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This thesis discusses the factors correlated with work disciplines of non-medical employee at Karya Bhakti Hospital in year 2012. The background of this research is the fact that non-medical employee?s work disciplines is decreasing, indicated by the decrease in percentage of employee coming on time to the hospital during June to November 2011, the increase in ethical and behavior violation and the increase of employee using non standard uniforms and attributes. This is quantitative research that supported by qualitative data using cross sectional research design to see the relationship between the independent variables (goals, capabilities, exemplary leadership, faimess, fringe benefits/compensation, inherent supervisory, penalties, assertiveness, and human relations) with dependent variable (work discipline). The results of statistical test using the chi square test showed that of the nine variables studied, only the fairness factors that have a significant relationship with the work discipline of non-medical employee at Karya Bhakti Hospital in year 2012. Therefore, it is recommended that Karya Bhakti Hospital need to increase the implementation of fairness principle in the work environment in order to improve employee?s discipline.
ABSTRAK Nama : Wirda Syari Program Studi : Magister Ilmu Kesehatan Masyarakat Judul : Evaluasi Ekonomi Parsial Antara Pemberian Terapi Rivaroxaban dan Terapi Kombinasi (UFH + Warfarin) untuk Pengobatan Trombosis Vena Dalam (Deep Vein Thrombosis) pada Pasien Kanker di Rumah Sakit Kanker Dharmais Tahun 2016 – 2018 Pembimbing : Dr. drg. Mardiati Nadjib, MS Berdasarkan penelitian-penelitian sebelumnya, diketahui bahwa terapi rivaroxaban memiliki beberapa kelebihan dibandingkan dengan terapi kombinasi (UFH + warfarin) untuk pengobatan trombosis vena dalam (deep vein thrombosis/DVT). Akan tetapi, masih sedikit dokter di RS Kanker Dharmais yang memberikan terapi rivaroxaban untuk pengobatan DVT. Penelitian evaluasi ekonomi parsial ini bertujuan untuk menganalisis efektivitas/outcome dan besarnya biaya yang dibutuhkan dari perspektif rumah sakit antara pemberian terapi rivaroxaban dan terapi kombinasi (UFH + warfarin) untuk pengobatan DVT pada pasien kanker di Rumah Sakit Kanker Dharmais tahun 2016 – 2018. Karena keterbatasan jumlah pasien yang mendapatkan terapi rivaroxaban selama 3 – 6 bulan, studi ini menganalisis biaya dan efektivitas/outcome dari pasien yang mendapatkan terapi selama 1 bulan. Efektivitas/outcome yang diukur adalah intermediate outcome, yang meliputi lama hari rawat, kesembuhan, dan kejadian perdarahan. Biaya dihitung berdasarkan biaya yang dibebankan kepada pasien (charge), yang meliputi biaya obat, pemeriksaan penunjang, tindakan, serta administrasi dan akomodasi. Hasil penelitian menunjukan bahwa untuk efektivitas/outcome terapi rivaroxaban, sebagian besar pasien tidak mendapatkan perawatan rawat inap, 40% pasien dinyatakan sembuh dari DVT, dan tidak ada pasien yang mengalami kejadian perdarahan. Rata-rata biaya terapi rivaroxaban hingga mencapai outcome yang diharapkan adalah Rp 8.824.791,00. Untuk efektivitas/outcome terapi kombinasi (UFH + warfarin), sebagian besar pasien memiliki lama hari rawat antara 8 – 14 hari, 46% pasien dinyatakan sembuh dari DVT, dan tidak ada pasien yang mengalami kejadian perdarahan. Rata-rata biaya terapi kombinasi (UFH + warfarin) hingga mencapai outcome yang diharapkan adalah Rp 13.201.698,00. Kata Kunci: Evaluasi ekonomi; kanker; rivaroxaban; trombosis vena dalam; warfarin
ABSTRACT Name : Wirda Syari Study Program : Magister of Public Health Title : Partial Economic Evaluation Between Rivaroxaban Therapy and Combination Therapy (UFH + Warfarin) for the Treatment of Deep Vein Thrombosis in Cancer Patients at Dharmais Cancer Hospital during 2016 - 2018 Counsellor : Dr. drg. Mardiati Nadjib, MS Based on previous studies, rivaroxaban therapy has several advantages compared to combination therapy (UFH + warfarin) for the treatment of deep vein thrombosis (DVT). However, the use of rivaroxaban in Dharmais Cancer Hospital is still low. This partial economic evaluation study aims to analyze cost and consequence of rivaroxaban therapy and combination therapy (UFH + warfarin) for DVT treatment in cancer patients at the Dharmais Cancer Hospital during 2016 – 2018. Data collection was done using cohort-retrospective and individual unit of analysis. Due to limited number of patient treated with rivaroxaban therapy within 3-6 months, we estimated the cost and consequence related to patients who were successfully treated in one month. The consequence was the intermediate outcome, i.e length of stay, recovery, and the occurrence of bleeding. The cost was calculated based on hospital perspective including drugs, laboratory tests, procedures, as well as the administrative and accommodation costs. The results showed that patients with rivaroxaban therapy were not admitted to inpatient care, 40% of patients were recovered from DVT, and none of the patients experienced bleeding. The average cost of rivaroxaban therapy to reach the expected outcome was Rp 8,824,791.00. The study also showed that the outcome of combination therapy (UFH + warfarin) were length of stay between 8 to 14 days, 46% of patients were recovered from DVT, and none of the patients experienced bleeding. The average cost of combination therapy (UFH + warfarin) to reach the expected outcome was Rp 13,201,698.00. Key words: Cancer; deep vein thrombosis; economic evaluation; rivaroxaban; warfarin