Abstrak: Tujuan penelitian ini adalah untuk Menggambarkan faktor-faktor terkait pelaksanaan rujukan PT Askes Cabang Jakarta Pusat di Puskesmas Kecamatan Senen dan Kecamatan Johar Baru Tahun 2012 dengan menggunakan pendekatan kualitatif. Selain itu ditelaah beberapa aspek yang terkait dengan ketersediaan dokter, ketersediaan obat-obatan, kelengkapan fasilitas alat kesehatan, pemahaman petugas kesehatan sebagai gate keeper dan pemahaman pasien peserta askes tentang rujukan dan rujuk balik. Hasil penelitian ini menunjukkan bahwa jika ketersediaan obat dan kelengkapan fasilitas di puskemas kurang akan membuat kemungkinan pasien dirujuk ke PPK tingkat lanjut semakin besar, pengetahuan pasien akan layanan rujukan juga mempengaruhi keputusan pasien untuk dirujuk, semakin besar pengetahuan pasien, maka akan kecil kemungkinan pasien dirujuk dan sebaliknya semakin sedikit pengetahuan pasien, maka akan semakin besar pasien dirujuk.

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The purpose of this study was to describe factors related to the implementation reference Askes Branch in Central Jakarta district health centers and sub-Johar Senen Year 2012 by using a qualitative approach. Moreover examined several aspects related to the availability of doctors, availability of drugs, medical devices complete facilities, understanding health as a gate keeper and patient understanding of participants askes about referral and refer back. The results of this study indicate that if the availability of drugs in health centers and complete facilities will make less likely the patient is referred to a greater PPK advanced, knowledge of patient referral service will also influence the decision to refer the patient, the greater the knowledge of the patient, the less likely the patient will be referred and conversely the less knowledge of the patient, the greater the patient is referred.

Abstrak:

Cakupan Peran Serta Masyarakat di Kabupaten Subang masih rendah, salah satu penyebab dari permasalahan tersebut berhubungan dengan kemampuan manajerial kepala Puskesmas. Berkaitan dengan hal tersebut maka dilakukan penelitian yang bertujuan untuk mendapatkan gambaran mengenai faktor-faktor yang berhubungan dengan kemampuan manajerial kepala Puskesmas dalam penggerakan masyarakat di Kabupaten Subang pada Tahun 2006. Dengan mempelajari hubungan antara kemampuan manajerial kepala Puskesmas tersebut dengan faktor internal yang terdiri dari Umur, Pendidikan dan Lama kerja serta faktor eksternal yang terdiri dari Supervisi, Pelatihan, Umpan balik dan Sarana kerja. Dalarn penelitian ini pendekatan yang digunakan adalah pendekatan kualitatif, dimana data yang dikumpulkan berupa data primer yang didapat melalui kegiatan wawancara mend alam dan Focus Group Discussion dengan informan dari Dinas Kesehatan, Kepala Puskesmas dan Tokoh Masyarakat, sedangkan data sekunder diperoleh melalui kegiatan penelusuran dokumen baik di tingkat Dinas Kesehatan maupun Puskesmas yang menjadi lokasi penelitian. Dari wawancara mendalam dapat diketahui bahwa rendahnya cakupan peran serta masyarakat dipicu oleh beberapa permasalahan mendasar, selain karena kualitas dan kuantitas tenaga kesehatan yang ada masih sangat terbatas, kemampuan manajerial kepala Puskesmas sebagai pimpinan tertinggi di wilayah kerjanya juga rata-rata masih kurang, mereka belum mampu memaksimalkan potensi yang ada untuk membantu pelaksanaan program Puskesmas. Hasil penelitian menunjukan bahwa dari ketiga faktor internal yang diteliti ternyata faktor yang tampak cenderung berhubungan dengan kemampuan manajerial kepala Puskesmas dalam penggerakan masyarakat adalah faktor lama kerja. Sedangkan dari keempat faktor eksternal temyata tidak ada satupun yang mempengaruhi kemampuan manajerial kepala Puskesmas dalam penggerakan masyarakat. Saran yang dapat disampaikan berdasarkan hasil penelitian ini ditujukan kepada pihak Dinas Kesehatan sebaiknya mempertimbangkan faktor-faktor tersebut diatas terutama lama kerja pegawai dalam pengangkatan Kepala Puskesmas di wilayah kerjanya. Disamping itu sebaiknya pihak Dinas lebih menyeimbangkan porsi pelatihan antara pelatihan teknis medis dengan pelatihan manajemen, khususnya mengenai manajemen dalam peningkatan peran serta masyarakat.

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Public Cooperation in health sector in Subang distric still far from adequate, one of the causes from those problems related with Puskesmas chief managerial ability. Related with those cases then done research that aim to get the view about related factors related with Puskesmas chief managerial ability in moving society Subang distric in year 2006. By learn the relation between Puskesmas chief managerial ability along with internal factor that consist of Age, Education, and Working Length and also external factor that consist of Supervision, Training, Feedback and Working tools. In this research, approach that used is qualitative approach, where collected data is primary data that got from deep interview activity and Focus Group Discussion with informant from Health Agency, Puskesmas Chief and Public Figure, while secondary data got from document study activity whether in Health Agency or Puskesmas that become research location. From deep interview also known that public cooperation in health sector still far from adequate those cases triggered by some basic problems, besides quality and quantity of health source that still limited, Puskesmas chief managerial ability as highest leader in his working area even still low, they not yet can maximize available potency to help in conduct Puskesmas program. Research result be known that from three researched internal factor obviously factor that affect Puskesmas chief managerial ability in moving society is working length. While from four external factors obviously no one that affect Puskesmas chief managerial ability in moving society. Suggestion that can be submitted based on this research result showed to Public Health office is better considering those factors especially employee working length in giving position of Puskesmas Chief in his working area. Besides, Agency should balance training portion between medical techniques with management training, especially about management in improving public role.

Abstrak: Penelitian ini bertujuan untuk mengetahui gambaran ketersediaan dokter, ketersediaan obat-obatan, fasilitas kesehatan, pemahaman dokter sebagai gatekeeper, pemahaman dokter tentang kapitasi, dan diagnosis medis terhadap kasus rujukan peserta Askes Sosial di Puskesmas Sumbersari Bantul tahun 2012.Penelitian ini menggunakan metode penelitian kualitatif dengan desain deskriptif.Hasil penelitian menunjukkan bahwa keterbatasan obat dan fasilitas kesehatan,rendahnya pemahaman dokter mengenai gatekeeper dan kapitasi, serta banyaknya pasien penyakit kronis menyebabkan kasus rujukan tinggi. Diperlukan ketegasan dokter untuk mengurangi kasus rujukan yang bukan berdasarkan indikasi medis serta koordinasi antara PT Askes, Dinas Kesehatan, dan puskesmas untuk menyediakan obat dan fasilitas kesehatan yang dibutuhkan di puskesmas.Kata kunci: Kasus rujukan, rujukan puskesmas, puskesmas sebagai gatekeeper ̧ kapitasi

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This study aims to describe the physician availability, drugs availability, healthfacilities, physician understanding as a gatekeeper, physician understanding ofcapitation, and medical diagnosis in referral case from primary health care ofAskes Sosial participants at Puskesmas Sumbersari Bantul in 2012. This studyuses descriptive qualitative research design. The result indicates that the limiteddrugs and health facilities, physician lack of understanding about gatekeeper andcapitation, and number of patients with chronic disease, causing high referralcases. The researcher suggests improving the physician decision to reduce referralcase that is not based on medical indication and also improving the coordinationbetween PT Askes, Dinas Kesehatan, and primary health care to provide thedemand of drugs and health facilities in primary health care.Key words:Referral case, referral from primary health care, primary health care as agatekeeper, capitation

Abstrak: Nationally, the rate of child marriage in Indonesia a decline, the trend for marriages decreased from 33.49% children who had been married before the age of 18 in 2000, fell to 27.36% in 2008, yet it still happens disparity, where child marriage is more common in rural than in urban areas (UNICEF, 2011). Pringkasap village is one of the highest Village that the number of marriages in the District Pabuaran in 2011, the number of marriage age <20 years is 28%, with 42% of them are mating with the level of primary and secondary school education.This study was conducted to understand the dynamics of early marriage on dropout in the Village Pringkasap 2014. Study was a qualitative study with indepth interviews, the results of this study indicate an intention to perform an early marriage is influenced by, the attitude of the parents, influence of peers, teen jobs, teen attitudes, patterns of dating and unwanted pregnancy. The impact of early marriage is the limited teenage promiscuity, lack of family economy, the obligation to take care of the household, and LBW (Low Birth Weight). The barriers program maturation Age of Marriag is not yet done BKR and PIK program in the village, it is necessary for the formation of a society PIK existing organizations such as youth clubs.