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Prevalensi penyakit Tuberkulosis (Tb) di Indonesia masih sangat tinggi dimana negara ini menduduki posisi kelima jumlah insiden kasus Tb terbesar di dunia (WHO, 2010a) yang salah satu penyebabnya adalah ketidakpatuhan pengobatan penderita Tb yang berdampak terhadap ancaman kasus MDR-Tb dan XDR-Tb. Perilaku ini dapat disebabkan oleh inefektivitas peran pengawas menelan obat (PMO) dimana sebagian besar penunjukkannya diarahkan ke anggota keluarga dibanding petugas kesehatan. Penelitian bertujuan mengetahui pengaruh peran pengawas menelan obat dari anggota keluarga terhadap kepatuhan pengobatan penderita tuberkulosis. Desain penelitian ini termasuk observational dengan rancangan penelitian analytic cross sectional melibatkan 113 PMO yang berasal dari anggota keluarga penderita Tb dari wilayah enam puskesmas di Kota Pariaman menggunakan tehnik simple random sampling. Uji Regresi Logistik menunjukkan bahwa peran pendampingan berobat ulang ke puskesmas oleh PMO dari anggota keluarga memberikan pengaruh terbesar terhadap kepatuhan pengobatan penderita Tb (25,238; p-value 0,000) apabila dikontrol dengan tingkat pengetahuan PMO yang baik (7,341; p-value 0,003) dan atau kedekatan hubungan kekeluargaan PMO dengan penderita Tb (11,203; p-value 0,029). Dalam rangka meningkatkan efektivitas pengawasan pengobatan penderita Tb di Indonesia maka direkomendasikan reformulasi kebijakan pengendalian Tb terkait kriteria pemilihan PMO yang berasal dari anggota keluarga. Kata kunci: keluarga, kepatuhan, pengobatan, peran, pengawas, tuberculosis.
The prevalence of Tuberculosis (Tb) disease in Indonesia is still very high when the country came in fifth largest number of incident cases of Tb in the world (WHO, 2010a) that one reason is lack of patient medication compliance of Tb affect the threat of MDR-Tb and XDR-Tb. This behavior can be caused by the ineffectiveness of a treatment observer role (PMO) in which most of his appointment was directed to family members rather than healthcare workers. The study aims to determine the effect of a treatment observer role of family members on patient medication compliance of Tb. The design of this study include observational with cross sectional analytic study design involving 113 PMO from family members of patients with Tb of the six community health centers in the city of Pariaman through simple random sampling technique. Logistic regression test showed that repeated treatment mentoring role to the community health center by the PMO of the family members have the greatest influence on patient medication compliance Tb (25.238, p-value 0.000) when controlled by the level of knowledge of PMO (7.341, p-value 0.003) and or a close familial relationship between the PMO with Tb patients (11.203, p-value 0.029). In order to increase the effectiveness of the treatment of patients Tb control in Indonesia then recommended reformulation of TB control policies related to the selection criteria for the PMO which comes from a family member. Key words: family, compliance, treatment, medication, role, observer, tuberculosis
Teleconsultation FKTP is one of the policies issued by BPJS Kesehatan. The definition used in this Teleconsultation is Indirect Contact Service, which is the provision of health services through an information system used by FKTP and Participants as a means of communication, or through an information system provided by BPJS Health, as a means of two-way communication/consultation. This policy began to be implemented in April 2020 and until August 2021, national achievements are still not optimal, only a few districts/cities have shown better achievements, one of which is the highest achievement in the Malang City FKTP. This study aims to analyze the implementation of the FKTP Teleconsultation policy in preventing the spread of COVID-19 without patients losing their rights to access health services, using qualitative methods, during October 2021 - December 2021 at the Malang City FKTP. Data collection techniques through FGD and in-depth interviews with key informants and document review, using the Van Meter and Van Horn Policy Implementation. The results of the research in November 2021 obtained that the KBK Contact Number reached 135/mill from the minimum target of 150/mill, the Indirect Contact Number for health facilities compliance indicators on quality was only achieved with a weight of 15% of the 20% target, 100% of Malang City FKTP had Teleconsultation implementation, and utilization by patients slowly increased up to 33.66% and there was an increasing trend of collaborative FKTP. In this study, the researcher suggests that the training of FKTP officers be carried out periodically, starting with teleconsultation to Prolanis participants, direct supervision as a routine activity and political support through the Malang City Government to be able to increase free hotspots that can be accessed by residents, so they can take advantage of the services. Teleconsultation
Tesis ini membahas analisis Implementasi Kebijakan Pelaporan Rumah Sakit Lanjutan Program Jamkesmas pada Pusat Pembiayaan dan Jaminan Kesehatan Tahun 2012. Penelitian ini menggunakan pendekatan kualitatif dengan melakukan wawancara mendalam dari informan terpilih. Hasil penelitian menunjukkan dari aspek Input Laporan masih ada Rumah Sakit yang melaporkan belum sesuai dengan manlak aspek proses berdasarkan kepada teori implementasi kebijakan Edward III faktor komunikasi, sumber daya, disposisi dan struktur birokrasi, serta aspek Umpan balik Kesimpulannya, Implementasi Kebijakan Pelaporan PPK Lanjutan Program Jamkesmas pada Pusat Pembiayaan dan Jaminan Kesehatan Tahun 2012 belum dilaksanakan secara maksimal, karena belum adanya batas waktu penyampaian Saran peneliti bagi Pusat Pembiayaan dan Jaminan Kesehatan adanya batas waktu penyampaian pelaporan dan umpan balik secara berkala dan tertulis terhadap Rumah Sakit lanjutan tersebut.
This thesis discusses the analysis of the Policy Implementation Advanced Reporting Hospital JAMKESMAS Program at the Center for Financing and Health Security in 2012. This study used a qualitative approach by conducting indepth interviews from selected informants. Results of the study showed there are still aspects of the Report Input Hospital reported manlak not in accordance with aspects of the process of policy implementation is based on the theory of Edward III factor of communication, resources, disposition and bureaucratic structure, aspect Feedback conclusion, Reporting Implementation Program Advanced Hospital JAMKESNAS the Central Financing and Health Insurance in 2012 has not been fully implemented, because there is no deadline for submission of suggestions researcher for the Center for Health Financing and Guarantee the deadline reporting and feedback on the advanced Hospital.
