Buletin Penelitian Sistem Kesehatan

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ISSN / EISSN : 14102935 / 23548738
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Hsr Managerxot
Buletin Penelitian Sistem Kesehatan, Volume 22; doi:10.22435/hsr.v22i4.2750

Asep Kusnali, Rustika Rustika, Herti Windya Puspasari, Primasari Syam, Ratih Oemiyati, Dede Anwar Musadad, Ristrini Ristrini
Buletin Penelitian Sistem Kesehatan, Volume 22, pp 245-254; doi:10.22435/hsr.v22i4.2244

Abstract:
The number of Indonesian pilgrims in 2018 was 205,886 people. Pilgrims who died in Saudi Arabia, both in Medina, Makkah, and Jeddah were 386 people. Based on the embarkation, the majority of hajj pilgrims who died in Saudi Arabia was from the embarkation of SUB (Surabaya) of 68 people (17.62%). This number was the highest compared with previous years. The increase in the number of pilgrims who died is closely related to the old age and the possession of chronic and degenerative diseases so that they experience complications during the pilgrimage. The Ministry of Health has issued a policy on the hajj health istithaah. To find out about the holding of the hajj pilgrims about health, a study was carried out on the description of knowledge of attitudes and actions as well as the dominant factors regarding health Istithaah. The study used a quantitative approach with a cross-sectional design for interviews. The research locations were selected based on the number of pilgrims, namely DKI Jakarta, West Java, Central Java, and East Java. Samples were pilgrims who would perform the pilgrimage in 2018. Data analysis was carried out bivariate and multivariate. The results showed that the dominant factors that determine health Istithaah actions are knowledge, attitudes and waiting times, while the highest OR value is knowledge with an OR value of 2.689 (CI; 1.081 - 2.839), p-value 0.000
Sarwititi Sarwoprasodjo, Muchlisah Harliani, Annisa Utami Seminar
Buletin Penelitian Sistem Kesehatan, Volume 22, pp 215-228; doi:10.22435/hsr.v22i4.2075

Abstract:
In Indonesia, the prevalence of cancer is increasing. Approaches to cancer prevention have been carried out by the government, hospitals, and non-governmental organizations. Health communication was one of the efforts to support cancer prevention. This study intends to describe the current conditions of research on cancer prevention communication as a reference to recommend further research on cancer prevention communication in the future. This study uses a systematic review method by analyzing 56 journal articles, undergraduate thesis, master thesis, and dissertations based on relevant keyword searches. All samples are then described as quantitatively and qualitatively. The results of the systematic review show that cancer prevention communication studies in Indonesia are in line with Indonesia’s government priorities in cancer prevention, however effective communication approach has not been used in cancer communication research. Two important variables to be researched to support the effective cancer communication are: credibility and competency of source and message design in cancer communication. Abstrak Kanker adalah salah satu penyakit tidak menular yang prevalensinya terus meningkat di Indonesia. Pendekatan-pendekatan untuk pengendalian kanker telah dilakukan oleh pemerintah, rumah sakit, bahkan lembaga swadaya masyarakat. Komunikasi kesehatan merupakan salah satu upaya mendukung pengendalian kanker. Kajian ini bermaksud untuk menggambarkan kondisi mutakhir penelitian-penelitian tentang komunikasi kanker sebagai acuan untuk dapat merekomendasikan penelitian mengenai komunikasi kanker di masa datang. Telaah ini menggunakan metode review sistematis, dengan menganalisa 56 artikel jurnal, skripsi, tesis, dan disertasi berbasis pencarian kata kunci yang relevan. Seluruh sampel kemudian dideskripsikan secara kualitatif. Hasil dari review sistematis menunjukkan bahwa fokus penelitian komunikasi kanker di Indonesia sudah sejalan dengan upaya promotif dan preventif pemerintah dalam pengendalian kanker, namun belum menggunakan pendekatan komunikasi efektif sehingga belum dapat dirumuskan strategi komunikasi kanker di Indonesia. Dua fokus utama yang menjadi peluang untuk menyumbang pada strategi komunikasi kanker di Indonesia adalah penelitian mengenai kredibilitas dan kompetensi sumber komunikasi kanker serta desain pesan komunikasi kanker.
Oktarina Oktarina Oktarina, Yurika Fauzia Wardhani
Buletin Penelitian Sistem Kesehatan, Volume 22, pp 236-244; doi:10.22435/hsr.v22i4.1550

Abstract:
Balanced nutrition during breastfeeding is important for breastfeeding mothers because it affects breastmilk production. The fulfillment of good nutrition for breastfeeding mothers will affect the nutritional status and the growth of their babies. The concept of sick and healthy, food and drink that is good for health, trust and abstinence, on one hand, can be a barrier for health development but on the other one can be a potential for overcoming health problems. This study is a secondary data analysis, which is sourced from Health Ethnographic Research data in 2012, 2014 and 2015. Samples taken were from the Rote, Sabu and Madura ethnic groups. Data collected included breastfeeding mothers' behavior as well as the adequacy of nutrition for breastfeeding mothers in the three ethnic groups. The results showed that maternal behavior in newborns gave a prelactal type of food, where in the ethnic Rote in the form of coffee water or sugar water, in the ethnic Sabu in the form of a concoction of chili leaves that were pounded, filtered and taken the juice, and the Madura ethnic in the form of honey and young coconut water aimed to smoothen baby’s digestion. Abstrak Gizi seimbang penting bagi ibu menyusui karena sangat erat kaitannya dengan produksi air susu. Pemenuhan gizi yang baik akan berpengaruh terhadap status gizi ibu menyusui dan tumbuh kembang bayinya. Konsep tentang sehat-sakit, makanan-minuman yang baik untuk kesehatan, kepercayaan dan pantangan, di satu lain bisa menjadi penghalang namun di sisi lain bisa menjadi potensi untuk mengatasi permasalahan kesehatan. Penelitian ini merupakan analisis data sekunder, yang bersumber dari data Riset Etnografi Kesehatan tahun 2012, 2014 dan 2015 yang bertujuan untuk mengetahui perilaku pemenuhan gizi ibu menyusui pada etnik Sabu, Rote dan Madura. Data yang dikumpulkan meliputi perilaku ibu menyusui serta kecukupan zat gizi ibu menyusui pada tiga etnik tersebut. Hasil menunjukkan bahwa perilaku ibu pada bayi baru lahir memberikan jenis makanan prelaktal, dimana pada etnik Rote berupa air kopi atau air gula, pada etnik Sabu berupa ramuan daun cabai yang ditumbuk, disaring dan diambil sarinya, serta etnik Madura berupa madu dan air kelapa muda yang bertujuan untuk melicinkan pencernaan bayi.
Lukman Prayitno, Selma Siahaan
Buletin Penelitian Sistem Kesehatan, Volume 22, pp 229-235; doi:10.22435/hsr.v22i4.2229

Abstract:
Pharmacy costs are one of the components that absorb the largest costs from the hospital's health budget. At present, there is still little information and data on the percentage of pharmaceutical costs to the costs of medical devices and non-medical devices. It is very useful in making financial planning. It can illustrate of pharmaceutical financing against other operational costs in hospitals, as financial planning, as scientific evidence for improving drug policy. This research was an analysis on the Indonesia Health Financing Survey data in the referral health care Facilities (FKRTL) in 2016. Data from 84 hospitals in 3 regions. The details were 9 class A hospitals, 37 class B hospitals, 38 class C hospitals. The analysis used a descriptive statistical approach. Pharmacy costs in 3 types of hospitals were 169.07 Billion, 23.66 Billion, 10.79 Billion. The percentage of the proportion of pharmaceutical costs to the cost of non-medical equipment in 3 types of hospitals is 1073.05%, 665.42%, 292.29%. The proportion of pharmaceutical costs to the cost of medical devices in 3 types of hospitals is 208.12%, 172.20%, 148.96%. In all types of hospitals the total pharmaceutical costs are greater than the costs of medical equipment and non-medical equipment costs. The proportion of pharmaceutical costs to the costs of non-medical devices and medical devices is high. This is due to the depreciation of the cost of medical devices and non-medical devices while the pharmaceutical costs always increase in price from the previous year. Abstrak Biaya farmasi merupakan salah satu komponen yang menyerap biaya terbesar dari anggaran kesehatan Rumah Sakit. Saat ini masih sedikit informasi dan data mengenai prosentase biaya farmasi terhadap biaya alat medis dan alat non-medis. Prosentase biaya di rumah sakit sangat bermanfaat dalam membuat perencanaan pembiayaan. Data penelitian sebagai gambaran pembiayaan farmasi terhadap biaya operasional lain di rumah sakit, sebagai perencanaan pembiayaan, sebagai bukti ilmiah untuk penyempurnaan kebijakan obat. Data riset merupakan analisis lanjut hasil Riset Pembiayaan Kesehatan Fasilitas Kesehatan Rawat Tingkat Lanjut (FKRTL) Tahun 2016. Data dari 84 rumah sakit yang di 3 regional. Dengan rincian adalah 9 rumah sakit kelas A, 37 rumah sakit kelas B, 38 rumah sakit kelas C. Data riset dimasukkan dalam dumy tabel untuk analisa lanjut. Analisis menggunakan pendekatan kuantitatif statistik diskriptif. Biaya farmasi pada 3 tipe RS masing-masing sebesar 169,07 Milyard, 23,66 Milyard, 10,79 Milyard. Prosentase proporsi biaya farmasi terhadap biaya alat non medis pada 3 tipe RS adalah 1073,05%, 665,42%, 292,29%. Prosentase proporsi biaya farmasi terhadap biaya alat medis pada 3 tipe RS adalah 208,12%, 172,20%, 148,96%. Di semua tipe RS total biaya farmasi lebih besar dibanding biaya alat medis dan biaya alat non medis. Prosentase proporsi biaya farmasi terhadap biaya alat non medis dan alat medis menjadi tinggi. Hal ini disebabkan terjadi penyusutan terhadap biaya alat medis dan alat non medis sedangkan biaya farmasi selalu terjadi peningkatan harga dari tahun sebelumnya.
Farida Wahyu Ningtyias, Rahma Fitri Fiamanatillah, Ninna Rohmawati Rohmawati
Buletin Penelitian Sistem Kesehatan, Volume 22, pp 265-271; doi:10.22435/hsr.v22i4.1297

Abstract:
School lunch facilities may be an alternative to solve food problems in school-age children. The contribution of food nutrients in schools will affect the total consumption of nutrients as well as nutritional status. The contribution of school lunch is 30% of nutritional needs per day. This study was to analyze both the nutritional contribution of school lunch and nutritional adequacy towards the nutritional status of students at Al-Furqan Jember Elementary School. This study was an observational analytic study with a cross-sectional approach. The population was 141 students with total samples of 58 students. This study indicated that most of the respondents did not meet 30% of the daily nutritional needs based on their lunch nutritional contribution. However, both the nutritional adequacy and nutritional status of most respondents were in the normal category. Abstrak Fasilitas makan siang sekolah dapat menjadi salah satu alternatif untuk mengatasi masalah makanan anak usia sekolah. Kontribusi zat gizi makanan di sekolah akan berpengaruh pada total konsumsi zat gizi yang juga akan berdampak pada status gizi. Kontribusi makan siang sekolah adalah 30% dari kebutuhan gizi sehari. Penelitian ini bertujuan untuk menganalisis kontribusi zat gizi makan siang sekolah dan kecukupan gizi terhadap status gizi siswa di SD Al-Furqan Jember.Penelitian ini merupakan penelitian analitik observasional dengan menggunakan pendekatan cross sectional. Populasi penelitian ini sebanyak 141 siswa dengan sampel sebanyak 58 siswa. hasil penelitian menunjukkan bahwa sebagian besar responden kontribusi zat gizi makan siang sekolahnya tidak memenuhi 30% kebutuhan gizi sehari. Sedangkan kecukupan gizi dan status gizi sebagian besar responden dalam kategori normal.
Revi Rosavika Kinansi, Mega Tyas Prihatin
Buletin Penelitian Sistem Kesehatan, Volume 22, pp 282-291; doi:10.22435/hsr.v22i4.2151

Abstract:
Discriminant analysis is one of the statistical techniques that may use to provide the most appropriate estimation for classifying individuals into one group based on the independent variable score (discriminant score). There are 2 main assumptions in discriminant analysis such as fulfilled data normality and similarity of variant-covariants. This study aims to determine whether there is a relationship between DHF Incidence Rate (IR) and entomology index if a region is classified as a coast-not a coast and rural-urban. This research conducted in 78 districts in Indonesia carried out in Disease Reservoir and Vector Specific Research from 2016 to 2017. The geographical area of ​​Indonesia which has a tropical climate with three months of rainy season in December, January, February and three months of the dry season in June, July, August can be a hyperendemic area of ​​DHF. This condition is exacerbated by the development of increasingly complex urban areas and the development of rural areas into cities that reduce environmental quality and have an impact on the expansion of the habitat of Aedes aegypti as vector of DHF. The data to be analyzed are the entomology index in the form of numbers of HI, BI, CI and ABJ against IR. The results of the analysis provide information that the very low value of Canonical Correlation is 0.076 classified as coast and not coast so that there is no relationship between the independent variable and the dependent variable. While the Canonical Correlation value is quite high, which is 0.219 classified as rural and urban showed that there is a relationship between the independent variable and the dependent variable. Based on the results, densely populated ecosystems in urban or rural areas have a great chance of cases of dengue hemorrhagic fever, so people need to monitor mosquito larvae to control DHF. Abstrak Analisis diskriminan adalah salah satu teknik statistik yang dapat digunakan untuk memberikan pendugaan yang paling tepat untuk mengklasifikasikan individu ke dalam salah satu kelompok berdasarkan skor variabel bebas (skor diskriminan). Terdapat 2 asumsi utama dalam melakukan analisis diskriminan, yaitu normalitas data harus terpenuhi dan kesamaan varian-kovarian. Penelitian ini bertujuan untuk mengetahui apakah terdapat hubungan antara Incidence Rate (IR) DBD dengan indeks entomologi jika suatu wilayah diklasifikasi menjadi pantai-bukan pantai dan perdesaan-perkotaan. Penelitian telah dilakukan di 78 kabupaten di Indonesia pada Riset Khusus Vektor dan Reservoir Penyakit tahun 2016 hingga 2017. Wilayah geografis Indonesia yang beriklim tropis dengan tiga bulan musim hujan pada Desember, Januari, Februari dan tiga bulan musim kemarau pada Juni, Juli, Agustus dapat menjadi wilayah hiperendemik DBD. Kondisi tersebut diperparah oleh perkembangan wilayah perkotaan yang semakin kompleks dan perkembangan wilayah pedesaan menjadi kota yang menurunkan kualitas lingkungan hidup dan berdampak pada perluasan habitat nyamuk Aedes aegypti vektor penyakit DBD. Data yang akan dianalisis adalah data indeks entomologi berupa angka HI, BI, CI dan ABJ terhadap IR. Hasil analisis memberikan informasi bahwa nilai Canonical Correlation yang sangat rendah yaitu 0,076, jika diklasifikasi menjadi pantai dan bukan pantai menunjukkan tidak terdapat hubungan antara variabel bebas dengan variabel terikat. Nilai Canonical Correlation yang cukup tinggi yaitu 0,219, jika diklasifikasi menjadi perdesaan dan perkotaan menunjukkan terdapat hubungan antara variabel bebas dengan variabel terikat nya. Berdasarkan hasil penelitian ini, ekosistem padat penduduk di perkotaan atau perdesaan memiliki peluang besar terhadap adanya kasus demam berdarah dengue, sehingga masyarakat perlu melakukan monitoring terhadap jentik nyamuk untuk pengendalian DBD.
Endang Puji Astuti, Mara Ipa, Aryo Ginanjar, Tri Wahono
Buletin Penelitian Sistem Kesehatan, Volume 22, pp 255-264; doi:10.22435/hsr.v22i4.1761

Abstract:
Indonesia is one of the malaria-endemic countries commits to eliminate malaria in 2030. The implementation of malaria control program policy is a determinant to achieve the goal. This research was qualitative that described the implementation of malaria control program policy in Garut Regency, West Java Province. The data collected through in-depth interviews and documents’ review. The implementation of malaria control had referred to guidelines from the Ministry of Health, Republic of Indonesia. This control was also technically adjusted to regional conditions. Case detection of malaria was conducted such as a mass blood survey, rapid diagnostic tests and a microscopic laboratory test both passive and active. The malaria case surveillance has already accomplished. However, the vector was left. The malaria vector control focused on the distribution of insecticide-treated nets and the insecticide spray by the Indoor Residual Spraying (IRS) technique. The analysis indicated that the cross-program cooperation at the central government was well coordinated. However, at the level of the district, this cooperation has to be tightened. Moreover, malaria control budget was still the under district level, so that controlling malaria program did not cover all aspects of the implementation. Abstrak Indonesia sebagai salah satu negara endemis malaria, berkomitmen melakukan eliminasi di tahun 2030. Implementasi kebijakan program pengendalian malaria menjadi determinan keberhasilan eliminasi. Tujuan penelitian ini memberikan gambaran pelaksanaan program pengendalian malaria di Kabupaten Garut, Provinsi Jawa Barat. Pengumpulan data dilakukan dengan wawancara mendalam pada pengelola Program Penanggulangan Malaria serta telaah dokumen dan data dianalisis secara kualitatif. Hasil penelitian menunjukkan bahwa kebijakan pelaksanaan program pengendalian malaria di Kabupaten Garut, Provinsi Jawa Barat sudah merujuk pada pedoman Kementerian Kesehatan RI, secara teknisnya disesuaikan dengan kondisi wilayah. Penemuan penderita dilakukan secara pasif maupun aktif melalui Mass Blood Survey (MBS), dengan pemeriksaan menggunakan Rapid Diagnostic Test (RDT) dan laboratorium secara mikroskopis, Surveilans yang dilakukan oleh Puskesmas hanya terfokus pada surveilans kasus dan belum dilakukan surveilans vektor malaria. Pengendalian vektor malaria yang dilakukan berupa pembagian kelambu dan penyemprotan insektisida dengan metode Indoor Residual Spraying (IRS). Kerjasama lintas program berjalan dengan baik, namun kerjasama lintas sektor terutama pada tingkat kabupaten masih perlu dilakukan dan ditingkatkan. Pembiayaan program pengendalian malaria hanya dari pemerintah daerah dan belum dapat mengakomodir kegiatan pengendalian secara keseluruhan.
Munari Kustanto, Ardi Anindita
Buletin Penelitian Sistem Kesehatan, Volume 22, pp 272-281; doi:10.22435/hsr.v22i4.2398

Abstract:
A relief letter (SKTM) from Social Service Office of Sidoarjo is a mechanism for non-quota poor people to access health services. The dilemma occurred when the office indicated that 80% of the target users of the letter were inaccurate. Understandings on terms of “poor”in relief letter and by health service providers play an important role in this phenomenon. This study identifies the reproduction of the meaning of poor on non-quota poor health services in Sidoarjo. This was a qualitative approach, conducted in Sidoarjo and Tarik District that had different characteristics to obtain comprehensive results. The structuration theory from Anthony Giddens used to analyze the data findings. The results indicated that poverty for non-quota poor users was interpreted as (i) unemployed conditions, and (ii) inability to meet health needs. Reproduction of “poor” meaning occurred when informants relate it to the accessibility of health services. This term was also reproduced into business and political interests by health officers and government officials at the poor village. Discursive awareness among agents involved in non-quota health services modified the service. Abstrak Surat Keterangan Tidak Mampu (SKTM) dari Dinas Sosial Kabupaten Sidoarjo menjadi sebuah mekanisme bagi masyarakat miskin non kuota untuk mengakses pelayanan kesehatan. Dilema terjadi manakala Dinas Sosial Kabupaten Sidoarjo mengindikasikan bahwa 80% pengguna surat tersebut tidak tepat sasaran. Pemahaman pengguna surat rekomendasi tidak mampu dan penyelenggara pelayanan kesehatan tentang makna miskin memiliki peran penting dalam fenomena tersebut. Penelitian ini berupaya mengidentifikasi reproduksi makna miskin pada pelayanan kesehatan masyarakat miskin non kuota di Kabupaten Sidoarjo. Menggunakan pendekatan kualitatif, penelitian ini dilakukan di Kecamatan Sidoarjo dan Kecamatan Tarik yang memiliki karakteristik berbeda guna memperolah hasil yang komprehensif. Teori Strukturasi dari Anthony Giddens digunakan untuk menganalisis temuan data. Hasil penelitian menemukan bahwa kemiskin bagi pengguna masyarakat miskin non kuota dimaknai sebagai (i) kondisi tanpa pekerjaan, dan (ii) ketidakmampuan memenuhi kebutuhan kesehatan. Reproduksi makna miskin terjadi manakala informan berhubungan dengan aksesibilitas layanan kesehatan. Melalui petugas medis dan aparatur pemerintah desa miskin direproduksi menjadi kepentingan bisnis dan politis. Kesadaran diskursif antar agen yang terlibat dalam pelayanan kesehatan non kuota telah memodifikasi layanan tersebut.
Sri Sularsih Endartiwi, Pramukti Dian Setianingrum
Buletin Penelitian Sistem Kesehatan, Volume 22, pp 158–166-158–166; doi:10.22435/hsr.v22i3.897

Abstract:
BPJS Health targets participant satisfaction to reach 95%, but until 2017 participant satisfaction reaches 85%. Participants who received service at the primary health facilities based on observations averaged 70%. Based on observations at the primary health facility can be seen that participant satisfaction is 70%. The objective was to evaluate the correlation between the quality services and participant satisfaction on the national health insurance at primary health facilities in the province of Yogyakarta. The type of research was quantitative descriptive with cross sectional design. The research location was primary health facilities that cooperate with BPJS Kesehatan in the Province of Yogyakarta. The study was conducted in July 2018. The number of samples in this study was 850 by proportional random sampling. Data analysis was using the Kendall Tau test. Results showed that the quality of health services both in terms of tangible, reliability, responsiveness, assurance and empathy were related to the satisfaction of BPJS Kesehatan participants in the primary health facilities. The results of bivariate analysis for each variable had a Sig. (2-tailed) 0,000 with a strong relationship. The quality of health services was related to the satisfaction of patients participating in the BPJS Kesehatan in the primary health facilities of the Province of Yogyakarta. Primary health facilities in order to maintain the quality of its health services so that patients participating in the National Health Insurance program remain satisfi ed with the services that have been provided. Abstrak BPJS Kesehatan menargetkan kepuasan peserta mencapai 95%, akan tetapi sampai tahun 2017 ini kepuasan peserta mencapai 85%. Peserta yang mendapatkan pelayanan di fasilitas kesehatan tingkat pertama berdasarkan hasil observasi di puskesmas, dokter keluarga dan klinik pratama rata-rata 70%. Berdasarkan hasil observasi di fasilitas kesehatan tingkat pertama (FKTP) yang bekerja sama dengan BPJS Kesehatan dapat diketahui bahwa kepuasan peserta sebesar 70%. Penelitian bertujuan untuk membuktikan bahwa kualitas pelayanan berhubungan dengan kepuasan peserta Jaminan Kesehatan Nasional (JKN) di Fasilitas Kesehatan Tingkat Pertama Di Provinsi Daerah Istimewa Yogyakarta. Jenis penelitian adalah deskriptif kuantitatif dengan rancangan cross sectional. Lokasi penelitian adalah FKTP yang bekerjasama dengan BPJS Kesehatan di Provinsi Daerah Istimewa Yogyakarta. Penelitian dilakukan pada bulan Juli 2018. Jumlah sampel dalam penelitian ini adalah 850 secara proportional random sampling. Analisis data dilakukan dengan menggunakan uji Kendall Tau. Kualitas pelayanan kesehatan baik dari sudut tangible, reliability, responsiveness, assurance maupun empathy berhubungan dengan kepuasan pasien peserta BPJS Kesehatan di FKTP Provinsi Daerah Istimewa Yogyakarta. Hasil analisis bivariat setiap variabel mempunyai nilai Sig. (2-tailed) 0,000 dengan hubungan yang kuat. Kualitas pelayanan kesehatan (tangible, reliability, responsiveness, assurance dan empathy) berhubungan dengan kepuasan pasien peserta BPJS Kesehatan di FKTP Provinsi Daerah Istimewa Yogyakarta. FKTP di Provinsi Daerah Istimewa Yogyakarta supaya tetap mempertahankan kualitas pelayanan kesehatannya sehingga pasien peserta program Jaminan Kesehatan Nasional (JKN) tetap merasa puas terhadap pelayanan yang sudah diberikan.
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