Penelitian ini bertujuan untuk melakukan evaluasi program latihan Klub Jantung Sehat Pondalisa sekaligus mengetahui hubungan frekuensi dan keteraturan senam terhadap penurunan tekanan darah. Dengan demikian diharapkan akan didapatkan tekanan darah yang terkendali pada anggota KJS Pondalisa khususnya dan masyarakat usia dewasa tua umumnya. Studi kohort retrospektif dilakukan dengan menggunakan data yang terdapat pada buku anggota KJS Pondalisa. Digunakan pendekatan analisis Cox Regression untuk melihat efek frekuensi dan keteraturan senam yang telah dilakukan oleh para anggota KJS Pondalisa selama 1 tahun pertama keanggotaan terhadap penurunan tekanan darah. HR (hazard ratio) digunakan sebagai estimasi RR (risiko relatif) efek frekuensi dan keteraturan senam terhadap penurunan tekanan darah. Anatisis multivariat digunakan untuk mengendalikan variabel-variabel perancu. Sebanyak 132 data anggota K7S Pondalisa dianalisis dalam penelitian ini. Dalam 1 tahun pertama keanggotaan terdapat 11,36% anggota yang melakukan senam 2x1minggu, 39,39 % anggota yang melakukan senam > 8 minggu (9-15 minggu) berturut-turut, dan 11,36% anggota yang melakukan senam 2xlminggu selama > 8 minggu (9-15 minggu) berturut-turut. Tidak ada anggota yang melakukan senam 3xlminggu sesuai program dan tidak ada anggota yang melakukan senam 2x1minggu selama < 8 minggu berturut-turut_ Keteraturan senam anggota maksimum selama 15 minggu. Didapatkan penurunan tekanan darah pada 32,58 % anggota dengan rata-rata penurunan tekanan darah sistolikldiastolik sebesar 6 mmHg/4 mmHg yang dapat dipertahankan minimal selama 1 bulan. Besarnya penurunan TD ini diharapkan dapat bermanfaat dalam menurunkan angka kesakitan dan kematian akibat hipertensi; sedikitnya dapat memperlambat perjalanan penyakit hipertensi serta bermanfaat dalam pencegahan primer. Efek frekuensi senam 2xlminggu terhadap penurunan tekanan darah meningkat sebesar 1 Va dibandingkan dengan frekuensi senam < 2xlminggu [RR 1,01;95%CI [0,43-2,38]. Efek senam teratur 9-15 minggu berturut-turut terhadap penurunan tekanan darah meningkat sebesar 36 % dibandingkan dengan senam teratur < 8 minggu berturut-turut [RR 1,36;95%CI [0,63-2,93]. Senam yang dilakukan 2xlminggu selama 9-15 minggu berturut-tunrt memberikan manfaat penurunan tekanan darah sebesar 34 % dibandingkan dengan senam

The aim of this research is to evaluate the performance of `Klub Jantung Sehat Pondalisa' as well as the association of frequency and regularity of exercise with blood pressure reduction. The long-term benefit achieved will be adequate control of blood pressure among members of the club and adults as a whole. Retrospective cohort study was conducted, using data found on the member's logbook. Cox Regression analysis approach was used to find the benefit of blood pressure reduction through exercise's frequency and regularity which have been done by all member of KJS Pondalisa during the first year of membership. HR (hazard ratio) was used to estimate the RR (relative risk) of both exercise's frequency and regularity to reduce blood pressure. Confounders were adjusted by multivariate analysis. There were 132 members analyzed in this research. In the first year of membership, there were 11.36% members doing exercise twice weekly, 39.39 % members doing exercise > 8 weeks (9-15 weeks) regularly, and 11.36% members doing exercise twice weekly in > 8 weeks (9-15 weeks) regularly. There were no member doing exercise thrice weekly as programmed. There were no member doing exercise twice weekly in < 8 weeks regularly. The maximum exercise's regularity was 15 weeks. There were 32.58 % blood pressure reduction among members. The mean systolic/diastolic reduction which can be maintained for at least I month were 6 mmHg/4 mmHg, This amount of BP reduction might reduce morbidity and mortality among hypertensives; at least might retard the natural history of hypertension and give benefit to primary prevention. The effect of twice weekly's exercise on blood pressure reduction increase 1 % as compared to less than twice weekly's exercise [RR 1,01;95%CI [0,43-2,38]. Effect of doing 9-15 weeks regular exercise on blood pressure reduction increase 36 % as compared to members doing 8 weeks regular exercise [RR 1,36;95%CI [ 0,63-2,93]. Members doing exercise twice weekly in 9-15 weeks regularly get benefit on blood pressure reduction 34 % more as compared to members doing exercise less than twice weekly in < 8 weeks regularly [RR 1,34;95% CI [0,50-3,60]. There were no difference in blood pressure reduction between members doing exercise less than twice weekly in 9-15 weeks regularly and members doing exercise less than twice weekly in < 8 weeks [RR 0,99;95% CI [ 0,42-2,32]. From this research, we conclude that there was no different effect of blood pressure reduction between twice weekly's exercise and less than twice weekly's exercise. The effect of exercise in 9-15 weeks regularly toward blood pressure reduction is bigger compared with effect of twice weekly's exercise. This fording shows the importance of maintaining exercise's regularity to get benefit of reducing blood pressure. The benefit of twice weekly's exercise for blood pressure reduction will be achieved when it is conducted in 9-15 weeks regularly. Although exercise has been conducted regularly up to 15 weeks, if done less than twice weekly, it will not yield the benefit of blood pressure reduction. There are still many factors which have not been considered such as the duration and intensity of exercise, the role of anti hypertensive drugs, and the presence of other diseases. All of those factors together with the wide range and inconsistent of confidence interval, make the results of this study fail to show the maximal effect of exercise's frequency and regularity to reduce blood pressure in population. Therefore, further research is needed using several degrees of exercise's frequency and regularity, considering also the above mentioned related factors and bigger number of sample size, to obtain the true benefit of blood pressure reduction and more accurate precision.

Tarif pelayanan persalinan di Puskesmas Cimanggis Kota Depok yang berlaku saat ini adalah Rp. 75.000,0. Tarif ini sudah tidak sesuai lagi dengan kebutuhan operasional kamar bersalin di Puskesmas di mana Puskesmas harus melaksanakan tugas dan fungsinya sebagai tempat pertolongan persalinan yang bermutu dengan tidak hanya selalu bergantung kepada subsidi Pemerintah.Dengan penyesuaian tarif diharapkan terwujud maksimalisasi pelayanan, karena tarif yang sesuai dengan kemampuan membayar masyarakat akan meningkatkan utilisasi. Penyesuaian tarif dilakukan melalui analisa tarif yang berdasarkan biaya satuan pelayanan persalinan ,tingkat pengembalian biaya, tingkat kemampuan (ability to pay ATP) dan kebijakan tarif dan tarif pesaing yang setara.Penelitian ini merupakan studi kasus yang dilakukan di unit kamar bersalin Puskesmas Cimanggis Kota Depok, yaitu menganalisa biaya dengan menggunakan data tahun 2000 dan menggunakan metode double distribution. Adapun untuk menilai tingkat kemampuan dan kemauan masyarakat membayar yaitu dengan mengolah data hasil survei terhadap masyarakat Kabupaten Bogor. Kemampuan masyarakat menurut ATP adalah : 92 % masyarakat mampu membayar Rp 72.000,0 ; 72% masyarakat mampu membayar Rp 270.000,0.; 50% masyarakat mampu membayar Rp.504.000,00.Dari hasil analisa biaya kamar bersalin, didapatkan biaya satuan aktual Rp.585.593,00 dan biaya satuan normative Rp.524.626,00 Tarif pertolongan persalinan yang akan disarankan adalah Rp. 270.000,0. Saran perubahan tarif tersebut disambut baik oleh kepala Dinas Kesehatan Kota Depok serta Kepala Puskesmas Cimanggis, selanjutnya akan diusulkan ke Pemda untuk diproses lebih lanjut.Daftar Pustaka : 21 (1996 - 2001)

A Case Study of Birth Delivery Rational Price Analysis at Puskesmas Cimanggis, City of Depok, 2002The current price of delivery service at Puskesmas Cimanggis City of Depok is Rp75.000,-. Considering the tasks and functions of Puskesmas as quality delivery service place that does not depend on government's support, the current price is not suitable with operational need of birth delivery room in Puskesmas. It is expected that price adjustment would maximize the service, because the appropriate price that is in line with people's ability to pay would increase utilization.The price adjustment was conducted through price analysis based on the unit cost of birth delivery service, cost recovery rate, ability to pay (ATP), price policy, and competitor's price. This study is a study case that was conducted in Birth Delivery Room Unit at Puskesmas Cimanggis City of Depok by analyzing the cost using double distribution method. The assessment of the ability to pay and the willingness to pay of the people in the District of Bogor was conducted by processing data from the survey result. The ability to pay according to ATP1 was 92% of people were able to pay as much as Rp72.000, 00; 72% of people were able to pay as much as Rp270.000,00 and 50% of people were able to pay as much as Rp504.000,00.Based on the cost analysis of birth delivery room of this study, the actual unit cost was Rp585.593, 00 and normative unit cost was Rp524.626,00. Nevertheless, the recommended price of birth delivery service is Rp270.000, 00. The recommendation of the price change is accepted by the Head of District Health Office as well as the Head of Puskesmas Cimanggis. Furthermore, the next step would be proposing this pricing to the Local Government.References: 21 (1996 - 2001)

Sebelum ditemukannya alat-alat canggih, pengobatan penyakit batu saluran kemih, khususnya batu ureter, adalah dengan cara operasi terbuka (invasif). Namun saat ini pengobatan yang bersifat invasif mulai ditinggalkan, dan beralih ke cara pengobatan yang minimal invasif, bahkan non invasif.Saat ini, di RSUPN-CM Jakarta, telah tersedia alat untuk mengobati penyakit batu saluran kemih, khususnya batu ureter distal, yang bersifat minimal invasif, yaitu Ureterorenoskop, dan yang bersifat non invasif, yaitu Extracorporeal Shock Wave Lithotripsy (ESWL). Cara pengobatan batu ureter dengan menggunakan alat Ureterorenoskop, disebut tindakan Ureteroskopi (URS).Tujuan dari penelitian ini adalah, untuk mengetahui efektivitas biaya dari pengobatan batu ureter distal, antara yang menggunakan cara URS dengan cara ESWL. Penelitian ini bersifat deskriptif, menggunakan data sekunder subbagian urologi swadana RSUPN-CM, tahun 2001 periode Juni s/d Desember. Analisis data biaya investasi menggunakan biaya investasi setahun. Analisis biaya menggunakan metode Activity Based Costing (ABC), karena metode ini yang paling cocok untuk menganalisis biaya dalam mengobati penyakit batu ureter distal yang merupakan salah satu jenis kegiatan yang ada di subbagian urologi yang memiliki berbagai jenis kegiatan.Hasil dari penelitian ini menunjukkan bahwa, pengobatan batu ureter distal yang paling efektif biaya adalah dengan cara ESWL. Bahkan tindakan ESWL kelas super VIP masih lebih efektif biaya dibandingkan dengan tindakan URS dengan ruang perawatan kelas III.

An Effectiveness Analysis of Distal Urethral Stones Treatment Compared with Ureterorenoskop and Extracorporeal Shock Wave Lithotripsy at RSUPN-CM Jakarta, 2001Before sophisticated-medical equipment was discovered, invasive surgery was used for Urinary Tract Stone treatments; especially urethral stone. Today, invasive surgery has been no longer implemented, and shifting into minimal or non invasive treatment.RSUPN-CM Jakarta, has two different medical equipments to treat Urinary Tract Stone patient which are Ureterorenoscop for minimal invasive treatment and Extracorporeal Shock Wave Lithotripsy (ESWL) for non invasive treatment. The treatment using Ureterorenoscop is called Ureteroscopy (URS).The aim of this research is to examine and compare the cost effectiveness of urethral distal stone treatment using both equipments. This research is descriptive, using secondary data from subbagian urologi RSUPN-CM in the period of June-December 2001. Meanwhile, data analysis for investment cost is considered in annual base.The analysis of this study is using Activity Based Costing (ABC) method. This method is the most appropriate method for urethral distal stone treatment since subbagian urologi comprises a broad range of interrelated activities. ABC method, therefore, will evaluate the cost of effectiveness for both URS and ESWL.The study shows that ESWL is the most effective cost compared to URS. Even, Super VIP using ESWL is more effective than class III URS.