Tesis ini bertujuan untuk mengembangkan alat ukur yang dapat digunakan untuk mengukur kualitas hidup terkait kesehatan pada orang dengan HIV/AIDS. Metode yang digunakan adalah konfirmatif eksploratif terhadap empat Gold Standard yaitu WHOQOL-HIV BREF, MOS HIV, EQ-5D-5L dan Ina-HRQoL. Dilakukan suatu studi literature dan uji validitas dan reliabilitas untuk memilih atribut yang sesuai untuk digunakan sebagai alat ukur. Ke-empat goldstandar diujikan pada masing-masing 30 responden. Dari 81 item pertanyaan diperoleh 70 item yang valid, dilakukan reduksi item dengan mengeliminasi item yang tidak sesuai dengan dimensi yang ditetapkan yaitu dimensi FISIK, MANDIRI, SOSIAL, MENTAL dan SPIRITUAL, sehingga diperoleh 40 item yang sesuai. Setelah itu dilakukan pengelompokan pada item yang sama atau menanyakan hal yang sama sehingga diperoleh 17 atribut. Ditambah satu atribut Bekerja yang dipandang penting maka keseluruhan atribut menjadi 18 yaitu Vitalitas, Rasa Sakit, Tidur, Mobilitas, Akyifitas Pribadi, Bepergian, Bekerja, Hubungan Personal, Dukungan Teman, Seksual,Aktifitas Sosial, Konsentrasi, Citra Diri, Menikmati Hidup, Perasaan Negatif, Hidup Berarti, Khawatir Masa Depan, Takut Kematian. Kedelapanbelas atribut kemudian dikembangkan menjadi kuesioner dan diujikan pada 30 responden dengan nilai alpha Cronbach 0,905, sehingga alat ukur ini dinilai valid dan reliable. Alat ukur yang baru dinamakan D-HIV HRQOL kemudian di aplikasikan pada 119 responden pada Yayasan Layak dengan nilai alpha Cronbach sebesar 0,895. Dari 119 responden ternyata 73,11% laki-laki dan 26,89% perempuan; kelompok umur terbanyak adalah 30-39tahun yaitu sebanyak 65,55% dan kedua terbanyak pada umur 20-29 tahun yaitu 23,53%. Tingkat pendidikan responden cukup baik yaitu 68,91% tingkat menengah atas, dan pekerjaan terbanyak adalah swasta 52,94%. Dari riwayat penggunaan narkotika diperoleh 52,10% pernah, dan 17,65% masih aktif, demikian juga riwayat penggunaan alkohol 42,86% pernah dan 3,36% masih aktif. Faktor penularan terbanyak adalah melalui pemakaian narkotika suntikan sebanyak 63,87% dan seksual sebanyak 35,29%. Untuk nilai CD4 hanya 103 responden yang melengkapi data 44,66% pada 200-500 cells/ml dan 38,83% pada kurang dari 200 cells/ml. Hanya 19 responden yang sudah pernah diperiksa viral load, 10 undetected dan 9 detected. Menurut stadium 52,10% pada stadium II, dan 29,41 pada stadium II. Sebanyak 26,89% belum menerima pengobatan ARV dan 22,69% sudah menjalani ARV selama lebih dari 2 tahun. Nilai utility rata-rata pada 50,61 (0,7) dengan nilai minimum pada 22 (0.30) dan maksimum pada 69 (0.96), time preference rata-rata adalah 17,06. Sehingga nilai QALY?s adalah 11,94.

The objective of this thesis is to develop an instrument that could be used in examining health related quality of life on people living with HIV/AIDS. The method used in this case is confirmative explorative to the four gold standards which is WHOQOL-HIV BREF, MOS HIV, EQ-5D-5L and Ina-HRQoL. Literature, validity, and reliability tests are conducted to choose the appropriate attributes to be used in the measuring instrument. These four gold standards were each tested on 30 respondents. Out of 81 items, 70 were found valid. An item reduction was carried by eliminating items that does not fit the dimensions, which is Physical, Social, Independence, Mental, and Spiritual dimensions, so that 40 suitable items was obtained. After that, classification on the same items, or items that was asking the same questions was done so that 17 attributes is obtained. And the ?Working? attribute was added because it was deemed important for the instrument. The result was 18 attributes which is Vitality, Pain, Sleep, Mobility, Personal Activity, Traveling, Working, Personal Relationship, Friend Support, Sexual, Social Activity, Concentration, Self-Image, Enjoying Life, Negative Feeling, Meaningful Life, Worries about the Future, and Fear of Death. These 18 attributes was then developed into a questionnaire and tested on 30 respondents with the Cronbach alpha values of 0.905, so that this instrument was deemed valid and reliable. The new instrument named D-HIV HRQOL was then applied to 119 respondents at ?Yayasan Layak? with the Cronbach alpha value of 0.895. Out of 119 respondents 73.11% were male and 26.59% were female; the largest age group was 30-39 years old as much as 65.55%, the second largest was 20-29 years old as much as 23.53%. The education level of the respondents was high enough, as much as 68.91% was middle class up. As much as 52.94% of the respondents were working in private sectors. As much as 52.10% of the respondents was using drugs in the past, with 17.65% is still actively using drugs, as much as 42.86% of the respondents was drinking alcohol in the past, with 3.36% is still actively drinking it. The largest factor of transmission was injection drugs as much as 63.87% and trough sexual as much as 35.29%. only 103 respondents fills in the CD4 value, of which 44.66% is at 200-250 cells/ml and 38.83% is at less than 200 cells/ml. Only 19 respondents were tested on viral load, 10 of which is proven undetected, and 9 detected. Stadium wise, as much as 52.10% of the respondents were at the second stadium, and 29.41% were at the third stadium. As much as 26.89% have yet to receive ARV treatment and 22.69% has received ARV treatment for the past 2 years. The average utility value is at 50.61 (0.7) with the lowest value being 22 (0.30) and the highest is 69 (0.96). The average time preference is 17.06, so the resulting QALY value is 11.94.

ABSTRAK Nama : Alifianti Lestari Program Studi : Kajian Administrasi Rumah Sakit Judul : EVALUASI PENGEMBANGAN PUSKESMAS KECAMATAN MENJADI RSUD KELAS D DENGAN STUDI KASUS DI   4 RSUD   JAKARTA PUSAT TAHUN 2017 Penelitian ini dilakukan dengan pendekatan kualitatif yang secara umum bertujuan untuk mendapatkan hasil evaluasi pengembangan Puskesmas Kecamatan menjadi  Rumah Sakit Kelas D di Jakarta Pusat tahun 2017. Penelitian dilakukan selama dua bulan ( April – Mei 2017 ) dengan mengambil lokasi di 4 RSUD Jakarta Pusat yaitu : RSUD Kemayoran, RSUD Cempaka Putih, RSUD Johar Baru dan RSUD Sawah Besar. Pengumpulan data melalui data primer berupa wawancara mendalam, yang dilengkapi dengan telaah dokumen dan observasi lapangan, kemudian data sekunder yang berasal dari 4 RSUD di Jakarta Pusat. Hasil penelitian menunjukkan banyak penyebab yang sangat mempengaruhi layanan kesehatan yang dberikan di 4 RSUD Jakarta Pusat. Seperti ketersediaan Dokter Spesialis yang tidak mudah mau bekerjasama dengan RSUD Kelas D di Jakarta Pusat. Salah satunya dikarenakan belum adanya kesepakatan pendapatan dokter spesialis. Selain itu kelengkapan sarana prasarana juga berpengaruh dalam pemberian layanan kepada masyarakat, lokasi Rumah sakit yang kurang strategis berpengaruh juga terhadap pemasaran layanan, serta kebijakan pengembangan Rumah sakit dengan layanan unggulan sesuai kebutuhan masyarakat sekitarnya. Sehingga pada penelitian ini dapat disimpulkan bahwa 4 RSUD di Jakarta Pusat  cukup berhasil menjadi RSUD Kelas D  di tahun 2017 dengan terus memperbaiki dan melengkapi sumber daya manusia termasuk Dokter Spesialis dan melengkapi sarana prasarana kesehatan rumah sakit yang belum terpenuhi secara optimal. Kata Kunci  :  RSUD KELAS D ,  Evaluasi

ABSTRACT Name : Alifianti Lestari Study Program : Magister of Hospital Administration Title : EVALUATION OF PUSKESMAS KECAMATAN DEVELOPMENT BECOMING CLASS D HOSPITAL WITH CASE STUDY IN 4 HOSPITALS IN CENTRAL JAKARTA 2017. This research was conducted with qualitative approach which generally aimed to get the evaluation result of development of Puskesmas Kecamatan into Class D Hospital in Central Jakarta in 2017. The research was conducted for two months (April - May 2017) by taking the location in 4 Central Jakarta Public Hospital namely: Kemayoran Hospital, Cempaka Putih Public Hospital, Johar Baru Hospital and RSUD Sawah Besar. Data collection through primary data is in-depth interview, completed with document review and field observation, then secondary data coming from 4 hospitals in Central Jakarta. The results showed many causes that greatly affect the health services provided in 4 Central Jakarta hospitals. As the availability of Specialist Doctors who are not easy to cooperate with RSUD Class D in Central Jakarta. One of them is because there is no specialist doctor's income agreement. In addition, the completeness of infrastructure facilities also affect the provision of services to the public, the location of hospitals that are less strategic also affect the marketing of services, as well as development policies of hospitals with excellent service according to the needs of the surrounding community. So in this study it can be concluded that 4 hospitals in Central Jakarta succeeded in becoming RSUD Class D in 2017 by continuously improving and completing human resources including Specialist Doctor and equipping hospital health infrastructure facilities that have not been fulfilled optimally. Keywords: RSUD CLASS D, Evaluation