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Ulfah Suryani
Abstrak :
Achievement of hospital marketing is strongly rely on their perception of costumer behaviour. Loyal costumer grow to be a valuable asset for health service provider. The understanding of costumer loyalthy development phases could construct costumer trustworthiness. Haji Hospitas is a private hospital located at Pondok Gede, East Jakarta From 2007's data of Out Patient Rate, can be concluded that the number tend to be decreasing and showed no significant improvement. Considering on the situation, which is more expensive to reach new costumer than to retain the old ones, then hospital management is willing to improve marketing strategy by identifying their marketing mix which related to I-laji?s costumer loyalty. Thesis objective is to discover relationship between Haji?s marketing mix with their costumer loyalthy. Therefore, this research is an observational study through cross-sectional quantitive analysis approach. Primary data collection is performed through self administrated questionaire toward I I0 respondents. Quantitive approach indicated majority of respondents are having a good perception with the existing marketing mix at Haji Hospital. The result of Chi Square test shows that the determining variables are : location aspect, waiting time aspect and access of informaton aspect. This research conclude : to perform the significance connection between products, prices, promotion and peoples with costumer loyalthy, this study should be completed with qualitative approach. This thesis is also proposing suggestion to perform study of building the costumer retention marketing programme by hospital management The application programme, based on the research result are Relationship Marketing Programme, Frequent Costumer Gilt, Testimonial Letter and Recommend a Frien and Family Member Reward.
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2007
T34551
UI - Tesis Membership  Universitas Indonesia Library
cover
Ulfah Suryani
Abstrak :
[ABSTRAK
Latar belakang. Hepatitis B merupakan salah satu masalah kesehatan yang serius, diperkirakan lebih dari 2 milyar orang didunia telah terinfeksi virus hepatitis B (VHB). Dari jumlah ini kira-kira 360 juta orang mengalami infeksi khronis. Kematian terutama disebabkan karena sirosis hepatis dan karsinoma hepatoseluler. Salah satu upaya pencegahan penularan infeksi VHB adalah uji saring darah donor terhadap hepatitis B surface antigen (HBsAg) yang merupakan pemeriksaan skrinning yang dilakukan oleh Unit Transfusi Darah (UTD) di negara berkembang seperti Indonesia. Banyak peneliti membuktikan bahwa darah HBsAg negatif masih berpotensi menularkan infeksi VHB. Untuk itu meningkatkan keamanan darah, beberapa negara menambahkan parameter pemeriksaan antibodi terhadap hepatits B core (anti-HBc) sebagai petanda paparan terhadap infeksi VHB dan pemeriksaan antibodi terhadap hepatitis B surface (anti-HBs) sebagai tanda respon imun terhadap infeksi VHB. Dengan berkembangnya teknologi biologi molekuler, masa jendela infeksi VHB dengan seronegatif dapat di ketahui lebih cepat melalui deteksi DNA VHB dengan metode Nucleic Acid Test (NAT) multipleks yang dilanjutkan dengan NAT discriminatory. Beberapa penelitian terdahulu menunjukkan, didapatnya DNA VHB pada spesimen darah donor yang seronegatif dengan metoda NAT. Darah dengan HBsAg negatif, DNA VHB positif dengan atau tanpa anti-HBc dan atau anti-HBs merupakan darah asal donor dengan Hepatitis B Occult (HBO). Prevalensi donor dengan HBO di Indonesia berkisar antara 8- 10%. Metodologi. Penelitian ini menggunakan desain potong lintang (cross sectional) yang dilakukan di UTDP dan Lembaga Biologi Molekul Eijkman, dengan jumlah sampel 4.973 asal subyek donor darah dari 4 UTD daerah DKI, Kota Tanggerang,kota Depok dan Kabupaten Tanggerang. Terhadap sampel penelitian dilakukan pemeriksaan serologis HBsAg,anti-HBc,anti-HBs, NAT, dan PCR kuantitatif dan kualitatif, selanjutnya pada sampel yang HBsAg negatif, NAT positif dan didapatkan hasil PCR kuantitatif positif dilakukan pemeriksaan lanjutan sequencing asam amino untuk mengetahui ada tidaknya mutan HBsAg penyebab lolosnya deteksi serologi HBsAg oleh reagensia HBsAg yang digunakan untuk uji saring darah donor. Hasil. Didapatkan hanya 20 subjek (0,40%) mempunyai hasil HBsAg negatif dan NAT positif multipleks, dan hanya 16 subyek (80%) HBsAg negatif dan NAT discrimenatory positif. Lebih lanjut hasil pemeriksaan anti-HBc negatif dan anti- HBs positif/negatif didapatkan hanya1 subyek (6,25%), anti-HBc positif dan anti- Hbs negatif didapatkan 9 subyek (56,25%), hasil pemerksaan anti-Hbc dan anti- HBs positif 5 subyek (31,25%). Lebih lanjut dilakukan pemeriksaan PCR kualitatif dan didapatkan 3 subyek (18,75%) tidak terdeteksi, , 6 (37,5%) subyek menunjukkan hasil viral load yang low detection (dibawah sensitivitas alat), dan 7 subyek (43,75%) menunjukkan hasil viral load dapat di ketahui. Pada pemeriksaan PCR kualitatif dan sequencing didapatkan 2 subyek (28,57%) ditemukan mutasi pada gen S pada posisi 143 dimana terjadi subsitusi asam amino T143M.
ABSTRACT
Background. Hepatitis B is one of the most serious health problem. It is estimated that more than 2 bilion people have been infected by this virus, of which 360 milion are chronically infected with severe and fatal risk especially of cirrosis and hepatocellular carcinoma. One of the main ways to prevent transfusion transmitted HBV infection is blood screening for HBsAg. However, many studies have proven that HBsAg negative blood can still be infection. Therefore to enhance blood safety same countries have added antibody parameters in blood screening of donors – antibody for hepatitis B core antigen (anti-HBc) as marker for HBV infection and antibody for hepatitis B surface antigen (anti-HBs) as marker for immunological response to HBV infection. And with the development of molecular biology technology, HBV infection can be knowing faster in seronegative windows period with HBV DNA examination inspection by methods Nucleic Acid Test (NAT) multiplex and discrimenatory. In fact the results of seronegative blood is still there HBV virus with NAT, and this result we can called with the Occult hepatitis B (HBO). Prevalence of donors with HBO ranges 8- 10% in Indonesia. This study aims to determine the efectivity analized by NAT method blood donor with HBO to see continuity with the examination of anti-HBc, anti-HBs, viral load, and the cause of the HBO that mutations in the gene encoding HBsAg. Methodology. This study used a cross-sectional design (cross-sectional) conducted in UTDP and Eijkman Institute for Molecular Biology, with a sample of 4,973 sampless blood bloods donor from 4 units of blood transfusion area of Jakarta, Tangerang City, Depok and Bekasi district. Against sample serological examination HBsAg, anti-HBc, anti-HBs, NAT, quantitative and qualitative PCR, then samples were HBsAg negative, positive NAT and quantitative PCR positive results obtained further investigation amino acid sequencing to determine whether there is a mutant HBsAg cause serological detection of HBsAg escape by HBsAg reagents used for screening of blood donors Result. There was 20 samples (0.40%) had results of HBsAg negative and positive NAT multiplex, and only 16 samples (80%) HBsAg negative and positive discrimenatory NAT. Furthermore, the results of the examination of anti-HBc and anti-HBs negative positive / negative obtained only 1 samples (6.25%), anti-HBc positive and negative anti-Hbs obtained 9 samples (56.25%), and anti-HBc , anti- HBs positive are 5 samples (31.25%). and then , qualitative PCR examination and had 3 samples (18.75%), is not detected, 6 (37.5%) samples, and some samples showed a low viral load results detection (sensitivity under tools value), and 6 samples (43.75%) shows viral load is positive. In qualitative PCR and sequencing obtained 2 samples (28.57%) found a mutation in the S gene at position 143 where there T143M amino acid substitution.;Background. Hepatitis B is one of the most serious health problem. It is estimated that more than 2 bilion people have been infected by this virus, of which 360 milion are chronically infected with severe and fatal risk especially of cirrosis and hepatocellular carcinoma. One of the main ways to prevent transfusion transmitted HBV infection is blood screening for HBsAg. However, many studies have proven that HBsAg negative blood can still be infection. Therefore to enhance blood safety same countries have added antibody parameters in blood screening of donors – antibody for hepatitis B core antigen (anti-HBc) as marker for HBV infection and antibody for hepatitis B surface antigen (anti-HBs) as marker for immunological response to HBV infection. And with the development of molecular biology technology, HBV infection can be knowing faster in seronegative windows period with HBV DNA examination inspection by methods Nucleic Acid Test (NAT) multiplex and discrimenatory. In fact the results of seronegative blood is still there HBV virus with NAT, and this result we can called with the Occult hepatitis B (HBO). Prevalence of donors with HBO ranges 8- 10% in Indonesia. This study aims to determine the efectivity analized by NAT method blood donor with HBO to see continuity with the examination of anti-HBc, anti-HBs, viral load, and the cause of the HBO that mutations in the gene encoding HBsAg. Methodology. This study used a cross-sectional design (cross-sectional) conducted in UTDP and Eijkman Institute for Molecular Biology, with a sample of 4,973 sampless blood bloods donor from 4 units of blood transfusion area of Jakarta, Tangerang City, Depok and Bekasi district. Against sample serological examination HBsAg, anti-HBc, anti-HBs, NAT, quantitative and qualitative PCR, then samples were HBsAg negative, positive NAT and quantitative PCR positive results obtained further investigation amino acid sequencing to determine whether there is a mutant HBsAg cause serological detection of HBsAg escape by HBsAg reagents used for screening of blood donors Result. There was 20 samples (0.40%) had results of HBsAg negative and positive NAT multiplex, and only 16 samples (80%) HBsAg negative and positive discrimenatory NAT. Furthermore, the results of the examination of anti-HBc and anti-HBs negative positive / negative obtained only 1 samples (6.25%), anti-HBc positive and negative anti-Hbs obtained 9 samples (56.25%), and anti-HBc , anti- HBs positive are 5 samples (31.25%). and then , qualitative PCR examination and had 3 samples (18.75%), is not detected, 6 (37.5%) samples, and some samples showed a low viral load results detection (sensitivity under tools value), and 6 samples (43.75%) shows viral load is positive. In qualitative PCR and sequencing obtained 2 samples (28.57%) found a mutation in the S gene at position 143 where there T143M amino acid substitution.;Background. Hepatitis B is one of the most serious health problem. It is estimated that more than 2 bilion people have been infected by this virus, of which 360 milion are chronically infected with severe and fatal risk especially of cirrosis and hepatocellular carcinoma. One of the main ways to prevent transfusion transmitted HBV infection is blood screening for HBsAg. However, many studies have proven that HBsAg negative blood can still be infection. Therefore to enhance blood safety same countries have added antibody parameters in blood screening of donors – antibody for hepatitis B core antigen (anti-HBc) as marker for HBV infection and antibody for hepatitis B surface antigen (anti-HBs) as marker for immunological response to HBV infection. And with the development of molecular biology technology, HBV infection can be knowing faster in seronegative windows period with HBV DNA examination inspection by methods Nucleic Acid Test (NAT) multiplex and discrimenatory. In fact the results of seronegative blood is still there HBV virus with NAT, and this result we can called with the Occult hepatitis B (HBO). Prevalence of donors with HBO ranges 8- 10% in Indonesia. This study aims to determine the efectivity analized by NAT method blood donor with HBO to see continuity with the examination of anti-HBc, anti-HBs, viral load, and the cause of the HBO that mutations in the gene encoding HBsAg. Methodology. This study used a cross-sectional design (cross-sectional) conducted in UTDP and Eijkman Institute for Molecular Biology, with a sample of 4,973 sampless blood bloods donor from 4 units of blood transfusion area of Jakarta, Tangerang City, Depok and Bekasi district. Against sample serological examination HBsAg, anti-HBc, anti-HBs, NAT, quantitative and qualitative PCR, then samples were HBsAg negative, positive NAT and quantitative PCR positive results obtained further investigation amino acid sequencing to determine whether there is a mutant HBsAg cause serological detection of HBsAg escape by HBsAg reagents used for screening of blood donors Result. There was 20 samples (0.40%) had results of HBsAg negative and positive NAT multiplex, and only 16 samples (80%) HBsAg negative and positive discrimenatory NAT. Furthermore, the results of the examination of anti-HBc and anti-HBs negative positive / negative obtained only 1 samples (6.25%), anti-HBc positive and negative anti-Hbs obtained 9 samples (56.25%), and anti-HBc , anti- HBs positive are 5 samples (31.25%). and then , qualitative PCR examination and had 3 samples (18.75%), is not detected, 6 (37.5%) samples, and some samples showed a low viral load results detection (sensitivity under tools value), and 6 samples (43.75%) shows viral load is positive. In qualitative PCR and sequencing obtained 2 samples (28.57%) found a mutation in the S gene at position 143 where there T143M amino acid substitution.;Background. Hepatitis B is one of the most serious health problem. It is estimated that more than 2 bilion people have been infected by this virus, of which 360 milion are chronically infected with severe and fatal risk especially of cirrosis and hepatocellular carcinoma. One of the main ways to prevent transfusion transmitted HBV infection is blood screening for HBsAg. However, many studies have proven that HBsAg negative blood can still be infection. Therefore to enhance blood safety same countries have added antibody parameters in blood screening of donors – antibody for hepatitis B core antigen (anti-HBc) as marker for HBV infection and antibody for hepatitis B surface antigen (anti-HBs) as marker for immunological response to HBV infection. And with the development of molecular biology technology, HBV infection can be knowing faster in seronegative windows period with HBV DNA examination inspection by methods Nucleic Acid Test (NAT) multiplex and discrimenatory. In fact the results of seronegative blood is still there HBV virus with NAT, and this result we can called with the Occult hepatitis B (HBO). Prevalence of donors with HBO ranges 8- 10% in Indonesia. This study aims to determine the efectivity analized by NAT method blood donor with HBO to see continuity with the examination of anti-HBc, anti-HBs, viral load, and the cause of the HBO that mutations in the gene encoding HBsAg. Methodology. This study used a cross-sectional design (cross-sectional) conducted in UTDP and Eijkman Institute for Molecular Biology, with a sample of 4,973 sampless blood bloods donor from 4 units of blood transfusion area of Jakarta, Tangerang City, Depok and Bekasi district. Against sample serological examination HBsAg, anti-HBc, anti-HBs, NAT, quantitative and qualitative PCR, then samples were HBsAg negative, positive NAT and quantitative PCR positive results obtained further investigation amino acid sequencing to determine whether there is a mutant HBsAg cause serological detection of HBsAg escape by HBsAg reagents used for screening of blood donors Result. There was 20 samples (0.40%) had results of HBsAg negative and positive NAT multiplex, and only 16 samples (80%) HBsAg negative and positive discrimenatory NAT. Furthermore, the results of the examination of anti-HBc and anti-HBs negative positive / negative obtained only 1 samples (6.25%), anti-HBc positive and negative anti-Hbs obtained 9 samples (56.25%), and anti-HBc , anti- HBs positive are 5 samples (31.25%). and then , qualitative PCR examination and had 3 samples (18.75%), is not detected, 6 (37.5%) samples, and some samples showed a low viral load results detection (sensitivity under tools value), and 6 samples (43.75%) shows viral load is positive. In qualitative PCR and sequencing obtained 2 samples (28.57%) found a mutation in the S gene at position 143 where there T143M amino acid substitution.;Background. Hepatitis B is one of the most serious health problem. It is estimated that more than 2 bilion people have been infected by this virus, of which 360 milion are chronically infected with severe and fatal risk especially of cirrosis and hepatocellular carcinoma. One of the main ways to prevent transfusion transmitted HBV infection is blood screening for HBsAg. However, many studies have proven that HBsAg negative blood can still be infection. Therefore to enhance blood safety same countries have added antibody parameters in blood screening of donors – antibody for hepatitis B core antigen (anti-HBc) as marker for HBV infection and antibody for hepatitis B surface antigen (anti-HBs) as marker for immunological response to HBV infection. And with the development of molecular biology technology, HBV infection can be knowing faster in seronegative windows period with HBV DNA examination inspection by methods Nucleic Acid Test (NAT) multiplex and discrimenatory. In fact the results of seronegative blood is still there HBV virus with NAT, and this result we can called with the Occult hepatitis B (HBO). Prevalence of donors with HBO ranges 8- 10% in Indonesia. This study aims to determine the efectivity analized by NAT method blood donor with HBO to see continuity with the examination of anti-HBc, anti-HBs, viral load, and the cause of the HBO that mutations in the gene encoding HBsAg. Methodology. This study used a cross-sectional design (cross-sectional) conducted in UTDP and Eijkman Institute for Molecular Biology, with a sample of 4,973 sampless blood bloods donor from 4 units of blood transfusion area of Jakarta, Tangerang City, Depok and Bekasi district. Against sample serological examination HBsAg, anti-HBc, anti-HBs, NAT, quantitative and qualitative PCR, then samples were HBsAg negative, positive NAT and quantitative PCR positive results obtained further investigation amino acid sequencing to determine whether there is a mutant HBsAg cause serological detection of HBsAg escape by HBsAg reagents used for screening of blood donors Result. There was 20 samples (0.40%) had results of HBsAg negative and positive NAT multiplex, and only 16 samples (80%) HBsAg negative and positive discrimenatory NAT. Furthermore, the results of the examination of anti-HBc and anti-HBs negative positive / negative obtained only 1 samples (6.25%), anti-HBc positive and negative anti-Hbs obtained 9 samples (56.25%), and anti-HBc , anti- HBs positive are 5 samples (31.25%). and then , qualitative PCR examination and had 3 samples (18.75%), is not detected, 6 (37.5%) samples, and some samples showed a low viral load results detection (sensitivity under tools value), and 6 samples (43.75%) shows viral load is positive. In qualitative PCR and sequencing obtained 2 samples (28.57%) found a mutation in the S gene at position 143 where there T143M amino acid substitution., Background. Hepatitis B is one of the most serious health problem. It is estimated that more than 2 bilion people have been infected by this virus, of which 360 milion are chronically infected with severe and fatal risk especially of cirrosis and hepatocellular carcinoma. One of the main ways to prevent transfusion transmitted HBV infection is blood screening for HBsAg. However, many studies have proven that HBsAg negative blood can still be infection. Therefore to enhance blood safety same countries have added antibody parameters in blood screening of donors – antibody for hepatitis B core antigen (anti-HBc) as marker for HBV infection and antibody for hepatitis B surface antigen (anti-HBs) as marker for immunological response to HBV infection. And with the development of molecular biology technology, HBV infection can be knowing faster in seronegative windows period with HBV DNA examination inspection by methods Nucleic Acid Test (NAT) multiplex and discrimenatory. In fact the results of seronegative blood is still there HBV virus with NAT, and this result we can called with the Occult hepatitis B (HBO). Prevalence of donors with HBO ranges 8- 10% in Indonesia. This study aims to determine the efectivity analized by NAT method blood donor with HBO to see continuity with the examination of anti-HBc, anti-HBs, viral load, and the cause of the HBO that mutations in the gene encoding HBsAg. Methodology. This study used a cross-sectional design (cross-sectional) conducted in UTDP and Eijkman Institute for Molecular Biology, with a sample of 4,973 sampless blood bloods donor from 4 units of blood transfusion area of Jakarta, Tangerang City, Depok and Bekasi district. Against sample serological examination HBsAg, anti-HBc, anti-HBs, NAT, quantitative and qualitative PCR, then samples were HBsAg negative, positive NAT and quantitative PCR positive results obtained further investigation amino acid sequencing to determine whether there is a mutant HBsAg cause serological detection of HBsAg escape by HBsAg reagents used for screening of blood donors Result. There was 20 samples (0.40%) had results of HBsAg negative and positive NAT multiplex, and only 16 samples (80%) HBsAg negative and positive discrimenatory NAT. Furthermore, the results of the examination of anti-HBc and anti-HBs negative positive / negative obtained only 1 samples (6.25%), anti-HBc positive and negative anti-Hbs obtained 9 samples (56.25%), and anti-HBc , anti- HBs positive are 5 samples (31.25%). and then , qualitative PCR examination and had 3 samples (18.75%), is not detected, 6 (37.5%) samples, and some samples showed a low viral load results detection (sensitivity under tools value), and 6 samples (43.75%) shows viral load is positive. In qualitative PCR and sequencing obtained 2 samples (28.57%) found a mutation in the S gene at position 143 where there T143M amino acid substitution.]
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
T58764
UI - Tesis Membership  Universitas Indonesia Library