Ditemukan 6 dokumen yang sesuai dengan query :: Simpan CSV
Atmiroseva; Pembimbing: Atik Nurwahyuni; Penguji: Pujiyanto, Mardiati Nadjib, Donni Hendrawan, Elsa Novelia
T-4888
Depok : FKM UI, 2017
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Devi Afni; Pembimbing: Adang Bachtiar; Penguji: Ede Surya Darmawan, Amal C. Sjaaf, Achmad Muchlis, Elsa Novelia
Abstrak:
Salah satu amanah UU No. 40 Tahun 2004 adalah masyarakat memperoleh manfaat pemeliharaan kesehatan serta perlindungan terpenuhinya Kebutuhan Dasar Kesehatan (KDK) dan jika masyarakat membutuhkan rawat inap di RS maka dilayani di kelas standar. Hal tersebut dituangkan dalam peta jalan Jaminan Kesehatan Nasional (JKN) 2012-2019 yaitu keseragaman paket manfaat medis dan nonmedis bagi peserta JKN di RS pada tahun 2019, namun sampai saat ini belum terwujud. Terbitnya PP 47 tahun 2021 mengatur kelas standar ini yang akan diberlakukan tanggal 1 Januari 2023 dan juga mengatur ruang intensif, ruang isolasi dan ketentuan sumber daya manusia (SDM) purna waktu. Penelitian dilakukan untuk menganalisis kesiapan implementasi Kelas Rawat Inap Standar (KRIS) JKN, ruang intensif,ruang isolasi dan ketentuan SDM purna waktu dengan menggunakan pendekatan kuantitatif (kuesioner rancangan 12 konsep kriteria KRIS JKN bulan November 2021) dan kualitatif (wawancara mendalam menggunakan teori Donald van Metter dan Carl van Horn) pada 22 RS di wilayah kabupaten Tangerang. Hasil penelitian menunjukan kesiapan RS di akhir tahun 2021, untuk KRIS masih kurang dari 60% RS yang baru memenuhi kriteria kepadatan ruangan (luas ruangan per TT, jarak antar TT minimal 1,5m2, jumlah maksimal TT per ruangan); untuk ruang intensif terpenuhi 23% RS; untuk ruang isolasi terpenuhi 36% RS; serta 15%-20% terpenuhi dokter spesialis purna waktu di RS swasta dan 100% di RS pemerintah (secara kuantitas bukan kualitas). Saran penelitian ini: RS melakukan mapping ketersediaan ruang rawat inap saat ini dan penyesuaian dilakukan setelah kriteria KRIS JKN ditetapkan pemerintah; pemerintah segera membuat peraturan pelaksana termasuk ketegasan jenis kepesertaan dan tarif yang akan diberlakukan sehingga RS dapat mempersiapkannya dengan tepat , melakukan harmonisasi regulasi, memberikan keringanan pajak alat-alat kesehatan, mengalokasikan dana khusus bagi RS pemerintah , sosialisasi masif kepada RS atau masyarakat luas, melakukan mapping tenaga dokter kemudian bekerjasama dengan institusi pendidikan yang memproduksi tenaga dokter spesialistik; RS swasta juga mempersiapkan dana khusus secara mandiri untuk persiapan KRIS JKN; penerapan KRIS JKN, ruang intensif dan ruang isolasi dilakukan bertahap dalam 2-4 tahun kedepan
One of the mandates of Law Number 40 Year 2004 that the community gets the benefits of health care and protection for Basic Health Needs (KDK), and if the community requires hospitalization then it is served according to standard inpatient room. This is stated in National Health Insurance (JKN) Roadmap 2012-2019, equality of medical and non-medical benefit packages for JKN participants in hospitals in 2019, but so far this has not been realized. The issuance of PP Number 47 Yearf 2021 regulates standard classes that will be implemented on January 1, 2023 and also regulates intensive rooms, isolation rooms and provisions for full-time human resources. The study aims to analyze the readiness of implementation standard inpatient room (KRIS), intensive rooms, isolation rooms and the provision of full-time human resources using a quantitative approach (a questionnaire designed 12 concepts of KRIS JKN criteria in November 2021) and qualitative approch (in-depth interviews using the theory of Donald van Metter and Carl van Horn) at 22 hospitals in the Tangerang district. The results of the study show that the readiness of hospitals at the end of year 2021 to implement KRIS is still less than 60% of hospitals fulfill the criteria for density room (area for bed, minimum distance between beds are 1.5m2, maximum number of bed in KRIS); hospitals fulfilled 23% for intensive care criteria, 36% for isolation room; and 15%-20% full-time specialist doctors in private hospitals and 100% in government hospitals (quantity not quality). Suggestions for this research: the hospital does a mapping of the current availability of inpatient rooms and adjustments are made after the KRIS JKN criteria are set by the government; the government immediately make implementing regulations including firmness on the type of participation and tariffs to be applied so that hospitals can prepare them properly, harmonize regulations, provide tax breaks for medical devices, allocate special funds for government hospitals, massive socialization to hospitals or the wider community, conduct mapping doctors then collaborate with educational institutions that produce specialist doctors; Private hospitals also prepare special funds independently for the preparation of the KRIS JKN; the implementation of KRIS JKN, intensive rooms and isolation rooms is carried out in stages over the next 2- 4 years
Read More
One of the mandates of Law Number 40 Year 2004 that the community gets the benefits of health care and protection for Basic Health Needs (KDK), and if the community requires hospitalization then it is served according to standard inpatient room. This is stated in National Health Insurance (JKN) Roadmap 2012-2019, equality of medical and non-medical benefit packages for JKN participants in hospitals in 2019, but so far this has not been realized. The issuance of PP Number 47 Yearf 2021 regulates standard classes that will be implemented on January 1, 2023 and also regulates intensive rooms, isolation rooms and provisions for full-time human resources. The study aims to analyze the readiness of implementation standard inpatient room (KRIS), intensive rooms, isolation rooms and the provision of full-time human resources using a quantitative approach (a questionnaire designed 12 concepts of KRIS JKN criteria in November 2021) and qualitative approch (in-depth interviews using the theory of Donald van Metter and Carl van Horn) at 22 hospitals in the Tangerang district. The results of the study show that the readiness of hospitals at the end of year 2021 to implement KRIS is still less than 60% of hospitals fulfill the criteria for density room (area for bed, minimum distance between beds are 1.5m2, maximum number of bed in KRIS); hospitals fulfilled 23% for intensive care criteria, 36% for isolation room; and 15%-20% full-time specialist doctors in private hospitals and 100% in government hospitals (quantity not quality). Suggestions for this research: the hospital does a mapping of the current availability of inpatient rooms and adjustments are made after the KRIS JKN criteria are set by the government; the government immediately make implementing regulations including firmness on the type of participation and tariffs to be applied so that hospitals can prepare them properly, harmonize regulations, provide tax breaks for medical devices, allocate special funds for government hospitals, massive socialization to hospitals or the wider community, conduct mapping doctors then collaborate with educational institutions that produce specialist doctors; Private hospitals also prepare special funds independently for the preparation of the KRIS JKN; the implementation of KRIS JKN, intensive rooms and isolation rooms is carried out in stages over the next 2- 4 years
T-6343
Depok : FKM-UI, 2022
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Sofia; Pembimbing: Anhari Achadi; Penguji: Pujiyanto. Elsa Novelia, Haruddin
Abstrak:
Read More
Tingginya angka kunjungan rawat jalan tingkat lanjutan (RJTL) pada klaim INA CBG dengan kode grouping Q-5-44-0 (penyakit kronis kecil lain-lain) sejak tahun 2014 dapat meningkatkan pembiayaan Jaminan Kesehatan Nasional (JKN). Dalam sistem INA CBG, kode Grouping Q-5-44-0 merupakan kode grouping yang terbentuk apabila terdapat kunjungan ulang dari pasien yang sifatnya adalah kunjungan kontrol ke fasilitas kesehatan rujukan tingkat lanjutan (FKRTL). Penelitian ini bertujuan untuk mengetahui faktor Peserta dan faktor FKRTL yang mempengaruhi jumlah kunjungan ulang RJTL. Penelitian ini menggunakan crossectional study dengan metode kuantitatif. Variabel pada faktor Peserta adalah: jenis kelamin, kelompok usia, dan segmen kepesertaan (PBI/ Non-PBI). Sedangkan variabel pada faktor FKRTL adalah: tipe kepemilikan rumah sakit (swasta/pemerintah), kelas FKRTL (A,B,C,D), dan poli spesialis. Data yang digunakan merupakan data retrospektif klaim INA CBG tahun 2017. Subjek penelitian adalah nomor kartu Peserta yang mewakili individu Peserta. Jumlah sampel sebanyak 2.947 dari 9 (sembilan) Kantor Cabang BPJS Kesehatan di wilayah Jabodetabek. Hasil penelitian menunjukkan rata-rata jumlah kunjungan ulang sebanyak 9,96 kali selama tahun 2017 terbanyak pada FKRTL kelas B sebesar 51,5% dan tujuan poli spesialis terbanyak adalah poli penyakit dalam sebesar 27,5%. Tidak ada perbedaan rata-rata antara jumlah kunjungan ulang RJTL pada jenis kelamin perempuan dan laki-laki, tidak ada perbedaan rata-rata jumlah kunjungan ulang RJTL antara FKRTL tipe kepemilikan pemerintah dan swasta, serta tidak terdapat perbedaan jumlah kunjungan ulang RJTL antara kelompok usia. Terdapat perbedaan rata-rata jumlah kunjungan ulang RJTL antara segmen kepesertaan PBI dan Non-PBI, terdapat perbedaan jumlah kunjungan ulang RJTL antara kelas FKRTL, serta terdapat perbedaan siginifikan jumlah kunjungan ulang RJTL antara poli spesialis. Variabel segmen Non-PBI, FKRTL kelas B, poli bedah saraf, poli gastrologi, poli geriatri, poli ginjal, poli UGD, poli mata, poli obgyn, dan poli rematologi berpengaruh negatif terhadap jumlah kunjungan ulang RJTL sedangkan segmen PBI, FKRTL kelas A, C, dan D serta poli spesialis lainnya berpengaruh positif terhadap jumlah kunjungan ulang RJTL
Backgorund: The high of outpatient revisit in hospital from INA CBG Claims with grouping code Q-5-44-0 since 2014 can be a burden on health assurance (JKN) financing. Based on INA CBG system, grouping code: Q- 5-44-0 is set for follow up after treatment visit at secondary health facilities. This condition needs indepth analysis to find factor which is related with outpatient revisit rate. Methodology: This study used a cross-sectional study (quantitative methods) to observe relationship between independent variables of JKN participant (gender, age cluster, participant cluster) and hospital (ownership type, hospital referral class, specialist clinic) with outpatient revisit rate (dependent variable). Sample size were 2.947 participant identities as uniqely code which is presented every participant from nine branch offices of BPJS Kesehatan (Indonesia administration bodies of social health security). Results: the average number of 9.96 visits in 2017 was highest in Class B FKRTL (51.5%) and the highest specialist poly destination was internal medicine poly (27.5%). There is no average difference between the number of outpatient revisit for women and men, there is no difference in the average number of outpatient revisit between government and private ownership, and there is no difference in the number of outpatient revisit between age groups. There is an average difference in the number of outpatient revisit between subsidized participan and Non-subsidized participan, there are differences in the number of outpatient revisit between hospital classes, and there is a significant difference in the number of outpatient revisit between specialists clinic. Hospital class and specialist clinic have a positive influence on the number of return visits while the participation segment has a negative influence on the number of return visits. Non-subsidized participan, hospital class B, neurosurgical poly, gastrology poly, geriatric poly, kidney poly, emergency clinic, eye clinic, poly obgyn, and poly rheumatology had negative effect while subsidized participan, hospital class A, C, and with other specialist clinic had a positive effect on the number of outpatient revisit.
T-5918
Depok : FKM-UI, 2020
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Riris Dian Hardiani; Pembimbing: Tris Eryando; Penguji: Iwan Ariawan, Besral, Elsa Novelia, Doni Arianto
Abstrak:
Read More
Beban penyakit dan kematian akibat PGK di Indonesia mengalami peningkatan seiring dengan meningkatnya prevalensi faktor risiko PGK seperti diabetes, hipertensi dan obesitas. Sejak diluncurkannya program Jaminan Kesehatan Nasional (JKN), jumlah renal unit di Indonesia berkembang sangat pesat diikuti dengan peningkatan jumlah pasien karena meningkatnya akses masyarakat. Namun peningkatan akses masyarakat untuk mendapatkan pelayanan kesehatan tidak diiringi dengan pemerataan akses pelayanan kesehatan antara penduduk perkotaan dan pedesaan. Untuk mengetahui hubungan wilayah tempat tinggal pasien (kabupaten/kota) dan peran variabel kontekstual di tingkat provinsi terhadap mortalitas pasien PGK rawat inap peserta JKN dilakukan penelitian potong lintang menggunakan data sampel BPJS Kesehatan 2015-2016. Analisis multivariat dilakukan dengan Generalized Estimating Equations dan dilanjutkan dengan analisis multilevel. Dari penelitian ini didapatkan proporsi kematian pasien PGK rawat inap JKN tahun 2015-2016 sebesar 19,95%. Pasien PGK rawat inap JKN yang tinggal di kabupaten dan dirawat di rumah sakit regional 1 memiliki risiko kematian lebih tinggi OR 1,37 (95% CI 1,33-1,4; p<0,05) dibandingkan dengan pasien yang tinggal di kota setelah dikontrol oleh variabel kovariat lain. Sedangkan pasien yang tinggal di kabupaten dibandingkan dengan tinggal di kota dan dirawat di rumah sakit regional 3, 4 dan 5 secara berurutan memiliki risiko kematian OR 1,82 (95% CI 1,72-1,92), OR 0,51 (95% CI 0,45-0,59), OR 5,90 (95% CI 4,28-8,12) dan bermakna secara statistik. (p<0,05). Tidak ada perbedaan kematian yang bermakna secara statistik untuk pasien yang tinggal di kabupaten dibandingkan kota dan dirawat di rumah sakit regional 2 dengan OR 1,03 ( 95% CI 0,96-1,12; p>0,05). Terdapat variasi mortalitas di tingkat provinsi dan variasi yang disebabkan oleh variabel kontekstual dari dimensi ketersedian yakni rasio rumah sakit, rasio unit hemodialisis, rasio dokter konsultan hipertensi, rasio dokter umum, rasio perawat bersertifikat dan rasio mesin hemodialisis sebanyak 8,98%. Untuk analisis multilevel lebih lanjut dapat digunakan variabel kontekstual lain dari dimensi aksesibilitas geografis, aksesibilitas keuangan dan akseptabilitas
Background: The burden of disease and mortality caused by Chronic Kidney Disease (CKD) has increased with the increasing prevalence of CKD risk factors. The National Health Insurance (JKN) program has increased healthcare access. However, the access in urban population is not the same as in rural. Objectives: To find out the relationship between the patients’ residential area (urban or rural) and the role of the contextual variables at the provincial level on the mortality of hospitalized JKN patients with CKD. Methods: A cross-sectional study was conducted using BPJS Kesehatan 2015-2016 sample data. Multivariate analysis was performed with Generalized Estimating Equations and continued with multilevel analysis. Results: The study showed the proportion of deaths was 19.95%. Respectively, rural residents compared to urban and treated in hospitals at Regional 1, 3 and 5 had higher mortality risk OR 1.37 (95%CI 1.33-1.41), 1.82 (95%CI 1.72-1.92), 5.90 (95%CI 4.28-8.12) with p<0.01. However, rural residents compared to urban and treated in hospitals at Regional 4 had reduced risk of death, OR 0.51 (95%CI 0.45-0.59;p<0.01) and those whom treated in hospitals at regional 2 had OR 1.03 (95%CI 0.96-1.12; p>0.05). The contextual variables of the study caused 8.98% mortality variance at provincial level. Conclusions: Rural residents had higher risk of death than those in urban and there was small variation in mortality between provinces.
T-5981
Depok : FKM-UI, 2020
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Elsa Novelia; Pembimbing: Hasbullah Thabrany; Penguji: Mardiati Nadjib, Kurniasari, Fajriadinur, M. Edison
Abstrak:
Jumlah pasien gagal ginjal terminal di Indonesia terus meningkat. Peningkatan prevalensi hipertensi dan diabetes adalah salah satu kontributor peningkatan kasus penyakit gagal ginjal kronik. Meskipun Continuous Ambulatory Peritoneal Dialysis(CAPD) telah diperkenalkan sebagai terapi pengganti ginjal CAPD masih jarang digunakan dan hemodialisa masih merupakan tindakan mayoritas yang dipilih diIndonesia. Tujuan dari studi ini adalah untuk melakukan analisa efektivitas biaya antara HD dan CAPD. Penelitian membandingkan 78 pasien HD di RS PMI Bogordan 10 pasien CAPD di RSUP Fatmawati Jakarta. Kualitas hidup pasienm enggunakan kuisoner SF 36. Beban ekonomi untuk biaya langsung medis menggunakan tarif INA CBGs dan biaya lainnya menggunakan kuisoner beban ekonomi. Biaya total hemodialisa setahun adalah Rp 133.396.692,- dan Rp81.680.000,- untuk CAPD. 46,2% pasien hemodialisa mempunyai kualitas hidupbaik dan 90% pasien CAPD mempunyai kualitas hidup baik. Analisa Bivariat menunjukkan bahwa kualitas hidup pasien CAPD terbukti siknifikan pada aspekperan fisik, emosi, rasa nyeri, energi, fungsi sosial dan kesehatan jiwa. CAPD lebihcost efektif dibandingkan HD dengan nilai ICER adalah Rp 2.032.889,- untuk setiap ekstra peran emosi lebih baik dan Rp 1.780.265,- untuk setiap ekstra peranfisik lebih baik serta dominan untuk biaya dan kualitas hidup pada CE Plan. Kata kunci: analisa efektifitas biaya, hemodialisa, CAPD
Number of patients with End Stage Renal Disease (ESRD) in Indonesia is growing.The increased prevalence of hypertension and diabetes mellitus is a contributor tothe increase in patients with CKD (Chronic Kidney Disease). Ever sinceContinuous Ambulatory Peritoneal Dialysis (CAPD) was intoduced as a form ofrenal replacement therapy, CAPD still small number of users and Haemodilysis stillconstitute the majority of renal replacement therapy in Indonesia. The aim of thisstudy is to analize the cost effectiveness between HD and CAPD on ESRD patients.Study compared 78 HD patients at PMI Hospital in Bogor and 10 CAPD patientsat Fatmawati Hospital in Jakarta. Patient quality of life interviewed by SF 36questionnaire. Economic burden divided in two measurement. Direct medical costmeasured by INA CBGs packet, direct non medical cost (transportation, food forpatient and family) and indirect medical cost (opportunity cost) will be measure byeconomic burden questionnaire. Haemodialysis total cost per year is Rp133.396.692,- and Rp 81.680.000,- for CAPD. 46,2% Haemodialysis patient hasgood quality of life and 90% for CAPD. Bivariat analysis showed Quality of lifeCAPD patient significant in phisical activities, emotional, pain, energy, sosialfunction and sanity. CAPD is cost effective compare to HD with ICER Rp2.032.889,- for ekstra better emotional role and Rp 1.780.265,- for ekstra betterphisical role and dominant for cost and quality of life at CE PlanKey words: cost effectiveness analysis, Haemodialysis, CAPD
Read More
Number of patients with End Stage Renal Disease (ESRD) in Indonesia is growing.The increased prevalence of hypertension and diabetes mellitus is a contributor tothe increase in patients with CKD (Chronic Kidney Disease). Ever sinceContinuous Ambulatory Peritoneal Dialysis (CAPD) was intoduced as a form ofrenal replacement therapy, CAPD still small number of users and Haemodilysis stillconstitute the majority of renal replacement therapy in Indonesia. The aim of thisstudy is to analize the cost effectiveness between HD and CAPD on ESRD patients.Study compared 78 HD patients at PMI Hospital in Bogor and 10 CAPD patientsat Fatmawati Hospital in Jakarta. Patient quality of life interviewed by SF 36questionnaire. Economic burden divided in two measurement. Direct medical costmeasured by INA CBGs packet, direct non medical cost (transportation, food forpatient and family) and indirect medical cost (opportunity cost) will be measure byeconomic burden questionnaire. Haemodialysis total cost per year is Rp133.396.692,- and Rp 81.680.000,- for CAPD. 46,2% Haemodialysis patient hasgood quality of life and 90% for CAPD. Bivariat analysis showed Quality of lifeCAPD patient significant in phisical activities, emotional, pain, energy, sosialfunction and sanity. CAPD is cost effective compare to HD with ICER Rp2.032.889,- for ekstra better emotional role and Rp 1.780.265,- for ekstra betterphisical role and dominant for cost and quality of life at CE PlanKey words: cost effectiveness analysis, Haemodialysis, CAPD
T-4179
Depok : FKM-UI, 2014
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Joan Xaveria Mahulae; Pembimbing: Jaslis Ilyas; Pujiyanto, Sandi Iljanto, Dintar Hutabalian, Elsa Novelia
Abstrak:
ABSTRAK Stroke merupakan penyebab kematian terbesar di Indonesia dan pembiayaan penyakit stroke oleh BPJS menduduki peringkat kedua terbesar setelah penyakit jantung. Tujuan penelitian ini adalah untuk mengetahui karakteristik dominan yang paling berhubungan dengan biaya klaim pasien stroke rawat inap peserta JKN yang dilakukan di RSU Tarutung dengan melakukan analisis multivariat dengan metode regresi linear. RSU Tarutung merupakan satu-satunya rumah sakit di Kabupaten Tapanuli Utara. Karakteristik yang berhubungan adalah kelas perawatan, jenis kepesertaan, umur, lama hari rawat dan tingkat keparahan. Ditemukan bahwa RSU Tarutung masih belum optimal dalam memberikan pelayanan akan penyakit stroke. Upaya yang dapat dilakukan adalah meningkatkan tenaga ahli neurovaskular dan penyediaan peralatan diagnostik yang membantu dalam menetapkan diagnosa sehingga dapat dilakukan penanganan yang tepat. Kata Kunci: penyakit stroke, biaya klaim penyakit stroke rawat inap, pengadaan alat medis ABSTRACT Stroke is one of the cause of high mortality rate in Indonesia and the funding for stroke by BPJS ranks second after heart disease. This study aims to determine the most dominant characteristics associated with the cost of claims of stroke patients covered by JKN that use inpatient (rawat inap) service at Tarutung Hospital by doing multivariate analysis with variable linear regression method. The most related characteristics are type of health care, type of membership, age, length of stay age, and level of severity. It was found that Tarutung Hospital is still not optimal in providing services for stroke. Some feasible efforts that can be considered are increasing the neurovascular experts and providing better diagnostic equipments in order to deliver the necessary treatment. Keywords: stroke, cost of claims of inpatient stroke, providing of better diagnostic equipments
Read More
T-5030
Depok : FKM-UI, 2017
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉