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Abstrak :
Dalam menyangsong era perdagangan bebas tahun 2003 serta sejalan dengan kebijakan pemerintah mengenai otonomi daerah, maka seluruh sumber daya yang ada harus dipersiapkan dengan sebaik-baiknya. Tidak terkecuali sentra ekonomi kawasan pesisir pantai yang selama ini lambat berkembang dibandingkan dengan sentra-sentra produksi lainnya. Selain itu wilayah Indonesia yang sebagian besar terdiri dari lautan dan wilayah pesisirnya merupakan garis pantai terpanjang di dunia ternyata belum dimanfaatkan dengan baik sampai saat ini. Salah satu usaha dalam meningkatkan kawasan pesisir pantai ini adalah dengan peningkatan pelayanan kesehatan bagi masyarakat yang tinggal di wilayah-wilayah pesisir. Ide dari penelitian ini adalah memberi respon terhadap peluang pengadaan Puskesmas Terapung (PT) yang berfungsi sebagai pelayanan kesehatan ini. Puskesmas Terapung (PT) ini dapat berpindah dari satu wilayah kc wilayah lainnya. Untuk itu penelitian ini ditujukan untuk mendapatkan konsep Puskesmas Terapung (PT) yang tepat sehingga di kemudian hari dapat diimplementasikan menjadi suatu produk Puskesmas Tcrapung (PT) yang dapat diandalkan.

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Facing the AFTA in the year 2003 and by considering the government?s policy on district autonomy, it is very important to prepare all available resources in Indonesia properly. Coastal region as one of the economic elements of Indonesia has a low growth rate compared to other elements. It is contrary to the fact that Indonesian territory mostly consists of oceans and has the longest coastline in the world. One of possible efforts to develop this ocean potential is by improving the health service to the people live in coastal regions. The main idea of this research is to find the possibility of building a General Clinic which is able to serve the health need as coastal people. This General Clinic boat should be able to be used as a distribution means of medical supply and can be move from a coastal region to another. Therefore this research is focused on making a good concept design of General Clinic in order to be implemented in the future.

Abstrak :
Rendahnya jumlah kunjungan masyarakat di klinik pengobatan Puskesmas Way Laga dan mempersiapkan Puskesmas Way Laga sebagai unit Swadana tahun 2004, sehingga perlu untuk dilakukan penelitian tentang seberapa jauh permintaan masyarakat terhadap klinik pengobatan Puskesmas Way Laga. Penelitian ini dilakukan dengan menggunakan metode cross sectional atau potong lintang dan sasaran adalah masyarakat di wilayah kerja Puskesmas Way Laga yang pernah memanfaatkan klinik pengobatan di Puskesmas Way Laga. Sedangkan dalam penelitian yang dilakukan oleh peneliti di Puskesmas Way Laga Kota Bandar Lampung tahun 2004 diperoleh hasil analisis bivariat variabel yang berhubungan dengan Demand masyarakat terhadap pelayanan adalah variabel Pendidikan, pekerjaan, waktu tunggu, pendapatan, jumlah anggota keluarga dan JPKM dan variabel yang paling dominan dalam mempengaruhi Demand masyarakat terhadap pelayanan kesehatan dalam analisis multivariat adalah variabel jumlah anggota keluarga setelah mendapatkan kontrol dart variabel pendapatan, namun demikian dart basil analisis multivariat dimana p value variabel jumlah anggota keluarga sebesar 0,029 kurang dart 0,05 dan 95% confident interval yang paling sempit adalah variabel jumlah anggota keluarga sehingga diambil kesimpulan bahwa variabel jumlah anggota keluarga yang sangat mempengaruhi Demand masyarakat terhadap pelayanan kesehatan khususnya di wilayah Puskesmas Way Laga tahun 2004. Hasil dari analisis interaksi antara kedua variabel tersebut di peroleh hasil bahwa variabel pendapatan dan variabel jumlah anggota keluarga tidak sating berinteraksi kepada Demand masyarakat terhadap pelayanan kesehatan sehingga kedua variabel tersebut tidak dapat secara bersama-sama dalam mempengaruhi Demand masyarakat terhadap pelayanan kesehatan. Dengan demikian Puskesmas Way Laga yang akan menerapkan Puskesmas Swadana perlu memikirkan faktor pendapatan dalam menentukan harga atau tarif yang akan diberlakukan hanya saja perlu ditingkatkan atau perlunya perubahan sistem dalam pelayanan kesehatan terhadap masyarakat sehingga waktu tunggu akan semakin singkat mengingat sebagian besar penduduk diwilayah kerja Puskesmas Way Laga memiliki pekerjaan non formal sehingga waktu bagi mereka sangat bermanfaat untuk memperoleh atau meningkatkan penghasilan keluarga.

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Demand analysis to public health service at Way Laga Health Center, Bandar Lampung Municipality , 2004Way Laga Public Health Centre has low visited and still prepared as Swadana Unit in 2004 , so community demand of health care at Way Laga Public Health Centre was unknown and research of them must be carried out. Some research have been done at some places like as the result of Husni Asbudin research at Bekasi that dominant factor of demand is price that be controlled by income and so the result of Ongko research at Ujung Pandang. While in this study at Way Laga Public Health Center Bandar Lampung Municipality 2004, have been got p value 0,029 by bivariate analysis that is relation between community demand to health service and in multivariate analysis that been got dominant is amount of famiiiy variable which have been controlled by income, that shown by multivariate analysis that p value of both variable are 0,029 ( < 0,05 , 95% CI) and amount of familiy variable is narrower variable and more influence community demand to health service, especially at Way Laga Public Health Service 2004. The result of interaction between time line and occupation is each interaction to community demand to health service, so the both variable are not separated to influence community demand to health service. Therefore, Way Laga Public Health Center will apply Swadana Public Health Center is not difficult to decide the tariff, just to arrange health service system, so time line will be short, because almost of the occupation of the community around Way Laga Public Health Center is non formal, and the time is more benefit for them.

Abstrak :
ABSTRAK
Awal tahun 2019 terjadi peningkatan insiden DBD di hampir seluruh wilayah Indonesia. Data 2014-2015 menunjukkan DKI Jakarta selalu memiliki IR DBD di atas angka Nasional. Pola peningkatan IR DBD di DKI Jakarta sangat bervariasi antar Kelurahan, beberapa Kelurahan mengalami peningkatan kasus sangat tinggi sementara Kelurahan lain justru turun. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan peningkatan IR DBD per Kelurahan periode Januari-Mei 2019. Jenis penelitian observasional analitik dengan disain cross sectional. Hasil penelitian mendapatkan model fit multivariat memuat 3 variabel yang mempengaruhi peningkatan IR DBD per Kelurahan, yakni Angka Bebas Jentik (ABJ) dengan nilai Prevalens Rasio (PR) 1,66 (95% CI= 1,14-2,41), IR DBD sebelumnya, PR 0,60 (95% CI = 0,42-0,86) dan proporsi umur 6-17 tahun PR sebesar 1,52 (95% CI= 1,06-2,16). Untuk mencegah peningkatan IR DBD tingkat Kelurahan maka ABJ perlu ditingkatkan minimal 90-95% dan dipertahankan bagi yang telah mencapai ≥ 95% melalui upaya pokok pengendalian vektor DBD yakni dengan melaksanakan kegiatan PSN 3 M Plus dan Gerakan 1 Rumah 1 Jumantik (G1R1J), pihak Sekolah perlu dilibatkan dalam gerakan PSN ini sebab proporsi usia Sekolah SD sd SMA yang tinggi berperan dalam peningkatan IR DBD, Dinas Kesehatan beserta jajarannya perlu memberikan feed back pelaporan DBD kepada masyarakat dan lintas sektor di tingkat Kelurahan secara rutin agar masyarakat dan aparat Kelurahan senantiasa waspada terhadap potensi peningkatan kasus DBD di wilayahnya, untuk menjaga kualitas PE DBD hendaknya senantiasa mendapat pembinaan dari Dinkes dan Sudinkes.

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ABSTRACT
Beginning 2019 year the incidence of dengue was increase in almost all of regions in Indonesia. Data from 2014 to 2015 shows that DKI Jakarta always has a DHF incidence rate above the national rate. The pattern of increasing DHF IR in DKI Jakarta varies greatly among urban villages, some urban villages have experienced very high increase in cases while other urban villages have actually declined. This study aims to determine the factors associated with an increase in DHF Incidence Rate by urban village in the period January to May 2019. This research is an analytic observational type with cross sectional design. The results get a multivariate fit model containing 3 variables that affect the increase in DHF per village, namely larvae free rate (ABJ) with a Prevalence Ratio (PR) 1.66 (95% CI = 1.14-2.41), DHF Incidence Rate previously, PR was 0.60 (95% CI = 0.42-0.86) and the proportion of ages 6-17 years of PR was 1.52 (95% CI = 1.06- 2.16). To prevent an increase in DHF at the Village level, the ABJ needs to be increased by at least 90-95% and maintained for those who have reached ≥ 95% through the main efforts to control the DHF vector, namely by carrying out the activities of the PSN 3M Plus and Movement 1 House 1 Larva Monitor (G1R1J), parties Schools need to be involved in this PSN movement because a high proportion of elementary school age to senior high school plays a role in increasing DHF Incidence Rate, the Health Office and its staff need to provide DBD reporting back to the community and cross-sectoral at the urban village level regularly so that the community and village's officials are always on the lookout for the potential increase in dengue cases in their region, to maintain the quality of DHF Epidemiological Investigation should always receive guidance from the Public Health Office of DKI Jakarta Provincial.

Abstrak :
Mutu Pelayanan Kesehatan merupakan standar layanan kesehatan untuk individu dan masyarakat yang dapat meningkatkan luaran kesehatan yang optimal. Indikator Nasional Mutu digunakan sebagai tolak ukur dalam mengukur mutu pelayanan kesehatan. Harapan pasien untuk mendapatkan mutu pelayanan yang baik dapat diberikan oleh dokter yang bertugas ketika melayani pasien yang mampu menerapkan kepemimpinan klinis dengan baik. Penelitian ini bertujuan untuk mengetahui hubungan domain-domain kepemimpinan klinis dokter terhadap mutu layanan kesehatan di rumah sakit. Penelitian ini dilakukan dengan metode survei dengan pendekatan kuantitatif. Penelitian dilakukan pada 42 orang dokter umum dan spesialis dengan kuesioner kepemimpinan klinis dokter. Sedangkan mutu layanan kesehatan di Rumah Sakit Izza dilihat pada capaian indikator nasional mutu rumah sakit. Terdapat 5 domain dengan masing-masing 8 dimensi pada kepemimpinan klinis dan 12 indikator nasional mutu yang dianalisis dari 13 total indikator nasional mutu. Pada penelitian ini didapatkan 2 domain kepemimpinan klinis yang berhubungan dengan mutu layanan kesehatan di rumah sakit, yaitu domain kualitas personal dan peningkatan pelayanan. Tiga domain lainnya, yaitu Kerja sama dengan sejawat dan interprofesi, pengelolaan pelayanan, dan penentuan arah pelayanan tidak berhubungan terhadap mutu layanan kesehatan di rumah sakit ......Quality of Health Services is a standard of health services for individuals and communities that can improve optimal health outcomes. National quality indicators are used as benchmark in measuring the quality of health services. Patient expectations for good quality of service can be provided by the doctor on duty when serving patients who are able to apply clinical leadership well. This study aims to determine the relationship of physician clinical leadership domains to the quality of health services in hospitals. This study was conducted using a survey method with a quantitative approach. The study was conducted on 42 general practitioners and specialists with a physician clinical leadership questionnaire. While the quality of health services at Izza Hospital is seen in the achievement of national indicators of hospital quality. There are 5 domains with 8 dimensions each in clinical leadership and 12 national quality indicators analyzed from 13 total national quality indicators. In this study, 2 domains of clinical leadership were found to be related to the quality of health services in the hospital, namely the domains of personal quality and service change. The other three domains, namely Collaboration with peers and interprofessionals, managing service, and setting direction are not related to the quality of health services in hospitals.

 

 

Abstrak :
Pemenuhan kebutuhan layanan kesehatan di masyarakat dilakukan terintegrasi melalui Puskesmas sebagai penanggungjawab sistem pelayanan kesehatan di tingkat kecamatan dan Posyandu Prima di tingkat desa/kelurahan. Posyandu Prima adalah Posyandu yang berasal dari Posyandu sebagai wadah pemberdayaan masyarakat dan menyelenggarakan pelayanan kesehatan dasar terpadu berdasarkan kebutuhan di desa atau kelurahan. Provinsi DKI Jakarta memiliki kekhususan sebagai ibukota negara, mempunyai sumber daya yang cukup untuk melayani kesehatan masyarakatnya hingga tingkat kelurahan melalui keberadaan Puskesmas dan tingkat rukun warga melalui layanan Posyandu Prima/Pustu. Tujuan penelitian untuk menganalisis kesiapan dalam pengembangan layanan Posyandu Prima tingkat Rukun Warga di provinsi DKI Jakarta. Penelitian kualitatif dengan desain penelitian eksploratif research dilakukan pada bulan April hingga Mei 2023 di Provinsi DKI Jakarta. Pengambilan data dilakukan melalui wawancara mendalam, observasi dan telaah dokumen. Hasil penelitian menunjukkan kesiapan pengembangan layanan Posyandu Prima/Pustu tingkat Rukun Warga belum optimal digambarkan dari 6 persyaratan Posyandu Prima/Pustu, hanya persyaratan sumber daya manusia dan mekanisme hubungan kerja dengan pemangku kepentingan yang siap, sedangkan peryaratan lokasi, anggaran, standar pelayanan, standar operasional prosedur memiliki kekurangan yang harus dipenuhi oleh Pemerintah. Diperlukan komitmen yang kuat dari Pemerintah dan stakeholder terkait untuk merealisasikan peningkatan akses layanan kesehatan melalui pengembangan layanan Posyandu Prima/Pustu tingkat Rukun Warga di Provinsi DKI Jakarta. ......Meeting the needs of health services in the community is carried out in an integrated manner through the Puskesmas as the person in charge of the health service system at the sub-district level and Posyandu Prima at the village/kelurahan level. Posyandu Prima is a Posyandu that originates from Posyandu as a forum for community empowerment and provides integrated basic health services based on needs in the village or sub-district. DKI Jakarta Province has the specialty of being the nation's capital, having sufficient resources to serve the health of its people down to the sub-district level through the existence of a Community Health Center (Puskesmas) and the neighborhood level through the services of Posyandu Prima/Pustu. The aim of the study was to analyze readiness in the development of Posyandu Prima services at the Rukun Warga level in the province of DKI Jakarta. Qualitative research with an exploratory research design was conducted from April to May 2023 in DKI Jakarta Province. Data collection was carried out through in-depth interviews, observation and document review. The results showed that the readiness to develop Posyandu Prima/Pustu services at the Rukun Warga level was not optimal as described from the 6 requirements of Posyandu Prima/Pustu, only the human resource requirements and working relationship mechanisms with stakeholders were ready, while the location requirements, budget, service standards, operational standards procedures have deficiencies that must be met by the Government. A strong commitment from the Government and related stakeholders is needed to realize increased access to health services through the development of services at the Posyandu Prima/Pustu at the Rukun Warga level in DKI Jakarta Province.

Abstrak :
Penelitian ini bertujuan untuk menganalisis hubungan karakteristik dokter, pelatihan
dokter, ketersediaan obat-obatan, ketersediaan fasilitas alat kesehatan, pemahaman dokter
dalam menangani 155 diagnosis non spesialitik, hubungan pemahaman dokter mengenai
reward dan punishment terhadap angka rujukan. Penelitian ini menunjukkan bahwa
Puskesmas Johar Baru memiliki angka rujukan di atas standar BPJS Kesehatan 15%
sedangkan di Puskesmas Kelurahan Petojo Selatan di bawah 15%. Hasil dari penelitian ini
menunjukan karakteristik dokter, pelatihan dokter, ketersediaan obatan-obatan,
pemahaman dokter dalam menangani 155 diagnosis non spesialitik, memiliki hubungan
dengan angka rujukan. ......This study aims to analyze the correlation of the physician’s characteristics, the
training they receive, availability of drugs, health facilities, the understanding of
physicians about how to handle 155 non specialist diagnosis, the understanding of
reward and punishment towards the referral number. The study revealed that Johar
Baru health center had high referral numbers and Petojo Selatan health center had
less than 15% referral ratio according to the standard that BPJS Kesehatan had
assign. The study concludes that the physician’s characteristics, the training they
receive, availability of drugs, the understanding of physicians about how to handle
155 non specialist diagnosis influence referral ratio.

Abstrak :
Customer oriented service quality was based on client oriented - provider efficient which was developed by engenderhealth in 1988. In its development, this kind of quality improvement was suggested to be implemented in health centres since it will be complied both the provider and patients demand....

Abstrak :
Research is a systematic search for information and new knowledge. It serves to essential and powerful purposes in accelerating advances in health. First, basic or traditional research is necessary to generate new knowledge and technologies to deal with major unresolved health problems. Second, applied research is necessary in identifying the priority problem and to design and evaluating policies and programs that will be of the greatest health benefit, using existing knowledge and available resources, both financial and human. During the past decades, concepts and research approaches to support health development have evolved rapidly. Many of this has been describe by specific terms such as operation research, health services research, health men power research, policy and economic analysis, applied research, and decision-linked research. Each of this has made crucial contribution to the development of client-oriented research or health system research (HSR). It is ultimately concerned with improving the health of a community, however defined by enhancing the efficiency and effectiveness of the health system as an integral part of the overall process of socio-economic development. The aim of client-oriented research or HSR is to provide health managers at all levels with the relevant information they need to solve the problem they may face. The participatory nature of such a research is one of its major characteristic because HSR addresses health problem in the broad context: research input from many different disciplines are required. This includes demography, epidemiology, health economics, policy and management sciences, social and behavioral science, statistics, and some aspect of the clinical sciences. With progressive development, the uses of HSR are becoming widely appreciated. As a result, it is being integrated into and applied in special areas of management such as quality assurances, technology assessment, and resource management.

Abstrak :
Sejak Covid-19 dinyatakan sebagai pandemi global oleh World Health Organization (WHO) pada 12 Maret 2020, berbagai kebijakan dibuat oleh pemerintah di seluruh dunia, salah satunya adalah lockdown. Kebijakan ini membuat perusahaan tidak dapat memproduksi dan mendistribusikan produknya sehingga menyebabkan gangguan rantai pasokan. Industri alat kesehatan merupakan salah satu rantai pasokan yang terkena dampak signifikan dari pandemi ini. Terdapat kekurangan alat pelindung diri (APD) dan alat kesehatan lainnya untuk perawatan Covid-19 pada rumah sakit di seluruh dunia. Salah satu negara yang mengalami gangguan dalam rantai pasokan alat kesehatan adalah Indonesia, karena ketergantungannya pada alat kesehatan dari negara lain, dan adanya larangan ekspor selama lockdown. Penting untuk mengadopsi ketangguhan rantai pasok karena ketergantungan dalam rantai pasokan. Ketika strategi ini diadopsi, diperlukan Key Performance Indicator (KPI) sebagai alat untuk memantau dan mengukur kinerja ketangguhan rantai pasokan pada industri alat kesehatan di Indonesia. Dalam penelitian ini, indikator yang dikumpulkan dari tinjauan literatur, terdapat 9 indikator dan 42 sub indikator untuk ketangguhan rantai pasokan. Setelah itu, indikator dan sub-indikator tersebut divalidasi oleh beberapa ahli dengan mengisi kuesioner. Dengan menggunakan modified kappa (k*) untuk validasi, didapatkan 35 sub indikator dinyatakan valid untuk industri alat kesehatan di Indonesia dengan nilai k* ≥ 0.74. Dengan menganalisa menggunakan Dematel-based ANP (DANP), indikator knowledge management merupakan indikator yang sangat mempengaruhi indikator lainnya sedangkan indikator agility merupakan indikator yang paling mudah dipengaruhi oleh indikator lainnya. ......Since Covid-19 was declared a global pandemic by the World Health Organization (WHO) on 12 March 2020, various policies have been made by governments around the world, one of which is a lockdown. This policy makes companies unable to produce and distribute their products, causing supply chain disruptions. The medical device industry is one of the supply chains significantly affected by this pandemic. There is a shortage of personal protective equipment (PPE) and other medical devices for Covid-19 treatment in hospitals around the world. One of the countries experiencing disruptions in the medical device supply chain is Indonesia, due to its dependence on medical device supplies from other countries, and the export ban during the lockdown. It is important to adopt Supply Chain Resilience (SCR) due to the dependency on the supply chain. When SCR is adopted, Key Performance Indicators (KPIs) are required as a tool to monitor and measure the performance of supply chain resilience in the medical device industry in Indonesia. In this study, indicators collected from the literature review, there are 9 indicators and 42 sub-indicators for supply chain resilience. After that, the indicators and sub-indicators were validated by several experts by filling out a questionnaire. Using modified kappa (k*) for validation, 35 sub-indicators were found to be valid for the medical device industry in Indonesia with a k* value ≥ 0.74. By analyzing using Dematel-based ANP (DANP), the knowledge management indicator is the indicator that strongly influences other indicators while the agility indicator is the indicator that is most easily affected by other indicators.

Abstrak :
Kesehatan adalah aspek paling penting dalam kehidupan setiap manusia. Mendapatkan lingkungan hidup yang sehat dan memperoleh pelayanan kesehatan adalah hak dasar yang harus dipenuhi bagi setiap warga negara. Salah satu bentuk upaya untuk menyelenggarakan pembangunan kesehatan yang menyeluruh, adil, dan merata adalah melakukan perbaikan dan peningkatan jumlah fasilitas pelayanan kesehatan seperti puskesmas. Terletak di wilayah ibukota negara, Kota Jakarta Timur memiliki 10 puskesmas kecamatan yang melayani masing-masing wilayah kecamatan. Dengan jumlah puskesmas tersebut, Kota Jakarta Timur dianggap mampu menjangkau kebutuhan pelayanan kesehatan dengan menyediakan tenaga kesehatan yang dapat melayani seluruh penduduknya. Akan tetapi, tidak meratanya distribusi tenaga kesehatan di fasilitas pelayanan primer bisa menjadi hambatan bagi masyarakat untuk mendapatkan kemudahan akses terhadap pelayanan kesehatan. Karena itu, tujuan penelitian ini adalah mengidentifikasi pola spasial aksesibilitas puskesmas kecamatan dan karakteristik wilayah layanan puskesmas kecamatan di Kota Jakarta Timur. Untuk mendapatkan nilai aksesibilitas digunakan metode pendekatan enhanced two-step floating catchment area (E2SFCA). Dari hasil analisis metode E2SFCA, wilayah kelurahan dengan nilai indeks aksesibilitas tertinggi adalah Kelurahan Rawa Bunga dan Kelurahan Balimester. Hasil tersebut menunjukkan pola spasial indeks aksesibilitas puskesmas kecamatan bervariasi pada wilayah kelurahan dengan tingkat aksesibilitas sangat tinggi hingga tingkat aksesibilitas sangat rendah, variasi pola dipengaruhi oleh jarak dan ketersediaan jaringan jalan. Sementara itu, masing-masing wilayah layanan puskesmas kecamatan memiliki karakteristik yang sangat beragam. Pada aspek kepadatan penduduk semua wilayah layanan didominasi oleh kepadatan sedang, aspek kerapatan jalan didominasi kerapatan rendah, sementara frekuensi tenaga kesehata berada di kelas sedang hingga tinggi. ......Health is the most important aspect of the life of every human being. Getting a healthy living environment and obtaining health services are fundamental rights that must be fulfilled for every citizen. One form of effort to organize comprehensive, fair, and equitable health development is to improve and increase the number of health service facilities such as health centers. Located in the national capital area, East Jakarta City has 10 sub-district health centers serving each sub-district area. With this number of public health centers, East Jakarta City is considered capable of meeting the needs of health services by providing health workers who can serve the entire population. However, the uneven distribution of health workers in primary care facilities can become an obstacle for the community to have easy access to health services. Therefore, the purpose of this study was to identify the spatial pattern of accessibility of sub-district health centers and the characteristics of the sub-district health center service areas in East Jakarta City. To get the accessibility value, the enhanced two-step floating catchment area (E2SFCA) approach is used. From the results of the analysis of the E2SFCA method, the urban village areas with the highest accessibility index values are Rawa Bunga and Balimester. These results show that the spatial pattern of the accessibility index of subdistrict health centers varies in kelurahan areas with a very high level of accessibility to a very low level of accessibility, the variation in pattern is influenced by the distance and availability of the road network. Meanwhile, each sub-district health center service area has very diverse characteristics. In the aspect of population density, all service areas are dominated by medium density, the aspect of road density is dominated by low density, while the frequency of health workers is in the medium to high class.