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Jumlah penderita TBC paru dari tahun ke tahun di Indonesia terus meningkat. Beberapa keadaan diduga merupakan faktor yang memegang peranan penting dalam meningkatnya infeksi TBC pada saat ini, antara memburuknya kondisi sosial ekonorni, belum optimalnya fasilitas pelayanan kesehatan masyarakat, meningkatnya jumlah penduduk yang tidak mempunyai tempat tinggal, meningkatnya infeksi HIV, daya tahan tubuh yang lemah/menurun, virulensi dan jumlah kuman yang meningkat. (Kardiana, 2007). Penelitian ini bertujuan untuk mengetahui gambaran mutu pelayanan program TB di Puskesmas terhadap tingkat keberhasilan program TB di Kabupaten Ciamis tahun 2007. Desain penelitian adalah kualitatif dengan melakukan wawancara mendalam terhadap petugas yang berkaitan langsung dengan program, diskusi kelompok terarah dengan masyarakat pengguna pelayanan dan telaah dokumen. Hasil penelitian menunjukan pada kelompok Puskesmas yang berhasil dalam peneapaian program penanggulangan TB, pelak.sanaan kegiatan melibatkan seluruh petugas dan sumber daya yang ada di Puskesmas. Sedangkan pada kelompok Puskesmas yang belurn berhasil dalam pencapaian program penangguIangan TB, belum terjalin kerja sama baik lintas program .dan lintas sektor serta belum adanya kepedulian dari seluruh staf Puskesmas terhadap program. Saran yang diajukan dalam penelitian ini adalah adanya kepedulian petugas dan karyawan Puskesmas terhadap program, peran aktif dokter terhadap program, peningkatan frekuensi penyuluhan dan sosialisasi program di lintas sektor, pemberian pelayanan yang bermutu sesuai standar dengan mengutamakan kepuasaxi pasien sebagai pelanggan ekstemal dalam pelayanan kesehatan, adanya pembinaan dan pertemuan rutin dari Dinas Kesehatan pengahargaan terhadap prestasi kerja.
Amount of TBC paru patient from year to year in Indonesia increasing. Some situation anticipated to represent factor playing a part important in the increasing of TBC infection at the moment, for example: deteriorating it condition of social economic, not yet is optimal of service facility of health society, the increasing of amount of resident which don't have residence, the increasing of HIV infection, weak body endurance/ downhill, germ amount and virulence which mounting. (Kardiana, 2007). This research aim to to know picture quality of TB program service in Puskesmas to level efficacy of TB program in Sub-Province Ciamis year 2007. Research Design is qualitative by conducting interview to direct interconnected officer with program, directional group discussion with service consumer society and document study. Research place conducted by in four Self-Supporting Puskesmas Executor (PPM) in TB program with selection of research place in two a success Puskesrnas in attainment of Puskesmas and program which not yet succeeded in attainment of program. Result of research show of a success Puskesmas group in attainment of TB overcome program, activity execution entangle entire resource and officer exist in Puskesmas, existence the same of activity pass by quickly program and pass by quickly good sector. While at Puskesmas group which not yet succeeded in attainment of TB overcome program not yet intertwined the same of activity the goodness pass by quickly program and pass by quickly sector. Recommendation in this research the existence of officer caring and Puskesmas employees to program, active the role of doctor on the program, the improving make-up of counseling frequency pass by quickly sector socialization, giving of certifiable service according to standard by majoring satisfaction of patient as the external client in health service, existence of routine meeting and construction from Public Health Service appreciation and reward to the achievement activity.
ABSTRAK Askesin merupakan salah satu program pemerintah dalam memberikan pelayanan kesehatan gratis bagi penduduk miskin dan tidak mampu di Pusat Kesehatan Masyarakat (Puskesmas) dan jaringannya serta pelayanan kesehatan rujukan di rumah sakit pemerintah kelas III. Dari hasil evaluasi pelaksanaan program askeskin pada tahun 2006 rata-rata jumlah cakupan puskesmas di Kabupaten Serang masih rendah apabila dibandingkan dengan target pencapaian Indikator, diketahui bahwa persentase cakupan jaminan pemeliharaan kesehatan gakin dan masyarakat rentan hanya 8,5% (target 14%) dan visit rate hanya 10,59 (target 15%). Sejak dilaksanakannya program Askeskin belum diketahui tingkat kepuasan pasien askeskin terhadap mutu pelayanan puskesmas. Pengukuran kepuasan pasien merupakan salah satu indikator keberhasilan pelaksanaan program dan merupakan elemen penting dalam menyediakan pelayanan yang lebih efisien dan lebih efektif. Dengan cara ini diharapkan ada upaya konkrit yang dapat disarankan kepada pihak pemberi jasa untuk meningkatkan pelayanan kesehatan kepada masyarakat miskin sehingga dapat memenuhi harapan masyarakat yang berpengaruh pada niat berkunjung kembali ke puskesmas. Tingkat kepuasan pasien diukur dengan menggunakan lima dimensi mutu yang dapat digunakan untuk mengukur kepuasan pelanggan, yaitu tangible, reliability, responsiveness, assurance, dan emphaty (Parasuraman et.al, 1990). Penelitian ini bertujuan untuk mengetahui tingkat kepuasan pasien rawat jalan yang menggunakan Askeskin terhadap mutu pelayanan Puskesmas yang dilaksanakan pada akhir bulan Juni sampai Agustus tahun 2007 di 38 Puskesmas se-Kabupaten Serang dengan jumlah sampel 676 orang dengan menggunakan metode analitik dengan rancangan penelitian cross sectional. Hasil Penelitian didapat tingkat kepuasan berdasarkan lima dimensi mutu bahwa masing-masing dimensi tangible, reliability, responsiveness, assurance dan empahty sudah diatas 50% dan dari kelima dimensi tersebut paling besar pada dimensi assurance. Kepuasan umum pasien sebesar 72,8% dengan niat berkunjung kembali sebesar 83%. Variabel karakteristik pasien yang paling dominan berpengaruh adalah status pendidikan, status pekerjaan dan status perkawinan, sedangkan variabel lainnya sebagai variabel confounding. Hasil Importance Performance Analysis didapat beberapa faktor yang menjadi prioritas utama yang harus diperhatikan dan perbaiki yaitu, waktu tunggu pemeriksaan cepat, petugas terampil dalam bekerja dan petugas mengerti yang dibutuhkan pasien. Dalam rangka memperbaiki mutu pelayanan tersebut disarankan bagi puskesmas agar memberikan pelayanan dengan terampil, membuat alur proses pelayanan, meningkatkan pengetahuan petugas puskesmas dan membuka waktu pelayanan puskesmas pada sore hari, melakukan ‘ghost shopping’ untuk melihat tingkat kepuasan pasien dan memantau kinerja pemberi pelayanan serta membentuk tim pengendali mutu dan diharapkan dinas kesehatan agar senantiasa membuat kebijakan yang mendukung upaya peningkatan mutu pelayanan di puskesmas. Daftar Pustaka: 78 (1980 – 2007).
ABSTRACT Askeskin is one of government programs in providing free health service for poor and not wealthy people in Public Health Center (Puskesmas) and the network and health service reference in government hospital III rd class. From evaluation result of askeskin program implementation in 2006 the average of puskesmas coverage in Serang Regency still low if compared to target of achievement indicator, known that coverage percentage of gakin health maintenance guarantee and susceptible people only 8,5% (target 14%) and visit rate only 10,59 (target 15%). Since Askeskin program conducted the askeskin satisfaction level toward puskesmas service quality was not yet known. Patient satisfaction measurement is one of the success indicators for program implementation and an important element in providing a more efficient and effective service. By this way, expected concrete efforts that could suggested for service giver to improve poor people health service that fulfilled people expectation, which affecting re-visit intention to puskesmas. Patient satisfaction level measured by using five dimensions quality that could be use for measuring client satisfactory, which are tangible, reliability, responsiveness, assurance, and empathy (Parasuraman et.al, 1990). This research aim was identifying outpatient satisfaction level that conducted in the end of June to August year 2007 in 38 Puskesmas of all Serang Regency with samples of 676 people by using analytical method with cross sectional research design. From research result, obtained satisfaction level that based on five dimensions quality, which are tangible, reliability, responsiveness, assurance, and empathy was over 50% and from those five dimensions, the largest was assurance dimension. General patient satisfactions as much as 72.8% with re-visit intention as much as 83%. The most dominant affecting patient characteristic variable are education status, working status and marriage status, while other variables as confounding variables. From result of Importance Performance Analysis obtained several factors that become main priority need to be paid attention and fixed, which are quick waiting duration for examination, skillful officer in working and officer understand patient needs. In order to fix those services quality, suggested for puskesmas to provide service that competent, making service plot processes, improving puskesmas officer knowledge and opening puskesmas service time at afternoon, conducting “ghost shopping” to identify patient satisfaction level and monitoring service giver performance, forming quality control, and expecting health agency always form policy that support service quality improvement efforts in puskesmas. References: 78 (1980 – 2007)
Kepuasan pasien merupakan salah satu indikator untuk melihat mum pelayanan kesehatan. Puskesmas merupakan tempat pelayanan kesehatan publik yang saat ini dimanfaatkan oleh seluruh lapisan masyarakat. Rendahnya kcpuasan pasien menggambarkan kualitas pelayanan belum maksimal dan belum sesuai dengan standar, sehingga harus diperbaiki. Kepuasan pasien dapat dipengaruhi oleh banyak faktor, misalnya karakteristik pasien sendiri Serta biaya yang ada untuk mendapatkan pelayanan tersebut. Penclitian ini dilakukan di enam Puskesmas DTP di Kabupaten Bekasi dan dua Puskesmas DTP di Kota Bckasi. Penelitian ini bertujuan untuk mclihat perbandingan tingkat kepuasan pasien Puskesmas DTP di Kabupatcn dan Kota Bekasi, melihat karakteristik pasien pengguna jasa pelayanan Puskesmas, serta mclihat faktonfaktor karakteristik mana yang berhubungan dengan tingkat kcpuasan pasien. Disain penelitian adalah cross sectional pada 480 responden. Dilakukan selarna 3 bulan dari Februari sampai April 2007. Secara keseluruhan kamkteristik pasien di kedua tempat diatas adalah sama, perbedaannya ada pada tingkat pendidikan, jenis pekerjaan dan pendapatan pasien. Tingkat kepuasan pasien di Kabupaten Bekasi (gratis) 2,14 kali lebih rendah dibandingkan tingkat kepuasan pasien di Kota Bekasi (bayar). Jumlah pasien yang puas di Kota Bekasi 64,2% sementara di Kabupaten Bekasi 45,5%. Tidak ada hubungan yang bermakna antara faktor-faktor karakteristik pasien dengan tingkat kepuasan di kedua tempat diatas, serta tidak ada faktor-faktor karakteristik yang menjadi faktor konfonding. Dari Importance and Pewrmance Anabvsis unsur yang harus diperhatikan di Kabupaten Bekasi adalah jadwal perikasa dokter tiap hari tepat waktu, obat diresepkan tersedia di Puskesmas, petugas segera memenuhi keinginan pasien serta dokter menjadi pendengar yang baik bagi pasien. Sementara itu di Kota Bekasi unsur-unsur yang hams diperhatikan adalah ruang rawat inap, sarana kamar mandi/WC, keberadaan petugas di mang rawat inap/jalan, ruang tunggu, suasana lingkungan, lantai dalam/luar ruangan, pelayanan oleh dokter, obat yang diresepkan tersedia di Puskesmas. -Iasil penelitian ini diharapkan dapat dimanfaatkan oleh Dinas Kcsehatan Kabupaten Bekasi dan Kota Bekasi dalam mengambil kebijakan serta Puskesmas DTP di Kabupatzh dan Kota Bekasi dalam meningkatkan kualitas pelayanan.
The patient's satisfaction was one of the indicators to see the quality of the health service. The community health centre was the place of the health service of the public at this time used by all social stratums. The low level of the patients satisfaction depicted the quality of the service was not yet maximal and did not yet be in accordance with the standard, so as to have to be improved. The patient satisfaction could be affected by many factors, for example the characteristics of the patient personally as well as the available cost to get this service. This research was carried out in six inpatient facility in the Bekasi Regency and two inpatient facilities in the Bekasi City. This research aimed at seeing the level comparison of patient satisfaction of the inpatient facility in the Regency and the Bekasi City, saw the characteristics of the user's patient in community health centre service, as well as saw what characteristics factor that was connected with the level of the patients satisfaction. 'Ihe design of the research was cross sectional to 480 respondents. Carried out for 3 months hom February to April 2007. On the whole the characteristics of the patient in the two places above was same, its difference was in the level of education, the work kind and the income ofthe patient. The level of the patient?s satisfaction in the Bekasi Regency (ti-ee) 2.14 times was lower compared with the level ofthe patient?s satisfaction in the Bekasi City (paid). The number of patients who was satisfied in the Bekasi City 64, 2% now in the Bekasi Regency 45, 5%. There is no relation that was significant between characteristics factors ofthe patient and the level of satisfaction in the two places above, as well as did not have characteristics factors that became the factor confounding. From Importance and Performance Analysis the element that must be paid attention to in the Bekasi Regency was the doctor schedule right on time, prescription medicine was available in the community health centre, the ofiicial immediately filled the patients wish as well as the doctor to become listeners who were good for the patient. In the meantime in the Bekasi City elements that must be paid attention to were space inpatient facilities, bathroom means/the Toilet, the existence of the official in room, the waiting room, the atmosphere of the environment, the floor in/outside the room, the service by the doctor, prescription medicine was available in the community health centre. From this research, we recommended for District Health Service of Bekasi Regency and Bekasi City in taking the policy, inpatient facility in the Regency and the Bekasi City in increasing the quality ofthe service.
The health service for people suspected of having TB is one of the minimum service standards (MSS) in the health sector that must be met by the district/city government. The Public Health Center is the leading unit in achieving the MSS performance targets in the health sector. TB MSS achievement in Depok city in 2021 only reached 36.17% and became the second lowest achievement of the 12 MSS in Depok City Health. The aim of this study was to analyze in depth aspects of the structure, aspects of the quality and performance improvement process using the PDSA (Plan-do-study-act) approach as well as outputs in an effort to increase the achievement of health services for people suspected of having TB at the Depok City Health Center in 2022. This research used a qualitative approach using a case study design through in-depth interviews with 31 informants, field observations and document searches. The results of the study, not all Public Health Centers have established TB Dots Teams, lack of trained personnel, not all facilities are up to standard, medicinal materials are not adequate, use of information technology is not optimal, leadership and staff commitment is still lacking. In terms of process factors, not all Public Health Centers have conducted monitoring and evaluation of TB MSS achievements at the study stage. On output; there has been an increase in the achievement of services for people suspected of having TB in 2022 compared to 2021, but not all Public Health Centers have reached the set TB MSS target. Conclusion: structural factors and quality and performance improvement processes carried out influence success in achieving TB MSS at the Public Health Centers
Public Health Nursing is an effort of health that integrates with all health communitycenter, aimed for individuals, families, groups and communitiesto achieve independence in their health endeavors. The purpose of this study toanalyze in depth implementation quality of public health nursing programin Ogan Ilir District. The research method used qualitative approach. The researchinformants were Head of Primary Health Service and Traditional Health ServiceSection, Program Holder of Ogan Ilir District Health Office, Head of Tanjung RajaPublic Health Center, Head of Rantau Alai Public Health Center, Holder HealthPromotion Program, Holder Environmental Health Program, Holder Maternal Childand Family Health Program, Holder of Disease Prevention and Control program,Nutrition program and Family built community health care. Methods of data collectionwere interviews, focus group discussions, observations and document reviews. Theresults consisted of input, process and output components. Input components, includinginsufficient human resources, no public health nursing training, facilities andinfrastructure were incomplete, funding was adequate, overall policy was notproblematic. Components of the process, including the planning had not run wellenough, the organization was good, the implementation of perkesmas were still manyobstacles, and monitoring was not optimal. The component of the output of the publichealth office was the achievement of vulnerable families that developed on below target.So it can be concluded that the implementation of public health nursing in Ogan IlirDistrict has not been good.Keywords: Public health nursing, Public health center, a system approach.
Selama tahun 2003 - 2005 jumlah kunjungan meningkat namun tidak seimbang dengan laju pertumbuhan penduduk dan pada tahun 2006 jumlah kunjungan pasien bayar ke Puskesmas Wisma Jaya mengalami penurunan. Indikator keberhasilan fungsi puskesmas sebagai pusat pelayanan kesehatan strata pertama antara lain melalui cakupan pelayanan dan kepuasan pasien. Pemanfaatan pelayanan kesehatan oleh masyarakat dipengaruhi oleh faktor kebutuhan terhadap sarana pelayanan kesehatan yang bermutu. Kepuasan paéien bayar atas mutu pelayanan kesehatan yang diselenggarakan oleh Puskesmas Wisma Jaya mempengaruhi pola perilaku pasien bayar selanjutnya untuk mengambil tindakan dengan berniat melakukan kunjungan ulang atau sebaliknya. Penelitian ini bertujuan membuktikan adanya hubungan kepuasan pasien bayar tcrhadap mutu pelayanan dengan minat kunjungan ulang ke Puskesmas Wisma Jaya Kota Bekasi Tahun 2007. Desain penelitian merupakan penelitian analilik dengan pcndekatan cross sectional, yang dilakukan di Puskesmas Wisma Jaya Kota Bekasi. Data dikmnpulkan dengan responden adalah pasien bayar (219 responden) yang berkunjung ke Puskesmas Wisma Jaya Kota Bekasi pada tahun 2007 dengan tehnik consequtive sampling quota. Analisis data menggunakan analisis univariat, bivariat dengan uji chi square dan multivariat dengan Kepuasan pasicn bayar mampu meningkatkan minat pasien bayar untuk mclakukan kunjungan ulang ke Puskesmas Wisma Jaya. Perlunya Pcmcrintah Kota dan Dinas Kesehatan Kota Bekasi mengunakan indikator bcrupa cakupan pelayanan dan kepuasan pasien untuk menilai keberhasilan kinexja puskesmas melalui fungsi puskcsrnas scbagai pusat pelayanan kesehatan strata pertama. Serta rnemprioritas pcrnbangunan fisik, menjaga kebersihan dan penambahan sumber daya manusia khususnya Puskesmas Wisma Jaya sesuai urutan nilai terendah kepuasan perlu menjadi perhatian semua pihak yang terkait. uji regresi logistik ganda. Hasil penelitian menunjukkan bahwa proporsi responden yang berminat melakukan kunjungan ulang ke Puskesmas Wisma Jaya sebesar 93,2%, proporsi responden yang puas terhadap pelayanan kesehatan Puskesmas Wisma Jaya sebesar 53,0%, tersedianya tempat parkir merupakan faktor kepuasan pasien bayar yang memiliki nilai terendah. Ada hubungan yang bermakna antara kepuasan pasien bayar dengan minat kunjungan ulang ke Puskesmas Wisma Jaya setelah mengendalikan variabel-variabel penganggu (variabelpendidikan dan variabel pengeluaran). Kepuasan pasien bayar mempunyai peluang 8,2 kali untuk berminat melakukan kunjungan ulang ke Puskesmas Wisma Jaya sebesar. Kepuasan pasien bayar mampu meningkatkan minat pasien bayar untuk mclakukan kunjungan ulang ke Puskesmas Wisma Jaya. Perlunya Pcmcrintah Kota dan Dinas Kesehatan Kota Bekasi mengunakan indikator bcrupa cakupan pelayanan dan kepuasan pasien untuk menilai keberhasilan kinexja puskesmas melalui fungsi puskcsrnas scbagai pusat pelayanan kesehatan strata pertama. Serta rnemprioritas pcrnbangunan fisik, menjaga kebersihan dan penambahan sumber daya manusia khususnya Puskesmas Wisma Jaya sesuai urutan nilai terendah kepuasan perlu menjadi perhatian semua pihak yang terkait.
During 2003 - 2005, number of customer visits increasing altough uneven with the population growth. Then in 2006, number of charged customer visits to Puskesmas Wisma Jaya had decreasing. Efficacy indicator of Puskesmas to its main function in providing public health services at the bottom level are scope of services type and customer satisfaction. Utilization of health service by society influenced by the need of qualified health service factor. Charged customer’s satisfaction to the quality of health services held by Puskesmas Wisma Jaya influencing their future behavior in having revisit or on the contrary. This research aim to determine the relationship of charged customer’s satisfaction to the quality of health services and revisit interest at Puskesmas Wisma Jaya Bekasi, in year of 2007. Research designed as analytic description research with cross sectional approach. Research held at Puskesmas Wisma Jaya Bekasi. Data collected using consecutive sampling quota from 219 respondent who belong to charged customer whom visiting Puskesmas Wisma Jaya during 2007. Data analysis using univariat analysis, bivariat with chi-square test and multivariate analysis with multiple logistic regression test. The result shows proportion of respondent who interest to revisit Puskesmas Wisma Jaya were 93,2 % in amount. The proportion of charged customer who satisfied with health services held by Puskesmas Wisma Jaya were 53,0 % in amount. The available of parking area become the charged customer’s satisfaction factor which has lowest score. There is significant relation between charged customer’s satisfaction with revisit interest after eliminating and controlling the dummy variable (respondent’s education and expenses). Satisiied charged customer have at 8,2 possibility to revisit Puskesmas Wisma Jaya in possibility value. The satisfaction of charged customer has able to raise their interest in having revisit in the future. Local Government and Local Public Health Service need to use scope of service and customer satisfaction as indicator to asses the efficacy performance of each Puskesmas through their function in providing public health services at the bottom level. Also giving priority in physical development and addition of human resources especially Puskesmas Wisma Jaya on low scored satisfaction indicator.