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Artha Prabawa; Promotor: Sudijanto Kamso; Kopromotor: Purwantyatuti; Soewarta Kosen; Penguji: Purnawan Junadi, Ratna Djuwita, Besral, Artha Budi Susila Duarsa, Bachti Alisjahbana
D-372
Depok : FKM-UI, 2017
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Vicky Danis Ilmansyah; Pembimbing: Masyitoh; Penguji: Popy Yuniar, Savitri Handayana, Verry Adrian
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Sejak diberlakukannya sistem Jaminan Kesehatan Nasional (JKN) pada tahun 2014, pasien peserta JKN yang mencari layanan kesehatan harus mengikuti sistem rujukan berjenjang. Untuk mengakomodir rujukan pasien gawat darurat, Kementerian Kesehatan RI menerapkan Sistem Penanggulangan Gawat Darurat Terpadu (SPGDT) dan mengembangkan Sistem Rujukan Terintegrasi (SISRUTE). Undang-Undang Nomor 17 Tahun 2023 mengamanahkan layanan kesehatan rujukan berbasis kompetensi sehingga Dinas Kesehatan Provinsi DKI Jakarta mengembangkan sistem informasi rujukan berbasis kompetensi JakConnected. Penelitian ini bertujuan untuk mengetahui penerimaan penggunaan sistem informasi rujukan berbasis kompetensi JakConnected di RS Daerah Provinsi DKI Jakarta. Desain penelitian menggunakan studi kualitatif dengan analisis deskriptif. Metode pengumpulan data dengan observasi, wawancara mendalam kepada dua puluh enam narasumber, dan telaah dokumen. Hasil Penelitian menunjukkan penerimaan penggunaan sistem informasi JakConnected lebih baik dibandingkan SISRUTE namun tren penggunaanya semakin menurun. Tidak ada kendala pendanaan, tata kelola, kelengkapan sarana dan prasarana pendukung, maupun dukungan manajemen. Persepsi kebermanfaatan dan kemudahan sistem baik namun niat perilaku pengguna perlu ditingkatkan. Perlu perbaikan manajemen SDM dan penguatan regulasi untuk meningkatkan penggunaan sehingga dapat memberikan user experience terhadap sistem yang lebih baik.
Since the implementation of the National Health Insurance (JKN) system in 2014, JKN participants seeking health services must follow a tiered referral system. To accommodate emergency referrals, the Indonesian Ministry of Health has implemented the Integrated Emergency Response System (SPGDT) and developed the Integrated Referral System (SISRUTE). Law No. 17 of 2023 mandates competency-based referral healthcare services, prompting the Jakarta Provincial Health Office to develop the competency-based referral information system JakConnected. This study aims to assess the acceptance of the JakConnected competency-based referral information system at regional hospitals in the Jakarta Provincial Government. The research design employs a qualitative study with descriptive analysis. Data collection methods included observation, in-depth interviews with twenty-six informants, and document review. The research findings indicate that the acceptance of the JakConnected system is better than SISRUTE, but its usage trend is declining. There are no funding, governance, infrastructure, or management support issues. Perceptions of the system's usefulness and ease of use are positive, but users' behavioural intentions need to be improved. Improvements in human resource management and strengthened regulations are needed to increase usage, thereby enhancing the user experience with the system.
Since the implementation of the National Health Insurance (JKN) system in 2014, JKN participants seeking health services must follow a tiered referral system. To accommodate emergency referrals, the Indonesian Ministry of Health has implemented the Integrated Emergency Response System (SPGDT) and developed the Integrated Referral System (SISRUTE). Law No. 17 of 2023 mandates competency-based referral healthcare services, prompting the Jakarta Provincial Health Office to develop the competency-based referral information system JakConnected. This study aims to assess the acceptance of the JakConnected competency-based referral information system at regional hospitals in the Jakarta Provincial Government. The research design employs a qualitative study with descriptive analysis. Data collection methods included observation, in-depth interviews with twenty-six informants, and document review. The research findings indicate that the acceptance of the JakConnected system is better than SISRUTE, but its usage trend is declining. There are no funding, governance, infrastructure, or management support issues. Perceptions of the system's usefulness and ease of use are positive, but users' behavioural intentions need to be improved. Improvements in human resource management and strengthened regulations are needed to increase usage, thereby enhancing the user experience with the system.
B-2554
Depok : FKM-UI, 2025
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Marisa Anggraini Indah Sari Br Haloho; Pembimbing: Masyitoh; Penguji: Jaslis Ilyas, Lies Nugrohowati, Agnes Vianti
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Latar belakang: Didasari oleh pentingnya patient experience sebagai salah satu faktor kunci dalam meningkatkan loyalitas pasien di rumah sakit. Loyalitas pasien sangat berpengaruh terhadap keberlangsungan dan reputasi rumah sakit, khususnya di tengah persaingan layanan kesehatan yang semakin ketat. Namun, masih terdapat keterbatasan penelitian terkait hubungan antara pengalaman pasien dengan loyalitas pasien di ruang rawat inap. Tujuan penelitian: Penelitian ini bertujuan untuk menganalisis hubungan antara patient experience dengan loyalitas pasien di ruang rawat inap Rumah Sakit Umum Hermina Depok. Metodologi penelitian: Penelitian ini menggunakan metode kuantitatif dengan desain cross-sectional. Data dikumpulkan melalui kuesioner yang dibagikan kepada pasien rawat inap, yang mencakup dimensi pengalaman pasien seperti komunikasi perawat/bidan, komunikasi dokter, respon staf, kenyamanan fasilitas fisik, manajemen nyeri, komunikasi tentang obat, dan discharge planning. Loyalitas pasien diukur melalui niat untuk kembali menggunakan layanan rumah sakit dan merekomendasikan rumah sakit kepada orang lain. Hasil penelitian: Hasil penelitian menunjukkan bahwa sebagian besar pasien memiliki pengalaman positif selama menjalani perawatan di RSU Hermina Depok. Analisis statistik bivariat dan multivariat menunjukkan adanya hubungan yang signifikan antara patient experience secara keseluruhan dengan loyalitas pasien. Dimensi komunikasi perawat/bidan, komunikasi dokter, kenyamanan fasilitas fisik, dan discharge planning merupakan faktor yang paling berpengaruh terhadap loyalitas pasien. Temuan ini menegaskan pentingnya peningkatan kualitas pelayanan berbasis pengalaman pasien untuk mempertahankan dan meningkatkan loyalitas pasien.
.Background:This study is based on the importance of patient experience as a key factor in enhancing patient loyalty in hospitals. Patient loyalty significantly influences the sustainability and reputation of hospitals, especially amid increasingly competitive healthcare services. However, there is still a lack of research on the relationship between patient experience and patient loyalty in inpatient care settings. Research Objective: This study aims to analyze the relationship between patient experience and patient loyalty in the inpatient ward of Hermina General Hospital Depok. Research Methodology: This research uses a quantitative method with a cross-sectional design. Data were collected through questionnaires distributed to inpatients, covering dimensions of patient experience such as nurse/midwife communication, doctor communication, staff responsiveness, physical facility comfort, pain management, medication communication, and discharge planning. Patient loyalty was measured by the intention to return to the hospital and to recommend the hospital to others. Research Results: The results show that the majority of patients had a positive experience during their stay at Hermina General Hospital Depok. Bivariate and multivariate statistical analyses revealed a significant relationship between overall patient experience and patient loyalty. The dimensions of nurse/midwife communication, doctor communication, physical facility comfort, and discharge planning were the most influential factors affecting patient loyalty. These findings emphasize the importance of improving service quality based on patient experience to maintain and increase patient loyalty.
T-7233
Depok : FKM-UI, 2025
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Annisa Putri S; Pembimbing: Agustin Kusumayati; Penguji: Adang Bachtiar, Sutopo
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Tesis ini membahas kepuasan pasien berdasarkan mutu pelayanan rawat inap di RSUD H. Abdul Manap Kota Jambi yang diukur melalui 5 dimensi mutu pelayanan kesehatan, terdiri dari tangibles, reliability, responsiveness, assurance, dan emphaty. Tujuan dari penelitian ini adalah untuk mengkaji dan menganalisis kepuasan pasien berdasarkan mutu pelayanan rawat inap di RSUD H. Abdul Manap Kota Jambi tahun 2023. Penelitian ini adalah penelitian dengan metode campuran (mix methode) dengan melakukan pengambilan data kuantitatif terlebih dahulu, kemudian dilanjutkan dengan data kualitatif kepada stakeholder melalui Focus Group Discussion (FGD). Berdasarkan analisis deskriptif statistik diketahui bahwa 36 item sudah mendapatkan nilai kesesuaian diatas 90%, artinya pasien sudah puas dengan dimensi mutu pelayanan rawat inap secara keseluruhan. Ada hubungan antara dimensi mutu pelayanan kesehatan tangibles (p-value 0.002), assurance (p-value 0.040) dan emphaty (p-value 0.014) dengan kepuasan pasien rawat inap di RSUD H. Abdul Manap Kota Jambi. Dari hasil analisis diagram kartesius didapatkan 5 item pada kuadran I yang menjadi prioritas untuk dilakukan perbaikan, 13 item pada kuadran II, 8 item pada Kuadran III dan 12 item pada kuadran IV. Hasil studi kualitatif menunjukkan bahwa manajemen rumah sakit juga telah melakukan inovasi dan improvement secara berkelanjutan dalam pemberian layanan kesehatan kepada pasien. Untuk meningkatkan kualitas layanan, rumah sakit dapat terus melakukan impelentasi manajemen mutu terpadu yang berfokus pada penjenjangan prioritas secara simultan sehingga dapat disusun upaya mempertahankan prestasi dimensi yang sudah baik dan meninjau efektivitas upaya-upaya perbaikan yang dilakukan dapat memenuhi harapan pasien.
This thesis explores patient satisfaction based on the quality of inpatient services at H. Abdul Manap General Hospital Jambi City. The study measures patient satisfaction using the five dimensions of healthcare service quality: tangibles, reliability, responsiveness, assurance, and emphaty. The research aims to assess and analyze patient satisfaction based on the quality of inpatient services at H. Abdul Manap General Hospital, Jambi City in 2023. The study employs a mixed-methods approach, collecting quantitative data followed by qualitative data through Focus Group Discussions (FGD). Descriptive statistical analysis reveals that 36 items have achieved a satisfaction score above 90%, indicating overall patient satisfaction with the dimensions of inpatient service quality. The study further establishes a significant relationship between the tangibles (p-value 0.002), assurance (p-value 0.040), and emphaty (p-value 0.014) dimensions of healthcare service quality and patient satisfaction with inpatient services at H. Abdul Manap General Hospital Jambi City. Cartesian diagram analysis identifies 5 items in quadrant I that require priority improvement, 13 items in quadrant II, 8 items in quadrant III, and 12 items in quadrant IV. The qualitative study findings indicate that the hospital management has implemented continuous innovation and improvement in providing healthcare services to patients. To enhance service quality, the hospital can continue implementing integrated quality management focusing on simultaneous prioritization. This approach will facilitate the development of strategies to maintain the performance of well-rated dimensions and review the effectiveness of improvement efforts to meet patient expectations.
T-7102
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Meita Nazla Adila; Pembimbing: Rita Damayanti; Penguji: Dian Ayubi, Sabarinah, Irwan Panca Wariaseno, Nurul Hikmah
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Latar Belakang: Kepuasan ibu hamil merupakan indikator penting dalam menilai mutu pelayanan antenatal care (ANC) di fasilitas kesehatan. Penelitian ini bertujuan untuk menganalisis determinan kepuasan ibu hamil terhadap kualitas pelayanan ANC di Kabupaten Tuban. Metode: Penelitian ini menggunakan desain kuantitatif dengan pendekatan cross sectional pada ibu hamil yang mendapatkan pelayanan ANC di puskesmas wilayah Kabupaten Tuban. Variabel yang dianalisis meliputi tingkat kepuasan ibu hamil, tingkat pendidikan, pemberian pelayanan ANC, pengalaman ibu, akses terhadap pelayanan ANC, serta manajemen dan organisasi. Data dianalisis menggunakan uji korelasi dan regresi linier berganda. Hasil: Tingkat kepuasan ibu hamil terhadap pelayanan ANC adalah 81,6%. Sementara itu, tingkat pelaksanaan untuk variabel pemberian pelayanan ANC sebesar 85,3%, pengalaman ibu sebesar 88,35%, akses terhadap pelayanan ANC sebesar 75%, serta manajemen dan organisasi sebesar 77,2%. Uji korelasi yang dilakukan menunjukkan adanya hubungan antara pemberian pelayanan ANC, pengalaman ibu, akses pelayanan, dan manajemen organisasi dengan tingkat kepuasan ibu hamil (p-value <0,001). Faktor manajemen dan organisasi merupakan determinan yang paling berpengaruh terhadap tingkat kepuasan ibu hamil (p < 0,001; B = 0,151; 95% CI = 0,085–0,217) setelah dikontrol dengan variabel tingkat pendidikan. Kesimpulan: Kepuasan ibu hamil terhadap pelayanan ANC di Kabupaten Tuban tergolong tinggi. Faktor manajemen dan organisasi pelayanan menjadi aspek yang paling berpengaruh. Hasil ini menekankan pentingnya tata kelola pelayanan yang baik untuk meningkatkan pengalaman positif ibu selama kehamilan.
Background: Maternal satisfaction is an important indicator for assessing the quality of antenatal care (ANC) services in healthcare facilities. This study aimed to analyze the determinants of maternal satisfaction with the quality of ANC services in Tuban Regency, Indonesia. Methods: A quantitative study with a cross-sectional design was conducted among pregnant women who received ANC services at community health centers (puskesmas) in Tuban Regency. The analyzed variables included maternal satisfaction level, education level, ANC service delivery, maternal experience, access to ANC services, and service management and organization. Data were analyzed using correlation and multiple linear regression tests. Results: The overall satisfaction level of pregnant women with ANC services was 81.6%. The implementation levels of ANC service delivery, maternal experience, access to ANC services, and management and organization were 85.3%, 88.35%, 75%, and 77.2%, respectively. Correlation analysis revealed significant relationships between ANC service delivery, maternal experience, service access, and management and organization with maternal satisfaction (p < 0.001). Among these factors, service management and organization showed the strongest influence on maternal satisfaction (p < 0.001; B = 0.151; 95% CI = 0.085–0.217) after it was controlled by education level. Conclusion: Maternal satisfaction with ANC services in Tuban Regency was relatively high. Service management and organizational factors were the most influential determinants, highlighting the importance of effective governance in improving positive maternal experiences during pregnancy
T-7447
Depok : FKM-UI, 2025
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Fajrin Birrulwalidain; Pembimbing: Atik Nurwahyuni; Penguji: Vetty Yulianty Permanasari, Erfan Chandra Nugraha
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Penelitian ini menganalisis utilisasi pelayanan kesehatan mental depresi di fasilitas kesehatan pada peserta JKN tahun 2023. Desain penelitian ini non-eksperimental dengan pendekatan cross sectional. Hasil penelitian menunjukkan bahwa mayoritas peserta memanfaatkan pelayanan kesehatan mental depresi dengan frekuensi kunjungan yang rendah atau 1-3 kali kunjungan dalam satu tahun, yaitu sebanyak 70.351 (88,3%) peserta. Faktor-faktor yang menunjukkan hubungan yang signifikan yaitu umur, jenis kelamin, status perkawinan, segmentasi peserta, jenis fasilitas kesehatan, kepemilikan fasilitas kesehatan, dan wilayah fasilitas kesehatan. Determinan utama adalah umur, dengan peserta yang berumur 45-54 tahun memiliki peluang tertinggi untuk berada pada kategori frekuensi kunjungan yang tinggi (OR: 2,583; 95% CI: 2,042-3,268). Temuan ini menunjukkan bahwa diperlukan edukasi, intervensi, peningkatan kualitas layanan dan tenaga kesehatan, serta pemerataan fasilitas dan tenaga kesehatan.
This study analyzes the utilization of mental health services for depression at healthcare facilities among JKN participants in 2023. The research design is non-experimental with a cross-sectional approach. The results show that the majority of participants utilized mental health services for depression with a low frequency of visits, ranging from 1 to 3 visits per year, totaling 70,351 (88.3%) participants. Factors that showed significant associations include age, gender, marital status, participant segmentation, type of healthcare facility, ownership of healthcare facility, and facility location. The main determinant is age, with participants aged 45-54 having the highest likelihood of being in the high-frequency visit category (OR: 2.583; 95% CI: 2.042-3.268). These findings indicate the need for education, interventions, improvement in service quality and healthcare providers, as well as the equitable distribution of healthcare facilities and workforce.
This study analyzes the utilization of mental health services for depression at healthcare facilities among JKN participants in 2023. The research design is non-experimental with a cross-sectional approach. The results show that the majority of participants utilized mental health services for depression with a low frequency of visits, ranging from 1 to 3 visits per year, totaling 70,351 (88.3%) participants. Factors that showed significant associations include age, gender, marital status, participant segmentation, type of healthcare facility, ownership of healthcare facility, and facility location. The main determinant is age, with participants aged 45-54 having the highest likelihood of being in the high-frequency visit category (OR: 2.583; 95% CI: 2.042-3.268). These findings indicate the need for education, interventions, improvement in service quality and healthcare providers, as well as the equitable distribution of healthcare facilities and workforce.
S-12077
Depok : FKM UI, 2025
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Salsabila Meirinsyah; Pembimbing: Atik Nurwahyuni; Penguji: Vetty Yulianty Permanasari, Amila Megraini
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Penyakit kardiovaskuler atau yang lebih dikenal dengan istilah Cardio Vascular Disease (CVD) merupakan kelompok penyakit yang berhubungan dengan jantung dan pembuluh darah. Kematian di Indonesia yang disebabkan oleh penyakit kardiovaskuler mencapai 651.481 penduduk per tahun. Prevalensi penyakit jantung di Indonesia berdasarkan diagnosis dokter adalah 0,85%, dengan Provinsi DI Yogyakarta memiliki angka tertinggi sebesar 1,67%. Dengan biaya untuk pelayanan kesehatan penyakit kardiovaskuler dan penyakit katastropik sangat besar. Penelitian ini bertujuan untuk Menganalisis dan mengetahui nilai besaran rata-rata Cost of Illness pada pasien kardiovaskular serta faktor-faktor yang mempengaruhi Cost of Illness peserta JKN khususnya di wilayah Provinsi DI Yogyakarta berdasarkan Data Sampel BPJS Kesehatan tahun 2022. Penelitian dilakukan dengan pendekatan Cross Sectional menggunakan data sampel BPJS Kesehatan tahun 2022 dengan pelayanan kardiovaskular sesuai inklusi dan eksklusi. Terdapat beberapa karakteristik peserta yang memiliki hubungan yang signifikan dengan Cost of Illness Peserta JKN dengan pelayanan kardiovaskular adalah variabel lama hari rawat, jenis kepemilikan FKTP dan jumlah kunjungan FKTP. Variabel yang paling dominan berhubungan dengan Cost of Illness pada pelayanan kardiovaskular adalah lama hari rawat . Berdasarkan hasil analisis pada Odds Ratio (OR), peserta yang dirawat lebih dari 3 hari memiliki kemungkinan 9.597 kali lebih besar dibandingkan peserta yang tidak dirawat (0 Hari). Penguatan program promotif dan preventif di FKTP bisa mengurangi total biaya per peserta yang tinggi. Langkah ini bertujuan untuk mendeteksi dan menangani lebih awal.
Cardiovascular disease (CVD) refers to a group of disorders affecting the heart and blood vessels. In Indonesia, cardiovascular diseases cause approximately 651,481 deaths annually. The prevalence of heart disease based on doctor diagnoses is 0.85%, with D.I. Yogyakarta Province recording the highest prevalence at 1.67%. The healthcare costs associated with cardiovascular and catastrophic diseases are notably high. This study aims to analyze and determine the average Cost of Illness (COI) for cardiovascular patients and identify the factors influencing COI among JKN participants in D.I. Yogyakarta Province, based on BPJS Kesehatan sample data from 2022. The research employed a cross-sectional approach using BPJS Kesehatan sample data from 2022, focusing on cardiovascular services that met inclusion and exclusion criteria. The findings revealed several participant characteristics significantly associated with COI, including the length of hospital stay, the type of FKTP ownership, and the number of FKTP visits. Among these factors, the length of hospital stay was the most dominant variable affecting COI for cardiovascular services. According to the Odds Ratio (OR) analysis, participants hospitalized for more than three days were 9.597 times more likely to incur high costs compared to those who were not hospitalized (0 days). Strengthening promotive and preventive programs at FKTP could help reduce the high per-participant costs by enabling early detection and intervention.
S-11846
Depok : FKM UI, 2025
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Vallery Violila; Pembimbing: Tris Eryando; Penguji: Kemal Nazaruddin Siregar, Lilik Aryani Falupi
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Indonesia menghadapi tantangan kependudukan yaitu bonus demografi dan total fertility rate (TFR) yang lebih tinggi dari target RPJMN. Program KB, khususnya penggunaan Metode Kontrasepsi Jangka Panjang (MKJP) kemudian menjadi upaya pemerintah dalam mengendalikan penduduk khususnya pada kelompok berisiko. Namun, penggunaan mix-method MKJP di Indonesia relatif masih rendah yaitu 24.6% dibandingkan negara ASEAN lainnya. Selain itu, WUS di Indonesia juga terkait dengan masalah akses kesehatan seperti masih tingginya unmet need dan belum semua wanita mendapat paparan informasi dari penyuluh lapangan KB, informed choice KB, ataupun memiliki jaminan kesehatan nasional (JKN). Oleh karena itu, penelitian ini bertujuan untuk mengidentifikasi indikator akses layanan kesehatan dan mengetahui hubungan akses layanan kesehatan dengan penggunaan MKJP. Penelitian ini menggunakan data SKAP KKBPK 2019 dengan desain penelitian cross-sectional. Analisis univariat dilakukan untuk mengidentifikasi indikator akses layanan kesehatan. Analisis bivariat dan multivariat digunakan untuk melihat hubungan akses layanan kesehatan dengan penggunaan MKJP. Ditemukan 75.3% (95% CI= 9.127-10.473) wanita masih mengalami minimal 1 masalah terkait akses layanan kesehatan. Proporsi penggunaan MKJP oleh Wanita yang Telah Menikah di Indonesia adalah 29.2% (95% CI=3.383-3.993). Ada hubungan yang signifikan antara akses layanan kesehatan dengan penggunaan MKJP (AOR=1,19; 95% CI=1,091-1,312). Dapat disimpulkan bahwa masih rendahnya penggunaan MKJP di Indonesia sehingga perlu upaya pemerintah untuk mengurangi masalah terkait akses layanan kesehatan.
Indonesia faces population challenges, namely the demographic dividend and the total fertility rate which higher than the national target. Family Planning Programme, especially the use of Long Acting and Permanent Contraceptive Method (LAPCM) is then become the government’s effort to control the population growth, especially for high-risk groups. However, the use of LAPCM in Indonesia is still relatively low, namely 24.6% compare to other ASEAN countries. In addition, married women in Indonesia is also related to health access problems such as high percentage of unmet need and not all women have received information from family planning field counselors, informed choice of family planning, or have national health insurance (JKN). Therefore, this study aims to identify indicators of access to health services and determine the relationship between access to health services and the use of LAPCM. This study uses data from the SKAP KKBPK 2019 with a cross-sectional research design. Univariate analysis uses to identify indicators of access to health services. Bivariate and multivariate analyzes were used to see the relationship between access to health services and the use of LAPCM. It was found that 75.3% of women still experienced at least 1 problem related to access to health services. The proportion of the LAPCM user among married women in reproductive age in Indonesia is 29.2%. There is a significant relationship between access to health services and the use of MKJP (AOR=1.19; 95% CI=1.091-1.312). It can be concluded that the use of MKJP in Indonesia is still low, so that government efforts are needed to reduce problems related to access to health services.
S-11303
Depok : FKM-UI, 2023
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Andi Afdal Abdullah; Promotor: Budi Hidayat; Kopromotor: Pujiyanto; Penguji: Atik Nurwahyuni, Mardiati Nadjib, Soewarta Kosen, Ali Ghufron Mukti; Mahlil Ruby; Teguh Dartanto
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Latar belakang: Kemudahan akses pelayanan kesehatan bagi peserta Jaminan Kesehatan Nasional (JKN) merupakan salah satu upaya untuk meningkatkan derajat kesehatan penduduk Indonesia. Kemudahan akses ini terwujud dengan bertambahnya fasilitas kesehatan yang melayani peserta JKN. Indikator kemudahan akses terlihat dari bertambahnya jumlah peserta yang berkunjung ke fasilitas kesehatan baik di tingkat pelayanan rawat jalan maupun rawat inap. Kunjungan peserta JKN per 1.000 penduduk dikenal dengan isitilah rate sebagai salah satu indikator utilisasi pelayanan kesehatan untuk menjaga kesinambungan program JKN. Tujuan: penelitian ini bertujuan menganalisis faktor yang mempengaruhi rate rawat jalan tingkat lanjutan (RJTL) maupun rawat inap inap tingkat lanjutan (RITL) dan pemodelan prediksi rate RJTL dan rate RITL. Data yang digunakan berasal dari database BPJS Kesehatan dan Survei Sosial Ekonomi Nasional (SUSENAS) tahun 2016 – 2019 yang diolah berdasarkan faktor predisposing, faktor enabling, dan faktor need dimana semua data digunakan dalam penelitian atau total sampling. Metode: analisis data panel dinamis yang ditujukan untuk membuat model prediksi rate RJTL dan rate RITL. Hasil: model prediksi yang digunakan pada rate RJTL dan rate RITL adalah estimator First Difference Generalized Method of Moment (FDGMM). Kesimpulan: rate RJTL dipengaruhi oleh variabel nilai tagihan klaim dibayar per kunjungan RJTL; jumlah rumah sakit kelas A, B, C, D; jumlah peserta pria; jumlah peserta berusia > 50 tahun; jumlah peserta dengan jumlah anggota keluarga > 3 orang; jumlah peserta berpengeluaran di bawah garis kemiskinan; jumlah peserta dengan penyakit tidak menular; rasio fragmentasi; rasio rujukan; dan jumlah peserta berpendidikan SMP. Sedangkan, rate RITL dipengaruhi oleh variabel nilai tagihan klaim dibayar per kunjungan RITL; jumlah rumah sakit kelas A, B, C, D; jumlah peserta pria; jumlah peserta berusia > 50 tahun; jumlah peserta dengan jumlah anggota keluarga > 3 orang; rate readmisi; jumlah peserta berpendidikan SMP; dan jumlah peserta berpendidikan Perguruan Tinggi. Saran: hasil penelitian menyarankan agar Pemerintah Daerah turut mendukung pemenuhan sarana prasarana pelayanan kesehatan agar masyarakat dapat menjangkau pelayanan kesehatan dengan mudah, mengelola perencanaan penambahan rumah sakit sesuai kebutuhan; Kementerian Kesehatan dapat memberikan regulasi terkait pemenuhan dan pemerataan fasilitas kesehatan maupun tenaga medis, terutama pada daerah dengan keadaan geografis yang sulit; BPJS Kesehatan dapat menggunakan model prediksi rate RJTL dan rate RITL sebagai alat bantu dalam menilai kebutuhan penambahan kerjasama dengan rumah sakit. Peneliti selanjutnya dapat melakukan penelitian dengan faktor utilisasi yang lebih luas dan lengkap serta melakukan kajian yang lebih mendalam pada satu wilayah tertentu dengan mempertimbangkan pengaruh aspek geografis, seperti jarak antar fasilitas kesehatan, luas wilayah dan kondisi akses ke fasilitas kesehatan.
Background: easy access to health services for participants of the National Health Insurance (JKN) is one of the efforts to improve the health status of the Indonesian population. This accessibility is achieved through an increase in health facilities serving JKN participants. The indicator of accessibility can be observed from the rising number of participants visiting health facilities, both at the outpatient and inpatient levels. The rate of visits by JKN participants per 1.000 population is considered an indicator of health service utilization, which contributes to the continuity of the JKN program. Objective: this study aims to analyze the factors that influence the advanced level of outpatient care (RJTL) and inpatient care (RITL) and to model the prediction of RJTL rates and RITL rates. The data used is derived from the BPJS Kesehatan database and the 2016-2019 National Socioeconomic Survey (SUSENAS), which are processed based on predisposing factors, enabling factors, and need factors. All data is utilized in the research, employing total sampling. Method: dynamic panel data analysis is employed to develop prediction models for RJTL rates and RITL rates. Results: the prediction model used for the RJTL rate and RITL rate is the First Difference Generalized Method of Moment (FDGMM) estimator. Conclusion: RJTL rate is influenced by several variables: value of claims bills paid per RJTL visit, number of class A, B, C, and D hospitals, number of male participants, number of participants aged over 50 years, number of participants with more than 3 family members, number of participants with expenditures below the poverty line, number of participants with non-communicable diseases, fragmentation ratio, referral ratio, and number of participants with junior high school education. On the other hand, the RITL rate is affected by value of claim bills paid per RITL visit, number of class A, B, C, and D hospitals, number of male participants, number of participants aged over 50 years, number of participants with more than 3 family members, readmission rate, number of participants with junior high school education, and number of participants with university education. Recommendations: the results of this study suggest that the Regional Government should also support the fulfillment of health service infrastructure so that partisipant can reach health services easily, manage plans for adding hospitals as needed; The Ministry of Health can provide regulations regarding the fulfillment and equity of health facilities and medical personnel, especially in areas with difficult geographical conditions; BPJS Kesehatan can use RJTL rate prediction model and RITL rate as a tool in assessing the need for additional collaboration with hospitals. Future researchers can conduct research with broader and more complete utilization factors and conduct more in-depth studies in a particular area by considering the influence of geographical aspects, such as the distance between health facilities, area size and conditions of access to health facilities.
D-483
Depok : FKM-UI, 2023
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Almira Fanny Rahmasari; Pembimbing: Adang Bachtiar; Penguji: Pujiyanto, Atmiroseva
Abstrak:
Latar Belakang: Kesehatan merupakan kebutuhan dasar manusia dan hak setiap warga negara yang dijamin oleh UUD 1945. Salah satu langkah strategis pemerintah dalam memastikan hak ini adalah melalui program Jaminan Kesehatan Nasional (JKN), yang dikelola oleh BPJS Kesehatan sejak 2014. Program ini bertujuan untuk mencapai cakupan kesehatan universal, meningkatkan akses, dan kesetaraan layanan kesehatan di Indonesia. Namun, pelaksanaan program ini menghadapi berbagai tantangan, seperti distribusi tenaga kesehatan yang tidak merata, keterbatasan infrastruktur, dan disparitas kualitas layanan. Data dari Profil Kesehatan Indonesia 2023 dan Survei Kesehatan Indonesia (SKI) 2023 menunjukkan bahwa fasilitas kesehatan tingkat pertama, seperti puskesmas, merupakan yang paling sering diakses masyarakat, meskipun aksesibilitas dan kualitas layanan masih menjadi isu utama. Berdasarkan Model Anderson, akses pelayanan kesehatan dipengaruhi oleh faktor predisposisi, pemungkin, dan kebutuhan. Penelitian ini menganalisis utilisasi fasilitas pelayanan kesehatan di Indonesia dengan menggunakan data SKI 2023, yang mencakup evaluasi tren akses dan pemanfaatan fasilitas kesehatan dalam lima tahun terakhir. Tujuan: Penelitian ini bertujuan Menganalisis utilisasi fasilitas kesehatan berdasarkan data SKI 2023. Metode: Penelitian ini menggunakan desain studi penampang dengan data sekunder dari SKI 2023. Populasi penelitian adalah peserta JKN yang tersebar di 38 provinsi. Analisis dilakukan melalui uji chi-square dan regresi logistic sederhana untuk mengidentifikasi hubungan antara variabel independen predisposisi (umur, jenis kelamin, tingkat pendidikan, dan status pekerjaan) dan enabling (kepemilikan jaminan kesehatan, waktu menuju fasilitas kesehatan dan biaya yang diperlukan menuju fasilitas kesehatan) dengan variabel dependen (pemanfaatan fasilitas kesehatan). Hasil: Hasil penelitian mengungkapkan terapat hubungan antara usia, jenis kelamin, pendidikan, kepemilikan jaminan kesehatan, waktu yang dibutuhkan untuk mencapai fasilitas kesehatan dan biaya yang dibutuhkan untuk mengunjungi fasilitas kesehatan dengan pemanfaatan fasilitas kesehatan dalam 1 tahun terakhir. Kesimpulan: Terdapat hubungan antara variable predisposisi dan enabling terhadap pemanfaatan fasilitas pelayanan kesehatan.
Background: Health is a basic human need and a fundamental right of every citizen, as guaranteed by the 1945 Constitution of Indonesia. One of the government's strategic efforts to ensure this right is through the National Health Insurance (JKN) program, managed by BPJS Kesehatan since 2014. This program aims to achieve universal health coverage, improve access, and ensure equity in healthcare services in Indonesia. However, the implementation of this program faces various challenges, such as unequal distribution of healthcare workers, limited infrastructure, and disparities in service quality. Data from the 2023 Indonesia Health Profile and the 2023 Indonesia Health Survey (SKI) show that primary healthcare facilities, such as puskesmas, are the most frequently accessed by the public, although accessibility and service quality remain key issues. According to Anderson's Model, access to healthcare services is influenced by predisposing, enabling, and need factors. This study analyzes the utilization of healthcare services in Indonesia using data from the 2023 SKI, which evaluates trends in access and utilization of healthcare facilities over the past five years. Objective: This study aims to analyze the utilization of healthcare services based on 2023 SKI data. Methods: This study employs a cross-sectional design using secondary data from the 2023 SKI. The study population consists of JKN participants spread across 38 provinces. Analysis was conducted using chi-square tests and simple logistic regression to identify the relationship between the independent variables (predisposing factors: age, gender, education level, and employment status; enabling factors: health insurance ownership, travel time to healthcare facilities, and costs required to access healthcare facilities) and the dependent variable (utilization of healthcare facilities). Results: The study revealed significant relationships between age, gender, education, health insurance ownership, travel time, and costs to access healthcare facilities and the utilization of healthcare services in the past year. Conclusion: There is a significant relationship between predisposing and enabling variables and the utilization of healthcare facilities.
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Background: Health is a basic human need and a fundamental right of every citizen, as guaranteed by the 1945 Constitution of Indonesia. One of the government's strategic efforts to ensure this right is through the National Health Insurance (JKN) program, managed by BPJS Kesehatan since 2014. This program aims to achieve universal health coverage, improve access, and ensure equity in healthcare services in Indonesia. However, the implementation of this program faces various challenges, such as unequal distribution of healthcare workers, limited infrastructure, and disparities in service quality. Data from the 2023 Indonesia Health Profile and the 2023 Indonesia Health Survey (SKI) show that primary healthcare facilities, such as puskesmas, are the most frequently accessed by the public, although accessibility and service quality remain key issues. According to Anderson's Model, access to healthcare services is influenced by predisposing, enabling, and need factors. This study analyzes the utilization of healthcare services in Indonesia using data from the 2023 SKI, which evaluates trends in access and utilization of healthcare facilities over the past five years. Objective: This study aims to analyze the utilization of healthcare services based on 2023 SKI data. Methods: This study employs a cross-sectional design using secondary data from the 2023 SKI. The study population consists of JKN participants spread across 38 provinces. Analysis was conducted using chi-square tests and simple logistic regression to identify the relationship between the independent variables (predisposing factors: age, gender, education level, and employment status; enabling factors: health insurance ownership, travel time to healthcare facilities, and costs required to access healthcare facilities) and the dependent variable (utilization of healthcare facilities). Results: The study revealed significant relationships between age, gender, education, health insurance ownership, travel time, and costs to access healthcare facilities and the utilization of healthcare services in the past year. Conclusion: There is a significant relationship between predisposing and enabling variables and the utilization of healthcare facilities.
S-11829
Depok : FKM UI, 2025
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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