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ABSTRACT Name Study Program Title Counsellor : : : : Rusmiati Dwi Rohanawati Magister of Public Health Analysis of White Spot Lesions and its Relationship with Nutrition Status In Primary Health Care Purwadadi of Ciamis Regency 2019 dr. Adang Bachtiar, MPH., DSc Health development in Indonesia is currently focused on the life cycle starting from pregnancy to the elderly, known as Continuum of Care. At the implementation of the National Health Work Meeting in 2018 it was agreed that three health efforts included tuberculosis treatment, stunting prevention, and immunization. There are several factors that are interrelated with the incidence of stunting, one of which is dental and oral health factors in infants. The purpose of this study was to determine the analysis of the incidence of white spot caries and their relationship with nutritional status in Purwad Puskesmas in Ciamis District 2019. The study used mixed methods with cross-sectional and explanatory designs which were preceded by quantitative data analysis in 36 infants and continued with in-depth interviews with informants . The independent variables of the research are toddler age, sex, exclusive breastfeeding, formula milk, mother's age, mother's education, mother's occupation, family income, maintenance of dental and oral health, and facility facilities. The covariate variable is white spot caries and the dependent variable is the toddler's nutritional status. The results of this study stated that the factors that influence the incidence of white spot caries in infants are age and consumption of formula milk. There is no relationship between white spot caries and nutritional status in infants. However, risk factors for infants with white spot caries have a 1.12 times chance of experiencing abnormal nutritional status. The results of the interviews stated that each case that occurred in the field was required to report and coordinate between officers for further action. The provision of counseling education is carried out on an ongoing basis. Key words: Dental Caries, White Spot Lesion, Nutrition Status
Dental radiology cannot be separated from the effects of radiation exposure. Radiology policies are needed to regulate the use of radiation equipment in health services. The government regulates radiology services in Indonesia through Regulation of Minister of Health Number 24 of 2020 to improve the quality of health services by paying attention to safety and security aspects which are organized based on the capabilities of health facilities including human resources and equipment. This study aims to analyze the implementation of Regulation of Minister of Health Number 24 of 2020 in dental care services, and to find out whether the policy can be implemented in General and Dental Hospitals. This research is a policy analysis with a qualitative approach through in-depth interviews and document review. The conceptual framework is based on various top down theories with the variables studied in the form of output, human resources, infrastructure, funding, organizational support, press attention, work culture, communication and bureaucratic structure. The results show that Regulation of Minister of Health Number 24 of 2020 cannot be implemented in Dental Hospitals because there are differences in needs with General Hospitals so that they are out of sync with the terminology and requirements stated in Regulation of Minister of Health Number 24 of 2020. Regulation of Minister of Health Number 24 of 2020 does not facilitate dental radiology specialists and equipment such as CBCT thus creating legal uncertainty. Work culture, communication and bureaucratic structure are not functioning as they should because the contents of the regulations are not conveyed to service providers. Support from organizations and press attention do not directly affect service delivery but are important in policy process. Review of the contents of Regulation of Minister of Health Number 24 of 2020 is needed, especially related to the aspects of policy effectiveness, clarity of policy formulation, and transparency.
Salah satu kelornpok yang rentan terhadap masalah kesehatan adalah tenaga kerja. Biaya kesehatan pegawai/tenaga kerja untuk pelayanan kesehatan sebesar 19,94% pada tahun 2001 dan 18,72% pada tahun 2002. Komponen obat dalam pelayanan kesehatan mencapai sekitar 35% dari total biaya pelayanan kesehatan. Dari hasil survei pendahuluan yang dilakukan di PT. Jamsostek Karawang diketahui hingga saat ini masih ada beberapa dokter yang tidak menuliskan resep sesuai dengan standar JPK Jamsostek dalam mengohati pasien. Penelitian ini bertujuan untuk meneliti beban biaya yang ditanggung peserta JPK Jamsostek di RSUD Karawang akibat jenis peresepan obat rawat jalan yang non standar. Jenis penelitian yang digunakan adalah survei untuk mengetahui total biaya yang timbul akibat jenis peresepan obat non standar pada peserta JPK Jamsostek di RSUD Karawang. Data yang digunakan adalah data yang berasal dari resep obat yang ditagihkan apotek kepada PT. Jamsostek cabang Karawang pada bulan Januari sampai dengan Febuari tahun 2007. Jumlah sampel yang diteliti sebanyak 412 lembar resep dengan jumlah items obat sebanyak 1360. Dari hasil penelitian diketahui bahwa rata-rata beban biaya yang ditanggwag pasien adalah sebesar Rp 25.886,425%) dengan rentang Rp 360,- sampai dengan Rp 337.560,- sedangkan rata-rata yang ditanggung Jamsostek adalah sebesar Rp 76.194,475%) dengan kisaran Rp 500,- sampai dengan Rp 816.030,-. Rata-rata beban biaya yang ditanggung JPK Jamsostek clan peserta di bagian poliklinik paru paling besar dibandingkan dengan poliklinik yang lain. Prosentase peresepan obat generik berlogo pada. JPK Jamsostek lebih kecil dibandingkan dengan penulisan obat bermerek dari total resep obat yang ada. Masih ada poliklinik yang peresepan obatnya polifarmasi untuk itu perlu dibuat pedoman pengobatan yang rasional di rumah sakit agar tidak terjadi polifannasi. Selain Ikatan Kerja Sama juga dibutuhkan komitmen dan sanksi yang kuat antara badan penyelenggara clan provider. Masih dibutuhkan penelitian farmakoekonorai lebih lanjut mengenai beban biaya yang ditanggung balk badan penyelenggara JPK Jamsostek maupun peserta path provider yang lain.
One of the groups which were sensitive to health problem is worker. Health expenses of workers for health services equal to 19,94 % in the year 2001 and 18,72 % in the year 2002. Drugs component in health services around 35% from total cost service of health. From pre survey which done in PT. Jamsostek Karawang known until now there are some doctors which do not write down recipe as according to standard of JPK Jamsostek in curing patient. The objective of this research to account the burden of cost beneficiaries Jr% Jamsostek in RSUD Karawang as a consequence of type Prescription of drug which non standard. Type of this research is survey to know arising out total cost effect of type prescription of drug non standard at beneficiaries of JPK Jamsostek in RSUD Karawang. Data was used from drug recipes beneficiaries PT. Jarnsostek branch Karawang in January Until Febuari year 2007. From the result known that the average of burden cost beneficiaries is Rp 25.886,- (25%) with coverage between Rp 360,- to Rp 337.560 and the average of burden cost of Jamsostek is Rp 76.194,475%) with coverage between Rp 500,- to Rp 816.030,- Percentage prescription of generic drugs in JPK Jamsostek still small compared to with writing of drug have brand from totalizing existing drug recipe. Polyclinic has prescription that indicated of polyphannacy. Existence of guidance of rational medication in hospital in order not to happened polypharmacy. It was required strong sanction and commitment between insurer and provider. Still required another pharmacoeconomy research regarding good accounted on charges of JPK Jarnsostek and beneficiaries for other provider to equip result of this research.
ABSTRAK
Nama : Karmellia Nikke Darnesti
Program Studi : Ilmu Kesehatan Masyarakat
Judul : Analisis Kinerja Unit Pelayanan Gigi Puskesmas Kelurahan di
Wilayah Kecamatan Koja Jakarta Utara Tahun 2018
Pembimbing : Prastuti Soewondo, S.E., MPH., Ph.D
Lebih dari 50% penduduk di Indonesia memiliki permasalahan gigi dan mulut, ironisnya
berdasarkan Riskesdas 2018, hanya sekitar 10% yang mampu mendapat akses ke layanan
kesehatan gigi. Rifaskes 2011 mengindikasikan cakupan program usaha kesehatan gigi
berbasis masyarakat di puskesmas masih sangat rendah, termasuk di wilayah DKI Jakarta.
Penelitian ini bertujuan untuk melakukan kajian atas kinerja unit pelayanan gigi
puskesmas kelurahan di wilayah Kecamatan Koja. Pendekatan wawancara mendalam,
observasi, dan telaah dokumen dilakukan pada dua jenis unit pelayanan gigi yang ada di
puskesmas kelurahan wilayah Kecamatan Koja. Terdapat dua skema, yaitu Pola I yang
memiliki dokter gigi saja dan Pola III memiliki dokter gigi dan terapis gigi. Hasil
penelitian menyatakan bahwa unit pelayanan gigi pola III memiliki kinerja pelayanan gigi
yang lebih baik karena dapat menangani lebih banyak pasien dan tindakan, serta dapat
memenuhi program Usaha Kesehatan Gigi Sekolah (UKGS) dan Upaya Kesehatan Gigi
Masyarakat (UKGM). Sebaliknya, unit pelayanan gigi pola I hanya dapat memenuhi
program UKGS dan menangani jumlah pasien yang lebih sedikit. Adanya kompetisi
waktu antara program kesehatan gigi masyarakat dan poli gigi membuat dokter gigi
kesulitan memenuhi semua pelayanan gigi. Pelaksanaan program UKGS maupun UKGM
yang dipenuhi hanya terbatas pada penyuluhan singkat dan pemeriksaan sederhana yang
dilaksanakan sekedar memenuhi target. Akibatnya, permasalahan gigi dapat terus
berkembang menjadi penyakit yang semakin parah dan membutuhkan perawatan lebih
kompleks. Hasil kajian juga menguak bahwa tindakan mayoritas, yaitu mumifikasi,
kurang sesuai dengan standar perawatan yang dibutuhkan karena keterbatasan sumber
daya. Disamping itu, tugas manajemen puskesmas ternyata menambah beban kerja dokter
gigi dan mempengaruhi kinerja unit pelayanan gigi. Kolaborasi dokter gigi dengan terapis
gigi akan meningkatkan kinerja unit pelayanan gigi karena dapat mengakomodasi
kenaikan permintaan pelayanan, membantu melaksanakan semua upaya kesehatan gigi,
dan meningkatkan kualitas pelayanan dalam era Jaminan Kesehatan Nasional (JKN).
Kata kunci: kinerja, pelayanan gigi, puskesmas, dokter gigi, terapis gigi
ABSTRACT
Name : Karmellia Nikke Darnesti
Study Program : Public Health Science
Title : Analysis of Dental Medical Unit Performance in Puskesmas
Kelurahan at Koja District North Jakarta 2018
Counsellor : Prastuti Soewondo, S.E., MPH., Ph.D
More than 50% of the population in Indonesia were reported to have dental problems,
ironically based on Riskesdas 2018, only around 10% are able to get access to dental
services. Rifaskes 2011 has indicated the coverage of the community-based oral health
program at the Puskesmas is quietly low, even in the DKI Jakarta. This study aims to
analyze the performance of the dental medical unit at the puskesmas kelurahan in Koja
District area. The approach is through in-depth interviews, observations, and document
studies were carried out on two types of dental medical units that mostly be divided into
Pattern I with only dentist and Pattern III which have dentist and dental therapist. The
results of the study indicated that Pattern III had higher dental service performance
primarily because it could handle more patients and type of treatments also could carry
out School-based Oral Health (UKGS) and Community-based Oral Health (UKGM)
programs. In contrast, Pattern I only fulfill the UKGS program and handle fewer patients.
Clash of time between community-based program and dental poly makes it difficult for
dentists to fulfill all dental services. The implementation of the UKGS and UKGM
programs which only brief counseling and screening tended merely meet the targets so
that dental problems become more severe then require more complex treatments. The
study also revealed that the mummification, which were among the most frequent
treatment, were not in accordance with the standard of care due to limited resources. In
addition, management duties within puskesmas adds further workload of dentists and
influenced the performance of dental service. Dentist collaboration with dental therapist
will improve the performance of the dental service, allowing them to accommodate the
increase in demand, support implementation of all dental health efforts, and improve
dental service quality in the era of National Health Insurance (JKN).
Keywords : dental services; performance; puskesmas; dentist; dental therapist
