scholarly journals Analisis Karakteristik dan Persepsi Pengguna Pelayanan Terhadap Pemanfaatan Puskesmas Sebagai Gatekeeper di Dua Puskesmas Kota Bekasi Tahun 2016

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Fitria Kusumawati Wulandari ◽  
Anhari Achadi

AbstrakKonsep pelayanan kesehatan primer pada era Jaminan Kesehatan Nasional (JKN) dikembangkan dengan penguatan pelayanan primer sebagai gatekeeper dengan konsep managed care. Pada konsep managed care, suksesnya sistem gatekeeper salah satunya dinilai dari angka kunjungan dan angka rujukan ke Fasilitas Kesehatan Tingkat Lanjutan (FKTL). Penelitian ini bertujuan untuk mengetahui karakteristik dan persepsi pengguna pelayanan terhadap pemanfaatan Puskesmas sebagai gatekeeper di dua puskesmas Kota Bekasi. Penelitian ini menggunakan desain cross sectional dan pengumpulan data melalui pengisian kuesioner oleh 208 pasien peserta JKN di dua puskesmas Kota Bekasi dengan metode pengambilan sampel secara stratified purposive sampling. Hasil penelitian menunjukkan pekerjaan (nilai p=0,018), persepsi terhadap sikap petugas kesehatan (nilai p=0,000), dan lama berobat (nilai p=0,048) berhubungan dengan pemanfaatan puskesmas sebagai gatekeeper. Persepsi terhadap sikap petugas kesehatan merupakan faktor dominan yang mempengaruhi pemanfaatan Puskesmas sebagai gatekeeper (r=0.720). Penerapan konsep gatekeeper dengan baik dapat meningkatkan pemanfaatan Puskesmas dan menekan angka rujukan ke FKTL. AbstractThe concept of primary health care in the era of National Health Insurance (JKN) is developed by strengthening primary health care as a gatekeeper with the concept of managed care. In this concept of managed care, one og the success story of the gatekeeper system is assessed by the visit and referral rates to the Higher Level of Health Facilities (ALHF/Fasilitas Kesehatan Tingkat Lanjut). This study aimed to determine the characteristics and perception of service users towards utilization of public health centers (PHC/Puskesmas) as gatekeeper in two PHC in City of Bekasi. This study used cross-sectional design and data collection by filling up questionnaires by 208 patients of JKN members in two health centers in Bekasi with stratified purposive sampling methods. The results showed that job(p=0.018), perceptions of the health workers’ attitudes (p=0.000), and treatment duration (p=0.048) were related to the utilization of PHC as a gatekeeper. Perceptions of the health workers’ attitude was the dominant factor affecting the utilization of PHC as a gatekeeper (r=0.720). The health workers’ attitude affected the repeated utilization services in PHC and its utilization as a gatekeeper, especially for continuum care. The proper application of gatekeeper concept should be able to increase the utilization of PHC and reduce the number of referrals to the Advanced Level of Health Facilities (ALHF).

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Fitria Kusumawati Wulandari ◽  
Anhari Achadi

AbstrakKonsep pelayanan kesehatan primer pada era Jaminan Kesehatan Nasional (JKN) dikembangkan dengan penguatan pelayanan primer sebagai gatekeeper dengan konsep managed care. Pada konsep managed care, suksesnya sistem gatekeeper salah satunya dinilai dari angka kunjungan dan angka rujukan ke Fasilitas Kesehatan Tingkat Lanjutan (FKTL). Penelitian ini bertujuan untuk mengetahui karakteristik dan persepsi pengguna pelayanan terhadap pemanfaatan Puskesmas sebagai gatekeeper di dua puskesmas Kota Bekasi. Penelitian ini menggunakan desain cross sectional dan pengumpulan data melalui pengisian kuesioner oleh 208 pasien peserta JKN di dua puskesmas Kota Bekasi dengan metode pengambilan sampel secara stratified purposive sampling. Hasil penelitian menunjukkan pekerjaan (nilai p=0,018), persepsi terhadap sikap petugas kesehatan (nilai p=0,000), dan lama berobat (nilai p=0,048) berhubungan dengan pemanfaatan puskesmas sebagai gatekeeper. Persepsi terhadap sikap petugas kesehatan merupakan faktor dominan yang mempengaruhi pemanfaatan Puskesmas sebagai gatekeeper (r=0.720). Penerapan konsep gatekeeper dengan baik dapat meningkatkan pemanfaatan Puskesmas dan menekan angka rujukan ke FKTL. AbstractThe concept of primary health care in the era of National Health Insurance (JKN) is developed by strengthening primary health care as a gatekeeper with the concept of managed care. In this concept of managed care, one og the success story of the gatekeeper system is assessed by the visit and referral rates to the Higher Level of Health Facilities (ALHF/Fasilitas Kesehatan Tingkat Lanjut). This study aimed to determine the characteristics and perception of service users towards utilization of public health centers (PHC/Puskesmas) as gatekeeper in two PHC in City of Bekasi. This study used cross-sectional design and data collection by filling up questionnaires by 208 patients of JKN members in two health centers in Bekasi with stratified purposive sampling methods. The results showed that job(p=0.018), perceptions of the health workers’ attitudes (p=0.000), and treatment duration (p=0.048) were related to the utilization of PHC as a gatekeeper. Perceptions of the health workers’ attitude was the dominant factor affecting the utilization of PHC as a gatekeeper (r=0.720). The health workers’ attitude affected the repeated utilization services in PHC and its utilization as a gatekeeper, especially for continuum care. The proper application of gatekeeper concept should be able to increase the utilization of PHC and reduce the number of referrals to the Advanced Level of Health Facilities (ALHF).


2019 ◽  
Vol 22 (3) ◽  
Author(s):  
Iin Nurlinawati ◽  
Rosita Rosita ◽  
Sefrina Werni

Referral System for Individual Health Services states that health services are conducted in stages according to medical needs, starting from basic, second, and then third level health . The BPJS standard on the referral ratio limitation from health center to hospital is 15%. A total of 22 out of 32 health centers (69%) in Depok have referral ratios above 15%. This study was to identify factors infl uencing high referral ratios at health centers in Depok..This study was implemented from March to October 2017 by cross sectional design. The population was 32 health centers in Depok. Samples were health centers in Depok registered by BPJS as FKTP. There were 12 health centers, each 6 with high and low referrals. The sample of health workers were providers such as: doctors and dentist, heads of health centers and health offi ces. The results showed that the most referenced disease was a refraction disorder, unspecifi ed. Most primary health care with a high referral ratio (> 15%) did not have the required compulsory services at the primary health care, especially emergency and laboratory services (66.7%). The type of health personnel was less than that at Permenkes 75 of 2014 (83.3%). Facilities and infrastructure in health center were out of standards. Less drugs supplies also affected to referral. Suggestion: The government needs to provide more types of services, numbers of health workers and infrastructure in order to support the capacity of the health centre as well as better services . Abstrak Sistem Rujukan Pelayanan Kesehatan Perorangan menyebutkan bahwa pelayanan kesehatan dilaksanakan secara berjenjang sesuai kebutuhan medis, dimulai dari pelayanan dasar ke pelayanan kesehatan tingkat kedua berlanjut ke tingkat ketiga. Standar BPJS mengenai batasan rasio rujukan puskesmas ke pelayanan kesehatan tingkat lanjut maksimal 15%. Sebanyak 22 puskesmas (69%) dari 32 puskesmas di Kota Depok yang memiliki rasio rujukan diatas 15%. Penelitian ini bertujuan untuk memberikan gambaran faktor yang mempengaruhi rasio rujukan tinggi di puskesmas Kota Depok. Penelitian dilaksanakan pada bulan Maret sampai Oktober 2017. Metode yang digunakan adalah cross sectional (potong lintang). Populasi penelitian sebanyak 32 puskesmas di Kota Depok. Sampel yang diambil adalah puskesmas Kota Depok yang telah terdaftar pada BPJS sebagai FKTP sebanyak 12 puskesmas, 6 puskesmas dengan rujukan tinggi dan 6 puskesmas dengan rujukan rendah. Sampel tenaga kesehatan yang diwawancara meliputi pemberi pelayanan (dokter dan dokter gigi), kepala puskesmas dan Kepala Bidang Yankes Dinas Kesehatan. Hasil penelitian menunjukkan bahwa penyakit yang paling banyak dirujuk adalah disorder of refraction, unspecifi ed (kelainan refraksi mata). Sebagian besar puskesmas dengan rasio rujukannya tinggi (>15%) tidak memiliki kelengkapan pelayanan yang wajib ada di puskesmas terutama pelayanan gawat darurat dan laboratorium (66,7%). Jenis tenaga kesehatan kurang dari jumlah yang ada berdasarkan Permenkes 75 tahun 2014 (83,3%). Sarana dan prasarana belum sesuai dengan standar yang harus ada di puskesmas. Obat-obatan yang tidak tersedia di puskesmas menjadi salah satu alasan melakukan rujukan. Saran: Pemerintah harus selalu berupaya melengkapi jenis pelayanan, tenaga kesehatan dan sarana prasarana di puskesmas, agar kemampuan puskesmas dalam memberikan pelayanan menjadi lebih baik lagi.  


2019 ◽  
Vol 14 (2) ◽  
Author(s):  
Niken Meilani ◽  
Nanik Setiyawati ◽  
Sammy Onyapidi Barasa

Curing and eradicating Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) are to the core principles of the United Nations’ Sustainable Development Goals (SDGs). The incidence of HIV in the world remains high. Although midwives play a pivotal role in PMTCT implementation, the factors associated with midwives’ role in its implementation are not well understood. The aim of this study was to determine factors associated with midwives’ role in implementation of PMTCT. This study used a cross-sectional design. The subjects were 80 midwives at 14 primary health care in Yogyakarta City, Indonesia. The study was conducted from April to August 2017. Data were analyzed through univariate, bivariate with chi-square and Fisher’s exact test, multivariate with logistic regression. The results showed that 47.5% of midwives were in the poor category regarding implementation of PMTCT. Information availability through socialization (p-value = 0.047) and knowledge level (p-value = 0.016) were found to be related to PMTCT implementation. There was no relationship between age, length of work, education level, marital status, availability of information, midwife’s attitude, perception of the availability of facilities and institutional support with midwife behavior in PMTCT implementation. Multivariate analysis showed that level of knowledge was the most dominant factor affecting PMTCT implementation (OR:6.2; CI 95% = 1.8-21.4). We recommend that efforts should be made to continuously improve the knowledge of midwives on PMTCT implementation through peer support and training in order to achieve sustainable development goals.


2018 ◽  
Vol 3 (3) ◽  
pp. 483
Author(s):  
Dewa Ayu Putu Satrya Dewi ◽  
Putu Eka Arimbawa ◽  
Abdul Khodir Jaelani

<p><em>The Government of Indonesia has a lot of intervention for rationalizing drug use of all levels of health services including Primary Health Care. One of the programs of rational use of drugs at Primary Health Care is monitoring and evaluation of drug use conducted by pharmacist. The purpose of this research was to evaluate the rationality of drug usein Kuta Primary Health Care that review from WHO prescribing indicators and knowing the difference percentage of rationality of drug use between Kuta Primary Health Care. This research used cross sectional design research conducted in Kuta Primary Health Care on October 2017. Data analyzed using descriptive analysis and Kruskall-Wallis test. The average number of drug prescribed per en counter was 2.9. The percentage of drugs prescribed by generic drugs was 85.91percent. The percentage prescribed of encounters in which an antibiotic on ARI non Pneumonia was 29.94 pecent  and percentage prescribing antibiotic drugs in a non-specific diarrhea was 23.84 percent. The percentage prescribed of encounters injection was 0 percent. On the basic of the finding of this study the prescribed practices for polypharmacy, generic prescribing, and antibiotic shows deviation from the standard recommended by WHO and Directorate General of Pharmaceutical and Medical Devices Indonesia. These finding suggested increase health workers knowledge through scientific meetings or Focus Group Disscution (FGD) that can support a rational use of drugs in the Primary Health Care.</em></p><p> </p><p>Pemerintah Indonesia telah banyak melakukan intervensi untuk merasionalkan penggunaan obat dari segala tingkat pelayanan kesehatan termasuk Puskesmas. Salah satu program Penggunaan Obat Rasional (POR) di Puskesmas adalah monev penggunaan obat yang dilakukan oleh farmasis. Tujuan penelitian ini adalah melakukan evaluasi rasionalitas penggunaan obat di Puskesmas Kecamatan Kuta ditinjau dari indikator peresepan (% peresepan obat generik, % persentase antibiotik, % peresepan injeksi) dan mengetahui perbedaan persentase rasionalitas penggunaan obat antar Puskesmas Kecamatan Kuta. Penelitian ini menggunakan rancangan penelitian<em> cross sectional </em>yang dilakukan pada Puskesmas Kuta I, Kuta II, dan Kuta Utara pada bulan Oktober 2017. Analisis data menggunakan analisis deskriptif dan uji Kruskall-Wallis. Analisis deskriptif dari tenaga kesehatan menunjukkan bahwa, profesi Apoteker masih langka di Puskesmas Kecamatan Kuta yaitu hanya ada di Puskesmas Kuta 1 per November 2018. Hasil penelitian tiap parameter pada Puskesmas Kecamatan Kuta tidak ada yang memenuhi target kriteria POR dari target Dirjen Binfar kecuali parameter peresepan injeksi. Rata-rata obat tiap pasien adalah 2,9, % peresepan obat generik adalah 85,91%, % peresepan obat antibiotik pada ISPA non Pneumonia adalah 29,94%, % peresepan obat antibiotik pada diare non spesifik adalah 23,84%, dan % peresepan injeksi adalah 0%. Hal tersebut menunjukkan bahwa Puskesmas Kecamatan Kuta masih mengalami masalah polifarmasi dan penggunaan antibiotik berlebihan. Hasil penelitian ini dapat menunjukkan adanya kebutuhan untuk meningkatkan pengetahuan tenaga kesehatan melalui pertemuan ilmiah atau <em>Focus Group Disscution (</em>FGD) yang dapat mendukung penggunaan obat yang rasional di Puskesmas.</p>


2017 ◽  
Vol 2 (2) ◽  
pp. 6
Author(s):  
Ledy Visna Asfiani ◽  
Yaslis Ilyas

The continuity of the participation in Prolanis is one of the primary health care services indicators of commitment, so finding out the level of adherence and the factors influencing it is very important. The aim of the study is to investigate the adherence level of Prolanis participanst and its determinants in type 2 diabetes patients at five BPJS primary health care in Bekasi. This is a cross sectional study, using questionnare to 220 participants with type 2 diabetes by simple random sampling method proportionally. Adherence level of the participants is 3.59 out of 6 times. Length of illness, perceived benefits, perceived barriers and the implementation of the program guidelines are correlated with the adherence level and the dominant factor is perceived barriers. Factors in individual and provider can be used as evaluation tools for the primary health care in facilitating the participants’ needs so that it would increase the level of adherence.


2021 ◽  
Vol 5 (1) ◽  
pp. 271-281
Author(s):  
Ayulia Fardila Sari ZA ◽  
Syafrawati Syafrawati ◽  
Laa Tania Fizikriy

Introduction: Health workers are groups that are vulnerable to contracting COVID-19. There are 20 health workers in West Sumatra test positive for COVID-19 until April 30th 2020, while six of them are Padang primary health care officers. Using Personal Protective Equipment (PPE) is important to prevent and reduce COVID-19 transmission risk of health workers. This study aimed to measure factors of using PPE for Padang primary health care officers. Methods: Research used a quantitative method with cross sectional design in 12 Padang primary health care from March to July 2020. Independent variables were age, PPE availability, leadership support, knowledge, and attitudes. Dependent variable was PPE usage behavior. Research population was health care officers who directly contacted with people in Padang primary health care area with 100 samples. Primary data collection used questionnaire with accidental sampling technique and analyzed using bivariate analysis. Results:There was a significant relationship between age and PPE usage behavior for health care officers, p value=0.037 (p


2021 ◽  
Author(s):  
Sandra Hakiem Afrizal ◽  
Achmad Nizar Hidayanto ◽  
Putu Wuri Handayani ◽  
Besral Besral ◽  
Adang Suhendra ◽  
...  

BACKGROUND It is necessary to assess readiness amongst health workers as an approach to successful IT implementation. However, little attention has been paid to assess demographic and associate factors related to such readiness. OBJECTIVE The study aims to describe factors related to the readiness of health workers with respect to implementation of a mobile Pregnancy Monitoring System in Primary Health Care (PHC) sites of the South Tangerang District in Banten Province, Indonesia using a socio-technical approach. METHODS A cross-sectional survey design was used among respondents who were involved during the antenatal care process. The participants (n=210) completed the questionnaire that measured information needs regarding the socio-technical aspect of readiness and factors affecting the readiness. The data was analysed using logistic regression analysis. RESULTS The findings of this study showed that the majority of the health workers who were involved in the antenatal care process were ready to implement the mobile pregnancy monitoring system. Having social media and willingness to be involved in IT implementation are associated with IT readiness, while there is no significant association between demographic factors to the readiness of the health workers. CONCLUSIONS Since there is no connectivity between the demographic factors to readiness, thus the supportive factors such as having a social media and willingness are easier to resolve than inferring from the demographic factors CLINICALTRIAL 783/UN2.F10/PPM.00.02/2018


2020 ◽  
Vol 9 (3) ◽  
pp. 224
Author(s):  
Simon Sumanjoyo Hutagalung ◽  
Dedy Hermawan ◽  
Devi Aulia

The purpose of this study is to explain: (1) Distribution of health workers in basic health services in Central Lampung, and (2). Factors that influence the process of procurement and distribution of health workers in primary health care in Central Lampung. Research conducted with this descriptive qualitative method involved health stakeholders in 34 health centers and 17 hospitals in the region. The results of this study include: (a). Analysis of the Distribution of Health Workers by Region, it is known that the pattern of distribution is not balanced and there are some districts that do not have several types of health workers. (b). Analysis of power distribution based on health workplaces is known that the majority of health workers are in health centers, even midwives and nurses are mostly in health centers and some types of health workers are not yet available in health centers. Also known factors that influence the process of procurement and distribution of health workers in primary health care include structural and environmental factors.


2018 ◽  
Vol 21 (2) ◽  
pp. 92-89
Author(s):  
Dina Dewi Anggraini ◽  
Windhu Purnomo ◽  
Bambang Trijanto

Anemia is a major cause of bleeding. And iron defi ciency is a major cause of anemia. Pregnant women have a high risk of iron defi ciency anemia. The prevention of iron defi ciency anemia is done through an iron supplementation program with a daily dosing of 1 consecutive tablet for at least 90 days during pregnancy. Fe1 and Fe3 coverage at Primary Health Care of Kediri City South Region is 69.81% and 66.29%. This coverage is still below the target program 95% of 2014. This study to analyze the infl uence of interaction of pregnant mother with health worker on compliance to consume iron tablet (Fe) and anemia in pregnant mother at Primary health Care of Kediri City South Region. Analytical observation with cross sectional design. The population consists of 63 trimester pregnant women III. With a simple random sampling technique, a sample of 34 trimester pregnant women III who have received 90 iron tablets (Fe). Data were obtained from questionnaires, Maternal and Child Health books, and in-depth interviews. Data analysis using ordinal regression and binarylogistic regression. Hypothesis of research that there is infl uence of interaction of pregnant woman with health worker to compliance consume iron tablet (Fe) at pregnant mother at Primary Health Care of Kediri City South Region. There was an effect of interaction of pregnant women with health workers with good category and suffi cient compared to the less category of compliance of pregnant women consuming iron tablet (Fe) (p = 0.000 < 0.05), and there was considerable compliance effect compared with non compliance iron tablet (Fe) to anemia in pregnant mother (p = 0.012 < 0.05). The better the interaction of pregnant women with health workers, the more likely the pregnant women to obediently consume iron tablets (Fe) to prevent anemia during pregnancy. Abstrak Anemia merupakan penyebab utama terjadinya perdarahan. Dan kekurangan zat besi merupakan penyebab utama terjadinya anemia. Ibu hamil mempunyai risiko yang tinggi untuk mengalami anemia defi siensi besi. Penanggulangan anemia defi siensi besi dilakukan melalui program pemberian suplemen zat besi dengan dosis pemberian sehari sebanyak 1 tablet berturut-turut minimal selama 90 hari selama kehamilan. Cakupan Fe1 dan Fe3 di Puskesmas Kota Wilayah Selatan Kota Kediri yaitu sebesar 69,81% dan 66,29%. Cakupan ini masih berada di bawah target program tahun 2014 yaitu sebesar 95%. Penelitian ini untuk menganalisis pengaruh interaksi ibu hamil dengan tenaga kesehatan terhadap kepatuhan mengonsumsi tablet besi (Fe) dananemia pada ibu hamil di Puskesmas Kota Wilayah Selatan Kota Kediri. Observasi analitik dengan rancang bangun cross sectional. Populasi terdiri dari 63 ibu hamil trimester III. Dengan teknik simpel random sampling, sampel sebanyak 34 ibu hamil trimester III yang telah mendapatkan 90 tablet besi (Fe). Data diperoleh dari kuesioner, buku Kesehatan Ibu dan Anak, dan wawancara yang mendalam. Analisis data dengan menggunakan regresi ordinal dan regresi logistik biner. Hipotesis penelitian yaitu ada pengaruh interaksi ibu hamil dengantenaga kesehatan terhadap kepatuhan mengonsumsi tablet besi (Fe) pada ibu hamil di Puskesmas Kota Wilayah Selatan Kota Kediri. Hasil penelitian ini ada pengaruh interaksi ibu hamil dengan tenaga kesehatan dengan kategori baik dan cukup dibandingkan dengan kategori kurang terhadap kepatuhan ibu hamil mengonsumsi tablet besi (Fe) (p = 0,000 < 0,05),dan ada pengaruh kepatuhan yang cukup dibandingkan dengan tidak patuh mengonsumsi tablet besi (Fe) terhadap anemia pada ibu hamil (p = 0,012 < 0,05). Semakin baik interaksi ibu hamil dengan tenaga kesehatan, maka semakin cenderung ibu hamil untuk patuh mengonsumsi tablet besi (Fe) untuk mencegah anemia pada masa kehamilan.


2020 ◽  
Author(s):  
Olaniyan Akintunde Babatunde ◽  
Muideen Babatunde Olatunji ◽  
Roseline Oluyemisi Akande ◽  
Joseph Muyiwa Olumoyegun

Abstract Background: The outbreak of COVID-19 has continued to threaten the existence of human race. The novelty and unstable epidemiologic pattern of the virus had generated so much concern among the global health experts. These concerns were found to be escalated among frontline health care workers to the extent of impeding the timeliness of the response activities. To slow down the spread of the already established community transmission through the surveillance activities, the concern of the health workers at the community level needs to be addressed. Therefore, this study assessed the concern about COVID-19 pandemic among the primary health workers in Oyo State, Nigeria.MethodsThis was an online cross-sectional survey conducted among primary health care workers in Oyo State between March and April 2020. Using a two-stage sampling technique, we recruited 284 respondents. A semi-structured questionnaire linked to the Google form was used to collect data. Data were analyzed using IBM SPSS version 25; bivariate analysis was done using Chi-square and binary logistic regression was used to identify the predictors of health workers’ concern at 5% level of significance.ResultsThe mean age of respondents was 45.0 + 9.0 years. About 52.5% had goodk knowledge of COVID-19. In the domains of concern, 66.9%, 53.2%, 51.4%, and 46.5% of the respondents expressed government-related concern, self-satisfaction related concern, work-related concern and social status related concern respectively. Male respondents were less likely to express concern about COVID-19 compared with their female counterparts (aOR= 0.39, 95% CI = 0.20 – 0.76). Nurses/midwives (aOR= 0.21, 95% CI = 0.05 – 0.85) had lesser likelihood of expressing concern about COVID-19 while middle staff (aOR= 2.5, 95% CI = 1.18 – 5.39) and income earner of ≥ N200, 000 (aOR= 2.3, 95% CI = 1.34 – 3.92) had higher likelihood of expressing concern about COVID-19.ConclusionThe study revealed an average knowledge of COVID-19 among the respondents. Government-related and self-satisfaction related concerns were majorly expressed by the majority of the PHC workers. Therefore, holistic policy that addresses the welfare and training of the HCWs is recommended.


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