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As the consequence of Competency-Based Curriculum (KBK) implementation,Indonesia Medical Internship Program (PIDI) has been conducted since 2010 as acontinuation of the medical education. In practice, a number of pros and consemerges from the various parties among students, education institutions,professional organizations , and the general public. This study aimed to analyzethe policy of PIDI through a retrospective approach. The results showed the stageof agenda-setting and policy formulation has been relatively well conducted butnot optimal in the legitimacy and implementation phases. The role of policy actorshave not been clearly delegated with the strong legal protection and details offunctions. Therefore, it is recommended to do a comprehensive evaluation of theimplementation of PIDI involving the key stakeholders.Keywords:PIDI, internship, medical intern, doctor, policy.
This thesis addressess key successes and constraints on the implementation ofpolicy adjustment on PBF referring to Ministrial Decree no. 1148/2011 in DKIJakarta and West Java in 2013 using theory of Edward III. Results onsurveillance on PBF in West Java and Jakarta of NADFC in 2012 until 2013, andthe data PBF Licensing of Ministry of Health in 2012 until May 2014, indicatesthat more than 90% PBF did not comply with CDOB, thus not make adjustmentspermission. Research using qualitative methods of content analysis and literaturereview. Results: aspects of competence and commitment to success of theofficers, the availability of instruments and applicable SOPs, coordination amongagencies run well. Obstacles found in several aspects including lack of cleardefinition of permits adjustment, lack of socialization, insufficient number ofofficers, inaccessibility of instruments online basis, and lack of availability ofresources and facilities.Key word: Policy implementation, adjustment policies, PBF, Edward III
Abstrak
Dalam Undang Undang Nomor 29 Tahun 2004 pasal 29 menyatakan bahwa setiap dokter dan dokter gigi yang melakukan praktik kedokteran di Indonesia wajib memiliki STR sesuai sertifikat kompetensi yang dimiliki. STR berlaku lima (5) tahun. Jika sampai masa berlaku STR habis dokter atau dokter gigi tidak melakukan registrasi ulang, akan kehilangan kewenangan untuk melakukan praktik kedokteran. Sanksi bagi yang menjalankan praktik dengan sengaja tanpa STR dan surat ijin adalah denda maksimal Rp 100 juta ( pasal 75). Hasil pencapaian registrasi ulang belum 100%.
Penelitian ini ditujukan untuk melakukan analisis terhadap kebijakan dan analisis untuk menyusun rekomendasi (analysis of policy dan analysis for policy) registrasi ulang dokter dan dokter gigi di Indonesia. Penelitian ini menggunakan pendekatan kualitatif dan untuk analisis data digunakan model content analisis diolah dengan pendekatan model Patton Savicky dengan kriteria boulton disajikan berdasarkan analysis of policy dan analisis for policy sebagai rekomendasi.
Hasil penelitian menemukan bahwa dokter dan dokter gigi kurang bersedia melakukan registrasi ulang karena : alur sertifikasi kompetensi untuk persyaratan registrasi ulang terlalu panjang, pemenuhan persyaratan terlalu sulit, pengisian borang borang terlalu banyak, pengumpulan SKP untuk memperoleh sertifikat kompetensi bagi registrasi ulang kurang menilai kompetensi (skill) lebih untuk menilai administrasi, pendidikan dan pelatihan yang diselenggarakan oleh organisasi profesi membutuhkan biaya dan hanya untuk peningkatan pengetahuan (knowledge) bukan untuk meningkatkan keterampilan (skill), proses penerbitan sertifikat kompetensi dan STR ulang menjadi terlalu lama.Kesimpulannya, implementasi kebijakan registrasi ulang dokter dan dokter gigi kurang efektif pelaksanaannya karena dipengaruhi oleh peraturan itu sendiri, upaya dokter atau dokter gigi, institusi yang melaksanakan kebijakan serta kondisi lingkungan.
Peneliti menyarankan agar mengembangkan sistem registrasi, meningkatkan komitmen, meningkatkan otoritas KKI, meningkatkan resources, meningkatkan pemahaman dan kesepakatan terhadap tujuan dan stakeholder agar meningkatkan pembinaan dan pengawasan.
According to the Law Number 29 in 2004 article 29 States that every doctors and dentists who conduct medical practices in Indonesia must have a certificate of competence in accordance STR owned .STR is expired after five (5) years. If until the expiration date of STR, doctor and dentist do not apply for the re-registration, so doctors or dentists will loss their authority to conduct medical practices. The consequence for doctors and dentists who running practice without STR and licence intentionally is a fine of up to Rp 100 million (article 75). The achievements of re-registration have not been 100% yet.
This study aimed to analysis the policy and analysis to make recomendations for reregistration policy of doctors and dentists in Indonesia. This study used qualitative approach and for data analysis using the content analysis model, prepared by "Patton Savicky model approach with Boulton criteria based on the analysis of policy and analysis for policy as a recommendation.
The study has found that doctors and dentists are less willingness to be registered as the competencies certification flow for the reregistration are too long, too difficult STR making requirements, too many forms must be fulfilled, the SKP activity colllecting to have competence certificate for the reregistration is not to assess the competencies (skills) but to assess the administration, education and training organized by professional organizations to expensive and only for knowledge increase, not for the skills the,and the waiting time for STR publishing is too long. To sum up, the implementation of the re-registration policies of doctors and dentists have not performed well because it was influenced by the re-registration policy and efforts of the doctors and dentists and institutions in implementing the policy and environmental circumstance.
Researchers suggests to develop a registration system, to increase the commitment, to improve KKI authority, increase resources, to increase the understanding and agreement on goals and stakeholders in order to improve the guidance and supervision
The choice of a doctor's career is very important in the effort to fulfill quality health services, considering the existence of a doctor in basic health care is vital and determines the quality of health services. This study aims to determine the career choice of an internship doctor and its determinants, and how it is aligned with stakeholder policies. This study used a mix method with a parallel convergent research design. Research respondents were internship doctors in Jakarta 2020 with a research sample of 154 people and research informants were stakeholders. The results of the study found that the career choice for interns was to be specialist doctors and the choice of work was mostly in hospitals, while those who were interested in working in primary and public health services were very few, especially in Puskesmas. The results of multivariate analysis showed that there are six variables that have a statistically significant relationship: gender, university origin, place of work, income, lifestyle and family demands. Government policies together with other stakeholders are not in line with the mandate of the law to distribute health services throughout Indonesia
Kata kunci : Panduan praktik klinis, fasilitas pelayanan kesehatan primer,implementasi kebijakan
This thesis discusses the puskesmas readiness to implement the Minister of HealthRegulation No. 5 of 2014 about Clinical Practice Guidelines for Doctors inPrimary Health Care Facilities. Doctors in primary health care facilities is the firstcontact patients who are expected to uphold a diagnosis and give treatment ofdiseases as early as possible in accordance with the medical needs of the patient.In order toimplement this policy in puskesmas, doctors need support/the role ofother health human resources, equipment, medicines, facilities and infrastructureof puskesmas that accordance with the guidelines. This research was qualitativeresearch with a sample of research are three puskesmas in Garut and there were 11people toexplorein depthinformation. The results showed that all three puskesmas are less ready to implementthe policy. It is recommended that puskesmas be the Badan Layanan Umum Daerah (BLUD) and increase promotiveand preventive activities,for the Ministry of Health in order to complement National Formularium with needed medicines in primary health care facilities, Garut Health Office makes the development of health planning in the region by integrating all a spectsandin doing renovations or create a new building puskesmas should follow technical guide lines for buildings and infrastructure of puskesmas.
Keyword : Clinical Practice Guidelines, primary health care facilities, policyimplementation
