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ABSTRAK
Nama : Karmellia Nikke Darnesti
Program Studi : Ilmu Kesehatan Masyarakat
Judul : Analisis Kinerja Unit Pelayanan Gigi Puskesmas Kelurahan di
Wilayah Kecamatan Koja Jakarta Utara Tahun 2018
Pembimbing : Prastuti Soewondo, S.E., MPH., Ph.D
Lebih dari 50% penduduk di Indonesia memiliki permasalahan gigi dan mulut, ironisnya
berdasarkan Riskesdas 2018, hanya sekitar 10% yang mampu mendapat akses ke layanan
kesehatan gigi. Rifaskes 2011 mengindikasikan cakupan program usaha kesehatan gigi
berbasis masyarakat di puskesmas masih sangat rendah, termasuk di wilayah DKI Jakarta.
Penelitian ini bertujuan untuk melakukan kajian atas kinerja unit pelayanan gigi
puskesmas kelurahan di wilayah Kecamatan Koja. Pendekatan wawancara mendalam,
observasi, dan telaah dokumen dilakukan pada dua jenis unit pelayanan gigi yang ada di
puskesmas kelurahan wilayah Kecamatan Koja. Terdapat dua skema, yaitu Pola I yang
memiliki dokter gigi saja dan Pola III memiliki dokter gigi dan terapis gigi. Hasil
penelitian menyatakan bahwa unit pelayanan gigi pola III memiliki kinerja pelayanan gigi
yang lebih baik karena dapat menangani lebih banyak pasien dan tindakan, serta dapat
memenuhi program Usaha Kesehatan Gigi Sekolah (UKGS) dan Upaya Kesehatan Gigi
Masyarakat (UKGM). Sebaliknya, unit pelayanan gigi pola I hanya dapat memenuhi
program UKGS dan menangani jumlah pasien yang lebih sedikit. Adanya kompetisi
waktu antara program kesehatan gigi masyarakat dan poli gigi membuat dokter gigi
kesulitan memenuhi semua pelayanan gigi. Pelaksanaan program UKGS maupun UKGM
yang dipenuhi hanya terbatas pada penyuluhan singkat dan pemeriksaan sederhana yang
dilaksanakan sekedar memenuhi target. Akibatnya, permasalahan gigi dapat terus
berkembang menjadi penyakit yang semakin parah dan membutuhkan perawatan lebih
kompleks. Hasil kajian juga menguak bahwa tindakan mayoritas, yaitu mumifikasi,
kurang sesuai dengan standar perawatan yang dibutuhkan karena keterbatasan sumber
daya. Disamping itu, tugas manajemen puskesmas ternyata menambah beban kerja dokter
gigi dan mempengaruhi kinerja unit pelayanan gigi. Kolaborasi dokter gigi dengan terapis
gigi akan meningkatkan kinerja unit pelayanan gigi karena dapat mengakomodasi
kenaikan permintaan pelayanan, membantu melaksanakan semua upaya kesehatan gigi,
dan meningkatkan kualitas pelayanan dalam era Jaminan Kesehatan Nasional (JKN).
Kata kunci: kinerja, pelayanan gigi, puskesmas, dokter gigi, terapis gigi
ABSTRACT
Name : Karmellia Nikke Darnesti
Study Program : Public Health Science
Title : Analysis of Dental Medical Unit Performance in Puskesmas
Kelurahan at Koja District North Jakarta 2018
Counsellor : Prastuti Soewondo, S.E., MPH., Ph.D
More than 50% of the population in Indonesia were reported to have dental problems,
ironically based on Riskesdas 2018, only around 10% are able to get access to dental
services. Rifaskes 2011 has indicated the coverage of the community-based oral health
program at the Puskesmas is quietly low, even in the DKI Jakarta. This study aims to
analyze the performance of the dental medical unit at the puskesmas kelurahan in Koja
District area. The approach is through in-depth interviews, observations, and document
studies were carried out on two types of dental medical units that mostly be divided into
Pattern I with only dentist and Pattern III which have dentist and dental therapist. The
results of the study indicated that Pattern III had higher dental service performance
primarily because it could handle more patients and type of treatments also could carry
out School-based Oral Health (UKGS) and Community-based Oral Health (UKGM)
programs. In contrast, Pattern I only fulfill the UKGS program and handle fewer patients.
Clash of time between community-based program and dental poly makes it difficult for
dentists to fulfill all dental services. The implementation of the UKGS and UKGM
programs which only brief counseling and screening tended merely meet the targets so
that dental problems become more severe then require more complex treatments. The
study also revealed that the mummification, which were among the most frequent
treatment, were not in accordance with the standard of care due to limited resources. In
addition, management duties within puskesmas adds further workload of dentists and
influenced the performance of dental service. Dentist collaboration with dental therapist
will improve the performance of the dental service, allowing them to accommodate the
increase in demand, support implementation of all dental health efforts, and improve
dental service quality in the era of National Health Insurance (JKN).
Keywords : dental services; performance; puskesmas; dentist; dental therapist
The high cost of treatment is one of the obstacles in accessing affordable health services for the poor and vulnerable, so the Indonesian government created the JKN program through a guarantee scheme for contributions / subsidy assistance to ensure groups meet health care needs without difficulty paying. This study aims to determine the effect of health insurance on the utilization and cost of outpatient health services (OOP) for participants in subsidized and non-subsidized insurance. The study design was cross- sectional and quantitative approach of secondary data (data Susenas 2018) with the amount of research sampels which fit with inclusive criteria was 66,132 respondents. The analysis shows that the existence of health insurance can increase the utilization of outpatient health care services for subsidized is 49% and non-subsidized is 48% and from the results of the analysis there are still OOP in outpatient health services due to the dual role of providers and asymmetries. information that causes the supplier induced demand (SID). Therefore it is necessary to monitor and evaluate the BPJS Health control function so that the goal of health insurance can provide financial protection can be realized.
Kata kunci : Kepuasan, rawat jalan eksekutif, tangibles
Waiting times on regular outpatient at Fatmawati Central Hospital still exceeds minimun healthcare service standard (≤ 60 minute). Waiting times can becontributing factor influence outpatient dissatisfaction. In December 2016, Fatmawati Central Hospital opened excevutive outpaient for BPJS patients. Patient satisfaction can be one of the indicators for measurement health care service and evaluation. The purpose of this research is to know determinant factor on BPJS patient satisfaction in Griya Husada executive outpatient at Fatmawati Central Hospital 2018. This research uses cross sectional design with questionnare based on likert scale from 100 respondent. The result shows that patient satisfaction on BPJS patient is 95%. Factor that influence patient satisfaction is tangibles (OR=11,2 and p-value=0,024). Therefore, it is important for Fatmawati Central Hospital to improve in facilities and infrastructure in executive outpatient.
Keywords : Executive outpatient, satisfaction, tangibles
One of the functions of hospital bylaws is as a means of legal protection for allparties associated with the hospital. Legal protection is very necessary when healthworkers get claim. One of the things that can cause the claim is unexpected incidence (adverse events). The purpose of this research is to know in depth about how thepolicy content of hospital bylaws in efforts to protect health workers against theclaim of adverse events and the content of policy conformance with existing guide lines. Research design with qualitative methods. Results of the study was RSKO Jakarta hospital bylaws policy already contains about legal protection for healthworkers but still need to be equipped with making other technical operationalpolicies and there is still a discrepancy contents policy with Hospital Bylawsguidelines. Suggestion is that the contents of the RSKO Jakarta hospital bylawspolicy can be improved, making technical operasional policies and improvement ofhospital bylaws guidelines by government. Keywords : Hospital Bylaws, Adverse events, legal Protection, Healthworkers.
