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The main problem of performance-based remuneration program design andimplementation is ineffective. This study aimed to analyze the quality of thepayment scheme of financial incentives based on the opinions and experience ofphysicians, to be input to drive improvement and successful implementation ofpayment patterns related financial incentives to improve the quality of health carein Persahabatan Hospital in 2016. The study used a qualitative approach to thetype of Rapid Assessment Procedure and the data collection was conducted inJune 2016. The study population was the whole of doctors who work inPersahabatan Hospital. The sample consisted of doctors who have receivedfinancial incentives and conduct health services directly to patients at least for 2years and management related to setting financial incentives doctors. Dataobtained by in-depth interviews and focus group discussions. Data analysis wasperformed using marginal notes and voice recordings and summarized by topiceach corresponding question. The result is a pattern of financial incentivepayments based on the performance improvement effect on attitudes and behaviorof physicians. Internal aligment that consider the content and the value of office,doctor persist because of the status of civil servants, a big difference in incentivesto outside is not too big, and opportunity in private practice. Management mustinnovate and continuous evaluation to involve the full participation of physiciansin improving the quality of service.Keywords :Financial incentives, doctor, Performance, Payment Patterns
The hospital as an organization engaged in the field of health services is required to always improve the quality of the services. A parameter for assessing the quality of hospitals is the assessment of accreditation by institutions that have been national and international certified. The focus of assessment on the accreditation process is continuous quality improvement that prioritizes patient safety. This study aims to analysis description of the behavior of health workers to adhere the service standards that prioritize patient safety so that the risk of patient safety incidents had been reduced and have impact on better service quality. This research was conducted with a mix method study of field observation and quantitative study with a cross sectional design. The study sample used simple random sampling with a total sample of 161 respondents. Secondary data collection was carried out through field observations and document studies while the primary data was carried out through filling in questionnaires. The results of the study revealed that the behavior of officers who supported patient safety at 90% compliance that amount of 64%. Factors that have a relationship with the behavior of supporting patient safety are education (p value 0.001), profession (p value 0.047), knowledge (p value 0.029), attitude (p value 0.001), supervision (p value 0.001) and teamwork (p value 0.001) with the dominant variable from the results of multivariate analysis is attitude (OR 12,382) and confounding factor are age, education, profession, knowledege, supervision and team work, in the otherside not found interaction of that varaible. The problems that are still low on behavior are related to workloads there are still who force work when conditions are tired and the concentration is reduced, the other who work that is beyond their authority. To improve behavior related to patient safety is to mapping and calculate employee workload, especially the unit of patient services, make educational materials related to patient safety through audio visual media, incorporate behaviors related to patient safety into employee performance indicator, create programs that can support employees to try make safety behavior to be a work culture
Based on data from the International Centre for Trade of Thailand ( 2012) , thequality of professional medical practitioners Indonesia placed on medium quality.Health services liberalization will lead to competitiveness outside of the healthservices in Indonesia , because it is not possible settlement of health problems inIndonesia requires foreign health workers to address health problems in Indonesia.This research was conducted to obtain in-depth information , describes and analyzesthe competence of medical practitioners in the era of the ASEAN economiccommunity . The informants are from several organizations associated withincreased competence of medical practitioners . This research is qualitative andimplemented from February through May 2016 by researchers . This study usesprimary data through in-depth interviews using guidelines depth interviews andreview documents. Interviews will be conducted by researchers.The study concluded personal skills, the skills and knowledge of Indonesian doctorsexplicit in terms of the competence of medical doctors do not lose competitivenesswith other ASEAN member countries , but in terms of the competence of the serviceremains to be repaired so that the patient Indonesia did not come out to foreignmarketsKeywords: Personal Skill, ability, Explicit Knowledge, MEA, PhysicianCompetency
The effort to improve maternal and neonatal health care is a priority program, principally focused on improving antenatal care services in all facilities with good quality and maximum service coverage, improving aid delivery by health personnel, improving early detection of high risk by health workers, improved neonatal care with good quality. This must be supported by quality performance of health workers, particularly midwifes. Coverage of deliveries by midwifes in the Serang City 54.8%, 64.4% coverage K1, K4 coverage 54.5%. KN1 coverage 62.2%, KN2 coverage 58.5% and is below the national target. Quality performance can be affected by the midwife predisposing factors (age, working time, employment status, marital status, knowledge, education) enabling factors (training, tools), reinforcing factors (supervision, leadership support, community support). This study aimed at obtaining information about the characteristics and performance quality of midwifes in maternal and neonatal health services in the city of Serang Year 2009. The research design was chosen in this research is quantitative analytical survey with cross sectional approach. Population is all the midwives at health centers in the city of Serang.
Dalam kurun waktu lima tahun terakhir ISPA terutama pneumonia masih merupakan penyumbang terbesar dalam kejadian kematian bayi di Indonesia pada umumnya dan di Kabupaten Sumedang khususnya. Hasil penelitian Depkes tahun 1997 menunjukkan penatalaksanaan kasus ISPA yang tepat dapat mencegah secara efektif sekitar 60-80 % kematian akibat pneumonia. Keadaan ini menjadi titik tolak Depkes untuk mengintensifkan program penanggulangan penyakit ISPA dengan salah satu program prioritasnya adalah meningkatkan kemampuan petugas dalam manajemen penatalaksanaan penyakit ISPA pada bayi yang dititikberatkan pada kepatuhan dalam pelaksanaan SOP ISPA. Tujuan penelitian ini adalah mengkaji pengaruh pelatihan terhadap tingkat kepatuhan petugas dalam pelaksanaan SOP ISPA dan dampaknya kepada kepuasan ibu bayi setelah memperoleh pelayanan oleh bidan di puskesmas.Pendekatan penelitian adalah quasi experimental dan panel survey non equivalent group design. Ada dua sampel penelitian. Kelompok pertama yaitu 10 orang bidan puskesmas di wilayah bekas Pembantu Bupati Darmaraja dan Tanjungsari Kabupaten Sumedang yang diukur kepatuhan dalam pelaksanaan SOP ISPA sebelum dan sesudah pelatihan. Kelompok kedua adalah 110 ibu bayi yang membawa bayinya berobat ke puskesmas di lokasi yang sama dengan keluhan batuk/sesak. Tingkat kepuasannya diukur setelah memperoleh pelayanan. Kelompok kontrol dengan jumlah bidan dan ibu bayi yang sama di 10 puskesmas pada wilayah bekas Pembantu Bupati Kota dan Congeang di Kabupaten Sumedang. Tingkat kepatuhan bidan dalam pelaksanaan SOP ISPA dianalisa secara univariat untuk menilai distribusi frekuensi dan besarnya proporsi diantara sampel. Sedangkan Mc Nemar test dipergunakan untuk menilai pengaruh pelatihan terhadap tingkat kepatuhan.Hasil analisa statistik menunjukkan rata-rata skor kepatuhan Bidan dalam pelaksanaan SOP ISPA dan skor kepuasan ibu bayi sebelum pelatihan pada kedua kelompok dalam keadaan setara. Dengan uji Mc Nemar menunjukkan bahwa kepatuhan sesudah pelatihan meningkat pada kelompok intervensi (p = 0,0001 dan OR = 5,8). Terdapat perbedaan proporsi tingkat kepuasan ibu bayi sebelum dan sesudah Bidan mendapat pelatihan (p = 0,028) dan ada hubungan yang bermakna antara tingkat kepatuhan Bidan dengan kepuasan ibu bayi (p = 0,018). Kesimpulan yang didapat, Bidan pada kelompok intervensi yang mendapat pelatihan manajemen penatalaksanaan ISPA mempunyai peningkatan skor kepatuhan lebih tinggi dibandingkan dengan kelompok yang tidak mendapat pelatihan. Ibu bayi yang dilayani oleh Bidan pada kelompok intervensi mempunyai skor kepuasan lebih tinggi dibandingkan ibu bayi yang dilayani Bidan yang tidak mendapat pelatihan manajemen penatalaksanaan ISPA.
The Influence or Acute Respiratory Infection Management Training for Midwives of Community Health Centers and Its Impact on Baby Mothers' Satisfaction in Sumedang District, 2001/2002In the last five years acute respiratory infection (ARI) disease especially pneumonia has been the main contributor for the death of babies in Indonesia in general and in Sumedang District in particular. Data of Indonesian Ministry of Health research in 1997 showed that the appropriate management to handle ARI cases could effectively reduce the death of babies from pneumonia by 60 to 80 %. This data has been assigned as a basis to intensify the program of preventing AFT. One of the priorities of the program is to improve the capability of health providers in managing ARI prevention for babies emphasized on the health providers' compliance with conducting SOP of ARI.This research is aimed to investigate the influence of training on the degree of health providers' compliance with conducting SOP of ARI and its impact on baby mothers' satisfaction on the quality of services from the community health centers' midwives.This research employs quasi experimental and panel survey non equivalent group design. There were two groups of samples. The first group was 10 community health centers' midwives in the former region of Darmaraja and Tanjungsari Regent Assistant in Sumedang District who were measured their degree of compliance with managing ARI before and after they had been trained. The second group was 110 baby mothers who visited community health centers in the same place with coughs and short-winded complaints. Their satisfactions of the service quality were measured. The control group samples were the same number of midwives and baby mothers in 10 community health centers in the former regions of Sumedang City dan Congeang Regent Assistant in Sumedang District. The midwives' compliance with ARI management was subjected to univariate analysis to determine frequency distribution and proportion compliance among them. Further, Mc Nemar test was applied to determine whether or not the training influenced the degree of compliance.Statistical analysis showed that, before the training, the average score of both midwives' compliance with conducting SOP of ARI and the baby mothers' satisfaction was equal. By Mc Nemar test, the data revealed that the degree of compliance had improved after they had been trained in the experimental group (p = 0.0001 and OR = 5.8). Furthermore, there was a different proportion of the degree of baby mothers' satisfaction before and after the midwives had been trained (p = 0.028). The degree of midwives' compliance is significant associated with the baby mothers' satisfaction (p = 0.018). It is concluded that the midwives from the experimental group who had been trained on ARI management have higher score of compliance than those who had not been trained. Accordingly, the baby mothers who received health services from the trained midwives have higher score of satisfaction than those who were served by the untrained midwives on ARI management.
Problems in the dental clinic of Gandoang health center are the large gap between the number of diagnoses and the number of dental health services provided, and also reduction in the number of patient visits in dental clinic, these can be caused by unuptimal communication. This study aims to determine the relationship between dentist communication quality variables and patient characteristics with dental patient satisfaction. Research with a mixed method design with a sequential explanatory approach, begins with quantitative research and then deepened through qualitative research. The population was dental clinic’s outpatients, with a sample size of 100, while the qualitative research informants consisted of 2 patients, 1 dentist, and 1 head of the Gandoang helat center, through in-depth interviews. Most respondents (52%) stated that the quality of dentist communication was good, the aspect of introduce (59%) and shows respect (78%) were good, while the aspects of explanation (53%) and listen carefully (55%) were poor criteria. Most of respondents (54%) showed dissatisfaction. Most respondents were disappointed with open-endedness (58%) and empathy dimensions (54%). Multivariate analysis showed that the most dominant variable related to patient satisfaction with dental dentists was ciommunication quality, p value = 0.001, OR = 4,8 (95% CI 1,984-11,752), that means poor communication quality of dentists would have an opportunity of 4,8 times causing dissatisfaction patients compared to the quality of good dentist communication.
Minimum Standard Services (MSS) can be used as an indicator to cover citizen’s rights of essential health service. Furthermore, MSS in women’s labour is expected to be in a certain quality and quantity standards to reduce MMR. Rawamerta Public Health centre reported in 2019, 77.9% and 68.95% achievement in K1 and K4, respectively. These figures are well below the acceptance target of 100%. This study aims to analyze the quality of SPM implementation in Antenatal services at Rawamerta Public Health Center with qualitative methods in concordance with Donabedian’s quality evaluation theory. Research informants were determined by purposive and snowballing sampling. Data collection performed with in-depth interviews, observations, and document reviews. Data analysis was performed descriptively and converted to a narrative. Rawamerta’s structure, process, and outcome to achieve MSS were evaluated. It is found that Rawamerta Public Health Center quality is still below the MSS standards.
The doctor has a strategic role for the hospital because it is an importantgroup in the process of care in the hospital, because it is central to the serviceprocess. . Job satisfaction has a function of the perceived relationship betweenwhat is desirable and what is the reality experienced. Physician job dissatisfactionalso have an impact on turnover intention. This study aims to determine therelationship of job satisfaction with turnover intention doctor at the hospital.Rumah Sehat Terpadu hospital in Bogor kapupaten 2014. Present study isdescriptive explanatory with cross sectional design using primary data collectedby giving questionnaires, in-depth interviews, observation. This study wasconducted in May 2014. Samples in this study amounted to 28 people with thecriteria physicians who actively work in the Irumah Sehat Terpadu hospital bewilling to answer questions and respondents, 1 month minimum employmentperiod, not a substitute for your doctor. The results of quantitative analysis known(42.9%) were less satisfied working as a doctor in Rumah Sehat Terpadu hospital.Respondents who perceive satisfied with job satisfaction but has the desireturnover amounted to 56.3%, while the respondents were not satisfied hissatisfaction but has the desire out of 16.7%. Job satisfaction has a relationshipwith the relationship between turnover intention (p value = 0.054, CI 95%).Key words: physician job statisfaction, Turnover Intention
