about attitude, and twenty questions about knowledge toward mental disorders.The analysis using by Crohnbach Alpha?s showed that this instrumen haven?t met good construct validity and reliability (< 0,7). There are also weak inter-item correlation in some of the questions. Internal consistency reliability is still not able to show good result. Some questions may improve Crohnbach?s Alpha if some items are deleted, but still cannot reach the level of good.The instrument of knowledge, attitudes and behavior of primare care physicians toward mental disorders is still not valid and reliabel and still need further research to develop this instrument."

"Latar BelakangSistitis akut non komplikata (SANK) adalah kondisi urologis tersering pada perempuan dan umumnya dikelola oleh dokter umum. Meskipun Panduan Tatalaksana Infeksi Saluran kemih dari Ikatan Ahli Urologi Indonesia (IAUI) telah tersedia, terdapat variasi dalam praktik klinis sehari-hari. Penelitian ini bertujuan untuk mengevaluasi kesesuaian antara manajemen dan panduan tatalaksana SANK oleh dokter umum di Indonesia. MetodePenelitian ini merupakan studi observasional potong lintang yang dilakukan dari November 2023 hingga April 2024 melalui survei daring kepada dokter umum di Indonesia. Survei ini mengevaluasi demografi dokter dan pasien, modalitas diagnostik, serta tatalaksana SANK. Data dari 385 dokter umum dianalisis menggunakan statistik deskriptif.HasilSebagian besar dokter umum melakukan anamnesis (98,7%) dan pemeriksaan fisik (92,4%) untuk diagnosis. Gejala tersering yang dilaporkan adalah disuria (75,8%) dan nyeri suprapubik (72,1%). Urinalisis sering digunakan (82,8%), sementara dipstik urin (9,6%) dan kultur urin (7%) jarang diterapkan. Sebanyak 96,6% dokter umum meresepkan antibiotik, dengan ciprofloxacin sebagai pilihan paling umum (77,6%). Penggunaan antibiotik lini pertama yang dianjurkan IAUI seperti nitrofurantoin dan fosfomisin trometamol sangat rendah, diresepkan oleh kurang dari 2% dokter. Selain itu, 59,5% dokter umum meresepkan pengobatan non-antibiotik, dengan analgesik sebagai yang tersering (68,5%).KesimpulanPenelitian ini menunjukkan beberapa kesesuaian antara manajemen SANK oleh dokter umum dengan panduan tatalaksana IAUI, namun masih terdapat ketidaksesuaian dalam pemilihan antibiotik lini pertama. Oleh karena itu, dibutuhkan optimalisasi penyediaan fasilitas dan obat untuk SANK yang dicakup oleh Jaminan Kesehatan Nasional dan sosialisasi panduan di tingkat layanan primer.

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Introduction

Acute uncomplicated cystitis (AUC), a prevalent urological condition among women, is predominantly managed by general practitioners (GPs). Despite clinical guidelines provided by Indonesian Urology Association (IUA), variations in management practices persist. This study aims to evaluate the concordance between management approaches and guideline employed by GPs in Indonesia for AUC.

Method

A cross-sectional observational study was conducted from November 2023 to April 2024 through an online survey targeting GPs across Indonesia. The survey assessed GP and patient demographics, diagnostic practices, and management pattern. Data from 385 GPs were analyzed using descriptive statistics.

Results

Most general practitioners performed anamnesis (98.7%) and physical examinations (92.4%) for diagnosis. The most frequently reported symptoms were dysuria (75.8%) and suprapubic pain (72.1%). Urinalysis was commonly used (82.8%), while urine dipstick (9.6%) and urine culture (7%) were less frequently applied as additional tests. Antibiotics were prescribed by 96.6% of general practitioners, with ciprofloxacin being the most common choice (77.6%). The use of first-line antibiotics recommended by the IAUI guidelines, such as nitrofurantoin and fosfomycin trometamol, was very low, prescribed by less than 2% of practitioners. Additionally, 59.5% of general practitioners prescribed non-antibiotic treatments, with analgesics being the most common (68.5%).

Conclusion

The findings of this study reveal that while several aspects of AUC management by GPs are already in accordance with IUA guidelines, discrepancies remain, particularly in the selection of first-line antibiotics for AUC treatment. Therefore, it is necessary to optimize the provision of facilities and drugs for SANK covered by the National Health Insurance and socialize the guidelines at the primary care level."