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Fery Rahman; Promotor: Amal Chalik Sjaaf; Kopromotor: Purnawan Junadi, Budi Wiweko; Penguji: Anhari Achadi, Ahmad Syafiq, Sutanto, Trihono, Zulfikar As'ad
Abstrak:
Current world developments have entered industrial revolution 4.0, which is a phenomenon where collaboration occurs between cyber technology and automation technology. This opens up opportunities for medical practitioners and the public to carry out health consultations, medical practice diagnoses in virtual space, without reducing the essence of health services commonly known as Telemedicine. Some of the benefits of Telemedicine in services are effectiveness and efficiency in health services without geographical distance restrictions, patients can also save time and travel costs, as well as increase access to health services. Telemedicine is also used by fellow health practitioners to get advice or further treatment plans for a patient. The most obvious use during the COVID-19 pandemic is being able to provide health services remotely because it reduces exposure to the SARS-CoV-2 virus. With obvious benefits especially in terms of accessibility and convenience, telemedicine also raises problems related to implementation, data security and patient satisfaction. Many countries have not developed a comprehensive regulatory framework, which also hinders the adoption of telemedicine in the health care system. In Indonesia, Minister of Health regulation no. 20/2019 is still considered general, but does not address comprehensive issues such as legal risks, unclear financing schemes, other policies for the continuation of effective, widespread and ethical telemedicine. The aim of this research is to analyze the telemedicine service model at the Nahdlatul Ulama network of hospitals. The research design used is descriptive qualitative with a descriptive interpretive approach. This qualitative research used in-depth interview methods with 14 leaders of NU network hospitals, implementing doctors, leaders of the Association which oversees all members of NU Hospitals and the Head of the Health Service. The information obtained is used for comprehensive analysis to obtain determinant factors that influence the implementation of telemedicine services in hospitals. The telemedicine service model at NU network hospitals is telemedicine in the form of teleconsultation and teleradiology with the basis used being WhatsApp / hospital hotline, personal cell phone and additional applications such as zoom meetings and google-meeting. Factors that influence this service include the creation of SOPs by hospital leaders, adequate internet infrastructure (> 200 Mbps), the existence of an Electronic Medical Record (EMR) that is integrated with telemedicine services, telemedicine literacy and competency of health workers, market share mapping is also needed. community needs and adequate and appropriate payment for medical services, so as not to cause resistance from health workers. Meanwhile, for the determination of units that provide guidance and supervision, there needs to be uniformity based on applicable regulations
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Penelitian ini adalah penelitian kualitatif dengan desain deskriptif. Hasil penelitian menyarankan bahwa perpustakaan perlu dilibatkan dalam pengembangan kurikulum; materi pendidikan pemakai perpustakaan harus dikembangkan sesuai dengan komponen-komponen yang ada dalam information literacy; perpustakaan juga harus menyediakan sarana dan fasilitas yang mendukungpeningkatan literacy mahasiswa. Perkembangan dunia saat ini sudah memasuki revolusi industri 4.0 yang merupakan fenomena dimana terjadinya kolaborasi antara teknologi siber dengan teknologi otomatisasi. Hal ini membuka peluang bagi praktisi kedokteran dan masyarakat untuk melakukan konsultasi kesehatan, diagnosa praktik kedokteran dalam ruang virtual, tanpa mengurangi esensi pelayanan kesehatan yang biasa dikenal dengan Telemedisin. Beberapa manfaat Telemedisin dalam pelayanan yaitu efektifitas dan efisiensi dalam Pelayanan kesehatan tanpa batasan jarak geografis, pasien juga dapat menghemat waktu dan ongkos biaya perjalanan, serta meningkatkan akses ke Pelayanan kesehatan. Telemedisin juga dimanfaatkan oleh sesama praktisi kesehatan dalam mendapatkan saran atau rencana pengobatan lanjutan bagi seorang pasien. Pemanfaatan selama pandemik COVID-19 dirasakan paling nyata yakni mampu menyediakan pelayanan kesehatan dari jarak jauh karena mengurangi paparan virus SARS-CoV-2. Dengan manfaat yang nyata terutama dalam hal aksesibilitas dan kenyamanan, Telemedisin juga menimbulkan permasalahan terkait implementasi, keamanan data, dan kepuasan pasien. Banyak negara belum mengembangkan kerangka peraturan yang menyeluruh, hal ini juga yang menghambat adopsi Telemedisin dalam sistem pelayanan kesehatan. Di Indonesia, peraturan Permenkes No. 20/2019 masih dianggap umum, namun tidak menjawab persoalan menyeluruh seperti adanya resiko hukum, ketidakjelasan skema pembiayaan, kebijakan lain untuk keberlangsungan Telemedisin yang efektif, luas dan etis. Tujuan penelitian ini menganalisis model pelayanan Telemedisin di Rumah Sakit jejaring Nahdlatul Ulama. Desain penelitian yang digunakan adalah deskriptif kualitatif dengan pendekatan Interpretatif Deskriptif. Penelitian kualitatif ini menggunakan metode wawancara mendalam dari 14 pimpinan rumah sakit jejaring NU, Dokter pelaksana, pimpinan Asosiasi yang menaungi seluruh anggota RS NU serta Kepala Dinas Kesehatan. Informasi-informasi yang diperoleh digunakan untuk dianalisis secara komprehensif guna mendapatkan faktor-faktor determinan yang mempengaruhi penerapan layanan Telemedisin di RS. Model layanan Telemedisin pada RS – RS jejaring NU didapatkan jenis Telemedisin berupa telekonsultasi dan teleradiologi dengan basis yang digunakan adalah WhatsApp / hotline RS, Ponsel pribadi serta aplikasi tambahan seperti zoom meeting dan google-meeting. Faktor yang mempengaruhi layanan ini antara lain adanya pembuatan SOP oleh pimpinan RS, Infrastruktur internet yang memadai (> 200 Mbps), Adanya Rekam Medis Elektronik (RME) yang terintegrasi dengan layanan Telemedisin, literasi Telemedisin dan kompetensi tenaga kesehatan, Diperlukan juga pemetaan pangsa pasar / kebutuhan masyarakat serta Pembayaran jasa medis yang layak dan berkesesuaian, sehingga tidak menimbulkan resistensi dari kalangan tenaga kesehatan. Sedangkan untuk penetapan unit yang memberikan pembinaan dan pengawasan (binwas) perlu ada keseragaman berdasarkan peraturan yang berlaku
Current world developments have entered industrial revolution 4.0, which is a phenomenon where collaboration occurs between cyber technology and automation technology. This opens up opportunities for medical practitioners and the public to carry out health consultations, medical practice diagnoses in virtual space, without reducing the essence of health services commonly known as Telemedicine. Some of the benefits of Telemedicine in services are effectiveness and efficiency in health services without geographical distance restrictions, patients can also save time and travel costs, as well as increase access to health services. Telemedicine is also used by fellow health practitioners to get advice or further treatment plans for a patient. The most obvious use during the COVID-19 pandemic is being able to provide health services remotely because it reduces exposure to the SARS-CoV-2 virus. With obvious benefits especially in terms of accessibility and convenience, telemedicine also raises problems related to implementation, data security and patient satisfaction. Many countries have not developed a comprehensive regulatory framework, which also hinders the adoption of telemedicine in the health care system. In Indonesia, Minister of Health regulation no. 20/2019 is still considered general, but does not address comprehensive issues such as legal risks, unclear financing schemes, other policies for the continuation of effective, widespread and ethical telemedicine. The aim of this research is to analyze the telemedicine service model at the Nahdlatul Ulama network of hospitals. The research design used is descriptive qualitative with a descriptive interpretive approach. This qualitative research used in-depth interview methods with 14 leaders of NU network hospitals, implementing doctors, leaders of the Association which oversees all members of NU Hospitals and the Head of the Health Service. The information obtained is used for comprehensive analysis to obtain determinant factors that influence the implementation of telemedicine services in hospitals. The telemedicine service model at NU network hospitals is telemedicine in the form of teleconsultation and teleradiology with the basis used being WhatsApp / hospital hotline, personal cell phone and additional applications such as zoom meetings and google-meeting. Factors that influence this service include the creation of SOPs by hospital leaders, adequate internet infrastructure (> 200 Mbps), the existence of an Electronic Medical Record (EMR) that is integrated with telemedicine services, telemedicine literacy and competency of health workers, market share mapping is also needed. community needs and adequate and appropriate payment for medical services, so as not to cause resistance from health workers. Meanwhile, for the determination of units that provide guidance and supervision, there needs to be uniformity based on applicable regulations
D-540
Depok : FKM UI, 2024
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Indah Sri Wahyuni; Promotor: Tris Eryando; Kopromotor: Martya Rahmaniati Makful, Meiwita Paulina Budiharsana; Penguji: Besral, Kemal Nazaruddin Siregar, Popy Yuniar, Wendy Hartanto, Harimat Hendarwan
Abstrak:
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Pemanfaatan pelayanan kesehatan dalam persalinan sangat penting karena proses persalinan merupakan fase krusial dalam kehidupan ibu dan anak. Persalinan ditolong oleh tenaga kesehatan terlatih di fasyankes merupakan salah satu intervensi kunci dan terbukti untuk mengurangi 16-33% kematian ibu. Di Indonesia, cakupan pemanfaatan persalinan di fasyankes berdasarkan SKI 2023 sebesar 89.9% namun cakupan tersebut belum mencapai target dari renstra kemenkes 2020-2024 sebesar 95%. Data riskesdas 2013, 2018 dan SKI 2023 menunjukkan adanya variasi dalam cakupan persalinan di fasyankes antar kabupaten/kota di Pulau Jawa sehingga mencerminkan adanya disparitas wilayah. Tujuan penelitian ini mengetahui model spasial pemanfaatan persalinan di fasyankes untuk setiap kabupaten/kota di Pulau Jawa, Indonesia. Studi ekologi dilakukan pada 118 kabupeten/kota di Pulau Jawa tahun 2023. Data berbentuk agregat dan bersumber dari publikasi SKI 2023, data sebaran tenaga medis dan tenaga kesehatan, buku publikasi BPS dan profil kesehatan masing-masing provinsi di Pulau Jawa. Analisis data menggunakan Spatial Error Model (SEM) dan Geographically Weighted Regression (GWR). Hasil penelitian menunjukkan terdapat autokorelasi spasial positif dan membentuk pola pengelompokan spasial. Hasil SEM menunjukkan adanya dependensi spasial yang signifikan dan mampu menjelaskan 77,78% variasi antarwilayah dan membentuk pola residual yang mengelompok. Pada Model GWR mampu menjelaskan 87,28% variasi spasial pemanfaatan persalinan melalui kombinasi variabel independen. Hasil model menunjukkan bahwa determinan yang memengaruhi pemanfaatan persalinan di fasyankes yaitu penolong persalinan, kepemilikan jaminan kesehatan, penduduk miskin, kunjungan ANC, pendidikan ibu, rasio dokter dan rasio PKM memiliki pengaruh yang bervariasi secara spasial antar kab/kota. Variabel-variabel tersebut memiliki kekuatan pengaruh yang berbeda antar kab/kota di Pulau Jawa. Dari hasil penelitian ini diharapkan dapat menjadi bahan perencanaan bagi program kesehatan ibu yang lebih terarah khususnya dalam penetapan wilayah prioritas intervensi di Pulau Jawa.
The utilization of healthcare services during delivery is essential, because process is a crucial phase in the lives of both mother and child. Delivery assisted by skilled birth attendant in healthcare facilities is a key intervention proven to reduce maternal mortality by 16–33%. In Indonesia, the coverage of healthcare facility delivery based on the 2023 Indonesian Health Survey (SKI) is 89.9%; however, this has not yet reached the 95% target set by the Ministry of Health's 2020–2024 strategic plan. Data from Riskesdas 2013, 2018, and SKI 2023 indicate variations in facility-based delivery coverage across regencies/cities on Java Island, reflecting regional disparities. This study aims to determine the spatial model of healthcare facility delivery utilization for each regency/city on Java Island, Indonesia. An ecological study was conducted across 118 regencies/cities in Java in 2023. Aggregate data were sourced from the 2023 SKI publications, medical and health personnel distribution data, BPS (Statistics Indonesia) publications, and health profiles from each province in Java. Data were analyzed using the Spatial Error Model (SEM) and Geographically Weighted Regression (GWR).The results indicate a positive spatial autocorrelation, forming a spatial clustering pattern. The SEM results show significant spatial dependency, explaining 77,78% of the inter-regional variation and forming clustered residual patterns. The GWR model was able to explain 87,28% of the spatial variation in delivery utilization through a combination of independent variables. The model results demonstrate that determinants affecting healthcare facility delivery utilization namely skilled birth attendants, health insurance ownership, poverty levels, ANC (Antenatal Care) visits, maternal education, physician ratios, and community health center ratios have spatially varying influences across regencies/cities. These variables exhibit different levels of influence across different regions in Java. The findings of this study are expected to serve as a planning resource for more targeted maternal health programs, particularly in identifying priority areas for intervention on Java Island.
D-607
Depok : FKM-UI, 2026
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Pradnya Paramita; Promotor: Purnawan Junadi; Ko-Promotor: Adang Bachtiar; Penguji: Anhari Achmadi, Tribudi, Suprijanto Rijadi, Hafizurrachman, Setyo Hari Wijanto, Soewarta Kosen, Sutoto
D-266
Depok : FKM UI, 2012
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Slamet Budiarto; Promotor: Anhari Achadi; Kopromotor: Sutanto Priyo Hastono, Pujiyanto; Penguji: Purnawan Junadi, Andi Arus Vector, Syafiq A. Mughni, Mahlil Ruby, Hasbullah Thabrany
Abstrak:
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Stunting anak 0-23 bulan di Indonesia merupakan masalah kesehatan masyarakat yang disebabkan oleh berbagai faktor langsung dan tidak langsung. Penelitian menggunakan data Riset Kesehatan Dasar, Survey Sosial Ekonomi Nasional dan Produk Domestik Regional Bruto per kapita tahun 2018 dengan pendekatan potong lintang bertujuan mengetahui model jalur hubungan langsung dan tidak langsung berbagai faktor risiko stunting dengan prevalensi stunting tingkat kabupaten/kota. Pengolahan data sekunder dilakukan pada Januari-April 2022. Sampel adalah 106 kabupaten/kota prevalensi stunting <20% dan 403 kabupaten/kota prevalensi stunting ≥20% (20%-<30%, 30%-40% dan >40%) yang diagregratkan pada tingkat kabupaten/kota dari 32.095 data individu anak usia 0-23 bulan yang diukur panjang badannya. Pemodelan menggunakan analisis jalur. Model jalur pencegahan risiko stunting memperlihatkan akses terhadap makanan (r=-0,31) dan pemeriksaan kehamilan (r=-0,29) berhubungan langsung dengan prevalensi stunting tingkat kabupaten/kota di kabupaten/kota prevalensi stunting <20%. Keluarga Berencana (r=-0,15), pemeriksaan kehamilan (r=-0,13) dan cuci tangan pakai sabun (r=-0,11) berhubungan langsung dengan prevalensi stunting tingkat kabupaten/kota di kabupaten/kota prevalensi stunting ≥20%. Tablet tambah darah ibu hamil (r=-0,02) dan inisiasi menyusu dini (r=-0,03) berhubungan tidak langsung melalui ASI eksklusif dengan prevalensi stunting tingkat kabupaten/kota di kabupaten/kota prevalensi stunting 20%-<30%. ASI eksklusif (r=-0,15) berhubungan langsung dengan prevalensi stunting tingkat kabupaten/kota di kabupaten/kota prevalensi stunting 20%-<30%. Cuci tangan pakai sabun berhubungan signifikan langsung dengan prevalensi stunting tingkat kabupaten/kota di kabupaten/kota prevalensi stunting 30%-40% (r=-0,22) dan >40% (r=-0,45). Model jalur menyimpulkan bahwa kabupaten/kota dapat memainkan peran penting dalam upaya pencegahan risiko stunting dengan memodifikasi sejumlah faktor risiko terutama pada keluarga anak 0-23 bulan.
Stunting in children 0-23 months in Indonesia is a public health problem caused by various direct and indirect factors. This study uses data from Basic Health Research, National Socio-Economic Survey and Gross Regional Domestic Product per capita in 2018 with a cross-sectional approach. Secondary data processing was carried out in January-April 2022. The samples were 106 districts/cities with stunting prevalence <20% and 403 districts/cities with stunting prevalence 20% (20%-<30%, 30%-40% and >40%) Aggregated at the district/city level from 32,095 individual data for children aged 0-23 months, whose body length was measured. The modeling uses path analysis. The stunting risk prevention pathway model shows that access to food (r=-0.31) and prenatal care (r=-0.29) is directly related to the prevalence of stunting at the district/city level in districts/cities with stunting prevalence <20%. Family planning (r=-0.15), pregnancy check-ups (r=-0.13) and hand washing with soap (r=-0.11) were directly related to the prevalence of stunting at the district/city level in districts/cities stunting prevalence 20 %. Blood supplement tablets for pregnant women (r=-0.02) and early initiation of breastfeeding (r=-0.03) were indirectly related through exclusive breastfeeding with the prevalence of stunting at the district/city level in districts/cities stunting prevalence of 20%-<30% . Exclusive breastfeeding (r=-0.15) was directly related to the prevalence of stunting at the district/city level in the district/city stunting prevalence of 20%-<30%. Hand washing with soap is directly related to stunting prevalence at district/city level in districts/cities, stunting prevalence is 30%-40% (r=-0.22) and >40% (r=-0.45). The pathway model concludes that districts/cities can play an important role in preventing stunting risk by modifying a number of risk factors, especially in families of children 0-23 months.
D-474
Depok : FKM UI, 2023
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Trisna Budy Widjayanti; Peromotor: Amal Chalik Sjaaf, Anhari Achadi, Budi Hidayat; Penguji: Meiwita Budiharsana, Mardiati Nadjib, Purnawan Junadi, Trihono, Harimat Hendrawan
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Penelitian ini bertujuan melihat hubungan antara faktor sosial ekonomi dan klinis dengan pemanfaatan Clinical Pathway (CP) Sectio Caesaria serta outcome klinis serta pembayaran klaim pada pelayanan Ibu melahirkan Sectio Caesaria (SC). Studi desain Cross Sectional pada unit analisis 1155 data rekam medis ibu melahirkan SC periode 1 Januari 31 Desember 2018 di 3 RS. Hasil penelitian menunjukan pemanfaatan Clinical Pathway Ibu melahirkan Sectio Caesaria peserta Jaminan Kesehatan Nasional dari ke 3 RS studi penelitian proporsinya sebesar 43.1% dengan skor dibawah nilai mean 10. RS Pemda memiliki Proporsi tertinggi skor pemanfaatan Clinical Pathway Sectio Caesaria dibawah nilai mean 10 (76.8%), kemudian diikuti RSP (36.8%). RSNP menunjukkan proporsi (98.1%) skor pemanfaatan Clinical Pathway Sectio Caesaria diatas dan sama dengan (≥) nilai mean 10. Faktor sosial ekonomi dan klinis ibu melahirkan SC peserta JKN antara lain jenis RS (p=0.000), Kelas rawat (p=0.014) dan Rujukan (p=0.008), jenis SC (p=0.005), Usia Ibu (p=0.053), Paritas (p=0.016), Riwayat ANC (p=0.000), Kondisi Panggul p=0.000), kondisi plasenta (p=0.001), penyakit penyerta (p=0.000) dan riwayat SC (p=0.000) menunjukkan berhubungan secara signifikan dengan pemanfaatan Clinical Pathway Sectio Caesaria (p<0.05). Pemanfaatan Clinical Pathway ibu melahirkan Sectio Caesaria peserta JKN menunjukan adanya hubungan yang signifikan dengan Outcome klinis (p=0.002) dan pembayaran klaim (p=0.000). Pemanfaatan Clinical Pathway ibu melahirkan Sectio Caesaria di RS menunjukkan ketidakseragaman dalam dimensi ICPAT dan tidak melibatkan kondisi pasien dalam penyusunannya. Pemerintah harus membuat payung hukum Pedoman Nasional Pelayanan Kedokteran (PNPK) yang menjadi standar prosedur operasional untuk menyelaraskam penyelenggaraan program jaminan kesehatan
D-417
Depok : FKM-UI, 2020
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Eko Setyo Pambudi; Promotor: Budi Utomo; Ko promotor: Budi Hidayat, Endang L Achadi; Penguji: Anhari Achadi, Soewarta Kosen, Prastuti Soewondo, Mardiati Nadjib
D-307
Depok : FKM-UI, 2015
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Guspianto; Promotor: Budi Hidayat; Kopromotor: Purnawan Junadi, Amal C. Sjaaf; Tim Penguji: Anhari Achadi, Dian Ayubi, Soewarta Kosen, Dumilah Ayuningtyas, Harimat Hendarwan
D-311
Depok : FKM UI, 2015
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Budi Hartono; Promotor: AMal C. Sjaaf; Kopromotor: Purnawan Djunadi, Adang Bachtiar; Penguji: Anhari Achadi, Tri Erri Astoeti, Sowarta Kosen, Ronnie Rivany
D-248
Depok : FKM-UI, 2011
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Widyastuti Wibisana; Promotor: Amal C. Sjaaf; Ko-promotor: Hasbullah Thabrany; Penguji: Ascobat Gani, Soewarta Kosen, Purnawan Junadi, Sudijanto Kamso, Mardiati Nadjib
D-205
Depok : FKM-UI, 2007
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Andi Afdal Abdullah; Promotor: Budi Hidayat; Kopromotor: Pujiyanto; Penguji: Atik Nurwahyuni, Mardiati Nadjib, Soewarta Kosen, Ali Ghufron Mukti; Mahlil Ruby; Teguh Dartanto
Abstrak:
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Latar belakang: Kemudahan akses pelayanan kesehatan bagi peserta Jaminan Kesehatan Nasional (JKN) merupakan salah satu upaya untuk meningkatkan derajat kesehatan penduduk Indonesia. Kemudahan akses ini terwujud dengan bertambahnya fasilitas kesehatan yang melayani peserta JKN. Indikator kemudahan akses terlihat dari bertambahnya jumlah peserta yang berkunjung ke fasilitas kesehatan baik di tingkat pelayanan rawat jalan maupun rawat inap. Kunjungan peserta JKN per 1.000 penduduk dikenal dengan isitilah rate sebagai salah satu indikator utilisasi pelayanan kesehatan untuk menjaga kesinambungan program JKN. Tujuan: penelitian ini bertujuan menganalisis faktor yang mempengaruhi rate rawat jalan tingkat lanjutan (RJTL) maupun rawat inap inap tingkat lanjutan (RITL) dan pemodelan prediksi rate RJTL dan rate RITL. Data yang digunakan berasal dari database BPJS Kesehatan dan Survei Sosial Ekonomi Nasional (SUSENAS) tahun 2016 – 2019 yang diolah berdasarkan faktor predisposing, faktor enabling, dan faktor need dimana semua data digunakan dalam penelitian atau total sampling. Metode: analisis data panel dinamis yang ditujukan untuk membuat model prediksi rate RJTL dan rate RITL. Hasil: model prediksi yang digunakan pada rate RJTL dan rate RITL adalah estimator First Difference Generalized Method of Moment (FDGMM). Kesimpulan: rate RJTL dipengaruhi oleh variabel nilai tagihan klaim dibayar per kunjungan RJTL; jumlah rumah sakit kelas A, B, C, D; jumlah peserta pria; jumlah peserta berusia > 50 tahun; jumlah peserta dengan jumlah anggota keluarga > 3 orang; jumlah peserta berpengeluaran di bawah garis kemiskinan; jumlah peserta dengan penyakit tidak menular; rasio fragmentasi; rasio rujukan; dan jumlah peserta berpendidikan SMP. Sedangkan, rate RITL dipengaruhi oleh variabel nilai tagihan klaim dibayar per kunjungan RITL; jumlah rumah sakit kelas A, B, C, D; jumlah peserta pria; jumlah peserta berusia > 50 tahun; jumlah peserta dengan jumlah anggota keluarga > 3 orang; rate readmisi; jumlah peserta berpendidikan SMP; dan jumlah peserta berpendidikan Perguruan Tinggi. Saran: hasil penelitian menyarankan agar Pemerintah Daerah turut mendukung pemenuhan sarana prasarana pelayanan kesehatan agar masyarakat dapat menjangkau pelayanan kesehatan dengan mudah, mengelola perencanaan penambahan rumah sakit sesuai kebutuhan; Kementerian Kesehatan dapat memberikan regulasi terkait pemenuhan dan pemerataan fasilitas kesehatan maupun tenaga medis, terutama pada daerah dengan keadaan geografis yang sulit; BPJS Kesehatan dapat menggunakan model prediksi rate RJTL dan rate RITL sebagai alat bantu dalam menilai kebutuhan penambahan kerjasama dengan rumah sakit. Peneliti selanjutnya dapat melakukan penelitian dengan faktor utilisasi yang lebih luas dan lengkap serta melakukan kajian yang lebih mendalam pada satu wilayah tertentu dengan mempertimbangkan pengaruh aspek geografis, seperti jarak antar fasilitas kesehatan, luas wilayah dan kondisi akses ke fasilitas kesehatan.
Background: easy access to health services for participants of the National Health Insurance (JKN) is one of the efforts to improve the health status of the Indonesian population. This accessibility is achieved through an increase in health facilities serving JKN participants. The indicator of accessibility can be observed from the rising number of participants visiting health facilities, both at the outpatient and inpatient levels. The rate of visits by JKN participants per 1.000 population is considered an indicator of health service utilization, which contributes to the continuity of the JKN program. Objective: this study aims to analyze the factors that influence the advanced level of outpatient care (RJTL) and inpatient care (RITL) and to model the prediction of RJTL rates and RITL rates. The data used is derived from the BPJS Kesehatan database and the 2016-2019 National Socioeconomic Survey (SUSENAS), which are processed based on predisposing factors, enabling factors, and need factors. All data is utilized in the research, employing total sampling. Method: dynamic panel data analysis is employed to develop prediction models for RJTL rates and RITL rates. Results: the prediction model used for the RJTL rate and RITL rate is the First Difference Generalized Method of Moment (FDGMM) estimator. Conclusion: RJTL rate is influenced by several variables: value of claims bills paid per RJTL visit, number of class A, B, C, and D hospitals, number of male participants, number of participants aged over 50 years, number of participants with more than 3 family members, number of participants with expenditures below the poverty line, number of participants with non-communicable diseases, fragmentation ratio, referral ratio, and number of participants with junior high school education. On the other hand, the RITL rate is affected by value of claim bills paid per RITL visit, number of class A, B, C, and D hospitals, number of male participants, number of participants aged over 50 years, number of participants with more than 3 family members, readmission rate, number of participants with junior high school education, and number of participants with university education. Recommendations: the results of this study suggest that the Regional Government should also support the fulfillment of health service infrastructure so that partisipant can reach health services easily, manage plans for adding hospitals as needed; The Ministry of Health can provide regulations regarding the fulfillment and equity of health facilities and medical personnel, especially in areas with difficult geographical conditions; BPJS Kesehatan can use RJTL rate prediction model and RITL rate as a tool in assessing the need for additional collaboration with hospitals. Future researchers can conduct research with broader and more complete utilization factors and conduct more in-depth studies in a particular area by considering the influence of geographical aspects, such as the distance between health facilities, area size and conditions of access to health facilities.
D-483
Depok : FKM-UI, 2023
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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