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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
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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
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Puspita Gaharu Nisaa; Pemimbing: Robiana Modjo; Penguji: L. Meily Kurniawidjaja, Stevan D. Anbiya, Achmad Muchlis, Corah Usman
Abstrak:
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Tenaga kesehatan senantiasa dihadapkan dengan tuntutan kerja dan bahaya risiko psikososial yang berpengaruh terhadap kesehatan mental seperti distress kerja, kondisi tersebut dapat bermanifestasi terhadap kesejahteraan tenaga kesehatan dan kualitas pelayanan pasien. Tahun 2024, diketahui terdapat tenaga kesehatan di RSUD Balaraja yang memiliki derajat distress sedang hingga berat terkait upaya kerja. Tesis ini bertujuan menganalisis hubungan faktor risiko psikososial serta faktor individu dan distress kerja pada tenaga kesehatan yang bekerja di RSUD Balaraja Kabupaten Tangerang Tahun 2025. Desain penelitian adalah cross-sectional dengan pendekatan kuantitatif pada total 140 tenaga kesehatan (dokter, perawat, farmasi, dan tenaga kesehatan lain seperti bidan, perekam medis, fisioterapis, analis kesehatan, radiografer, dsb.) Distress kerja diukur menggunakan instrumen distress dari DASS-21 yang dikategorikan menjadi “Normal-Ringan” dan “Sedang-Berat”. Faktor risiko psikososial (berdasarkan model Effort-Reward Imbalance, COPSOQH III dan NIOSH Generic Stress Scale) dan faktor individu diukur melalui kuesioner. Hasil penelitian ditemukan 14,3% responden dengan distress kerja sedang-berat. Analisis inferensial menunjukan hubungan signifikan antara faktor psikososial dengan distress kerja. Variabel yang berhubungan dengan distress kerja diantaranya ketidakseimbangan kerja-rumah (OR=17,34; 95% CI 3,84–78,41; p<0,001), komitmen kerja berlebihan (OR=14,48; 95% CI 3,21–65,31; p<0,001), upaya kerja yang tinggi (OR=6,44; 95% CI 2,03–20,44; p=0,001) dan penghargaan kerja yang tidak baik (OR=4,14; 95% CI 1,31–13,10; p=0,02). Tidak ditemukan hubungan statistik yang signifikan antara faktor individu dan distress kerja (p >0,05). Faktor individu yang perlu diberi perhatian yakni pada variable status single dan perilaku tidak sehat (kurang aktifitas fisik, merokok, minum kopi, dan minum alkohol.) Kesimpulan adalah distress kerja pada tenaga kesehatan di RSUD Balaraja secara dominan berasosiasi dengan faktor psikososial yang bersifat organisasional dan dapat dimodifikasi. Intervensi berbasis prioritas terutama untuk perbaikan area kritis diantaranya ketidakseimbangan antara kehidupan kerja-rumah serta komitmen berlebihan. Rekomendasi difokuskan pada kebijakan organisasional sehingga tercipta budaya kerja yang sehat, suportif dan positif, diantaranya adalah, pertama, pemberian pelatihan sesuai kompetensi, edukasi pengelolaan distress dan manajemen waktu serta fleksibilitas pemilihan waktu libur atau cuti; Kedua, evaluasi beban kerja agar tidak berlebihan dan lebih merata, fit to work bagi tenaga kesehatan pasca dengan keterbatasan fisik atau pemulihan dari sakit, komunikasi dan transparansi sistem penghargaan maupun kompensasi kepada seluruh tenaga kesehatan, termasuk dalam pemberian insentif dan kebijakan upah kerja lembur dalam rangka keseimbangan upaya kerja dan penghargaan kerja yang lebih baik; Ketiga, evaluasi tugas kerja dan beban kerja oleh manajemen secara periodik yang disertai adanya keterlibatan karyawan dalam pengambilan keputusan. Rekomendasi lain adalah kegiatan senam rutin 150 menit per minggu, kelompok konseling kesehatan mental dan perilaku tidak sehat, serta perbaikan sistem antrian pasien rawat jalan dengan pemberlakuan kode booking kunjungan ulang atau fast track untuk pasien kontrol merupakan strategi yang dapat diambil untuk peningkatan kesehatan kerja dan upaya penurunan distress kerja bagi tenaga kesehatan di RSUD Balaraja.
Healthcare workers are constantly faced with work demands and psychosocial hazards that affect their mental health, such as work related distress. This condition can manifest in the well-being of healthcare workers and the quality of patient care. In 2024, it was found that a number of healthcare workers at Balaraja Regional General Hospital (RSUD) experienced moderate to severe distress related to their work effort. This thesis aims to analyze of risk factors associated with work-related distress to healthcare workers of RSUD Balaraja, Tangerang Regency In 2025. This study used cross-sectional design with a quantitative approach, involved total 140 healthcare workers as respondens (doctors, nurses, pharmacists, and other health care workers such as midwife, medical recorders, physichal therapist, health analysts, radiographer, etc.) Work related distress was measured using a standardized instrument based on distress scale from DASS 21 and categorized as "Normal-Mild" and "Moderate-Severe". Psychosocial risk factors (based on the Effort-Reward Imbalance model, COPSOQ III, and the NIOSH Generic Job Stress Questionnaire) and individual factors were measured through a questionnaire. The results showed that 14.3% of respondents experienced moderate-to-severe work related distress. Inferential analysis indicated an association between psychosocial factors and work related distress, included work-life imbalance (OR=17.34; 95% CI 3.84–78.41; p<0.001), overcommitment (OR=14.48; 95% CI 3.21–65.31; p<0.001), high effort (OR=6.44; 95% CI 2.03–20.44; p=0.001), and low reward (OR=4.14; 95% CI 1.31–13.10; p=0.02). No statistical significant association was found between individual factors and work related distress (p > 0.05). Individual factors that may warrant attention include single marital status and unhealthy bahaviors (lack of physical activity, smoking, and consumption of coffee or alcohol.) The conclusion is that work related distress among healthcare workers at RSUD Balaraja is predominantly associated with modifiable, organizational psychosocial factors. Priority-based interventions are needed, especially to improve critical areas such as work-life imbalance and overcommitment. Recommendations focus on organizational policies to create a healthy, supportive, and positive work culture. These include provide competency-based training, education on distress and time management, and offer flexibility in scheduling holiday or day off; Second, conduct workload evaluations to prevent overload and ensure equitable distribution. Implement "fit-to-work" assessments for healthcare workers with physical limitations or recovering from illness. Ensure transparent communication regarding reward and compensation systems for all staff, including incentives and overtime pay policies, to achieve a better effort-reward balance. Third, reviewing workload policies for better distribution and prevention of excessive demands, providing competency-based training, and offering distress management, priority management, and coping mechanisms to restore work-life balance. Other recommendations include group exercise sessions, aiming for 150 minutes per week, Establish counseling groups for mental health support and to address unhealthy behaviors, improve the outpatient queuing system by implementing “a booking code system” for return visits or “a fast-track pathway." Furthermore, promoting a healthy work culture and controlling overcommitment through periodic evaluation of job tasks and workload by management, with input from employees, is advised. These strategies can be adopted to enhance occupational health and reduce work-related distress among healthcare workers at RSUD Balaraja.
Healthcare workers are constantly faced with work demands and psychosocial hazards that affect their mental health, such as work related distress. This condition can manifest in the well-being of healthcare workers and the quality of patient care. In 2024, it was found that a number of healthcare workers at Balaraja Regional General Hospital (RSUD) experienced moderate to severe distress related to their work effort. This thesis aims to analyze of risk factors associated with work-related distress to healthcare workers of RSUD Balaraja, Tangerang Regency In 2025. This study used cross-sectional design with a quantitative approach, involved total 140 healthcare workers as respondens (doctors, nurses, pharmacists, and other health care workers such as midwife, medical recorders, physichal therapist, health analysts, radiographer, etc.) Work related distress was measured using a standardized instrument based on distress scale from DASS 21 and categorized as "Normal-Mild" and "Moderate-Severe". Psychosocial risk factors (based on the Effort-Reward Imbalance model, COPSOQ III, and the NIOSH Generic Job Stress Questionnaire) and individual factors were measured through a questionnaire. The results showed that 14.3% of respondents experienced moderate-to-severe work related distress. Inferential analysis indicated an association between psychosocial factors and work related distress, included work-life imbalance (OR=17.34; 95% CI 3.84–78.41; p<0.001), overcommitment (OR=14.48; 95% CI 3.21–65.31; p<0.001), high effort (OR=6.44; 95% CI 2.03–20.44; p=0.001), and low reward (OR=4.14; 95% CI 1.31–13.10; p=0.02). No statistical significant association was found between individual factors and work related distress (p > 0.05). Individual factors that may warrant attention include single marital status and unhealthy bahaviors (lack of physical activity, smoking, and consumption of coffee or alcohol.) The conclusion is that work related distress among healthcare workers at RSUD Balaraja is predominantly associated with modifiable, organizational psychosocial factors. Priority-based interventions are needed, especially to improve critical areas such as work-life imbalance and overcommitment. Recommendations focus on organizational policies to create a healthy, supportive, and positive work culture. These include provide competency-based training, education on distress and time management, and offer flexibility in scheduling holiday or day off; Second, conduct workload evaluations to prevent overload and ensure equitable distribution. Implement "fit-to-work" assessments for healthcare workers with physical limitations or recovering from illness. Ensure transparent communication regarding reward and compensation systems for all staff, including incentives and overtime pay policies, to achieve a better effort-reward balance. Third, reviewing workload policies for better distribution and prevention of excessive demands, providing competency-based training, and offering distress management, priority management, and coping mechanisms to restore work-life balance. Other recommendations include group exercise sessions, aiming for 150 minutes per week, Establish counseling groups for mental health support and to address unhealthy behaviors, improve the outpatient queuing system by implementing “a booking code system” for return visits or “a fast-track pathway." Furthermore, promoting a healthy work culture and controlling overcommitment through periodic evaluation of job tasks and workload by management, with input from employees, is advised. These strategies can be adopted to enhance occupational health and reduce work-related distress among healthcare workers at RSUD Balaraja.
T-7373
Depok : FKM UI, 2025
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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