scholarly journals Kemampuan Klinik Pratama dalam Menangani 195 Diagnosis di Kota Surabaya

2021 ◽  
Vol 24 (1) ◽  
pp. 11-19
Author(s):  
Eka Fitria Sari ◽  
Faihatul Mukhbitin ◽  
Ernawaty Ernawaty

Head of Surabaya City Health Department Decree No.440/19547/436.3/2016 is based on Indonesian Minister of Health Decree No.HK.02.02/MENKES/514/2015. The regulation explains the need for the management of 195 clinical diagnoses in primary health facilities because it is related to the primary health facilities' capability to handle 195 clinical diagnoses. The RRNS achievement table in January-May 2017 shows that primary care clinics were primary health facilities that occupy the unsafe zone (RRNS>5%) namely 16.68% in Surabaya City. The research objective is to analyze the primary care clinics' capability in Surabaya City to handle the 195 clinical diagnoses. This research used a descriptive cross-sectional design in four primary care clinics with 20 people sampled. The results showed that all clinics had not been able to provide complete services. Clinical doctors had good capabilities in accordance with the Head of Surabaya City Health Department Decree No.440/19547/436.3/2016 but were not supported by the completeness of supply following the Indonesia Minister of Health Decree No.HK.02.02/MENKES/514/2015. In conclusion, only 65 (≤33%) clinical diagnoses can be handled properly with the imbalance between the doctors' capabilities and completeness of supply. This research suggests the regulation makers must also review the primary care clinics' capability to provide supplies and clinics can determine the right cost-containment strategy to handle 195 clinical diagnoses. Abstrak SK Kadinkes Kota Surabaya No.440/19547/436.3/2016 didasari oleh Kepmenkes RI No.HK.02.02/MENKES/514/2015. Peraturan yang menjelaskan tentang kebutuhan penatalaksanaan penanganan 195 diagnosis klinis di FKTP karena berkaitan dengan kemampuan FKTP melakukan penanganan. Tabel pencapaian RRNS bulan Januari-Mei 2017 menunjukkan klinik pratama merupakan jenis FKTP yang paling banyak menempati zona tidak aman (RRNS>5%) yakni 16,68% di Surabaya. Penelitian bertujuan menganalisis kemampuan klinik pratama di Kota Surabaya dalam menangani 195 diagnosis klinis. Penelitian menggunakan desain crosssectional deskriptif di empat klinik pratama dengan sampel 20 orang. Hasil menunjukkan semua klinik yang diteliti belum mampu menyediakan pelayanan secara lengkap. Dokter klinik memiliki kemampuan yang baik sesuai SK Kadinkes Kota Surabaya No.440/19547/436.3/2016 tetapi tidak didukung dengan kelengkapan supply yang dibutuhkan sesuai Kepmenkes RI No.HK.02.02/MENKES/514/2015. Kesimpulannya, diagnosis klinis yang dapat ditangani dengan baik hanya sebanyak 65 (≤33%) dengan hambatan ketidakseimbangan antara kemampuan dokter dan kelengkapan supply. Penelitian ini menyarankan pembuat kebijakan juga meninjau kemampuan klinik dalam menyediakan supply dan klinik dapat menentukan strategi cost containment yang tepat untuk menangani 195 diagnosis klinis.

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 290
Author(s):  
Khabo Mahlangu ◽  
Perpetua Modjadji ◽  
Sphiwe Madiba

The study determined the nutritional status of adult antiretroviral therapy (ART) recipients, and investigated the association between the duration on ART and the nutritional status. This study was based in primary health facilities in Gauteng, South Africa. The data collected included sociodemographic variables; the duration of the treatment; and the body mass index (BMI), classified as undernutrition (<18.5 kg/m2), normal (18.5–24.9 kg/m2), or overweight/obesity (≥25 kg/m2). ART recipients (n = 480) had a mean age of 35 (± 8.4SD) years. All had taken ART for six months or more (range 6–48 months). The data were analyzed using STATA 13.0. The overall prevalence of overweight/obesity was 39%, it was higher in females (46%) than in males (30%), 26% were overweight, and 13% were obese. Underweight was 13%, and was higher in males (18%) than females (9%). Being overweight was more likely in those aged ≥35 years and those in smaller households. Being obese was less likely in males, in the employed, and in those with a higher income, but was more likely in those with a longer duration on ART. Abdominal obesity was high, but less likely in males. Interventions to prevent overweight/obesity should be integrated into routine HIV care, while at the same time addressing the burden of undernutrition among ART recipients.


2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Edosa Tesfaye Geta ◽  
Yibeltal Siraneh Belete ◽  
Elias Ali Yesuf

Patient self-referral is a condition when patients refer themselves to higher level health facilities without having to see anyone else first. Despite the expansion in the number of health facilities, it has been seen when patients routinely accessed referral hospitals without a formal referral. The study aims to evaluate cost of treatment among self-referred outpatients at referral hospitals compared to primary health care facilities. Comparative cross-sectional study design was used and the required sample size for the study was determined by using formula of double populations mean comparison cost of treatment for diseases leading to outpatient visits. A total of 794 participants (397 from referral hospital and 397 from primary health facilities) were included in the study. Data was collected using face-to-face interview from December 1 to 30, 2017. Data entry and analysis were made using SPSS version 20. Descriptive statistics and independent samples t-test were performed. A total of 783 outpatients responded to the interview of the study and 391 of them were from referral hospital and 392 from primary health facilities. The mean of outpatient visit cost per visit for the treatment of diseases leading to outpatient visits was significantly higher at referral hospitals compared to primary health facilities [95% CI=6.13 (5.07-7.18)] USD. The mean cost of outpatient visits for the treatment of all type of diseases leading to outpatient visits was significantly higher at referral hospitals and at least two times of primary level health facilities. Health care providers should create awareness in the community about referral linkages to inform patients and their families the additional costs they incur when they bypass the proximal primary health facilities.


Author(s):  
Yogi Bhakti Marhenta ◽  
Satibi Satibi ◽  
Chairun Wiedyaningsih

Health services in the era of JKN are organized by all Health Facility in cooperation with BPJS. Patient satisfaction is a critical indicator whether a program is a success or not. Satisfaction is the pleasure of someone who comes from the comparison between a product or performance with expectations, if performance is below expectations then the customer is not satisfied. This study aims to determine the effect of membership, service, and financing of patient satisfaction with BPJS in Primary Health Facilities. This research is an analytical descriptive research with cross sectional survey design. The data was taken quantitatively by using questionnaires and completed with qualitative data through interviews to deepen the findings of the field. Sampling technique used is purposive sampling with inclusion criteria. The number of respondents samples used were 278 respondents and the sample of the study sites was determined by random sampling method including health center, clinic and pharmacy network. The data were analyzed by using multiple linear regression analysis in the form of t test and F test. The result of research at Primary Health Facilities Regency showed that there was positive and significant influence to patient satisfaction of BPJS, including membership variable (p = 0,02), variable of service (p = 0,00), and financing variable (p = 0,00), while F test simultaneously also shows there are positive and significant influence to patient satisfaction BPJS with value (p = 0,00).


2021 ◽  
Author(s):  
Babatunde Adelekan ◽  
Erika Goldson ◽  
Zubaida Abubakar ◽  
Ulla Mueller ◽  
Audu Alayande ◽  
...  

Abstract BackgroundNigeria, like many other countries, has been severely affected by the COVID-19 pandemic. While efforts have been devoted to curtailing the disease, a major concern has been its potential effects on the delivery and utilization of reproductive health care services in the country. The objective of the study was to investigate the extent to which the COVID-19 pandemic and related lockdowns had affected the provision of essential reproductive health, maternal and child health, and adolescent health services in primary health care facilities across the Nigerian States.MethodsThis was a cross-sectional study of 307 primary health facilities in 30 Local Government Areas in 10 States, representing the six geopolitical regions of the country. A semi-structured interviewer-administered questionnaire was used to obtain data on issues relating to access and service provision before, during and after COVID-19 lockdowns from the head nurses/midwives in the facilities. The questionnaire was entered into Open Data Kit mounted on smartphones. Data were analysed using non-parametric statistics.ResultsThe results show that a large proportion of the primary health facilities in the selected states opened for the provision of essential sexual and reproductive health and rights services during the COVID-19 pandemic lockdown. However, there was a significant reduction in clients’ utilization of services due to challenges experienced in service implementation such as stock-outs, and low demand for services by clients. Although the health facilities reported identifying cases of COVID-19, there was limited provision for primary protective equipment and other special offers that would motivate the health workers to optimize services for clients. ConclusionsWe conclude that efforts made to address these challenges by governments, non-governmental agencies, the private sector, and donor agencies working in low resource settings would reduce the health and social burden posed by COVID-19 in Nigeria.


2019 ◽  
Vol 22 (3) ◽  
Author(s):  
Sri Sularsih Endartiwi ◽  
Pramukti Dian Setianingrum

BPJS Health targets participant satisfaction to reach 95%, but until 2017 participant satisfaction reaches 85%. Participants who received service at the primary health facilities based on observations averaged 70%. Based on observations at the primary health facility can be seen that participant satisfaction is 70%. The objective was to evaluate the correlation between the quality services and participant satisfaction on the national health insurance at primary health facilities in the province of Yogyakarta. The type of research was quantitative descriptive with cross sectional design. The research location was primary health facilities that cooperate with BPJS Kesehatan in the Province of Yogyakarta. The study was conducted in July 2018. The number of samples in this study was 850 by proportional random sampling. Data analysis was using the Kendall Tau test. Results showed that the quality of health services both in terms of tangible, reliability, responsiveness, assurance and empathy were related to the satisfaction of BPJS Kesehatan participants in the primary health facilities. The results of bivariate analysis for each variable had a Sig. (2-tailed) 0,000 with a strong relationship. The quality of health services was related to the satisfaction of patients participating in the BPJS Kesehatan in the primary health facilities of the Province of Yogyakarta. Primary health facilities in order to maintain the quality of its health services so that patients participating in the National Health Insurance program remain satisfi ed with the services that have been provided. Abstrak BPJS Kesehatan menargetkan kepuasan peserta mencapai 95%, akan tetapi sampai tahun 2017 ini kepuasan peserta mencapai 85%. Peserta yang mendapatkan pelayanan di fasilitas kesehatan tingkat pertama berdasarkan hasil observasi di puskesmas, dokter keluarga dan klinik pratama rata-rata 70%. Berdasarkan hasil observasi di fasilitas kesehatan tingkat pertama (FKTP) yang bekerja sama dengan BPJS Kesehatan dapat diketahui bahwa kepuasan peserta sebesar 70%. Penelitian bertujuan untuk membuktikan bahwa kualitas pelayanan berhubungan dengan kepuasan peserta Jaminan Kesehatan Nasional (JKN) di Fasilitas Kesehatan Tingkat Pertama Di Provinsi Daerah Istimewa Yogyakarta. Jenis penelitian adalah deskriptif kuantitatif dengan rancangan cross sectional. Lokasi penelitian adalah FKTP yang bekerjasama dengan BPJS Kesehatan di Provinsi Daerah Istimewa Yogyakarta. Penelitian dilakukan pada bulan Juli 2018. Jumlah sampel dalam penelitian ini adalah 850 secara proportional random sampling. Analisis data dilakukan dengan menggunakan uji Kendall Tau. Kualitas pelayanan kesehatan baik dari sudut tangible, reliability, responsiveness, assurance maupun empathy berhubungan dengan kepuasan pasien peserta BPJS Kesehatan di FKTP Provinsi Daerah Istimewa Yogyakarta. Hasil analisis bivariat setiap variabel mempunyai nilai Sig. (2-tailed) 0,000 dengan hubungan yang kuat. Kualitas pelayanan kesehatan (tangible, reliability, responsiveness, assurance dan empathy) berhubungan dengan kepuasan pasien peserta BPJS Kesehatan di FKTP Provinsi Daerah Istimewa Yogyakarta. FKTP di Provinsi Daerah Istimewa Yogyakarta supaya tetap mempertahankan kualitas pelayanan kesehatannya sehingga pasien peserta program Jaminan Kesehatan Nasional (JKN) tetap merasa puas terhadap pelayanan yang sudah diberikan.


2020 ◽  
Author(s):  
Pratik Khanal ◽  
Bishnu P Choulagai ◽  
Pawan Acharya ◽  
Sharad Onta

Abstract BackgroundWork motivation and job satisfaction are linked with the performance and retention of health workforce. Primary health facilities, mostly comprising mid-level health workers, serve the majority of the population in Nepal. The aim of the study was to assess the determinants of job satisfaction in relation to socio-demographics, job characteristics and work motivation status among health workers working in primary health facilities. MethodsA cross-sectional study was conducted in Jhapa district in Eastern Nepal covering 40 primary health facilities. The data collection involved 151 self-administered questionnaire interviews and 16 in-depth interviews with health workers. Mean differences in work motivation among those satisfied and unsatisfied with their job was examined using t tests. Logistic regression with 95% confidence interval at p<0.05 was used for identifying associated factors with job satisfaction. Thematic analysis was done to analyze qualitative data. ResultsAmong the study participants, 78.2% were either auxiliary health workers or auxiliary nurse midwives. The median employment period of health workers was 174 months. On the 5-point Likert scale, the mean score of work motivation was highest for team work (3.99) and lowest for financial motivation (2.21). Higher age of health workers and satisfaction with career development, and financial motivation were significantly associated with job satisfaction. The qualitative findings also revealed that the majority of the health workers were not satisfied with the existing career development opportunities, availability of resources in health facility, or financial motivation. ConclusionSatisfaction with career development and financial motivation significantly increased job satisfaction among health workers. Resource availability in health facility, recognition of work and management support affected work motivation and job satisfaction of health workers. A focus on improving work environment through increased financial motivation and career development opportunities as well as investing in primary health facilities with increased resource support is recommended to improve job satisfaction.


Author(s):  
Khotimatul Khusna ◽  
Rita Septiana

ABSTRAKDiabetes mellitus (DM) didefinisikan sebagai penyakit kronis yang disebabkan karena keturunan atau kurangnya produksi insulin oleh pankreas, atau tidak efektifnya insulin yang dihasilkan. Pelayanan obat untuk peserta Jaminan Kesehatan Nasional pada fasilitas kesehatan mengacu pada daftar obat yang tercantum dalam Formularium Nasional (Fornas). Selain itu, pelayanan kesehatan juga harus sesuai dengan algoritma terapi. Pemilihan obat hipoglikemik oral (OHO) yang tepat sangat menentukan keberhasilan terapi DM. Penelitian ini bertujuan untuk mengetahui gambaran kesesuaian penggunaan OHO berdasarkan Fornas dan algoritma terapi DM tipe 2 di Faskes Tingkat Pertama X di Surakarta. Penelitian ini termasuk jenis penelitian deskriptif. Pengambilan data dilakukan secara retrospektif dari catatan rekam medik pasien. Sampel dalam penelitian ini adalah OHO di Faskes Tingkat Pertama X di Surakarta pada periode Januari sampai Mei 2019. Hasil penelitian menunjukkan bahwa pasien yang mendapatkan OHO sesuai rekomendasi Fornas sebanyak 105 dan pasien yang mendapatkan OHO sesuai rekomendasi Algoritma Terapi DM sebanyak 75. Kesimpulan penelitian ini adalah 100% penggunaan OHO sesuai rekomendasi Fornas dan 71,43 % penggunaan OHO sesuai rekomendasi Algoritma Terapi DM.Kata kunci : Kesesuaian, Diabetes, Fornas, Algoritma terapiDiabetes mellitus (DM) is a chronic disease caused by heredity or when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Medication services for National Health Insurance participants in health facilities refer to the list of drugs listed in the National Formulary. In addition, health services must also be in accordance with the therapy algorithm. The selection of the right oral hypoglycemic (OH) drug greatly determines the success of DM therapy. This study aimed to know the description of conformity of OH drug use based on the national formulary and type 2 diabetes mellitus therapy algorithm at primary health facility X in Surakarta. This research was a descriptive research with data collection in Retrospective from medical record patient. Sample in this research was OH drug in Primary Health Facilities X at Surakarta period January to May 2019. The results showed that patients who received OH drug according to Fornas recommendations were 105. Patients who received OH drug according to the recommendations of the DM Therapy Algorithm were 75. The conclusion of this study is 100% OH drug according to National recommendations and 71,43% OH drug according to DM Therapy Algorithm recommendations Keywords: Conformity, Diabetes, National Formulary, Therapy Algorithm


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