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The Implementation of Credentialing for First-Level Health Facilities of Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan Denpasar Ulandari, Luh Putu Sinthya; Indrayathi, Putu Ayu
Jurnal Kesehatan Masyarakat Vol 12, No 1 (2016): JURNAL KESEHATAN MASYARAKAT (KEMAS) JULY 2016
Publisher : Jurusan Ilmu Kesehatan Masyarakat Fakultas Ilmu Keolahragaan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/kemas.v12i1.4944

Abstract

The implementation of credentialing program in JKN is different from the previous era, particularly for new medical facilities and medical provider of PT. Jamsostek and ASABRI. Therefore, this study aims at finding out the description associated with the process of credentialing implementation of the first-level health facilities from the perspective of PPK 1 and BPJS Kesehatan, Denpasar Branch. This research was conducted in January 2014 using qualitative approach. Data was collected through in-depth interviews to 11 medical facilities, as well as 2 executive credentialing teams from BPJS Kesehatan, Denpasar Branch. The subjects were selected purposively and the data was analyzed using thematic analysis. There are still some obstacles in the implementation of such credentialing program: there are still existing providers, especially TNI/Polri, which have the value below standard but are still contracted to serve JKN participants because the number is still relatively small. The new medical facilities have difficulty in self-assessment because there are many indicators that must be met, but the budget is limited. The study concludes that credentialing program has not yet fully applied the concept of managed care, thus regular monitoring to improve medical quality is needed.
Penilaian Kualitas Hidup Pasien Kanker Serviks dengan Kemoterapi Paklitaksel–Karboplatin di RSUP Sanglah Tunas, I Ketut; Yowani, Sagung C.; Indrayathi, Putu A.; Noviyani, Rini; Budiana, I Nyoman G.
Indonesian Journal of Clinical Pharmacy Vol 5, No 1 (2016)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (310.193 KB) | DOI: 10.15416/ijcp.2016.5.1.35

Abstract

Pemberian kemoterapi pada pasien kanker serviks stadium IIB-IIIB selain menimbulkan efek terapi juga menimbulkan efek samping berupa penurunan kualitas hidup. Penelitian ini dilakukan pada Februari–Juni 2014 di Bagian Obstetri dan Gineklogi RSUP Sanglah Denpasar secara observasional dengan metode case study prospective. Pengumpulan data dilakukan menggunakan kuesioner EORTC QLQ C30 yang dikombinasikan dengan wawancara sebelum dan setelah kemoterapi paklitaksel-karboplatin sebanyak 3 seri pada pasien kanker serviks sel skuamosa stadium IIB-IIIB. Penelitian kualitas hidup dilakukan secara umum dan pada 15 domain yang memengaruhi kualitas hidup. Terdapat 12 pasien yang memenuhi kriteria inklusi. Pemberian kemoterapi regimen paklitaksel-karboplatin dapat meningkatkan kualitas hidup dengan penurunan nilai mean dari 48,083±5,451 menjadi 44,083±3,872. Terdapat perbedaan bermakna pada nilai kualitas hidup pasien sebelum dan setelah kemoterapi paklitaksel-karboplatin (nilai p=0,038). Terdapat penurunan kualitas hidup pada domain mual muntah, penurunan nafsu makan, fatigue, dan fungsi sosial. Domain dengan peningkatan kualitas hidup yaitu nyeri, fungsi fisik, fungsi emosional, sulit tidur, dan kesulitan keuangan. Pemberian kemoterapi paklitaksel-karboplatin pada 12 pasien dapat meningkatkan kualitas hidup pasien kanker serviks.Kata kunci: Domain kualitas hidup, kanker serviks, kualitas hidup, paklitaksel-karboplatinThe Assessment Quality of Life For Patients with Cervical Cancer Using Chemotherapy Paclitaxel-Carboplatin in Sanglah Chemotherapy administration to patients with cervical cancer stage IIB-IIIB not only causing a therapeutic effect but also decrease in quality of life. This study was conducted in February–June 2014 in the Department of Obstetrics and Gynecology Sanglah Hospital with observational prospective case study method. Data were collected using the EORTC QLQ C30 questionnaire combined with interview before and after chemotherapy paclitaxel-carboplatin as much as 3 series in patients with squamous cell cervical cancer stage IIB-IIIB. Assesment was done in general quality of life and 15 domains that affect the quality of life. There were 12 patients who met the inclusion criteria. Administration chemotherapy with paclitaxel-carboplatin can improve the quality of life shown by decrease mean value from 48.083±5.451 to 44.083±3.872. There were significant differences in the value of the quality of life before and after being given chemotherapy paclitaxel-carboplatin (p-value 0.038). There were decrease in the quality of life of the domain nausea, vomiting, decreased appetite, fatigue, and social functions. Domains that have increased the quality of life is pain, physical functioning, emotional functioning, sleeplessness, and financial difficulties. Administration of chemotherapy paclitaxel-carboplatin can improve the quality of life of patients with cervical cancer.Key words: Domain quality of life, cervical cancer, paclitaxel-carboplatin, quality of life
Perbedaan Fungsi Ginjal, Hati dan Darah pada Pasien Kanker Serviks dengan Kemoterapi Bleomisin, Oncovin®, Mitomisin dan Karboplatin (Studi Kasus di RSUP Sanglah Denpasar Tahun 2015) Noviyani, Rini; Budiana, I Nyoman G.; Indrayathi, Putu A.; Niruri, Rasmaya; Tunas, I Ketut
Indonesian Journal of Clinical Pharmacy Vol 5, No 4 (2016)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (552.043 KB) | DOI: 10.15416/ijcp.2016.5.4.269

Abstract

  Regimen Bleomisin Oncovin® Mitomisin-Karboplatin (BOM-Karboplatin) sebagai kemoterapi tidak terlepas dari efek samping yang ditimbulkan yaitu toksisitas pada organ tubuh diantaranya adalah ginjal, hati, dan darah, dimana terjadinya toksikitas pada organ ginjal dapat diindikatorkan dengan parameter Serum Kreatinin dan Blood Urea Nitrogen (BUN). Terjadinya toksisitas pada organ hati dapat diukur dengan parameter SGOT dan SGPT serta toksisitas pada fungsi darah diindikatorkan dengan nilai hemoglobin, trombosit, leukosit. Belum terdapat data mengenai efek toksik dari kemoterapi BOM-Karboplatin pada pasien kanker serviks sel skuamosa stadium IIB–IIIB di RSUP Sanglah Denpasar, sehingga penelitian ini dilakukan melalui pemantauan terhadap fungsi ginjal, hati dan darah. Penelitian ini merupakan studi kasus observasional terhadap sembilan pasien yang diikuti selama tiga seri kemoterapi dari bulan Februari hingga Agustus 2015. Data serum kreatinin, BUN, SGOT, SGPT, hemoglobin, trombosit, dan leukosit yang diperoleh dianalisis menggunakan uji t berpasangan untuk data yang terdistribusi normal dan uji Wilcoxon untuk data yang tidak terdistribusi normal dengan tingkat kepercayaan 95% dan dikatakan berbeda bermakna bila p<0,05. Hasil studi kasus ini menunjukkan nilai serum kreatinin (p=0,530), BUN (p=0,553), SGOT (p=0,162), SGPT (p=0,054), Hemoglobin (p=0,034), Trombosit (p=0,028), dan Leukosit (p=0,011), sehingga dapat disimpulkan bahwa terdapat penurunan fungsi darah yang signifikan ditandai dengan adanya penurunan signifikan pada parameter hemoglobin, trombosit dan leukosit sebelum kemoterapi I dan sesudah kemoterapi III BOM-Karboplatin, sehingga diperlukan monitoring ketat terhadap fungsi darah pasien yang menerima kemoterapi BOM-Karboplatin di RSUP Sanglah Denpasar.Kata kunci: BOM-Karboplatin, fungsi darah, kanker serviks, kemoterapi, RSUP Sanglah, toksisitasThe Difference of Kidney, Heart and Blood Function on Cervical Cancer Patients with Chemotherapy, Bleomycin, Oncovin®, Mitomycin and Carboplatin (Case Study in Sanglah General Hospital, Denpasar in 2015) Oncovin® bleomycin mitomycin-carboplatin (BOM-carboplatin) regimen as chemotherapy is inseparable from the side effects it can caused which is toxicity to organs including the kidneys, liver, and blood where the toxicity in the kidneys can be indicated by the parameter of Serum Creatinine and Blood Urea Nitrogen (BUN), the occurrence of toxicity in the liver can be measured by the parameters of SGOT and SGPT, and toxicity to blood function can be indicated by the value of hemoglobin, platelets, leukocytes. The absence of data on the toxic effects of chemotherapy BOM-carboplatin in patients with squamous cell cervical cancer stage IIB–IIIB in Sanglah General Hospital in Denpasar, had made this research conducted through monitoring of kidney, liver and blood function. This study is an observational case study of nine patients who were followed for three rounds of chemotherapy from February to August 2015. Data of creatinine serum, BUN, SGOT, SGPT, hemoglobin, platelets, and leukocytes were analyzed using paired t-test for the data that were normally distributed and Wilcoxon test for the data that were not normally distributed with a confidence level of 95% and was said to be significantly different when p<0.05. The results of this case study demonstrated the value of serum creatinine (p=0.530), BUN (p=0.553), SGOT (p=0.162), SGPT (p=0.054), hemoglobin (p=0.034), platelets (p=0.028), and leukocytes (p=0.011) so it could be concluded that there was a significant decrease of blood function which could be characterized by a significant decrease in the parameters of hemoglobin, platelets and leucocytes before chemotherapy I and after chemotherapy III BOM-carboplatin, so it required strict monitoring of the blood function of the patients who received chemotherapy BOM-carboplatin in Sanglah General Hospital in Denpasar.Keywords: BOM-carboplatin, blood function, cervical cancer, chemotherapy, Sanglah General Hospital, toxicity
Uji Validitas dan Reliabilitas Kuesioner EORTC QLQ C-30 untuk Menilai Kualitas Hidup Pasien Kanker Ginekologi di RSUP Sanglah Denpasar Noviyani, Rini; Tunas, I Ketut; Indrayathi, Ayu; Budiana, Nyoman G.
Indonesian Journal of Clinical Pharmacy Vol 5, No 2 (2016)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (556.049 KB) | DOI: 10.15416/ijcp.2016.5.2.106

Abstract

Dampak dari penyakit dan pengobatan kanker dapat diukur dengan indikator kualitas hidup menggunakan kuesioner EORTC QLQ C-30. Penelitian cross-sectional dilakukan menggunakan 30 pasien. Data dikumpulkan melalui metode purposive sampling pada pasien yang memenuhi kriteria inklusi, yaitu wanita berusia 30–70 tahun yang didiagnosis kanker ginekologi, pernah menjalani kemoterapi di RSUP Sanglah Denpasar, dan bersedia menandatangani formulir persetujuan pasca penjelasan. Pasien yang tidak dapat berkomunikasi secara rasional menjadi bagian kelompok eksklusi. Validitas dan reliabilitas instrumen diuji menggunakan analisis faktor konfirmatori dengan program STATA® versi 12. Hasil analisis faktor konfirmatori menunjukkan seluruh item pertanyaan memiliki loading factor ( ) > 0,70 sehingga seluruh butir pertanyaan adalah valid. Uji reliabilitas item memberikan nilai >0,50 untuk seluruh item pertanyaan yang menunjukkan seluruh item pertanyaan adalah reliabel. Hasil perhitungan validitas konstrak menghasilkan nilai VE= 0,90 dan reliabilitas konstrak (RF) adalah 1 yang berarti kuesioner EORTC QLQ C-30 memenuhi validitas dan reliabilitas konstrak. Kuesioner EORTC QLQ C-30 sebagai alat ukur kualitas hidup pasien kanker ginekologi di RSUP Sanglah Denpasar adalah valid dan reliabel.Kata kunci: Analisis faktor konfirmatori, kanker ginekologi, kuesioner EORTC QLQ C-30, RSUP Sanglah Denpasar, uji validitas dan reliabilitas Validity and Reliability of EORTC QLQ C-30 Questionnaire in Assessing Quality of Life of Gynecological Cancer Patients in Sanglah Hospital Denpasar  The impacts of cancer and its treatment can be measured by indicators of quality of life using the EORTC QLQ C-30 questionnaire. A cross-sectional study was done on 30 patients in Sanglah Hospital Denpasar. Data were collected through purposive sampling of patients who fit the inclusion criteria: women who were 30–70 years old were diagnosed with gynecological cancer, had chemotherapy in Sanglah Hospital, and had agreed to be part of the research by signing the informed consent form. Patients who were unable to rationally communicate became part of the exclusion group in this research. Validity and reliability of the tools in this study were tested using confirmatory factor analysis with STATA ®version 12. Confirmatory factor analysis indicates that all items have a loading factor ( )> 0.70 so that it can be said that all the questions are valid. Reliability items have the value > 0.50 for all questions which shows all questions are reliable. Construct validity of the results of the calculation produce a value VE = 0.90 and the reliability construct (RF) of 1, which meet both validity and reliability constructs. Questionnaire EORTC QLQ C-30 as a measurement of the quality of life of gynecological cancer patients in Sanglah Hospital are valid and reliable.Key words: EORTC QLQ C-30 questionnaire, confirmatory factor analysis, gynecological cancer,Sanglah Hospital Denpasar, the validity and reliability 
Efek Kemoterapi Bleomisin, Vincristin, Mitomisin dan Karboplatin terhadap Massa Tumor dan Infiltrasi Parametrium pada Pasien Kanker Serviks: Studi Kasus di RSUP Sanglah Denpasar Suwiyoga, Ketut; Noviyani, Rini; Budiana, I Nyoman G.; Tunas, I Ketut; Indrayathi, Ayu; Niruri, Rasmaya
Indonesian Journal of Clinical Pharmacy Vol 6, No 3 (2017)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (394.506 KB) | DOI: 10.15416/ijcp.2017.6.3.164

Abstract

Penggunaan regimen BOM-cisplatin untuk kemoterapi pasien kanker serviks masih belum memberikan hasil efektivitas yang memuaskan, sehingga dilakukan penggantian agen cisplatin dengan karboplatin. Kemoterapi BOM-karboplatin merupakan salah satu regimen terapi kanker serviks di RSUP Sanglah Denpasar. Informasi tentang efektivitas penggunaan BOM-karboplatin untuk kemoterapi kanker serviks masih sangat minim, maka dari itu penelitian ini dilakukan dengan melihat massa tumor dan infiltrasi parametrium. Penelitian ini merupakan penelitian studi kasus terhadap 9 pasien kanker serviks sel skuamosa stadium IIB–IIIB sebelum dan sesudah kemoterapi BOM-karboplatin di RSUP Sanglah dari bulan Februari hingga Agustus 2015 yang memenuhi kriteria. Pemeriksaan Massa Tumor dan Infiltrasi Parametrium (%CFS) dilakukan sebelum kemoterapi seri I dan sesudah kemoterapi seri III. Pengambilan sampel menggunakan consecutive sampling. Data penelitian dianalisis menggunakan uji normalitas yaitu uji Shapiro-Wilk, selanjutnya dianalisis menggunakan uji t berpasangan dengan taraf kepercayaan 95%, sedangkan data berdistribusi tidak normal ditranformasi ke bentuk fungsi logaritma lalu dianalisis dengan uji Wilcoxon. Berdasarkan analisis statistik diketahui bahwa terdapat penurunan bermakna pada massa tumor dan infiltrasi parametrium kiri sesudah 3 seri kemoterapi dengan nilai p<0,05 yaitu masing-masing p=0,001 dan p=0,025, tetapi tidak terdapat penurunan bermakna pada infiltrasi parametrium kanan dengan nilai p>0.05 yaitu p>0,083.Kata kunci: BOM-cisplatin, cancer free space, kanker serviks, RSUP Sanglah Effect of Chemotherapy Bleomycin, Vincristin, Mitomycin and Carboplatin by Tumor Mass and Infiltration Parametrial for Cervical Cancer Patients: Case Study in Sanglah General Hospital, DenpasarBOM-cisplatin regimen for chemotherapy for cervical cancer patients has not resulted high efficacy, hence a replacement of cisplatin with carboplatin is proposed. BOM-carboplatin chemotherapy is at present a treatment for cervical cancer patients in Sanglah Hospital in Denpasar. Information about the efficacy of using the BOM-carboplatin for cervical cancer chemotherapy is not provided, therefore this research performed by observing tumor mass and parametrial infiltration. This research was carried out using case study method on 9 patients with squamous cell cervical cancer stage IIB–IIIB before and after BOM-carboplatin chemotherapy at Sanglah Hospital from February until August 2015. Examination of tumor mass and parametrial infiltration (%CFS) conducted prior to chemotherapy series I and after chemotherapy series III. Sampling was done consecutively. The research data were analyzed using the normal distribution Shapiro-Wilk test continued by paired t-test with 95% confidence level, while data that is classified otherwise is transformed to logarithmic function and were analyzed using the Wilcoxon test. Based on statistical analysis, there is significant reduction in tumor mass and left parametrial infiltration after the third chemotherapy with (p<0.05) which are p=0.001 and p=0.025, but there is no significant reduction of right parametrial infiltration with p>0.05 that is p>0,083.Keywords: BOM-cisplatin, cancer free space, cervix cancer, Sanglah hospital
The Implementation of Credentialing for First-Level Health Facilities of Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan Denpasar Ulandari, Luh Putu Sinthya; Indrayathi, Putu Ayu
KEMAS: Jurnal Kesehatan Masyarakat Vol 12, No 1 (2016)
Publisher : Department of Public Health, Faculty of Sport Science, Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/kemas.v12i1.4944

Abstract

The implementation of credentialing program in JKN is different from the previous era, particularly for new medical facilities and medical provider of PT. Jamsostek and ASABRI. Therefore, this study aims at finding out the description associated with the process of credentialing implementation of the first-level health facilities from the perspective of PPK 1 and BPJS Kesehatan, Denpasar Branch. This research was conducted in January 2014 using qualitative approach. Data was collected through in-depth interviews to 11 medical facilities, as well as 2 executive credentialing teams from BPJS Kesehatan, Denpasar Branch. The subjects were selected purposively and the data was analyzed using thematic analysis. There are still some obstacles in the implementation of such credentialing program: there are still existing providers, especially TNI/Polri, which have the value below standard but are still contracted to serve JKN participants because the number is still relatively small. The new medical facilities have difficulty in self-assessment because there are many indicators that must be met, but the budget is limited. The study concludes that credentialing program has not yet fully applied the concept of managed care, thus regular monitoring to improve medical quality is needed.
Mutu Pelayanan Puskesmas Perawatan yang Berstatus Badan Layanan Umum Daerah Putu Ayu Indrayathi; Rina Listyowati; Ni Made Sri Nopiyani; Luh Putu Sinthya Ulandari
Jurnal Kesehatan Masyarakat Nasional Vol 9 No. 2 November 2014
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (539.955 KB) | DOI: 10.21109/kesmas.v9i2.519

Abstract

Kebijakan pusat pelayanan kesehatan masyarakat (puskesmas) sebagai Badan Layanan Umum Daerah (BLUD) diimplentasikan untuk meningkatkan kualitas pelayanan kesehatan dasar. Kebijakan BLUD puskesmas telah diterapkan di Kabupaten Gianyar sejak tahun 2010 dan berlaku pada puskesmas perawatan maupun nonperawatan. Pelaksanaan BLUD puskesmas tidak selalu meningkatkan mutu layanan. Penelitian ini bertujuan mengetahui gambaran mutu pelayanan puskesmas perawatan yang berstatus BLUD di Kabupaten Gianyar. Penelitian ini merupakan penelitian potong lintang dengan pendekatan kuantitatif dan kualitatif. Tempat dan waktu penelitian ini dilakukan di Kabupaten Gianyar, Agustus hingga Desember 2013. Data kuantitatif dikumpulkan melalui penyebaran kuesioner kepada 105 pengguna layanan di empat puskesmas yang dipilih dengan cara multistage random sampling. Data kualitatif dikumpulkan melalui wawancara mendalam kepada 13 penyedia pelayanan kesehatan yang dipilih secara purposive sampling. Data kuantitatif dianalisis secara deskriptif dan data kualitatif dianalisis dengan analisis tematik. Dari hasil penelitian, pelayanan di puskesmas perawatan berstatus BLUD di Gianyar dinilai kurang memuaskan karena keterbatasan peralatan medis dan kurangnya tenaga yang kompeten dalam pengelolaan keuangan. Pelatihan pengelolaan keuangan pada staf puskesmas dan perekrutan tenaga berlatar belakang akuntansi penting untuk dilakukan. Quality of Services in Health Care Center with General Services Agency StatusThe policy of primary health care as local public service agencies (BLUD) was established to improve the quality of basic health care services. The public service agencies primary health care policy has been implemented to all primary health care in Gianyar district since 2010. The implementation does not always improving health service quality. This research was aimed to overview the quality of services in primary health care with general services agency status in Gianyar district. This research was a crosssectional study with mixed of quantitative and qualitative approaches.This research was conducted in Gianyar between August and December 2013. The quantitative data was collected through questionaire survey to 105 patients in four primary health care who were chosen with multistage random sampling technique. The qualitative data was collected through in-depth interviews to 13 health care providers in primary health care who were chosen with pusposive sampling. The quantitative data was analysed descriptively and the qualitative data was analysed using thematic analysis. The result of the study was primary health care quality in BLUD puskesmas with inpatient services was perceived as poor due to the limited availability of medical equipment and lack of staff who major in financial management. Training on financial management and recruitment of staff with accounting background should be conducted.
Akses Jaminan Kesehatan Nasional pada Pekerja Seks Perempuan Ni Made Sri Nopiyani; Putu Ayu Indrayathi; Rina Listyowati; I Ketut Suarjana; Pande Putu Januraga
Jurnal Kesehatan Masyarakat Nasional Vol. 9 No. 4 Mei 2015
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (138.866 KB) | DOI: 10.21109/kesmas.v9i4.734

Abstract

AbstrakPekerja seks perempuan (PSP) merupakan kelompok yang termarginalkan secara sosial dan memiliki kerentanan yang tinggi terhadap masalah kesehatan. Upaya perluasan Jaminan Kesehatan Nasional (JKN) pada PSP masih terbatas sehingga penting dilakukan untuk mendukung pencapaian universal health coverage. Penelitian ini bertujuan untuk memperoleh gambaran mengenai akses JKN pada PSP di Denpasar. Penelitian ini merupakan studi kualitatif. Data dikumpulkan melalui wawancara mendalam terhadap 15 orang PSP dan empat orang mucikari di Denpasar pada Agustus hingga Oktober 2014. Hasil wawancara diolah dengan analisis tematik. Kerangka analisis yang digunakan adalah The Health Access Livelihood Framework. Kepemilikan JKN pada PSP di Denpasar masih rendah, meskipun sebagian PSP memiliki kemauan untuk menjadi peserta JKN dan memiliki kemampuan membayar iuran JKN. Faktor penghambat akses JKN pada PSP adalah rendahnya pengetahuan mengenai prosedur pendaftaran dan portabilitas JKN, kekhawatiran keberlanjutan pembayaran iuran, persepsi buruk mengenai kualitas layanan yang akan diterima jika menggunakan JKN, ketidaklengkapan administrasi kependudukan serta kebijakan yang mengharuskan peserta bukan penerima bantuan iuran (Non-PBI) Mandiri untuk mendaftarkan seluruh anggota keluarga. Akses JKN pada PSP terhambat oleh faktor-faktor individual, layanan dan kebijakan yang perlu diatasi untuk meningkatkan cakupan JKN pada PSP. AbstractFemale sex workers (FSW) is marginalized social group having a high vulnerability of health problems. Effort to expand national health insurance on FSW is still limited, so it is necessarily performed in order to support the achievement of universal health coverage. This study aimed to obtain the depiction of the insurance access among FSW in Denpasar. This study was qualitative. Data was collected through in-depth interview of 15 FSW and four pimps in Denpasar from August to October 2014. The interview result was analyzed using thematic analysis. The analysis framework used was The Health Access Livelihood Framework. The insurance ownership among FSW in Denpasar was low, even though some FSW were willing to be participants and afford to pay the premium. Factors inhibiting the insurance access were the lack of knowledge regarding registration procedures and portability, fear of premium payment sustainability, negative perceptions of quality of services that would be received if using the insurance, incomplete population administration and policy requiring independent non-premium support receiver participants to register all of their family members. The insurance access among FSW was hindered by individual, service and policy factors that need to be conquered to increase the insurance coverage among FSW.
Basis for Development of Business Strategic Plan Primary Health Care with Local Public Service Entity Status in Gianyar District Putu Ayu Indrayathi; Luh Putu Sinthya Ulandari
Jurnal Kesehatan Masyarakat Nasional Volume 11, Issue 2, November 2016
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1095.986 KB) | DOI: 10.21109/kesmas.v11i2.846

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Primary health care as Local Public Service Entity needs to make the right business strategic plan. Arranging business plan needs to pay attention to its competitors operating around its working area. This study aimed to determine internal and external environmental factors in Ubud 1 and Tegallalang 1 Primary Health Care and develop model of business strategic plan development in both primary health cares with Local Public Service Entity status. This study was descriptive explorative conducted in 2014. Data were collected through questionnaires, and documentation study. Samples were determined purposively or taken non-proportionally, consisting of Ubud 1 and Tegallalang 1 Primary Health Care heads and staff. Data were analyzed by descriptive quantitative analysis. Results of internal and external factor analysis in both primary health cares showed similar findings. Most indicators of internal variable were strength, only quantities of medical and non-medical workers were the weaknesses in program development. Meanwhile, external factor analysis showed that most indicators of external variable were opportunities and it was only people’s lifestyle toward environment as the threat in program development. In conclusion, the development strategic position in Ubud 1 Tegallalang 1 was growth strategy.AbstrakPuskesmas yang berbentuk Badan Layanan Umum Daerah (BLUD) perlu membuat rencana strategi bisnis yang tepat. Penyusunan rencana strategi bisnis perlu memerhatikan pesaing yang beroperasi di sekitar wilayah kerja. Penelitian ini bertujuan untuk mempelajari aspek lingkungan internal dan eksternal di Puskesmas Ubud 1 dan Tegallalang 1 serta mengembangkan model pengembangan rencana strategi bisnis di kedua puskesmas yang berstatus BLUD tersebut. Penelitian ini merupakan penelitian deskriptif eksploratif yang dilakukan pada tahun 2014. Data dikumpulkan melalui penyebaran kuesioner dan studi dokumentasi. Sampel penelitian ditentukan secara purposif dan diambil secara non proporsional, terdiri dari kepala dan staf Puskesmas Ubud 1 dan Tegallalalng 1. Data dianalisis secara deskriptif kuantitatif. Hasil analisis faktor internal dan eksternal kedua puskesmas menunjukkan hasil yang sama. Sebagian besar indikator variabel internal merupakan kekuatan, hanya kuantitas tenaga kerja bidang medis dan nonmedis sebagai kelemahan dalam pengembangan program. Sedangkan hasil analisis faktor eksternal menunjukkan sebagian besar indikator variabel eksternal merupakan peluang dan hanya perilaku masyarakat terhadap lingkungan yang merupakan ancaman dalam pengembangan program. Sebagai kesimpulan, posisi strategis pengembangan di Puskesmas Ubud 1 dan Tegallalang 1 adalah strategi pertumbuhan.
Penilaian Kualitas Hidup Pasien Kanker Serviks dengan Kemoterapi Paklitaksel–Karboplatin di RSUP Sanglah I Ketut Tunas; Sagung C. Yowani; Putu A. Indrayathi; Rini Noviyani; I Nyoman G. Budiana
Indonesian Journal of Clinical Pharmacy Vol 5, No 1 (2016)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (291.444 KB) | DOI: 10.15416/ijcp.2016.5.1.35

Abstract

Pemberian kemoterapi pada pasien kanker serviks stadium IIB-IIIB selain menimbulkan efek terapi juga menimbulkan efek samping berupa penurunan kualitas hidup. Penelitian ini dilakukan pada Februari–Juni 2014 di Bagian Obstetri dan Gineklogi RSUP Sanglah Denpasar secara observasional dengan metode case study prospective. Pengumpulan data dilakukan menggunakan kuesioner EORTC QLQ C30 yang dikombinasikan dengan wawancara sebelum dan setelah kemoterapi paklitaksel-karboplatin sebanyak 3 seri pada pasien kanker serviks sel skuamosa stadium IIB-IIIB. Penelitian kualitas hidup dilakukan secara umum dan pada 15 domain yang memengaruhi kualitas hidup. Terdapat 12 pasien yang memenuhi kriteria inklusi. Pemberian kemoterapi regimen paklitaksel-karboplatin dapat meningkatkan kualitas hidup dengan penurunan nilai mean dari 48,083±5,451 menjadi 44,083±3,872. Terdapat perbedaan bermakna pada nilai kualitas hidup pasien sebelum dan setelah kemoterapi paklitaksel-karboplatin (nilai p=0,038). Terdapat penurunan kualitas hidup pada domain mual muntah, penurunan nafsu makan, fatigue, dan fungsi sosial. Domain dengan peningkatan kualitas hidup yaitu nyeri, fungsi fisik, fungsi emosional, sulit tidur, dan kesulitan keuangan. Pemberian kemoterapi paklitaksel-karboplatin pada 12 pasien dapat meningkatkan kualitas hidup pasien kanker serviks.Kata kunci: Domain kualitas hidup, kanker serviks, kualitas hidup, paklitaksel-karboplatinThe Assessment Quality of Life For Patients with Cervical Cancer Using Chemotherapy Paclitaxel-Carboplatin in Sanglah Chemotherapy administration to patients with cervical cancer stage IIB-IIIB not only causing a therapeutic effect but also decrease in quality of life. This study was conducted in February–June 2014 in the Department of Obstetrics and Gynecology Sanglah Hospital with observational prospective case study method. Data were collected using the EORTC QLQ C30 questionnaire combined with interview before and after chemotherapy paclitaxel-carboplatin as much as 3 series in patients with squamous cell cervical cancer stage IIB-IIIB. Assesment was done in general quality of life and 15 domains that affect the quality of life. There were 12 patients who met the inclusion criteria. Administration chemotherapy with paclitaxel-carboplatin can improve the quality of life shown by decrease mean value from 48.083±5.451 to 44.083±3.872. There were significant differences in the value of the quality of life before and after being given chemotherapy paclitaxel-carboplatin (p-value 0.038). There were decrease in the quality of life of the domain nausea, vomiting, decreased appetite, fatigue, and social functions. Domains that have increased the quality of life is pain, physical functioning, emotional functioning, sleeplessness, and financial difficulties. Administration of chemotherapy paclitaxel-carboplatin can improve the quality of life of patients with cervical cancer.Key words: Domain quality of life, cervical cancer, paclitaxel-carboplatin, quality of life