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"Latar belakang penelitian ini adalah peningkatan biaya kesehatan yang terus meningkat sedangkan anggaran yang disediakan terbatas. Sehingga memerlukan analisis yang lebih mendalam mengenai faktor-faktor yang mempengaruhi peningkatan biaya kesehatan tersebut. Penelitian ini menggunakan studi crosssectional dengan metode kuantitatif, dengan melihat factor umur, jenis kelamin, pendidikan, diagnosis dan rata-rata biaya obat yang diresepkan sesuai dengan data sekunder yang didapat melalui data tagihan provider yang menjadi langganan PT PLN dalam memberikan layanan kesehatan. Dan berdasarkan hasil penelitian, faktor yang mempengaruhi biaya kesehatan dalah umur dan diagnosis penyakit.Disamping hal tersebut, tempat layanan kesehatan rumah sakit juga memiliki andil dalam peningkatan biaya kesehatan dibandingkan dokter praktek.Sehingga menyikapi permasalahan tersebut, diperlukan kebijakan di PT PLN untuk memberlakukan sistem pengobatan yang berjenjang, dari dokter umum ke pengobatan dokter spesialis.

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The background of this research is to increase health costs continue to rise while the budget is limited. Thus require a more in-depth analysis of the factors that affect the health cost increases. This study used cross sectional study with quantitative methods, by looking at the factors age, sex, education, diagnosis, and the average cost of prescription drugs in accordance with secondary data obtained through billing data providers be subscribed by PT PLN in providing health services. And based on research results, factors that affect health care costs is age and diagnosis of the disease. Where health-care hospital also has contributed to the increase in health costs than doctors practice. So addressing these problems, needed policy at PT PLN to enforce treatment system a tiered, from general practitioners to medical specialists."

"Penelitian ini bertujuan untuk mengetahui Kinerja Pegawai Dinas Kesehatan Kota Palangka Raya. Jenis penelitian ini adalah survei cross-sectional dengan menggunakan kuesioner penilaian kinerja berdasarkan metoda penilaian sendiri dan metoda 360° yang dimodifikasi. Populasi dan sampel adalah semua Pegawai Negeri Sipil Dinas Kesehatan Kota Palangka Raya sebanyak 69 orang. Dari 10 unsur penilaian kinerja, ada 6 (enam) unsur yang telah terbukti tidak memiliki perbedaan yang bermakna yaitu pengetahuan terhadap pekerjaan, kuantitas kerja, kualitas kerja, kreativitas, kemauan belajar dan inisiatif, dan komunikasi, sementara 4 (empat) unsur lainnya seperti kerjasama, integritas, disiplin kerja, dan kepemimpinan memiliki perbedaan yang bermakna. Berdasarkan hasil penelitian ini, diperlukan perbaikan manajemen dan peningkatan efektivitas kepemimpinan di lingkungan Dinas Kesehatan Kota Palangka Raya.

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This study aims to determine the Performance of Employee of Palangka Raya Municipality Health Office. This type of research is a cross-sectional survey using modified questionnaires of performance asssessment based on self assessment and 360° methods. Population and sample are all Civil Servants of Palangka Raya Municipality Health Office as many as 69 persons. Of the 10 elements of performance assessment, there are 6 (six) elements that have been proved no significant difference such as knowledge of work, quantity of work, quality of work, creativity, willingness to learn and initiative, and communication, while 4 (four) other elements like cooperation, integrity, work discipline, and leadership have significant differences. Based on the results of this study, improved management and increased effectiveness of environmental leadership are needed in Palangka Raya Municipality Health Office."

"Lama waktu tunggu pelayanan di Unit Rawat Jalan menggambarkan kinerjadan mutu pelayanan Rumah Sakit terhadap para pelanggannya. Tujuanpenelitian ini untuk mengetahui rata-rata lama waktu tunggu rawat jalan sertafaktor-faktor yang terkait dengan hal itu, ditinjau melalui pendekatan kriteriaMalcolm Baldrige di bidang kesehatan yang meliputi : Profil Organisasi,Kepemimpinan, Rencana Strategis, Fokus pada Pelanggan, Pengukuran,Analisa dan Manajemen Pengetahuan, Fokus pada Sumber Daya Manusia,Fokus pada Proses dan Hasil-hasil.Metode penelitian yang dipergunakan adalah eksplanatori sekuensial, yaitusuatu metode campuran antara penelitian kuantitatif yang diperkuat olehpenelitian kualitatif. Pengumpulan data kuantitatif dengan cara pengamatan,penghitungan dan pencatatan waktu tunggu pasien. Data-data kualitatifdiperoleh melalui proses wawancara mendalam secara terstruktur danmelakukan telaah dokumen yang terkait.Hasil penelitian menunjukkan bahwa nilai rata-rata lama waktu tunggurawat jalan sebesar 66,58 menit per pasien yang berarti melebihi standard waktupelayanan minimal yaitu le; 60 menit sebagaimana yang ditetapkan olehKementerian Kesehatan Republik Indonesia. Hasil analisa terhadap faktorfaktoryang berpengaruh terhadap lama waktu tunggu rawat jalan menunjukkanbahwa ketujuh kriteria Malcolm Baldrige tersebut sangat berpengaruh terhadapnilai rata-rata lama waktu tunggu rawat jalan tersebut di atas.

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Long waiting time of service in the Outpatient Unit describes theperformance and quality of hospital rsquo s service against its customers. The purpose ofthis research is to know the average length of outpatient waiting time as well as thefactors associated with it, are reviewed through the approach of Malcolm Baldrigein health which includes Organization Profile Leadership Strategic plan Focuson Customers Measurement, Analysis and Management of knowledge Focusingon Human Resources Focus on Process and Outcomes.The research method used was the sequential explanatory, a mix methodsbetween quantitative research that reinforced by qualitative research. Quantitativedata collection by way of observation, calculation and recording patient waitingtime. Qualitative data obtained through in depth interviews are structured and dostudy related documents.The results showed that the average value of long outpatient waiting time is66.58 minutes per patient means exceeding the standard minimum of service time, le 60 minutes as defined by the Health Ministry of the Republic of Indonesia. Theanalysis results of the influential factors against the long of outpatient waiting timeshowed that seven criteria of Malcolm Baldrige is really influential against theaverage value of the long of outpatient waiting time."

"RSUD Haji Abdul Manap merupakan satu-satunya rumah sakit tipe C yang memberikan pelayanan CST (Care, Support and Treatment) untuk ODHA (Orang Dengan HIV-AIDS) di Kota Jambi, namun 5 tahun terakhir trend utilisasi klinik CST cenderung menurun. Penelitian ini bertujuan untuk menganalisis sistem pelayanan klinik CST yang perperan dalam penurunan utilitas layanan klinik CST RSUD H. Abdul Manap Kota Jambi yang akan dijadikan dasar rekomendasi pemecahanan masalah terkait Penelitian mengunakan desain kualitatif dengan metode deskriftip analitik. Pengambilan sampel dengan purposive sampling, data primer dari observasi dan wawancara mendalam dengan key informan yaitu tim menajemen (3 orang), tim klinik CST (7orang), ODHA(18 orang) dan konselor sebaya (8 orang) serta FGD (Focus Group Discussion). Data sekunder diperoleh dari telah dokumen terkait Klinik CST. Validitas dan realibilitas data dilakukan Triangulasi metode dan sumber. Hasil yang didapat adalah komitmen, monitoring dan evaluasi terutama dari pimpinan RS terhadap klinik CST belum maksimal. Program PMKP (Peningkatan Mutu dan Keselamatan Kerja) belum berjalan. Alokasi anggaran masih terbatas, pemeriksan CD4(Helper-T- cell) sudah ada tapi catrige expired, ruang CST nyaman. Kebijakan terkait layanan CST belum jelas. SPO (Standar Prosedur Operasional) layanan belum lengkap, tidak ada indikator kinerja, sosialisasi SPO belum baik, pelaksanakan SPO belum optimal terutama pelaksanaan SPO pengobatan ARV(Anti Retro Viral) dan konseling. Waktu tunggu lama (> 2 jam) terutama di rekam medis, manajemn belum memahami prosedur pengklaiman layanan CST melalui JKN(Jaminan Kesehatan Nasional) sehingga ODHA peserta JKN masih membayar karcis, koordinasi dengan mitra terkait (Konselor Sebaya, Kelompok ODHA, PKVHI (Persatuan Konselor VCT/(Voluntary counselling and testing ) HIV Indonesia) dan dinas kesehatan belum maksimal. Menurunnya utilisasi Klinik CST disebabkan kurangnya komitmen, monitoring dan evaluasi terutama dari pimpinan rumah sakit terhadap klinik CST. Implementasi kebijakan dan prosedur layanan CST belum optimal dan sumber daya manusia belum sesuai standar kompetensi. Perlunya monitoring dan evaluasi terjadwal dan kontinyu terhadap pelaksaan SPO bekerjasama dengan tim PMKP, koordinasi dengan dinas kesehatan dan PKVHI untuk pelatihan petugas CST, analisis beban kerja perawat dan petugas rekam medis, merevisi Surat Keputusan Direktur RS terkait nama ketua tim CST, advokasi Pemda untuk kejelasan kebijakan terkait layanan CST dan meningkatkan anggaran layanan HIV di rumah sakit, perlu pemahaman prosedur pengklaiman layanan CST bagi ODHA peserta JKN. Meningkatkan kerjasama dengan mitra kerja terkait.

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H Abdul Manap Public Hospital is the only type-C hospital which provides CST (Care, support and Treatment) service to PLWHAs (People Live With HIV-AIDS) in Jambi City. However, in the past five years, the trend of CST clinic utilization has tended to decrease. This research aims to analyze the CST clinic service system which affecting the decrease in the utilization of the CST Clinic of H. Abdul Manap Regional Public Hospital, Jambi City to be used as a basis for problem solving recommendations. This research utilized qualitative design, descriptive analytical method with purposive sampling technique. The primary data sources from observation and in-depth interviews with Key informants included the management team (3 people), CST Clinic team (7 people), PLWHAs (18 people) and peer counselors (8 people) as well as FGDs (Focus Group Discussions). The secondary data were obtained from the relevant documents of the CST Clinic. The data validity and reliability were examined by the triangulation method and source. Results is the comitment, monitoring and evaluation especially from the chairman of the hospital to the CST service, has not been maximum. Safety and quality program has not run. The budget allocation was limited. CD4 test was available, but the CD4(Helper-T-cell) catrige was not available. The CST room was convenient, the policies related to CST service were not yet clear. The service SOP was incomplete, lacking performance indicators, and its socialization had not been conducted well. Therefore, not all staffs implemented the SOP(Standar Opertional Procedure) properly, especially the SOP on ARV (Anti Retro Viral) treatment, and counseling. The average waiting time was more than 2 hours, and the hospital had not known the procedure to claim CST service. Therefore, PLWHA with JKN (National Health Insurance) still needed to pay the ticket to access CST service. Coordination with related partners (Peer Counselors, PLWHA Groups, PKVHI (Association of Indonesian HIV VCT(Voluntary, Counselling and Testing) Counselors) and health services has not been maximum. Decreasing utilization of CST Clinic due to lack of the comitment, monitoring and evaluation especially from the chairman of the hospital to the CST service. As well as the scheduled and continuous monitoring on SOP implementation are required in collaboration with the PMKP (Safety and quality program) team. The local government needs to make advocacy to the clarity of regional policies related to CST service, increase HIV service budget in the hospital, management teams should understand the procedure for claiming CST service for PLWHAs with National Health Insurance. Last, improvement in cooperating with work partners is required."