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Kecenderungan peningkatan penggunaan antibiotika di Pelayanan Kesehatan Dasar merupakan penggunaaan obat yang tidak rasional dan akan menghambat penurunan angka morbiditas dan mortalitas penyakit. Pemberian antibiotika yang berlebihan akan meningkatkan resistensi terhadap bakteri, sehingga pembiayaan obat akan menjadi lebih tinggi di masa mendatang. Ada dua indikator utilisasi obat yang diteliti yaitu rata-rata biaya obat perlembar resep dan rata-rata R/ per-lembar resep. Tujuan penelitian ini adalah mengetahui gambaran utilisasi obat antibiotika pada dua indikator diatas dan faktor faktor yang mempengaruhinya. Hasil penelitian menemukan bahwa persentase resep obat pasien RJTP yang berisi antibiotika 37,74 %. Proporsi terbesar pemanfaatan obat antibiotika pada pasien RJTP di Puskesmas Tebet tahun 2005 ditemukan pada kelompok usia dewasa (12-65 tahun) yaitu sebesar 56,5 %, pasien yang bayar sendiri yaitu sebesar 89,8 %, penyakit infeksi lain selain ISPA yaitu sebesar 61,6% dan rata-ratal hari pemberian obat antibiotika adalah 4 hari dimana nilai ini tidak sesuai dengan pedoman pengobatan antibiotika yang belaku. Rata-rata harga obat per-lembar resep adalah Rp. 6.226,01,- sedangkan rata-rata jumlah R/ nya adalah 3 R/. Hasil analisis bivariat dari ke dua indikator utilisasi obat terhadap variabel independen didapatkan adanya perbedaan yang signifikan menurut usia, status pembayaran pasien dan jenis penyakit. Hasil analisis multivariat menunjukkan bahwa usia, status pembayaran, jenis penyakit (ISPA) dan lama hari pemberian obat secara signifikan mempengaruhi rata-rata harga obat dan rata-rata jumlah R/ per-lembar resepnya. Disarankan perlu dilakukan upaya peresepan pengobatan sesuai dengan standar pengobatan yang berlaku terutama lama hari pemberian obat. Analisa lebih lanjut mengenai rata-rata harga obat per-lembar resep yang lebih spesifik yaitu dengan hanya menganalisa rata-rata harga obat antibiotika.
The tendency of overused of antibiotics in primary health care indicate the irrational used and inhibit lowering morbidity and mortality of diseases and hence increase bacterial resistance and so that elevate drug expenditure at future. There were two drug utility indicators examined named average drug cost per encounter and average drug per encounter. The objective of this research was to know the description of antibiotics drug utilization on two indicators mentioned above and the factors influence it. Results of this research were the percentages of encounter containing antibiotics was 37,74 %. The biggest proportion of antibiotics utilization based on adult patients (12 -65 year old) was 56,5 %. Based on payment status of self payer patients was 89,8 %. And based on type of diseses at other infection beyond UTI was 61,6 %. The average number of days antibiotics dispensed was 4 days, that the values incompatible with Antibiotics drug guidelines. The average of single encounter was Rp. 6.226,01 where the average R/ per encounter was 3 items. Bivariate analysis of two drug utilization indicators, with independent variable showed significant differences among age, payment status and type of diseases. The result of multivariate analysis indicated age (except elderly), payment status, diagnosis of UTI and number of days antibiotics dispensed significantly able to predict variable of drug price per encounter and the average R/ per-encounter. It was Suggested the treatment prescription that compatible with standard treatment guidelines that usually used, the length of therapy. More specific continuing of the analysis about average drug price per-encounter with analyzing average antibiotic drugs price.
Non-communicable diseases (NCDs) contribute to more than 87.14% of total deaths in Indonesia. One of the non-communicable diseases that has gained attention is diabetes. Its high prevalence and its role as a primary factor for the development of other diseases as comorbidities make DM a chronic disease with widespread impacts. The low utilization of primary healthcare services for diabetes mellitus patients, such as Primary Healthcare (RJTP), is considered to contribute to the high referral rates to advanced healthcare facilities, resulting in higher healthcare costs. This study analyzes the utilization of Primary Healthcare (RJTP) services among JKN participants with diabetes mellitus in 2023 based on BPJS sample data from 2024. This research is non-experimental with a cross-sectional approach. The results show that the majority of JKN participants with diabetes mellitus use RJTP services irregularly, at 88.4%, while only 11.6% of participants, or 75,165 individuals, made regular visits (≥12 times per year), with 2,402 participants with type 1 diabetes and 72,763 participants with type 2 diabetes. Factors significantly related to service utilization include age, gender, care class, membership segmentation, family relationship, type of FKTP, FKTP regional area, and place of residence. Meanwhile, marital status showed no significant relationship (p-value >0.05). The conclusion of this study is that innovative approaches are needed to target communities with high disparities who have low utilization of RJTP healthcare services.
Kata kunci: Utilisasi, Angka Rujukan, Jaminan Kesehatan Nasional.
This study discusses the overview of outpatient utilization and referrals based on thecharacteristics of National Health Insurance (JKN) participants in Puskesmas TabananIII and Puskesmas Pupuan I from January until March 2016. This is a quantitativeresearch with cross sectional study design. Based on this research, it is known that thenumber of outpatient visits (9,32%) and referral rates (9,67%) in Tabanan III PHC(urban area) was higher than the number of visits (5,04%) and referral rates (3,81%)in Pupuan I PHC (rural area). It can be caused by the Puskesmas Tabanan III is moreaccessible than Puskesmas Pupuan I.
Keywords: Utilization, Referral Rate, National Health Insurance.
Tesis ini membahas tentang waktu tunggu pelayanan resep pasien umum di Farmasi URJ Selatan P. K. St. Carolus. Dari penelitian didapatkan bahwa rata-rata waktu tunggu pelayanan resep pasien umum sebesar 21.90 menit untuk resep non-racikan dan 39.40 menit untuk resep racikan. Untuk resep non racikan, waktu untuk tindakan sebesar 8.78 menit lebih kecil dari waktu jeda yaitu 13.13 menit. Sedangkan untuk resep racikan, waktu tindakan sebesar 26.75 menit lebih lama dari waktu jeda yaitu 12.75 menit, hal ini dikarenakan adanya proses peracikan. Faktor-faktor yang mempengaruhi waktu tunggu pelayanan resep pasien umum di P. K. St. Carolus adalah adanya jeda waktu dimana resep tidak diproses, adanya proses peracikan, ketidaksesuaian pengetahuan dan keterampilan SDM, SDM yang belum memadai, ketersediaan obat yang kurang, kecepatan dan keterampilan petugas, sistem komputerisasi yang belum memadai, dan sarana ruangan yang kurang luas.
Tujuan : Penelitian ini bertujuan untuk mengetahui apakah pemanfaatan dana Program Jaminan Pemelihaan Keluarga Miskin (JPK-Gakin) di Puskesmas sudah sesuai dengan peruntukannya atau tidak, dan bagaimana pengaruh kebijakan yang berlaku.
Disain : Penelitian ini adalah riset evaluasi (evaluative research). Populasi adalah 27 Puskesmas yang menyampaikan Laporan Pelaksanaan Kegiatan dan Keuangan PKPS BBM Bidang Kesehatan kepada Dinas Kesehatan kota Depok untuk tahun 2004, yang secara purposif di pilih 6 (Enam) puskesmas yang merupakan sample penelitian. Enam Puskesmas yang di pilih adalah 3 (tiga) Puskesmas dengan jumlah Keluarga miskin (Gakin) tertinggi dan 3 (tiga) Puskesmas dengan jumlah Keluarga miskin (Gakin) terendah di kota Depok, dan di lakukan kajian pada data sekunder yang bersifat kuantitatif, serta di lakukan penelusuran kepada data primer (wawancara, dan diskusi dengan pihak puskesmas) yang bersifat kualitatif. Pengolahan data kuantitatif menggunakan analisis univariat, analisis bivariat (uji T Independent).
Hasil : penelitian menunjukkan bahwa pemanfaatan dana pada jenis pelayanan kesehatan dasar (yankesdas) dan revitalisasi posyandu (revipos) tidak terkait dengan jumlah keluarga miskin (gakin) yang terdaftar pada masing-masing puskesmas, karena sebagian besar pemanfaatan dana dialokasikan kepada biaya yang bersifat non pelayanan medis kepada pasien Jaminan Pemeliharaan Keluarga Miskin (JPK-Gakin). Sementara untuk persalinan, di ketahui bahwa dari laporan yang di sampaikan oleh masing-masing puskesmas kepada Dinas Kesehatan kota Depok masih belum sesuai dengan standar cost yang ditetapkan untuk setiap ibu bersalin (bulin) dari keluarga miskin yang di tolong bidan, yakni Rp. 200.000,-.
Kesimpulan : Dalam analisa kesesuaian pemanfaatan dana kesehatan program JPK-Gakin untuk Pelayanan Rawat Jalan Tingkat Pertama (RJTP) pada 6 (Enam) Puskesmas di kota Depok tahun 2004, masih belum sesuai dengan kebijakan yang di tetapkan, proporsi kunjungan terhadap jumlah peserta keluarga miskin (gakin) pada masing-masing puskesmas belum optimal, hal ini di tunjukkan oleh adanya perbedaan yang signifikan expenditure per unit kunjungan untuk pelayanan kesehatan dasar pada masing-masing puskesmas yang di teliti.
Kata Kunci : RJTP, JPK-GAKIN, Expenditure, Yankesdas, Revipos, riset evaluasi.
Background : First Level Outpatient Services provided by a community health center are Primary Health Care (Yaskandes), giving birth services, and revitalization of community-based integrated service posts (Posyandu) (Revipos). The proportion of poor family visit to the number of poor families registered at each community health center and the policies established are expected to be related to the utilization of the Poor Family Care Guarantee Program (JKP-Gakin) health funds for first level outpatient services in the health centers. This is revealed by the research on Analysis of the Conformity of Health Fund Utilization of Poor Family Care Guarantee Program for First Level Outpatient Services at six community health centers in Depok, in 2004.
Aim : This research is aimed at knowing whether the utilization of the fund at health centers has conformed to what it is meant for or not, and how the policy influences are.
Design : This research is an evaluative research. The population is 27 community health centers giving the Report of Activity Implementation and Subsidy Reduction Compensation Program Finance (PKPS BBM) in health to Health Office in Depok in 2004. Six community health centers were purposively selected as research samples. Three of the health centers are the highest poor family number's health centers and the rest are the lowest in Depok. The secondary data were analyzed quantitatively, while the primary one (interview, discussion with health center personnel) were studied qualitatively. The quantitative data were processed using univariate and bivariate analyses (Independent T test).
Result : The results show that the fund utilization for Primary Health Care and revitalization of community-based integrated service posts is not related to the number of poor families registered in each health center because the funds are mostly allocated to finance non-medical services for poor family care guarantee outpatients. Meanwhile, for giving birth, it was known from reports given by each of the health centers to Depok Health Offices that the utilization has still not conformed to the standard cost determined for every giving birth mother of poor families helped by midwives, namely Rp 200,000.
Conclusion : Hence, it is concluded that the utilization of the health funds has not complied with the policy determined; the proportion of visit to the number of poor family participants at each health center has not been optimum. This is indicated by significant difference of expenditure per unit of visit for primary health care at every community health centers studied.