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Salah satu indikator untuk mengukur kualitas pelayanan kesehatan adalah kepuasan responden. Kepuasan responden yang rendah bisa menggambarkan kualitas layanan yang belum standar dan masih perlu perbaikan. Kepuasan responden yang rendah berdampak terhadap citra fasilitas pelayanan kesehatan. Kepuasan responden itu dipengaruhi oleh banyak faktor, diantaranya adalah karakteristik responden itu sendiri. Penelitian ini dilakukan untuk memperoleh gambaran tentang kepuasan responden dan faktor-faktor yang berhubungan dengan kepuasan responden tersebut. Disain penelitian adalah cross-sectional pada 710 responden yang pernah menjaiani rawat map di fasilitas pelayanan kesehatan di Indonesia tahun 2004. Analisis data yang digunakan adalah analisis regresi logistik ganda. Dari data yang diperoleh, didapatkan 322 (45,35%) responden merasa puas dengan pelayanan kesehatan, hal ini masih dikategorikan rendah. Responden perempuan lebih merasa puas 201 (47,45%) dibandingkan responden laki-laki (44,3I%). Usia tidak berpengaruh terhadap pelayanan kesehatan. Tingkat pendidikan responden tidak berpengaruh pada tingkat kepuasan. Responden yang tidak bekerja lebih merasa puas dibandingkan yang bekerja. Sumber biaya perawatan tidak mempengaruhi tingkat kepuasan responden. Responden yang dirawat difasilitas pelayanan kesehatan milik swasta cenderung merasa lebih puas 53,21% dibandingkan dengan responden yang dirawat difasilitas pelayanan kesehatan milik pemerintah. Faktor dominan yang berhubungan dengan tingkat kepuasan responden adalah tempat menjalani rawat inap. Dari penelitian ini disarankan bagi petugas kesehatan untuk memperhatikan pelayanan kesehatan yang diberikan pada rnasyarakat. Bagi Departemen Kesehatan hasil penelitian ini sebagai bahan masukan bagi perbaikan kinerja di fasilitas pelayanan kesehatan milik pemerintah.
One of the indicators to measure quality of health service is respondent satisfaction. The low satisfaction can describe of health unit under standard and needs recovery. The low satisfaction will give image to unit health facility. A satisfaction respondent is influent by multifactor like a characteristic factor of the subject. The purpose of this analysis to find a describe of a satisfaction respondent and factors that influence the satisfaction. Design of analysis is cross sectional and 710 respondents be participated which ever stay in hospital in Indonesia at 2004. The method of analysis is multiple logistic regressions. From reached of the data, founded 322 (45, 35%) of respondents had satisfied to health service, but that result still low in category. Female respondents has satisfied 47,45%, compare than male respondent 44,31%. Age does not influence to health service, education level respondent too, group not working respondent, more satisfaction compare group of working. Sources of nursing cost did not influence the satisfied respondent. Respondent who get nursing in private facility 53,21% more satisfied compare respondent who get nursing in government facility. The dominant factor which related to satisfied is the place of nursing care. From this research, we recommended for health service officer, to make attention about services to people. To Health Department become an input for improving government facility.
Background: The burden of disease and mortality caused by Chronic Kidney Disease (CKD) has increased with the increasing prevalence of CKD risk factors. The National Health Insurance (JKN) program has increased healthcare access. However, the access in urban population is not the same as in rural. Objectives: To find out the relationship between the patients’ residential area (urban or rural) and the role of the contextual variables at the provincial level on the mortality of hospitalized JKN patients with CKD. Methods: A cross-sectional study was conducted using BPJS Kesehatan 2015-2016 sample data. Multivariate analysis was performed with Generalized Estimating Equations and continued with multilevel analysis. Results: The study showed the proportion of deaths was 19.95%. Respectively, rural residents compared to urban and treated in hospitals at Regional 1, 3 and 5 had higher mortality risk OR 1.37 (95%CI 1.33-1.41), 1.82 (95%CI 1.72-1.92), 5.90 (95%CI 4.28-8.12) with p<0.01. However, rural residents compared to urban and treated in hospitals at Regional 4 had reduced risk of death, OR 0.51 (95%CI 0.45-0.59;p<0.01) and those whom treated in hospitals at regional 2 had OR 1.03 (95%CI 0.96-1.12; p>0.05). The contextual variables of the study caused 8.98% mortality variance at provincial level. Conclusions: Rural residents had higher risk of death than those in urban and there was small variation in mortality between provinces.
Tujuan: untuk mengetahui karakteristik pasienDM tipe 2 di RSUP NTB tahun 2012-2013, serta mengukur asosiasi sederhana DSME terhadap lama hari rawat pasien di RSUP NTB. Desain dan
Metode: Tinjauan secara retrospektif terhadap 199 rekam medis pasien DM tipe 2.
Hasil: DSME disampaikan oleh perawat dan ahli gizi. Akan tetapi, tidak seluruh pasien mendapat edukasi. Di RSUP NTB, yang tercatat edukasi tentang: diet (53%),aktivitas fisik (33%), tentang obat (8%), komplikasi (1%), edukasi lainnya (6%),dan 27% pasien yang tidak mendapat edukasi apapun oleh perawat. Sebanyak 43.7% pasien yang mendapat konseling gizi oleh ahli gizi. Pasien yang mendapatDSME memiliki lama hari rawat yang lebih singkat dibandingkan dengan yang tidak mendapat edukasi.
Kesimpulan: berdasarkan catatan rekam medis DSMEdi RSUP NTB belum optimal dan DSME berperan mempersingkat lama harirawat pasien.
Kata kunci: Diabetes Self Management Education, DM tipe 2, lama hari rawat,rawat inap, RSUP NTB.
Background: Type 2 Diabetes Mellitus (type 2 DM) is a disease that can not becured. An adequate education is one of way management of type 2 DM. DiabetesSelf Management Education (DSME) in hospitals not adequate and impact onlength of stay.
Purpose: this study to describe characteristics of patients withtype 2 DM at General Hospital West Nusa Tenggara 2012-2013, and measuredassociation of DSME to length of stay.
Design and Method: Descriptiveresearch method with retrospective design. Number of samples involved in thisstudy is 199 medical records of patients with type 2 DM.
Result: DSMEdelivered by nurses and nutritionists. But, not all patients get DSME. DSMErecorded was about: diet (53%), exercises (33%), medicines (8%),complications of type 2 DM (1%), other education (6%), and 27% of patients donot get any DSME. Patients with DSME has shorter length of stay than patientwithout DSME.
Conclusion: according to medical records, DSME at GeneralHospital West Nusa Tenggara 2012-2013 is not optimal and DSME role inlength of stay of patients with type 2 Diabetes Mellitus.
Keywords: Diabetes Self Management Education; type 2 DM; length of stay,inpatient, RSUP NTB.
Type 2 diabetes mellitus is a non-communicable disease that can be treated, and its consequences can be prevented or delayed through proper diet, physical activity, medication, as well as regular screening and treatment of complications. However, this disease is often diagnosed several years after onset, by which time complications and comorbidities may have developed, making it one of the top 10 causes of hospitalizations. This study aims to determine the effect of severity and comorbidity on the length of hospital stay among patients with type 2 diabetes mellitus in advanced referral health facilities (FKRTL) among BPJS Kesehatan participants in 2023, controlled for variables such as FKRTL type, FKRTL ownership, segmentation, care class, age, and gender. This research used 2023 BPJS Kesehatan sample data with a cross-sectional study design. The analysis included univariate, bivariate, and multivariate methods. Bivariate analysis showed a significant relationship between severity and length of stay (p-value = 0.001), while comorbidities were not significantly associated with length of stay (p-value = 0.285). Moderate to severe severity and comorbidities with a CCI score of ≥1 were associated with a higher risk of prolonged hospitalization and a lower risk of short hospitalization compared to the ideal length of stay (RRR = 4.95; 95% CI = 0.82–29.85; RRR = 0.46; 95% CI = 0.29–0.72 | RRR = 1.11; 95% CI = 0.25–4.92; RRR = 0.67; 95% CI = 0.41–1.10). Multivariate analysis controlling for FKRTL type, FKRTL ownership, segmentation, care class, age, and gender showed that the association between severity and length of stay remained significant after controlling for FKRTL type and FKRTL ownership, while the association between comorbidity and length of stay remained insignificant even after adjusting for control variables. Efforts to enhance clinical early detection programs for the severity level and comorbidities of type 2 diabetes mellitus are necessary to prevent prolonged hospital stays due to complications and disease severity, which contribute to a significant healthcare burden.
Kata Kunci : LSL, Penggunaan Kondom Konsisten, Pulau Jawa, Indonesia
Men Who Have Sex with Men (MSM) are population at high risk for HIVinfection. Promoting consistent condom use (CCU) is a key risk reduction strategyfor HIV prevention among MSM. This thesis reports the factors associated withCCU among MSM with their regular, casual, client, and sex worker partners. Thisthesis used cross-sectional design from Integrated Biological and BehaviourSurveillance for MSM in Java Island in 2011. Binary logistic regression analyseswere conducted to assess the determinants of CCU with socio-demographic,perceived, cues to action, and past condom use factors. CCU ranged from 37 to49% with male partners and 28% with female partner. Multivariate analysesshowed that MSM who had a single status, comprehensive knowledge, no STDsymptoms, and past condom use were likely to be consistent condom users. HIVinterventions among MSM need to increase comprehensive knowledge of HIVand promote CCU with all types of sex partners.
Keywords : MSM, Consistent condom use, Java Island, Indonesia
ABSTRAK Penelitian ini bertujuan untuk mengetahui estimasi lama hari rawat dan total tagihan rawat inap pasien stroke hemoragik di Unit Stroke Rumah Sakit “X” Yogyakarta tahun 2011-2012. Desain penelitian yang digunakan yaitu cross sectional. Sampel dalam penelitian ini yaitu seluruh pasien di unit stroke dengan diagnosis utama stroke hemoragik yang memenuhi kriteria inklusi. Hasil penelitian mendapatkan persamaan regresi untuk estimasi lama hari rawat pada pasien keluar hidup yaitu; Lama Hari Rawat = 7,046 + 0,023 (umur) + 0,935 (jenis kelamin) + 0,118 (diagnosis sekunder) + 8,024 (riwayat ICU) + 1,744 (hari keluar). Persamaan regresi untuk mengestimasi total tagihan rawat inap yaitu; Total Tagihan Rawat Inap = Rp 2.854.882 + Rp 7.810 (umur) + Rp 162.803 (diagnosis sekunder) + Rp 3.738.001 (ICU) + Rp 364.164 (lama hari rawat) – Rp 384.543 (hari masuk) + Rp 854.197 (kelas I) Rp 1.971.282 (VIP). Diharapkan hasil penelitian ini berguna bagi penderita stroke dan keluarga, manajemen rumah sakit, pihak pembayar dan para pembuat kebijakan dalam mengantisipasi dampak ekonomi dari meningkatnya kasus stroke.Beban ekonomi akibat stroke terutama karena biaya perawatan di rumah sakit semakin meningkat seiring meningkatnya kejadian stroke. Penelitian ini bertujuan untuk mengetahui estimasi lama hari rawat dan total tagihan rawat inap pasien stroke hemoragik di Unit Stroke Rumah Sakit “X” Yogyakarta tahun 2011-2012. Desain penelitian yang digunakan yaitu cross sectional. Sampel dalam penelitian ini yaitu seluruh pasien di unit stroke dengan diagnosis utama stroke hemoragik yang memenuhi kriteria inklusi. Hasil penelitian mendapatkan persamaan regresi untuk estimasi lama hari rawat pada pasien keluar hidup yaitu; Lama Hari Rawat = 7,046 + 0,023 (umur) + 0,935 (jenis kelamin) + 0,118 (diagnosis sekunder) + 8,024 (riwayat ICU) + 1,744 (hari keluar). Persamaan regresi untuk mengestimasi total tagihan rawat inap yaitu; Total Tagihan Rawat Inap = Rp 2.854.882 + Rp 7.810 (umur) + Rp 162.803 (diagnosis sekunder) + Rp 3.738.001 (ICU) + Rp 364.164 (lama hari rawat) – Rp 384.543 (hari masuk) + Rp 854.197 (kelas I) Rp 1.971.282 (VIP). Diharapkan hasil penelitian ini berguna bagi penderita stroke dan keluarga, manajemen rumah sakit, pihak pembayar dan para pembuat kebijakan dalam mengantisipasi dampak ekonomi dari meningkatnya kasus stroke.
ABSTRACT The economic burden of stroke due primarily because of the cost of hospital care are increasing with the increasing incidence of stroke. This study aims to determine the estimated length of stay of hospitalization and the total hospitalization billings of hemorrhagic stroke patients in Stroke Unit "X" Hospital, Yogyakarta, 2011-2012. The research design used was cross-sectional. The sample in this study were all patients at the Stroke Unit with a primary diagnosis of hemorrhagic stroke who meet the inclusion criteria. The results got the regression equation for estimating length of stay is; Length of Stay = 7,046 + 0,023 (age) + 0,935 (sex) + 0,118 (secondary diagnose) + 8,024 (history in ICU) + 1,744 (day of discharge). The regression equation for estimating Inpatient Total Billings = Rp 2.854.882 + Rp 7.810 (age) + Rp 162.803 (secondary diagnose) + Rp 3.738.001 (history in ICU) + Rp 364.164 (length of stay) – Rp 384.543 (day of admission) + Rp 854.197 (class I) Rp 1.971.282 (VIP).
