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ABSTRAK Analisis Kepatuhan Dokter Dalam Penulisan Resep Sesuai Formularium RSU Prima Medika Denpasar Salah satu unsur dalam peningkatkan mutu pelayanan kesehatan adalah terjaminnya aksesibilitas obat yang aman, berkhasiat, bermutu, dan terjangkau. Pengelolaan obat yang tidak efisien dapat memberikan dampak negatif secara medik dan ekonomi. Salah satu penyebabnya adalah ketidakpatuhan dokter dalam meresepkan obat sesuai dengan formularium. RSU Prima Medika merupakan salah satu rumah sakit swasta di Denpasar yang telah memiliki formularium sendiri. Tujuan penelitian ini adalah untuk menganalisis faktor-faktor yang berhubungan dengan kepatuhan dokter dalam penulisan resep sesuai formularium RSU Prima Medika Denpasar. Penelitian ini merupakan penelitian kuantitatif dengan desain crossectional. Sampel adalah 120 dokter yang memiliki Surat Ijin Praktek (SIP) di RSU Prima Medika. Data dikumpulkan dengan wawancara menggunakan kuesioner terstruktur dan data kepegawaian. Data dianalisis secara univariat, bivariat dan multivariat dengan software statistik. Hasil penelitian didapatkan bahwa lebih banyak dokter laki-laki dengan rerata umur 44.4 ± 11.7 tahun dan paling banyak dokter spesialis. Gambaran kepatuhan sesuai fomularium RSU Prima Medika Denpasar adalah 27.5%. Faktor yang berhubungan terhadap kepatuhan dokter dalam penulisan resep sesuai dengan formularium RSU Prima Medika Denpasar adalah Pengetahuan, Informasi, Penghargaan, Sosialisasi, Supervisi, dan Lingkungan Tempat Kerja sedangkan faktor yang tidak berhungan kepatuhan dokter dalam penulisan resep sesuai dengan formularium RSU Prima Medika Denpasar adalah Jenis Kelamin, Pendidikan, Lama Praktek, Sanksi, Permohonan Pasien, Pihak Membayar, dan Industri Farmasi. Variabel yang diteliti pada penelitian ini berhubungan terhadap kepatuhan penulisan resep sesuai dengan formularium RSPM sebesar 60.2%, sedangkan sisanya sebesar 39.8% dipengaruhi oleh variabel lain Disimpulkan bahwa tingkat kepatuhan dokter dalam penulisan resep sesuai dengan formularium RSU Prima Medika Denpasar masih cukup rendah. Faktor yang paling berhubungan adalah penghargaan, pengetahuan, dan informasi. Disarankan kepada pihak manajemen untuk membuat suatu sistem kebijakan penghargaan dan sanksi, membuat buku saku formularium yang praktis, format dan tampilan yang menarik serta didistribusikan ke seluruh dokter praktek serta melakukan sosialisasi dan supervisi berkala. Kata Kunci: kepatuhan, dokter, penulisan resep, formularium RS, RSU Prima Medika Denpasar
ABSTRACT Complience Analysis of Formularium Drug Prescription in Prima Medika Hospital Denpasar One of component to increase hospital’s quality service is assurance of safe drug’s accessibility, beneficial, quality and affordable. Unefficient of drug management lead to medically and economicall negative effects. Prima Medika Hospital Denpasar is one of the private hospital in Denpasar which had their own formularium. In 2016, various types of excessive inventory drug lead to stuck and expired which have detrimented hospital. Aims of this study were to analyze factors related to doctor’s complience about formularium drug prescription in Prima Medika Hospital Denpasar. This was a quantitative study using crossectional design. Samples were 120 doctors who had legal permit practice in Prima Medika Hospital Denpasar. Data were collected by interview using structured questionnaires and analyzed univariate, bivariate dan multivariate with statistic software. Results showed that most doctors were male, mean of age is 44.4 ± 11.7 year; most of Specialist Doctors. Rate for complience of drug prescribing following formularium Prima Medika Hospital Denpasar is 27.5%. Factors related to compliance knowledge, information, reward, socialization, supervision, and Working environment. Meanwhile factors which were not related were gender, education, working experience, punishment, patient request, payment type, and Pharmaceutical industry. Variable on this study were 60.2% related with compliance and 39.8% were related to other factors. In conclution, complience of drug prescribing following formularium Prima Medika Hospital Denpasar is low. The most related factors including rewards, knowledge, and information. It can be suggested that hospital management to produce a sistem of rewards and punishment as well as periodically socialized and supervised for the prescription. Key words: complience, doctors, drug prescribing, hospital formularium, Prima Medika Hospital Denpasar
Dokter adalah tenaga kesehatan yang memiliki peran dan otoritas dalam penulisan resep obat untuk pasien. Proses seleksi dan pemilihan obat seharusnya dilakukan secara rasional dan mengikuti pedoman panduan obat yang ditetapkan oleh World Health Organization. Masih banyak ditemui peresepan obat di luar formularium di Rumah Sakit Risa Sentra Medika, 70 % dari 100% target penggunaan formularium. Penelitian ini bertujuan mengetahui motivasi dokter dalam penulisan resep. Faktor yang mempengaruhi dilihat dari faktor motivasi instrinsik (persepsi, kepentingan, dan aspirasi) faktor ekstrinsik (diagnosis, konsistensi, dan kerjasama), organisasi (kepemimpinan, sosialisasi, supervisi, fee), industri farmasi (promosi dan imbalan), serta implementasi kebijakan. Penelitian ini dilakukan dengan pendekatan kualitatif dan desain studi kasus. Data primer diperoleh dari wawancara mendalam dan dilengkapi dengan observasi dan telaah dokumen sebagai bentuk triangulasi. Penelitian ini menyimpulkan bahwa motivasi dokter dalam menuliskan resep dipengaruhi oleh banyak faktor antara lain, diagnosis penyakit, kondisi keuangan pasien, imbalan dari hasil kerjasama dengan industri farmasi. Imbalan dari pihak luar memberikan pengaruh yang kuat pada dokter dalam menuliskan resep. Sebagai saran untuk tindak lanjut, diperlukan peraturan yang jelas mengenai penerapan formularium oleh Direktur Rumah Sakit Risa Sentra Medika. Hal lain yang penting untuk diperhatikan dalam proses pelaksanaan penggunaan formularium adalah pemberian imbalan dan sanksi yang jelas bagi para dokter.
Doctor are health profesionals who have a role and authority in prescribing drugs to patients. Selection process and selection of drugs should be done rationally and follow the guidelines established drug guidelines by the World Health Organization. There are mostly found outside the formulary prescriptions at Risa Hospital Medical Center, 70% of the 100% target of the use of formularies. This study aims to find motivation in the prescribing physician. Factors influencing views of intrinsic motivation factors (perceptions, interests, and aspirations), extrinsic factors (diagnosis, consistency, and cooperation), organization (leadership, socialization, supervision, fee), the pharmaceutical industry (promotion and compensation), as well as policy implementation. The research was conducted with a qualitative approach and case study designs. Primary data obtained from interviews and observations and is equipped with a document review as a from of triangulation. This study concluded that the motivation of doctors in prescribing is influenced by many factors, among others, the diagnosis of diseases, the financial condition of the patient, the rewards of collaboration with the pharmaceutical industry. Remuneration from an outside party provides a strong influence on the prescribing physician. As a suggestion for a follow-up, needed clear rules for the application of the formula by the Director Risa Hospital Medical Center. Another important point to consider in the process of implementing the use of formularies is giving a clear rewards and sanctions for physicians.
Background: The failure to achieve the target for outpatient visits at RSIA Kenari Graha Medika over the last 3 years indicates a problem that needs to be addressed immediately. Not achieving the old patient target during this period indicates the patient's low interest in returning (repurchase intention). Communication between doctors and patients in the RSIA Kenari Graha Medika outpatient unit has become a concern because several times patient complaints have been received. Objective: to determine the relationship between doctors' communication skills and repurchase intention of outpatients at RSIA Kenari Graha Medika. Method: Cross sectional research design with a sample size of 152 samples. The variable studied is the doctor's communication skills which are associated with repurchase intention which is mediated by the customer satisfaction variable. Data analysis was carried out using univariate (descriptive) and multivariate analysis with SEM PLS. Results: From data analysis, it was found that all constructs were declared valid and reliable based on the results of loading factor, AVE and Corbach alpha calculations. Hypothesis testing shows all variables are accepted. Conclusion: Doctors' communication skills are positively and significantly related to repurchase intention through patient satisfaction. The higher the doctor's communication skills, the higher the repurchase intention. Based on the finding that physician communication skills are significantly related to patient satisfaction and repurchase intention, it is important to continue training physicians in effective communication skills.
Tesis ini membahas tingkat kepatuhan dokter dalam meresepkan obat formularium nasional di RS Multazam Medika tahun 2018. Pelayanan farmasi yang bermutu merupakan salah satu indikator untuk menilai kinerja rumah sakit dalam hal kendali mutu dan biaya. Pada lokasi tempat penelitian didapatkan gambaran peresepan obat pasien BPJS diluar formularium nasional sehingga mengakibatkan peningkatan biaya paket. Tingkat kepatuhan dokter dalam meresepkan obat formularium nasional di RS Multazam Medika tahun 2018 adalah 79,4%, dimana tingkat kepatuhan terendah terjadi di UGD (58,4%), dan poli syaraf (68,4%). Pada wawancara terdapat hubungan antara pengetahuan, informasi, sikap dan motivasi yang mempengaruhi faktor kepatuhan. Metode yang dipakai dalam penelitian ini dengan metode kuantitatif untuk mengetahui persentase kepatuhan dokter dan metode kualitatif dengan wawancara mendalam. Kata Kunci: Farmasi, Formularium Nasional (Fornas), Kepatuhan Dokter, Peresepan Obat.
This thesis discusses the level of compliance of doctors in prescribing national formulary drugs at Multazam Medika Hospital in 2018. Quality pharmaceutical services are one of the indicators to assess hospital performance in terms of quality and cost control. At the location where the study was obtained, an overview of the prescription of drugs for BPJS patients outside the national formulary resulted in an increase in package costs. The level of compliance of doctors in prescribing national formulary drugs at Multazam Medika Hospital in 2018 was 79.4%, where the lowest level of adherence occurred in the ER (58.4%), and neuroscientists (68.4%). In the interview, there is a relationship between knowledge, information, attitudes and motivation which influence the compliance factor. The method used in this research is quantitative methods to determine the percentage of doctors' compliance and qualitative methods with in-depth interviews. Keywords: Pharmacy, National Formulary, Doctor's Compliance, Prescribing Medicines.