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"Penelitian ini bertujuan untuk memahami penerapan Anggaran Berbasis Kinerja Badan Layanan Umum (BLU) di RSUP Dr. Kariadi tahun 2006-2012. Materi penelitian ini terdiri dari proses-proses penganggaran termasuk perencanaan, implementasi, pengukuran dan evaluasi kinerja serta pelaporan. Disamping itu penelitian ini juga menggambarkan faktor-faktor regulasi, sumber daya manusia, komitmen dan kinerja keuangan, serta kendala-kendala yang dihadapi dalam proses penganggaran. Dalam penelitian kualitatif ini, data diperoleh dengan setting alamiah. Teknik pengumpulan data dilakukan dengan observasi, wawancara dan studi dokumentasi. Hasil pengumpulan data dianalisis dengan metode kualitatif menggunakan paradikma diskriptif. Temuan dari penelitian ini menunjukkan bahwa secara umum Penganggaran Berbasis Kinerja Badan Layanan Umum yang ideal belum tercapai, dan para pegawai dan pimpinan kurang begitu memahami makna Penganggaran Berbasis Kinerja BLU. Faktor-faktor regulasi, sumber daya manusia, komitmen dan kinerja keuangan berpengaruh secara koordinatif, sehingga terdapat beberapa kesalahan dalam tahapan proses penganggaran termasuk perencanaan, penerapan, pengukuran dan evaluasi kinerja serta pelaporan. Penerapan Kurangnya komunikasi dan sistem aplikasi komputer yang sudah terintegrasi menjadi penyebab kendala dan permasalahan yang dihadapi dalam penerapan anggaran berbasis kinerja BLU.

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This study aims to understand the implementation of Performance-Based Budgeting Public Service Agency (BLU) in Dr. Kariadi years 2006-2012. The research material consists of budgetary processes including planning, implementation, measurement and evaluation of performance and reporting. Besides, this study also describes the regulatory factors, human resources, commitment and financial performance, as well as the constraints faced in the budgeting process.

In this qualitative study, the data obtained with the natural setting. Data was collected through observation, interviews and documentary studies. Results were analyzed by the method of data collection using qualitative descriptive paradigm.

The findings of this study indicate that the overall Performance-Based Budgeting Public Service Board that ideal has not been achieved, and the employees and leaders understand the significance less BLU Performance Based Budgeting. Regulatory factors, human resources, commitment and financial performance in coordination effect, so there are some errors in the stages of the budgeting process, including planning, implementation, measurement and evaluation, and reporting. Lack of communication and application of computer application systems which are integrated into the causes of the problems and constraints faced in the implementation of performance based budgeting BLU."

"ABSTRAKJumlah pekerja yang menggunakan sistem kerja shift sangat tinggi di dunia termasuk Indonesia. Saat ini pekerja shift di Indonesia diperkirakan memberikan kontribusi terhadap angka kesakitan, kecelakaan kerja dan kematian dengan prevalensi 0,035%; 0,0033%; 0,00064%, sehingga perlu dicegah melalui intervensi keperawatan. Penelitian ini bertujuan mendapatkan model intervensi keperawatan: Manajemen Kelelahan Kerja (MARIKERJA), untuk menurunkan nilai kelelahan dan meningkatkan status kesehatan melalui asuhan keperawatan pada pekerja. Desain penelitian ini adalah riset operasional dengan tiga tahap, yaitu tahap I identifikasi masalah, tahap II pengembangan model dan modul, tahap III uji coba model MARIKERJA menggunakan studi penelitian kuantitatif quasy experiment pre dan post test with control group, dengan jumlah responden, 116 pekerja di PT X. Uji statistik yang digunakan chi square, uji t, General Linier Model-Repeated Measure (GLM-RM). Model MARIKERJA dikembangkan berdasarkan hasil eksplorasi 6 tema dan studi literatur menggunakan integrasi Occupational Health Nursing Model, Main Determinants of Health for Workers, model Promosi Kesehatan Pekerja. Hasil uji didapatkan, model MARIKERJA, efektif menurunkan nilai kelelahan dan meningkatkan status kesehatan pekerja, setelah 12 minggu dilakukan intervensi. Penetapan diagnosis keperawatan kesehatan kerja, sebagai bagian dari tahapan proses keperawatan dalam pelaksanaan asuhan keperawatan individu dan kelompok pekerja memberikan gambaran peran dan fungsi perawat kesehatan kerja, yang membedakan intervensinya dengan profesi kesehatan lain. Diharapkan model MARIKERJA dapat digunakan oleh perawat kesehatan kerja di Indonesia, sebagai salah satu intervensi keperawatan, yang digunakan oleh perawat yang bertugas di institusi/ tempat kerja.

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ABSTRACTThe number of companies implementing the shift-work system is very high around the world including Indonesia. Shift workers in Indonesia are estimated to contribute to the morbidity rate, accident rate, and mortality rate within workplace with the prevalence 0,035%; 0,0033%; 0,00064%, so these issue needs to be prevented through nursing intervention. This study aims to observe the developed nursing intervention model called MARIKERJA (fatigue management in the workplace), to reduce fatigue and improve the health status of workers. This study uses operational research with three phases, namely phase I problem identification, phase II model and module development, phase III MARIKERJA model testing using quantitative research studies with quasi-experiment pre and post-test with control group. The MARIKERJA model is performed at PT X. The statistical tests used in this study are chi square, t test, and General Linear Model-Repeated Measure (GLM-RM). The process of developing the model is based on the observation results of 6 themes and literature review using the integration of Occupational Health Nursing Models, Main Determinants of Health for Workers, and Worker Health Promotion models. The results show that MARIKERJA model can effectively reduce fatigue score and improve the health status of workers after 12 weeks of intervention. By establishing nursing diagnosis in occupation health as a part of occupational nursing care can determine the role and function of occupational health nurse which in particular is different from other health workers. It is expected that the MARIKERJA model can be used by occupational health nurses in Indonesia as one of the nursing interventions."

"Implementasi Program Jaminan Kesehatan Nasional mendapatkan berbagai tantangan salah satunya adalah peningkatan utilisasi pelayanan kesehatan yang berakibat tingginya beban biaya pelayanan kesehatan. Tren persalinan dengan metode bedah caesar mengalami peningkatan setiap tahunnya. Disertasi ini bertujuan untuk menganalisis kebijakan dan menyusun suatu usulan kebijakan untuk pengendalian utilisasi tindakan bedah caesar dalam penyelenggaraan program Jaminan Kesehatan Nasional. Jenis penelitian adalah analitik dengan mixed method melalui analisis data kuantitatif dan data kualitatif, analisis kebijakan menggunakan Eugene Bardach’s eightfold framework yang dimodifikasi oleh Collins. Penelitian kuantitif melalui analisis data rekam medis tahun 2019 pada pasien bedah caesar di tiga rumah sakit dengan aspek bisnis yang berbeda di Provinsi Jakarta. Penelitian kualitatif dilakukan dengan wawancara mendalam dengan para pemangku kepentingan. Hasil penelitian menunjukkan bahwa Proporsi persalinan caesar dibanding normal di RSSP Y 99,3% di RSSK Z 63,66%, dan di RSUD X 13,42%. Tidak terdapat perbedaan karakteristik sosial dan karakteristik medis pasien bedah caesar di ketiga rumah sakit. Tidak terdapat perbedaan upaya pengendalian utilisasi operasi bedah caesar di ketiga rumah sakit. Bekas SC 1x memiliki persentase tertinggi sebagai indikasi SC dengan persentase 41,67% di RSUD X, di RSSK Z 39,48% dan di RSSP Y 24,11%. Terdapat hubungan antara usia, adanya komplikasi dalam kehamilan, malposisi janin, hipertensi, diabetes mellitus, penyakit jantung, dengan metode persalinan ibu secara caesar. Hasil penelitian kualitatif menunjukkan belum terdapat metode/tools khusus untuk pengendalian utilisasi caesar. Berdasarkan analisis kebijakan menggunakan Bardach’s eightfold framework yang dimodifikasi oleh Collins terdapat skenario/alternatif kebijakan pengendalian utilisasi bedah caesar diantaranya penyusunan program promotive preventif yang melibatkan organisasi-organisasi profesi terkait (seperti: Kebidanan Kandungan, Penyakit Dalam, Gizi, Penyakit Jantung) dengan sasaran wanita usia subur yang merencanakan kehamilan dan ibu hamil, yang khususnya berfokus untuk meminimalisir adanya penyulit kehamilan seperti: Hipertensi, Diabetes mellitus, obesitas, penyakit jantung. Hal ini penting dalam upaya menekan penyulit kehamilan yang dapat berpotensi meningkatkan angka utiliasi bedah caesar.

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The implementation of the National Health Insurance Program faces various challenges, one of which is the increase in the utilization of health services which results in high health service costs. The trend of childbirth by Caesarean section method has increased every year. This dissertation aims to analyze the policy and prepare a policy proposal for controlling the utilization of Caesarean section procedures in the implementation of the National Health Insurance program. The type of research is analytical with a mixed method through quantitative and qualitative data analysis, policy analysis using Eugene Bardach's eightfold framework modified by Collins. Quantitative research through analysis of medical record data in 2019 on caesarean section patients in three hospitals with different business aspects in Jakarta Province. Qualitative research was conducted through in-depth interviews with stakeholders. The results showed that the proportion of caesarean deliveries compared to normal in RSSP Y was 99.3% in RSSK Z 63.66%, and in RSUD X 13.42%. There were no differences in the social characteristics and medical characteristics of caesarean section patients in the three hospitals. There were no differences in efforts to control the utilization of caesarean section operations in the three hospitals. Former 1x CS has the highest percentage as an indication for CS with a percentage of 41.67% in RSUD X, in RSSK Z 39.48% and in RSSP Y 24.11%. There is a significant influence between age, complications in pregnancy, fetal malposition, hypertension, diabetes mellitus, heart disease, and the method of maternal delivery by caesarean section. The results of qualitative research indicate that there are no specific methods/tools for controlling caesarean section utilization. Based on policy analysis using Bardach's eightfold framework modified by Collins, there are scenarios/alternative policies for controlling caesarean section utilization including the preparation of promotive preventive programs involving related professional organizations (such as: Obstetrics and Gynecology, Internal Medicine, Nutrition, Heart Disease) targeting women of childbearing age who are planning pregnancy and pregnant women, which specifically focus on minimizing pregnancy complications such as: Hypertension, Diabetes mellitus, obesity, heart disease. This is important in an effort to reduce pregnancy complications that can potentially increase the rate of caesarean section utilization."