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This study is seeking the impact of structure and process as the qualityaspect according to Donabedian 's theory that affecting to the Net Death Rate/NDR Stroke disease. Selected data source are Stroke patients, consisting ofIntracerebral Haemorrhage and Cerebral Infarction at Dr Kanujoso DjatiwibowoBalikpapan Hospital in the year 2014. This study is a qualitative research usingdescriptive analytic retrospective method. Structure and Process Factors that areinfluencing each other. It reveals that Structure Factors in hospitalization that areaffecting sequentially are the condition of the patient, facilities, policies andhuman resource. On the other hand it reveals that Process Factors includeobstacle on running the primary instruction and also Hospital AccociatedInfections/ HAIs occurs due to the nursing process. In Emergency Unit there isobstacle in Process Factor as the CT Scan service is not available sometime. It isrecommend to improve the quality of Stroke patient to overcome the Structure andProcess Factors and to develop the on stop service Stroke Unit.Keywords : Quality, Donabedian , NDR Stroke , Structure Factor, Process Factor.
Penelitian ini dilatarbelakangi jumlah resep dari unit rawat jalan yang ditebus di luar unit farmasi PK Sint Carolus pada tahun 2009 sebesar 21,37%. Proses pembelian obat di unit farmasi rawat jalan PK Sint Carolus masih manual, setelah berkonsultasi dengan dokter, pasien menerima resep dan memilih sendiri tempat membeli obat. Tujuan penelitian adalah untuk mengetahui faktorfaktor yang mempengaruhi pasien dalam memilih tempat membeli obat di PK Sint Carolus. Penelitian ini dilaksanakan selama 2 bulan mulai bulan April sampai awal Juni 2010 di Poliklinik spesialis PK Sint Carolus, Jakarta. Penelitian ini menggunakan pendekatan kualitatif dengan menggunakan data sekunder sebagai data awal dan kemudian dikembangkan dengan wawancara mendalam kepada informan yang terlibat dalam proses pemilihan tempat membeli obat di PK Sint Carolus. Hasil penelitian menunjukkan bahwa besarnya persentase resep obat yang dibeli di luar unit farmasi PK Sint Carolus disebabkan oleh kualitas pelayanan unit farmasi yang belum optimal, belum semua dokter meresepkan sesuai formularium, kurangnya kontrol manajemen terhadap fungsi panitia farmasi dan terapi dan belum terjalin relationship antara pasien dengan petugas farmasi. Kata kunci : Pemilihan tempat membeli obat, farmasi
This research conducted because the amount of prescription from outpatient unit which be redeemed outside pharmacy unit of PK Sint Carolus in the year of 2009 has reached the number of 21,37%. The process to buy medicine in the pharmacy unit is still working manually. After consulting with the doctor, patient receive a prescription dan choose by themselves where to buy the medicine. The objective of this research is find out factors that influence patients in choosing where to buy drugs in PK Sint Carolus. This research was conducted for 2 months since April until early June 2010 in spesialist polyclinic of PK Sint Carolus, Jakarta. This research was using qualitative approach, with secondary data as initial data dan then improved by indepth interview with informans who involved with the selection of places to buy drugs. The result of this research shows that the big percentage of prescription which bought outside the pharmacy unit of PK Sint Carolus is caused by the lack of control towards the function of pharmacy and therapy commitee, the service quality of pharmacy unit which is not optimal yet, not all the doctors prescribe according to formularium, and there hasn’t been a relationship between patients and pharmacysts. Keywords : Selection of places to buy drugs, pharmacy
ABSTRAK
Pemanfaatan suatu pelayanan kesehatan merupakan hasil interaksi antara pengguna jasa pelayanan kesehatan dan penyelenggara pelayanan kesehatan. Interaksi ini merupakan suatu hal yang sangat kompleks dan berhubungan dengan banyak faktor. Rumah Sakit Hermina Bekasi adalah rumah sakit umum swasta yang terletak di Kota Bekasi dengan unggulan pelayanan pada kebidanan dan anak. Tingginya jumlah kunjungan Ante Natal Care ternyata tidak diikuti oleh tingginya jumlah persalinan. Data selama tiga tahun berturut-turut menunjukkan jumlah kelahiran tidak pernah mencapai target yang ditetapkan oleh Rumah Sakit, hal ini menjadi menarik untuk diteliti lebih lanjut apa penyebabnya dari sisi penyelenggara dan pendukung pelayanan. Penelitian ini merupakan penelitian analitik dengan pendekatan kuantitatif. Sedangkan desain penelitiannya adalah cross sectional. Pengumpulan data dengan menggunakan kuesioner yang diisi oleh responden. Populasi adalah seluruh pasien yang melahirkan di RS Hermina Bekasi. Pengambilan sampel dengan purposive dan quota sampling. Analisis data menggunakan analisis univariat yaitu distribusi frekuensi, analisis bivariat dengan uji Chi Square, analisis multivariat tidak dilakukan karena tidak memenuhi syarat pengujian. Hasil uji statistik semua variabel bebas tidak adanya hubungan dengan frekuensi selalu memanfaatkan, namun berdasarkan hasil angka, proporsi terbesar frekuensi pemanfaatan pelayanan responden ada pada semua variabel bebas yang baik. Setelah dilakukan pemilahan dan penilaian lebih mendalam dengan menjabarkan hasil penilaian skala Likert yang ada dari masing- masing variabel bebas, didapatkan kekurangan pada hampir semua peryataan dari variabel bebas kecuali perilaku SDM (dokter dan perawat) dan kenyamanan. Sehingga perlu untuk ditelaah lebih lanjut terhadap kekurangan- kekurangan yang ada dari sisi provider. Analisa multivariat tidak bisa diolah lebih lanjut karena hanya satu yang bisa masuk permodelan multivariat (tidak memenuhi syarat).
ABSTRACT
Utilization of health services is the result of an interaction between the users health services and providers of health services. This interaction is a very complex matter and is associated with many factors. Hermina Bekasi Hospital is a general hospital located in Bekasi with superior service in obstetrics and children. The high number of Ante Natal Care visits was not followed by the high number of births. Data for three years in a row shows the number of births has never reached the target set by the hospital, it becomes interesting to study further about the causes from provider and health services side. This research use a quantitative analytical approach while the study design was cross-sectional. Data collection used questionnaires completed by respondents. The population was all patients who give birth in Hermina Bekasi hospital with purposive and quota sampling. Analysis of the data using univariate frequency distributions, bivariate analysis with Chi Square test, multivariate analysis was not performed because it does not meet the test requirements. The results of the all the independent variables statistical test are not always the relationship with the frequency of use, but based on the numbers, the largest proportion of respondents frequency of service utilization for all the independent variables are good. After sorting and more deep assessment by outlining the results of the existing Likert scale assessment of each of the independent variables, found flaws in nearly all variables except the stationing of human behavior (doctors and nurses) and comfort. So it needs to be examined against the existing shortcomings of the provider. Multivariate analysis could not be processed further because the only one who can get in multivariate modeling (not eligible).
Health services have begun to shift by placing patients at the center of health services. Continuity of service runs well if all service providers are able to provide the information needed to make the right decisions. This research was conducted to analyze the factors that influence the implementation of patient centered care in the inpatient room of Wangaya Hospital in Denpasar. The method in this study use a quantitative method using a descriptive analytic design with a cross Sectional approach. Data were analyzed using cross tabulation analysis and chi square analysis. Data were collected through a questionnaire given to 70 respondents who were selected and in accordance with the inclusion and exclusion criteria. The results showed that 50% of respondents applied patient-focused services well, 81.43% of respondents had a good level of knowledge about patient-focused services, 44.29% of respondents had a good attitude category, 48.57% of respondents had high motivation, 50 % have good skills in the application of patient-focused services. The logistic regression test results show that knowledge is the most dominant factor in the application of patient-focused services. This is indicated by the significance (0.048) which is smaller than the real level value (α = 0.05). The regression coefficient of Nurse Knowledge (1,848) which is positive indicates a positive and significant influence, the Nagelkerke R Square value. This value is 0.372. This means that the contribution of the influence of the nurse's knowledge, attitude, motivation and skills to the application of PCC is 37.2%
