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Penelitian ini bertujuan untuk melakukan analisis kebijakan rekrutmen Tim Kesehatan Haji Indonesia (TKHI). Kebijakan rekrutmen TKHI dapat dipandang sebagai suatu sistem, dengan input berupa permintaan, sumber daya dan dukungan, proses mencakup tiga dimensi kebijakan publik yang meliputi dimensi politik, dimensi hukum dan dimensi manajemen, untuk menghasilkan kebijakan rekrutmen TKHI sebagai output. Dari penelitian yang dilakukan, diketahui bahwa kebijakan yang ada sekarang cukup memadai untuk mencapai tujuannya, namun masih memerlukan perbaikan dalam aspek manajemen yang meliputi perencanaan, penilaian kinerja dan pemberian kompensasi serta diperlukan suatu prosedur operasional standar sebagai pedoman pelaksanaan kegiatan. Kata kunci : Analisis kebijakan, rekrutmen, TKHI, professional
This thesis is focused on the analysis of Indonesian Hajj Health Team (TKHI) Recruitment Policy. TKHI recruitment policy can be seen as a system consisting of demand, resources and support as the input, three dimensions of public policy as the process which aimed at the policy for recruiting TKHI itself as the output. In this research, the writer found that the policy is effective in gaining its objective. However, there are still several aspects needs to be strengthened i.e. planning, performance appraisal and compensation as part of management functions and the need for a standard operating procedure as guidelines for implementation to be fulfilled. Key words : Policy analysis, recruitment, TKHI, professional
Implementasi Program Jaminan Kesehatan Nasional mendapatkan berbagai tantangan salah satunya adalah peningkatan utilisasi pelayanan kesehatan yang berakibat tingginya beban biaya pelayanan kesehatan. Tren persalinan dengan metode bedah caesar mengalami peningkatan setiap tahunnya. Disertasi ini bertujuan untuk menganalisis kebijakan dan menyusun suatu usulan kebijakan untuk pengendalian utilisasi tindakan bedah caesar dalam penyelenggaraan program Jaminan Kesehatan Nasional. Jenis penelitian adalah analitik dengan mixed method melalui analisis data kuantitatif dan data kualitatif, analisis kebijakan menggunakan Eugene Bardach’s eightfold framework yang dimodifikasi oleh Collins. Penelitian kuantitif melalui analisis data rekam medis tahun 2019 pada pasien bedah caesar di tiga rumah sakit dengan aspek bisnis yang berbeda di Provinsi Jakarta. Penelitian kualitatif dilakukan dengan wawancara mendalam dengan para pemangku kepentingan. Hasil penelitian menunjukkan bahwa Proporsi persalinan caesar dibanding normal di RSSP Y 99,3% di RSSK Z 63,66%, dan di RSUD X 13,42%. Tidak terdapat perbedaan karakteristik sosial dan karakteristik medis pasien bedah caesar di ketiga rumah sakit. Tidak terdapat perbedaan upaya pengendalian utilisasi operasi bedah caesar di ketiga rumah sakit. Bekas SC 1x memiliki persentase tertinggi sebagai indikasi SC dengan persentase 41,67% di RSUD X, di RSSK Z 39,48% dan di RSSP Y 24,11%. Terdapat hubungan antara usia, adanya komplikasi dalam kehamilan, malposisi janin, hipertensi, diabetes mellitus, penyakit jantung, dengan metode persalinan ibu secara caesar. Hasil penelitian kualitatif menunjukkan belum terdapat metode/tools khusus untuk pengendalian utilisasi caesar. Berdasarkan analisis kebijakan menggunakan Bardach’s eightfold framework yang dimodifikasi oleh Collins terdapat skenario/alternatif kebijakan pengendalian utilisasi bedah caesar diantaranya penyusunan program promotive preventif yang melibatkan organisasi-organisasi profesi terkait (seperti: Kebidanan Kandungan, Penyakit Dalam, Gizi, Penyakit Jantung) dengan sasaran wanita usia subur yang merencanakan kehamilan dan ibu hamil, yang khususnya berfokus untuk meminimalisir adanya penyulit kehamilan seperti: Hipertensi, Diabetes mellitus, obesitas, penyakit jantung. Hal ini penting dalam upaya menekan penyulit kehamilan yang dapat berpotensi meningkatkan angka utiliasi bedah caesar.
The implementation of the National Health Insurance Program faces various challenges, one of which is the increase in the utilization of health services which results in high health service costs. The trend of childbirth by Caesarean section method has increased every year. This dissertation aims to analyze the policy and prepare a policy proposal for controlling the utilization of Caesarean section procedures in the implementation of the National Health Insurance program. The type of research is analytical with a mixed method through quantitative and qualitative data analysis, policy analysis using Eugene Bardach's eightfold framework modified by Collins. Quantitative research through analysis of medical record data in 2019 on caesarean section patients in three hospitals with different business aspects in Jakarta Province. Qualitative research was conducted through in-depth interviews with stakeholders. The results showed that the proportion of caesarean deliveries compared to normal in RSSP Y was 99.3% in RSSK Z 63.66%, and in RSUD X 13.42%. There were no differences in the social characteristics and medical characteristics of caesarean section patients in the three hospitals. There were no differences in efforts to control the utilization of caesarean section operations in the three hospitals. Former 1x CS has the highest percentage as an indication for CS with a percentage of 41.67% in RSUD X, in RSSK Z 39.48% and in RSSP Y 24.11%. There is a significant influence between age, complications in pregnancy, fetal malposition, hypertension, diabetes mellitus, heart disease, and the method of maternal delivery by caesarean section. The results of qualitative research indicate that there are no specific methods/tools for controlling caesarean section utilization. Based on policy analysis using Bardach's eightfold framework modified by Collins, there are scenarios/alternative policies for controlling caesarean section utilization including the preparation of promotive preventive programs involving related professional organizations (such as: Obstetrics and Gynecology, Internal Medicine, Nutrition, Heart Disease) targeting women of childbearing age who are planning pregnancy and pregnant women, which specifically focus on minimizing pregnancy complications such as: Hypertension, Diabetes mellitus, obesity, heart disease. This is important in an effort to reduce pregnancy complications that can potentially increase the rate of caesarean section utilization.
ABSTRAK
Tesis ini membahas tentang kebijakan layanan kesehatan umum di Rumah Sakit Jiwa dr. H. Marzoeki Mahdi Bogor. Penelitian ini adalah penelitian kualitatif dianalisis memakai analisis isi (content analysis). Hasil penelitian menyarankan agar dalam pelayanan rumah sakit jiwa dikembangkan layanan Consultation Liaison Psychiatry (CLP) sebagai center of excellent yang menunjukkan layanan kesehatan jiwa dan umum yang komprehensif dan terintegrasi.
ABSTRACT
This thesis discusses about general health care policy (non psychiatri) at dr. H. Marzoeki Mahdi Mental Hospital Bogor. This is a qualitative study were analyzed using content analysis (content analysis). The results of study suggest that develoving of psychiatri care in dr. H. Marzoeki Mahdi Mental Hospital should be focussed to developed Consultation Liaison Psychiatry (CLP) program as a centers of excellence. to realize a comprehensive and integrated service
Health Law Number 36 of 2009 states that every child deserved in basic immunizationaccording the provisions to prevent the occurrence of diseases that can be avoided throughimmunization. The government is also required to provide a complete basic immunizationto every baby and child. In 2017, Depok became outbreak with 12 cases suspectdiphtheria and 1 person died. The city of Depok is an area with high transmission potentialfor communicable diseases due to high population and high mobility. Complete BasicImmunization (IDL) is one of the old immunization policy implemented but has not metthe expected success. Complete Basic Immunization Program is one of the oldimmunization policy programs implemented but has not met the expected success. Theimplementation analysis is intended to see how the implementation of the complete basicimmunization program at the Puskesmas. This research is a qualitative research with in-depth interview technique and related document study which using the policyimplementation theory of Van Meter and Van Horn based on 6 (six) variables. The resultsobtained that the standard and objective have not been fully achieved. Resources areconstrained by incentive indicators that have not been felt optimally in supporting theoptimal implementation of complete basic immunization in Puskesmas. Inter-organizational communication is good. Characteristic of implementing agencies areconstrained by human resource constraints. Disposition of implementors supported, butstill found some implementers who are not orderly. Economic and political conditions aregood, but social condition are not yet supportive. Conclusion found that implementationof complete basic immunization in Depok still has constraints in each variable and needto be done process of fulfillment of less variable. The recommendation of this research isthe success of implementation will be achieved if the improvement of deficiency, bothfrom the side of standard and objective, policy resources, interorganizationalcommunication, characteristic of implementing agencies, disposition of implementors,and social, economy, political condition. Barriers to existing programs can be overcomeby optimizing the Puskesmas's authority as a regional coach.