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Abstrak :
[ABSTRAK
Latar Belakang: Osteoporosis laki-laki adalah penyakit degeneratif yang penting diperhatikan oleh dokter gigi dalam memberikan pelayanan kesehatan gigi dan mulut, karena osteoporosis pada bagian tubuh yang lain juga bedampak pada tulang rahang. Osteoporosis pada tulang rahang dapat mengakibatkan kegagalan dalam pembuatan gigi tiruan, pemasangan implan dan perawatan penyakit periodontal. Untuk mengatasi kegagalan perawatan perlu pemeriksaan kadar testosteron dan pemeriksaan densitas tulang. Pemeriksaan kadar testosteron dan pemeriksaan densitas tulang mahal dan hanya ada di kota-kota besar di Indonesia, karena itu perlu dibuat indeks untuk memprediksi penurunan kadar testosteron darah dan indeks untuk memprediksi penurunan densitas tulang mandibula lansia laki-laki. Tujuan: mengetahui faktor risiko yang berperan pada penurunan kadar testosteron dan faktor risiko yang berperan pada penurunan densitas tulang mandibula lansia laki-laki dan untuk membuat indeks prediksi penurunan kadar testosteron dan indeks densitas tulang mandibula. Metode: uji diagnostik dan uji kasus kontrol pada lansia laki-laki usia > 60 tahun dengan wawancara pengisian kuesioner, pemeriksaa klinis dan radiografi. Hasil: Faktor-faktor Risiko yang berperan pada penurunan kadar testosteron dan penurunan densitas tulang mandibula serta indeks untuk menentukan penurunan kadar testosteron dan indeks untuk menentukan penurunan densitas tulang mandibula lansia laki-laki. Dihasilkan software dan indeks sebagai alat bantu prediksi.

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ABSTRACT
Background: Osteoporosis in men is a degenerative disease which is an important subject to be apprehended by dentists in order to provide an optimal dental and oral health service because osteoporosis can also affect the mandible. Examination of testosterone level and bone density in Indonesia is relatively expensive and can only be accessed in big cities. This highlights the importance of establishing both an index to determine the decrease of total blood testosterone level and index to determine the decrease of mandibular bone density in elderly patients. Objective: to know risk factors that contributes to the decrease of testosterone level and the decrease of mandibular bone density in elderly men; to make a prediction model for the decreasing level of testosterone and mandibular bone density. Methods: diagnostic test and case control study in elderly men above 60 years old by way interviews to fill questionnares, clinical and radiographic examination. Results: Risk factors that contribute to the decrease of testosterone level and index to determine the decrease of mandibular bone density in elderly men. A software and index are produced as prediction tools;Background: Osteoporosis in men is a degenerative disease which is an important subject to be apprehended by dentists in order to provide an optimal dental and oral health service because osteoporosis can also affect the mandible. Examination of testosterone level and bone density in Indonesia is relatively expensive and can only be accessed in big cities. This highlights the importance of establishing both an index to determine the decrease of total blood testosterone level and index to determine the decrease of mandibular bone density in elderly patients. Objective: to know risk factors that contributes to the decrease of testosterone level and the decrease of mandibular bone density in elderly men; to make a prediction model for the decreasing level of testosterone and mandibular bone density. Methods: diagnostic test and case control study in elderly men above 60 years old by way interviews to fill questionnares, clinical and radiographic examination. Results: Risk factors that contribute to the decrease of testosterone level and index to determine the decrease of mandibular bone density in elderly men. A software and index are produced as prediction tools;Background: Osteoporosis in men is a degenerative disease which is an important subject to be apprehended by dentists in order to provide an optimal dental and oral health service because osteoporosis can also affect the mandible. Examination of testosterone level and bone density in Indonesia is relatively expensive and can only be accessed in big cities. This highlights the importance of establishing both an index to determine the decrease of total blood testosterone level and index to determine the decrease of mandibular bone density in elderly patients. Objective: to know risk factors that contributes to the decrease of testosterone level and the decrease of mandibular bone density in elderly men; to make a prediction model for the decreasing level of testosterone and mandibular bone density. Methods: diagnostic test and case control study in elderly men above 60 years old by way interviews to fill questionnares, clinical and radiographic examination. Results: Risk factors that contribute to the decrease of testosterone level and index to determine the decrease of mandibular bone density in elderly men. A software and index are produced as prediction tools;Background: Osteoporosis in men is a degenerative disease which is an important subject to be apprehended by dentists in order to provide an optimal dental and oral health service because osteoporosis can also affect the mandible. Examination of testosterone level and bone density in Indonesia is relatively expensive and can only be accessed in big cities. This highlights the importance of establishing both an index to determine the decrease of total blood testosterone level and index to determine the decrease of mandibular bone density in elderly patients. Objective: to know risk factors that contributes to the decrease of testosterone level and the decrease of mandibular bone density in elderly men; to make a prediction model for the decreasing level of testosterone and mandibular bone density. Methods: diagnostic test and case control study in elderly men above 60 years old by way interviews to fill questionnares, clinical and radiographic examination. Results: Risk factors that contribute to the decrease of testosterone level and index to determine the decrease of mandibular bone density in elderly men. A software and index are produced as prediction tools;Background: Osteoporosis in men is a degenerative disease which is an important subject to be apprehended by dentists in order to provide an optimal dental and oral health service because osteoporosis can also affect the mandible. Examination of testosterone level and bone density in Indonesia is relatively expensive and can only be accessed in big cities. This highlights the importance of establishing both an index to determine the decrease of total blood testosterone level and index to determine the decrease of mandibular bone density in elderly patients. Objective: to know risk factors that contributes to the decrease of testosterone level and the decrease of mandibular bone density in elderly men; to make a prediction model for the decreasing level of testosterone and mandibular bone density. Methods: diagnostic test and case control study in elderly men above 60 years old by way interviews to fill questionnares, clinical and radiographic examination. Results: Risk factors that contribute to the decrease of testosterone level and index to determine the decrease of mandibular bone density in elderly men. A software and index are produced as prediction tools, Background: Osteoporosis in men is a degenerative disease which is an important subject to be apprehended by dentists in order to provide an optimal dental and oral health service because osteoporosis can also affect the mandible. Examination of testosterone level and bone density in Indonesia is relatively expensive and can only be accessed in big cities. This highlights the importance of establishing both an index to determine the decrease of total blood testosterone level and index to determine the decrease of mandibular bone density in elderly patients. Objective: to know risk factors that contributes to the decrease of testosterone level and the decrease of mandibular bone density in elderly men; to make a prediction model for the decreasing level of testosterone and mandibular bone density. Methods: diagnostic test and case control study in elderly men above 60 years old by way interviews to fill questionnares, clinical and radiographic examination. Results: Risk factors that contribute to the decrease of testosterone level and index to determine the decrease of mandibular bone density in elderly men. A software and index are produced as prediction tools]

Abstrak :
ABSTRAK
Ruang Lingkup dan Metode: Pada murid kelahiran Palembang dievaluasi kebiasaan mengkonsumsi makanan tradisional dengan cuko (Kuah Asam Manis atau KAM), yang dikaitkan dengan latar belakang sosial demogratik dan perilaku kesehatan gigi. Risiko terjadinya karies yang meliputi multifaktor dianalisis dengan menggunakan univariat dan logistik regresi ganda. Respon aktivitas bakteri S. mutans, kecepatan aliran saliva dan kapasitas dapar saliva di analisis terhadap pemberian KAM. Untuk menetapkan peran KAM pada anak-anak berusia 12 tahun dengan karies ringan dilakukan perbandingan kejadian karies berdasarkan intensitas mengkonsumsi KAM di dua wilayah sekolah Ulu dan ilir. Evaluasi dilanjutkan dengau Kariogram dari Bratthall (1996) untuk mengetahui faktor-faktor yang berinteraksi pada terjadinya karies atau pencegahannya.

Hasil dan kesimpulanz: 75% murid yang biasa mengkonsumsi KAM mempunyai kejadian karies yang rendah, tetapi kejadian fluorosis yang dijumpai lebih tinggi. Dari analisis regresi logistik ganda diperoleh bahwa frekuensi mengkonsumsi KAM, fluorosis email, gender, asal orangtua, dan rasa takut pada perawatan gigi berhubungan dengan kejadian karies. Bakteri plak ternyata tidak memperlihatkan pengaruhnya pada kelompok yang mengkonsumsi KAM atau tidak. Sesudah 2 jam pemberian KAM, aktivitas bakteri cenderung menurun dan pada kelompok karies terlihat pH saliva lebih rendah dari sebelum pemberian KAM. Dari gambaran Kariogram diketahui bahwa lama mengkonsumsi KAM sejak usia sebelum gigi tetap erupsi merupakan faktor yang paling berperan terhadap karies. Pada model ini diperoleh kemungkinan untuk tidak karies sangat rendah, yaitu antara 1 - 13%. Faktor yang turut berperan terhadap kerentanan gigi yang fluorosis mungkin karena terdapat gula dan rendahnya pH dalam diet KAM yang meningkatkan demineralisasi email bila KAM dikonsumsi setiap hari. Frekuensi mengkonsumsi KAM merupakan faktor yang paling berperan terhadap rendahnya karies. Demikian juga pada kelompok dengan kebiasaan mengkonsumsi KAM atau tanpa KAM disertai karies atau tanpa karies, mempunyai kebiasaan jajan di antara waktu makan, jajan yang manis-manis, mempunyai orangtua asal Palembang.

Kesimpulan penelitian adalah: (1) Kejadian karies di Ulu lebih rendah daripada di Ilir; (2) KAM menghambat tenjadinya karies yang dikonsumsi setiap minggu dan setiap bulan; (3) Kelompok bebas karies tidak bergantung pada perilaku kesehatan gigi yang diperoleh di sekolah; (4) KAM tidak menyebabkan terjadinya fluorosis bila dikonsumsi sesudah usia 8 tahun; (5) Kebiasaan mengkonsumsi KAM berhubungan dengan faktor tempat lahir pada latar belakang sosial demografik; (6) Fluorosis berhubungan dengan faktor tingkat pendidikan orangtua pada latar belakang sosial demografik; (7) Kemungkinan tidak karies tidak bergantung pada frekuensi mengkonsumsi KAM semata, tetapi lebih bergantung pada saat anak mulai mengkonsumsi KAM. Faktor yang paling lemah dalam model Kariogram ini adalah diet KAM dan kerentanan gigi karena fluorosis. Dengan model Kariogram ini dapat dikembangkan berbagai model sesuai dengan ciri-ciri individu, sehingga perlu observasi lanjutan dengan latar belakang yang sama agar dapat disusun strategi penyuluhan dan intervensi pencegahan karies yang spesifik. Selain itu perlu dilakukan pemetaan fluor di masyarakat, dan penelitian lanjut agar dapat menjelaskan mekanisme karies pada kelompok dengan fluorosis.

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Abstract
Field of study and Methods. Children born in Palembang were evaluated to detect their habitual KAM consumption, social demographic backgrotmd, and oral hygiene practice. The risks involving preventive factors were calculated using univariant and multiple logistic regression analysis. Response to KAM administration was analysed on S- mutans activities, salivary flow rates, and the change of salivary pH. The role of KAM in high caries risk children was determined by comparing caries experience and the intensity of KAM consumption using two different school locations (Ulu and Ilir). A cariogram model was used to evaluate the interaction among all factors in caries development or prevention.

Result and Conclusions. Seventy five percent of children that regularly consumed KAM had a lower caries occurrence, but higher enamel fluorosis. Multiple logistic regression analysis disclosed that the frequency of KAM consumption, enamel iluorosis, gender, parental origin, and fear of dental procedures were associated with the development of dental caries. Dental plaque bacterial activity was not significantly different between KAM consumers and non-consumers. After administering KAM in both regular and non-regular KAM consumers, bacterial activity tended to decrease and in the caries group after two hours the salivary pH slightly decrease. Cariograms revealed that the period of fluoride intake from KAM before the age of eight was the most significant factor in caries, neither a daily or a weekly basis. They appeared to have a very low chance of avoiding caries, i.e. between 1 to 13%. The other factors that influence dental caries might be explained by the sugar content and low pH of the KAM. The low pH may increase enamel demineralization when used on a daily basis to influence the susceptible tooth which was a hypomineralised enamel. They were also constant in KAM and non KAM users as well as carious or caries free children either frequents intake of snacks between meals, or sweets, and parents origin of Palembang were additional factors to increase the caries risk.

The conclusions of the study were: (1) Caries occurrence in Ulu were less than in llir; (2) KAM inhibits caries when consumed on a weekly or monthly basis. (3) Caries free children were not dependant on the preventive oral hygiene methods taught in schools. (4) KAM did not induce fluorosis when constuned after the age of eight. (5) KAM consumption was related to the birth location of the social demographic factors. (6) Fluorosis was related to the parents education level of the social demographic factors. (7) The chance for not having caries was not only dependant on how frequent, but more on when the children started consuming KAM. Vulnerable factors shown in Cariogram was correlated to particular diet KAM and fluorosis as a susceptible tooth. More Cariogram model can be developed due to the individual characteristics, therefore observation in a similar background is needed to determine a particular strategy for health promotion and preventive intervention. There is also a need to have a fluoride mapping in community, and iilrther investigation to explain the mechanism of caries in fluorosis group.

Abstrak :
Depresi pada lansia Indonesia memiliki prevalensi sebesar 7,7%, lebih tinggi daripada kelompok usia yang lebih muda secara nasional yaitu 6,1%, namun tindakan untuk mengatasinya belum optimal karena asuhan yang diberikan belum holistik dan tidak terintegrasi dengan program maupun sektor layanan lainnya. Pengembangan model tindakan holistik integratif kesehatan jiwa merupakan salah satu upaya dalam menurunkan depresi pada lansia dengan meningkatkan perkembangan psikososial dan kebahagiaan lansia melalui optimalisasi sumber daya yang ada di masyarakat. Tujuan penelitian ini menguji efektifitas model tindakan holistik integratif kesehatan jiwa terhadap perkembangan psikososial dan kebahagiaan lansia depresi. Desain operational research diterapkan menjadi 3 tahap yaitu: 1) Tahap eksplorasi pada 452 sampel kuantitatif dan 27 partisipan kualitatif, 2) Tahap pengembangan model, dan 3) Tahap uji efektifitas model menggunakan studi true experiment dengan randomisasi dan matching pada 122 responden. Hasil penelitian tahap pertama didapatkan gambaran masalah kesehatan jiwa lansia yaitu GME 67,5 % dan 58,7% diantaranya mengalami depresi, serta teridentifikasi 8 tema, yaitu: Sindrom sarang kosong sebagai killer silent lansia depresi; Kegelisahan dalam interaksi sosial karena social approval addiction; Kurangnya apresiasi masa sekolah dan remaja pada lansia depresi; Cabin fever memperburuk depresi; Love language sumber kepuasan lansia deprei: Self-healing untuk mengurangi luka masa lalu; Stimulus fisik dan mental untuk kesehatan jiwa lansia depresi yang holistik; dan Kemudahan akses pelayanan kesehatan jiwa lansia yang terintegrasi. Hasil penelitian tahap kedua tersusunnya model Tindakan Holistik Integratif Kesehatan jiwa (THIKA) pada lansia depresi. Hasil tahap 3 uji efektifitas model THIKA yang diberikan secara synchronous berpengaruh secara bermakna terhadap pencapaian perkembangan psikososial (integritas diri), peningkatan kebahagiaan, penurunan tingkat depresi dan kortisol. Hasil analisis GLM menunjukkan: Faktor yang paling mempengaruhi perkembangan psikososial adalah intervensi model THIKA, perkembangan sebelumnya dan indeks kebahagiaan sebesar 89,9%; Faktor yang paling mempengaruhi indeks kebahagiaan yaitu intervensi model THIKA, status mental, status fungsional, dan status nutrisi sebesar 90,01%; Faktor yang paling mempengaruhi tingkat depresi yaitu intervensi model THIKA, dan perkembangan psikososial sebesar 57,1%; Faktor yang paling mempengaruhi tingkat kortisol yaitu intervensi model THIKA, status nutrisi dan status fungsional sebesar 43,6%. Rekomendasi menggunakan model THIKA diperlukan untuk tindakan kesehatan jiwa oleh tenaga kesehatan, kader dan keluarga pada lansia sehingga active ageing dapat dicapai optimal. ......Depression in older adults in Indonesia has a prevalence of 7.7%, higher than the younger age group nationally, which is 6.1%. Still, measures to overcome it are not optimal because the care provided is not holistic or integrated with other programs or services sectors. Developing a mental health integrative holistic intervention model is an effort to reduce depression in older adults by increasing psychosocial development and happiness by optimizing existing community resources. This study aimed to test the effectiveness of a holistic, integrative mental health intervention model on psychosocial developmental tasks and happiness in the older adults depression. The operational research design was implemented into three phases: 1) The exploratory stage used 452 quantitative samples and 27 qualitative participants, 2) The model development stage, and 3) The model effectiveness test phase used a true-experiment study with randomization and matching on 122 respondents. The results of the first stage of the study showed an overview of elderly mental health problems, namely GME 67.5% and 58.7% of them experienced depression, and eight themes were identified: Empty-nest syndrome as a silent killer; Anxiety in social interactions due to social approval addiction; Lack of appreciation of school age and adolescence phase; Cabin fever exacerbates depression; Love language is a source of satisfaction for depressed older adults: Self-healing to reduce inner-child; Physical and mental stimulus for holistic mental health intervention; and The integrated mental health services accesibility. The results of the second study's phase were the formulation of a holistic, integrative mental health intervention model (THIKA) for depressed older adults. The final results of the effectiveness test of the THIKA model given synchronously had a significant effect on achieving psychosocial development (self-integrity), increasing happiness, decreasing levels of depression and cortisol. The results of the GLM analysis showed: The factors that most influence psychosocial development are the THIKA model intervention, previous development and happiness index by 89,9%; The factors that most influence the happiness index are the THIKA model intervention mental status, functional status, and nutritional status by 90,01%; The factors that most influence the level of depression are the THIKA model intervention and psychosocial development by 57,1%; The factors that most influence cortisol levels are the THIKA model intervention, nutritional status and functional status by 43,6%. Recommendations for using the THIKA model are needed for mental health intervention by health workers, cadres and families for older adults to achieve active ageing optimally.

Abstrak :
Meningkatnya populasi lansia di dunia termasuk Indonesia merupakan dampak dari kemajuan ilmu pengetahuan dan teknologi bidang kesehatan dan sosial ekonomi. Keadaan ini mengakibatkan bertambahnya berbagai penyakit lanjut usia termasuk gigi dan mulut. Berbagai faktor risiko yang muncul seiring proses penuaan mengakibatkan hilangnya gigi geligi. Akan tetapi faktor risiko yang paling berperan dengan kehilangan gigi di Indonesia masih belum diketahui. Tujuan penelitian ini memperoleh indeks prediksi kehilangan gigi berdasarkan faktor-faktor risiko. Penelitian ini menggunakan desain kasus kontrol pada 208 lansia berusia >60 tahun, 82 subjek kasus dengan kehilangan gigi >12 dan 126 kontrol dengan kehilangan gigi < 12. Mayoritas subjek adalah perempuan 82,7%; usia >65 tahun 53,9%; pendidikan menengah 51,9%, kebersihan mulut sedang 51,2%, pendarahan gusi ringan 44,4%; penghasilan rendah 94,7%; periodontal indeks berat 61,2%; tekanan darah tinggi 79,8%; fungsi kognitif normal 74,5%; dugaan diabetes melitus 22,6%; perilaku baik 52,4%; kepadatan tulang normal 81,6%, kehilangan perlekatan gingiva baik 62,9%, aktivitas sehari-hari normal 90,4%. Model akhir yang didapat adalah dugaan diabetes melitus, perilaku, dugaan demensia, kehilangan perlekatan sedang dan buruk memiliki hubungan dengan kehilangan gigi pada lansia. Penelitian ini menghasilkan suatu indeks prediksi kehilangan gigi dengan faktor risiko yang paling berperan terhadap kehilangan gigi pada lansia. ...... The expanding population of elders in Indonesia and worldwide influenced by the advances in science and technology, especially the health and socio-economic progress. The aging process results in susceptibility to infection of the oral cavity resulting in loss of teeth. The aim of this study was to develop and test a model of tooth loss prediction index based on risk factors. A case-control study was conducted among 208 elders aged above 60 years old, 82 subjects who had lost more than 12 teeth were participated as case group while 126 subjects who had lost 12 or less teeth were participated as control group. At examination, 53.9% of participants were aged above 65 years old, with 82.7% females, 51.9% were middle educated, 51.2% have moderate oral hygiene level, 44.4% have mild level of gingival bleeding, 94.7% have low income, 61.2% have severe periodontal index, 79.8% having hypertention, 74.5% having normal cognitive function, 22.6% diabetes melitus, 52.4% having good oral health behavior, 81.6% with normal bone density, 62.9% good level of gingival attachment loss, 90.4% having normal daily activity. Logistic regression analyses demonstrated that diabetes melitus, oral health behavior, cognitive function, moderate and severe level of gingival attachment loss were associated with tooth lost. The study produced a tooth loss prediction index based on risk factors most responsible for tooth loss in elderly.

Abstrak :
Cedera terkait jatuh pada lanjut usia diidentifikasi sebagai masalah kesehatan masyarakat yang memiliki konsekuensi besar dalam mempengaruhi kualitas hidup lanjut usia. Identifikasi risiko jatuh penting dilakukan dalam upaya deteksi dini dan pencegahan untuk menurunkan morbiditas dan mortalitas akibat jatuh pada lansia. Penelitian ini ditujukan untuk mengembangkan instrumen penilai risiko jatuh pada lansia di masyarakat, dengan memodifiksi instrumen IFRAT (Indonesian Fall Risk Assessment Tool) yang pernah dikembangkan sebelumnya, namun memiliki nilai akurasi yang rendah. Instrumen Modifikasi IFRAT mengidentifikasi risiko jatuh secara multifaktor meliputi status sosiodemografi (umur jenis kelamin, wilayah tempat tinggal), faktor instrinsik (riwayat jatuh seblumnya, riwayat penyakit kronis, depresi, inkontinensia, gangguan penglihatan, gangguan pendengaran dam gangguan keseimbangan) dan faktor ekstrinsik (lingkuran tempat tinggal dan konsumsi obat). Hasil penelitian ini mengidentifikasi prevalensi jatuh pada lansia dalam satu tahun terakhir sebesar 20% dan prevalensi jatuh selama monitoring ssebesar 12,5%. Instrumen M-FRAT memiliki akurasi yang baik berdasarkan nilai Receiver operating characteristic sebesar 0.76; 95%CI (0,688 – 0,824), dengan sensitifitas 71,15% dan spesifisitas 73,26%. Hasil uji kepraktisan menunjukkan bahwa instrumen M-IFRAT dapat diterima dan digunakan di lapangan. Dapat disimpulkan bahwa instrumen M-IFRAT akurat dan praktis untuk menilai risiko jatuh pada lansia di masyarakat. ......Fall-related injuries in the elderly are identified as a public health problem that has major consequences in affecting the quality of life of the elderly. One in four elderly people fall every year. Early detection of fall risk is useful in primary prevention efforts to reduce morbidity and mortality in the elderly caused by fall. This study is aimed at developing an instrument for assessing the risk of falls in elderly living in the community dwelling, by modifying the former instrument called IFRAT (Indonesian Fall Risk Assessment Tool) that has a low accuracy level. The Modified IFRAT identifies the risk of falling in a multifactorial approach including sociodemographic status (age, gender, region of residence), intrinsic factors (previous fall history, history of chronic disease, depression, incontinence, visual impairment, hearing loss and balance disorders) and extrinsic factors (home environment hazard and medication). The study identified the prevalence of falls in the elderly in the past year by 20% and the prevalence of falls during monitoring of 12.5%. The M-FRAT instrument has good accuracy based on the Receiver operating characteristic score of 0.76; 95%CI (0.688 – 0.824), with a sensitivity of 71.15% and a specificity of 73.26%. The practicality test show that the M-IFRAT is practical and acceptable to be applied in community. It can be concluded that the M-IFRAT is accurate and practical to assess the risk of falls in the elderly in the community.

Abstrak :
Tujuan: Tujuannya mendapatkan model kompetensi manajer puncak RS Swasta se JABODETABEK, 2010. Kompetensi ini akan menjadi ciri kualitas untuk kinerja yang unggul dari manajer puncak RS yang digunakan di seluruh proses manajemen kinerja yang terkait fungsi SDM di RS. Desain / metodologi / pendekatan: Penggunaaan metode delphy, dan analisis KJ dikombinasikan dengan wawancara pemilik dan para pakar untuk memproses pengembangan model kompetensi. Dengan menggunakan analisis jalur dari manajer puncak RS dari 165 RS Swasta se JABODETABEK diperoleh model akhir dari kompetensi manajer puncak RS Swasta yang dapat digunakan untuk penerimaan mereka dalam memimpin serta mengelola RS. Temuan: Kompetensi teridentifikasi oleh lima variabel keterampilan, sikap, tujuan, sifat dan pengetahuan dengan sepuluh subvariabel yaitu kepemimpinan, manajemen tim, manajemen perubahan, hubungan personal, karakter, fokus pada hasil, komunikasi, komitmen manajemen, manajemen projek, kemampuan diri. Penelitian keterbatasan / implikasi: Jumlah kepustakaan mengenai kompetensi manajer puncak serta keterbatasan waktu manajer puncak RS dan peneliti, maka penelitian perlu dilanjutkan para peneliti selanjutnya. Implikasi Praktis: Penelitian memberikan gambaran yang berguna dari konsep manajemen kinerja dan merangkum kekuatan dan kelemahan kompetensi manajemen berbasis kinerja. Orisinalitas/nilai: Penelitian menyajikan gambaran tentang manajemen kinerja berbasis kompetensi seperti yang diterapkan di luar negeri sesuai dengan kepustakaan dan dipayungi dengan peraturan UU No. 44, 2009 tentang RS dan Peraturan MENKES No.971/Menkes/Per/XI/2009 tentang standar kompetensi pejabat struktural kesehatan. Kompetensi inti yang menjadi ciri kualitas yang diperlukan untuk kinerja yang unggul dari staf perpustakaan dijelaskan. ......Purpose: the purpose of this research is to find a competency model for top-level managers of private hospitals in Jabodetabek, 2010. This competency will become the quality requirements for high performance of top-level hospital managers used in every performance management process related to the function of human resources in hospitals. Design/methodology/approach: Using the delphy approach and KJ analysis combined with interviewing the owners and experts on competency development process. By using pathway analysis of top-level hospital managers from 165 private hospitals in Jabodetabek, we obtained a final model. obtained a final model of the competence of top managers of private hospitals. This model can be used for their acceptance in leading /managing the hospital. Findings: Competence is identified with five variables skills, attitude, purpose, behavior and knowledge with ten sub-variables which are leadership, team management, change management, personal relationship, character, focus on results, communication, management commitment, project management, self capacity. Research limitations/implication: The number of literature review on competencies of top-level managers as well as time limitations of top-level hospital managers and the researcher, thus the research needs to be continued by the next researchers. Practical implication: The research provides a useful overview of the performance management concept and summarizes the strength and weaknesses of performance-based management. Originality/value: The research provides an overview of competency-based performance management as implemented abroad according to literature review and is under the umbrella of Law No. 44 year 2009 on Hospitals and MENKES Regulation No. 971/Menkes/Per/XI/2009 on competency standard of medical structural official. The core competency that becomes the quality criteria needed for top performance from the library staff is explained.