EKOWATI

ABSTRAK

Program Jaminan Sosial Kesehatan (Jamsoskes) Sumatera Selatan Semesta merupakan salah satu bentuk sistem jaminan kesehatan. Program ini mengcover selLiruh penduduk Sumatera Selatan yang belum mempunyai jaminan kesehatan, dimana dana penyelenggaraan berasal dari sharing dana provinsi dan kabupaten/kota. Untuk mengelola pembiayaan program Jamsoskes, agar lebih efektif dan efisien serta berkembang, dirasakan perlu dibentuk Badan Layanan Umum (BLU) Jamsoskes. Selain hal tersebut, saat ini perangkat hukum untuk penerapan UU Nomor 40 tahun 2004 tentang SJSN sudah hampir selesai, diperkirakan tahun 2011 sudah siap dan tahun 2014 diharapkan universal coverage akan terwujud. Sehubungan dengan hal tersebut diperlukan kajian untuk mengetahui kelayakan BLU program Jamsoskes di Sumatera Selatan.

Penelitian ini merupakan riset operasional dengan pendekatan kualitatif. Unit analisis adalah program Jamsoskes Sumsel Semesta yang ada di wialayah kerja Dinas Kesehatan Provinsi Surnatera, Selatan. Data diperoleh melalui wawancara mendalam pada informan kunci, dan Focus Group Discussion (FGD) dengan menggunakan pedoman. Analisis dilakukan dengan pendekatan content analysis dan analisis for policy.

Dari hasil penelitian diketahui bahwa daerah yan^g akan mengembangkan sistem jaminan kesehatan terlebih dahulu harus memerlukan payung peraturan/perundangan tentang pembentukan dan status Bapel jaminan tersebut. Untuk jangka panjang, Pemerintah Daerah harus menunggu dulu payung kebijakan di tingkat nasional dengan disyahkannya UU tentang BPJS, jangan sampai program yang sudah dibuat menjadi dibatalkan karena keluarnya UU BPJS yang terbit belakangan. Tetapi jika dalam kondisi yang mendesak, status BLU sementara dapat dipertimbangkan sebagai alternatif UPTD yang dibentuk dengan SK Gubernur atau Pergub. Namun agar sesuai dengan persyaratan pembentukan BLU pada PP No.23 tahun 2005, prosesnya harus melalui studi kelayakan, penyusunan rencana bisnis (business plan) dan rencana strategic. Persyaratan-persyaratan tersebut penting dilakukan untuk menjamin bahwa Bapel yang akan dibentuk memang layak termasuk dari aspek financial.

Dari hasil penelitian dapat disimpulkan bahwa bentuk Badan Layanan Umum dalam penyelenggaraan Jamsoskes Sumsel Semesta dapat dilakukan dengan berlandaskan payung hukum baik tingkat nasional maupun tingkat daerah. Rekomendasi bagi Pemerintah daerah untuk jangka panjang sebaiknya menunggu payung hukum tingkat nasional yaitu dengan keluarnya Undang-undang tentang Badan Penyelenggara Jaminan Sosial pada tingkat nasional.

Ekowati Retnaningsih*, Yulian Taviv, Yahya

ABSTRAK

Penelitian ini bertujuan untuk memperoleh model prediksi faktor resiko infeksi TB pada kontak serumah di Kabupaten OKU Provinsi Sumatera Selatan Tahun 2010. Penelitian ini menggunakan paradigma kuantitatif dengan pendekatan rancangan penelitian kros seksional (potong lintang). Populasi penelitian adalah seluruh anggota keluarga yang tinggal serumah dengan penderita TB yang akses pelayanan kesehatan. Pengambilan sampel dilakukan secara kuota sesuai dengan jumlah responden yang mampu dijangkau yaitu 100 orang.  Disimpulkan bahwa prevalensi keluarga penderita TB Paru yang tertular mencapai 80%. Probabilitas seseorang beresiko terinfeksi TB adalah 0,94 bila memiliki status gizi kurang, tinggal di rumah yang padat, tidak melakukan pemeriksaan TB dan tingkat pendidikannya rendah (< SD).

Kata Kunci : Risiko Infeksi TB, Status Gizi,

ABSTRACT

This study aims to obtain TB infection predictive model of home contact in OKU district of South Sumatra Province in 2010. Research design used cross sectional design with quantitative paradigm. Population of the study were all family members that living with TB patient in one home. Quota sampling was carried out in accordance with the number of respondents who are capable of reaching 100 persons. The Result of this study was the prevalence of a family who contact with pulmonary tuberculosis patients are 80%. The probability that someone at risk of TB infection is 0.94 if they are under nutrition, living in overcrowded homes, did not get TB exam and have a low education level (< SD).

Key words: TB Infection Risk and Nutritional Status

KOTA PALEMBANG

Ekowati Retnaningsih* dan Rini Rusmiati

ABSTRAK

Penyakit Hepatitis B merupakan salah satu penyakit yang menjadi masalah kesehatan masyarakat di seluruh dunia. Di Indonesia, angka kejadian infeksi Hepatitis B kronis mencapai 5%-10% dari total penduduk . Jumlah kasus Hepatitis B di Sumatera Selatan terus meningkat.

Tujuan penelitian ini adalah untuk mengetahui faktor predisposisi yang berhubungan dengan perilaku ibu dalam pemberian imunisasi Hepatitis B₀ di Kelurahan Silaberanti Palembang tahun 2010. Penelitian ini merupakan penelitian observasional analitik dengan rancangan cross sectional  Besar sampel 101 orang.

Kesimpulan yang didapat: 1) Ada hubungan bermakna antara pendidikan, pekerjaan, penngetahuan ibu dengan perilaku pemberian imunisasi Hepatitis B₀ pada bayinya. 2) Ibu berpendidikan tinggi mempunyai peluang 2,88 kali dibanding ibu berpendidikan rendah; Ibu yang tidak bekerja mempunyai peluang 4,99 kali dibanding ibu bekerja; Ibu yang tingkat pengetahuannya baik mempunyai peluang 2,87 kali dibanding ibu pengetahuan kurang, untuk memberikan imunisasi Hepatitis B₀ pada bayinya.

Kata Kunci: Faktor predisposisi, imunisasi, hepatitis B₀

ABSTRACT

Hepatitis B is one of all diseases becoming public health problem in the world. In Indonesia, prevalence of hepatitis B is 5-10%. It is increases in South Sumatera. The aims of study were to know relation between predisposing factor with immunization hepatitis B practice. Research design use the cross sectional design and total samples were 101 respondents.

The result of the research were: 1) There was relation between the education, occupation, knowledge with the practice of baby immunization hepatitis B. 2) Mothers with height education have odd 2,88 times compare low education; Mothers do not have job have odd 4,99 times compare have job; Mothers with height knowledge have odd 2,87 times compare low knowledge, to give hepatitis B₀ for her baby.

Key word: predisposing  factor, immunization, hepatitis B₀

UMUR DIATAS 15 TAHUN  DI INDONESIA

Ekowati Retnaningsih

Abstrak

Saat ini Indonesia dihadapkan pada masalah gizi ganda yaitu masalah gizi kurang dan masalah gizi lebih. Masalah utama pada orang dewasa saat ini adalah kelebihan gizi yang dapat menimbulkan kasus obesitas yang selanjutnya dapat memicu timbulnya penyakit-penyakit degeneratif.

Tujuan penelitian adalah untuk mengetahui faktor yang berhubungan dengan prevalensi obesitas pada umur diatas 15 tahun di Indonesia dan model prediksinya. Penelitian ini menggunakan pendekatan studi ekologi dan rancangan penelitian kros seksional. Populasi penelitian adalah wilayah provinsi se Indonesia yaitu sejumlah 33 provinsi. Jumlah sampel penelitian adalah seluruh populasi yang ada yaitu 33 provinsi dengan unit analisis adalah data rata-rata prevalensi wilayah provinsi. Data yang digunakan adalah data sekunder hasil RISKESDAS tahun 2007 menggunakan uji regresi linier ganda.

Hasil penelitian menunjukkan bahwa prevalensi obesitas pada umur > 15 tahun di Indonesia adalah 19,10 %. Hanya ada 1 varibel yang berhubungan dengan prevalensi obesitas secara bermakna yaitu variable prevalensi konsumsi lemak dengan p 0,027. Model prediksi prevalensi Obesitas = 15,1 + 0,31(prevalensi konsumsi makanan berlemak).

Berdasar hasil penelitian dapat disimpulkan bahwa prevalensi konsumsi makanan berlemak mempunyai hubungan yang bermakna dengan prevalensi obesitas di suatu wilayah dan kenaikan prevalensi konsumsi makanan berlemak 1 % akan meningkatkan prevalensi obesitas 0,31 %.

Kata kunci: Obesitas, konsumsi makanan berlemak, model prediksi.

Abstract

Indonesia has two malnutrition problems. They are under nutrition and over nutrition. The main malnutrition problem in old people is over nutrition that can lead to obesity problem. It influences the case of degenerative diseases. The aim of this research is to get information about the factor that related with obesity and to get information of obesity predictive model in the over 15 years old population. This research use ecology study and cross sectional design. Population are 33 provinces in Indonesia, sample is total population. It uses Riskesdas data in 2007. Data analysis use multi regression linier test.

Result of this research show that obesity prevalence in Indonesia is 19,10 %. Prevalence of fat consumption have significant relation with prevalence of = 15,1 + 0,31(prevalence of fat consumption). The conclusions of this research are prevalence of fat consumption influences obesity prevalence of province population in Indonesia. The increase of fat consumption prevalence 1% cause the increase of obesity prevalence 0,31%.

Key word: obesity, fat consumption, predictive model.

PROGRAM JAMINAN SOSIAL KESEHATAN SEMESTA

SUMATERA SELATAN SEBAGAI IMPLEMENTASI URUSAN WAJIB PEMERINTAH DAERAH DI BIDANG KESEHATAN

DALAM KERANGKA OTONOMI DAERAH DI KABUPATEN OKI

Ekowati Retnaningsih*

Abstract

Indonesia has low number 40/2004 about National Social Security System that is all of Indonesia people must have health insurance. Low number 32/2004 about autonomy to instruct that province and district region have obligation to improve health status all of our people. South Sumatra Province Government with District Government launching Social Health Insurance Program start 22 January 2009.

The means this research are to know existing condition of input aspect, process aspect and output aspect with all of problem in Ogan Komering Ilir (OKI) District. This research use policy analysis design with approach mix paradigms are quantitative and qualitative design. Quantitative research get secondary data and qualitative research get primer data. It uses 24 people informant representative. Collecting of quantitative data uses in-depth interview and focus group discussion method. Validation of data use source triangulation and method triangulation.     

Research results were: 1) The out patient utilization was 118.346 visitor (30,6%) in part were 3.394 visitor (2,87%) are pay. 2) The in patient was 4.620 visitor (1,2%) in part were 1.317 visitor (28,5%) are pay. 3) The room of secretariat is too small, without airship wardrobe and computer. 4) They have not budget for operational and secretariat budget. 5) Verification of member need long time because have not the member database. 6) Visiting hours was not enough.

Key word: policy analysis, health insurance system, free of medical treatment.

Ekowati Retnaningsih

Abstract

In the year 2004, maternal mortality rate (MMR) of South Sumatra Province was 467 per 100,000 live births. Target of Healthy South Sumatra 2008 are 175 each 100.000 live births. Based on Blum concept, health seeking behavior factor has strong influence the community health status, including mortality rate.

The research objective is to get information about contribution of health seeking behavior factors, specialty birth attendant to prevent maternal mortality. This is case control study. Locations of research are 4 districts in South Sumatra Province, e.g Musi Banyu Asin, Muara Enim, Ogan Ilir, and Palembang in 2007.  Respondents of case group were husbands of dead mother and respondent of control group were mothers who were a live. Total sample were 78 mothers, from case group were 26 mothers and control group were 52 mothers.

Results of the research were 1) Attributable Fraction Effect (AFE) was 0.78 and 2) Attributable Fraction Effect of Population (AFP) was 0.35. Conclusion of the researches was health behavior to choose kind of birth attendant influence maternal mortality. The choice of health provider as birth attendant has contribution 78% to prevent maternal mortality at group of mother who were choose non-health providers as birth attendant and has contribution 35% to prevent maternal mortality in population. A recommendation of further research is to do qualitative research to get information about cause of pregnancy women choose non-health provider as birth attendant.

Key Words: case control, contribution, birth attendant, maternal mortality.

Ekowati Retnaningsih

Abstract

The presence of house that healthy, secure, suitable, regular is very needed so that the functions and advantages of the house can be fulfilled well and can give healthy influence to the occupants in the house. The objection of this research was to know proportion of healthty house in each kecamatan in Palembang so we can set the right planning to the right target. This research use quantitative paradigm and it use cross sectional design. The sampling method was done by multistage randomsampling in all kecamatan in Palembang, that are 103 kelurahan. With estimate the possibilities of drop out sample is 5%, so the minimal sample amount that needed were 9.496 houses. Based on the descriptive analysis result in this research, we can conclude that kecamatan with proportion of healthty house is > 80 % are: 1) roof: 2 kecamatan, 2) floor: 14 kecamatan, 3) wall: 14 kecamatan, 4) ventilation: 9 kecamatan, 5) clean water source: 7 kecamatan, 6) family lavatory: 10 kecamatan, 7) SPAL: 1 kecamatan, Garbage can: 1 kecamatan. Community knowledge about healthy environment that already good has reach > 80 % only 3 kecamatan and defecate bahaviour in lavatory that already reach > 80 % are 13 kecamatan. Key word: Proportion, healthy house, healthy environment

Harga obat di Indonesia dinilai lebih mahal dari negara-negara lain, tidak hanya dibandingkan dengan negara berkembang, tetapi juga dibandingkan dengan negara maju dan kaya. Sebagai gambaran, total belanja obat di Indonesia pada tahun 2009 mencapai 30 triliun rupiah. Belanja obat tersebut merupakan 40% dari total biaya pelayanan kesehatan. Tinggginya proporsi biaya obat akan mempengaruhi pembayaran pelayanan kesehatan terutama oleh institusi besar seperti BUMN, korporasi, dan industri asuransi. Oleh karena itu, diperlukan upaya untuk mencari solusi melalui diskusi, seminar dan workshop untuk mengetahui rasionalitas dan efisiensi penggunaan obat.

Narasumber
Prof. dr. Hasbullah Thabrany, MPH, DrPH (FKM UI)
Ahmad Fuad Afdhal, PhD (Executive Committee Member of International Society of Pharmaco-economics and Outcomes Research)
Abdulkadir Keskinasian, MD, MBA, MPH (Market Pricing Director, Asia-Pacific Region, Novartis Pharma AG, Basel, Switzerland)
Lieven Annemans, PhD, MMan, MSc (Professor of Health Economics at Ghent University and Brussels University)
Diana I Brixner, RPh, PhD (Executive Director Outcomes Research Center, University of Utah College of Pharmacy, USA)
Gary M.Oderda, Pharm.D, MPH (Professor of the University of Utah and Director of the University of Utah Pharmacotherapy Outcomes Research center, USA)

Agenda
Hari I : Seminar
Sesi 1 : Basic Concept
Topik :
Health Care and Economics
Basic Concepts and Pronciples of Health Economics Evaluation
Pricing & Reimbursement
Pharmaceutical Evaluations

Sesi 2 : A Journey of Around The World
Topik :
Asia Perspective
Europe Perspective
US Perspective

Hari II : Workshop (hanya dapat diikuti oleh mereka dengan latar belakang farmasi, kedokteran atau ekonomi)
Topik :
Introduction to Health Economic Evaluation in Medicine
Introduction to Modelling + Decision Tree Budget Impact Analysis
Cost Efeectiveness Analysis
Database Analysis and Compliance
Working Groups with Topics : Budget Impact Analysis, Data Analysis and Compliance, Cost Effectiveness Analysis

Sasaran Peserta
Dokter, Direktur/Manager pada Perusahaan Farmasi, Direktur/Manager pada RS Swasta, Dosen dan Mahasiswa Pascasarjana Bidang Kesehatan, Ekonomi, Farmasi, Direktur/Manager Perusahaan Asuransi

Investasi
Sebelum 22 Desember 2009
Hari I dan Hari II : Rp.. 750.000,-
Hari I saja : Rp. 400.000,-
Hari II saja : Rp. 500.000,-

Sesudah tanggal 22 Desember 2009
Hari I dan Hari II : Rp. 1.500.000,-
Hari I saja : Rp 800.000,-
Hari II saja : Rp 1.000.000,-

Registrasi dan Informasi
Fakultas Kesehatan Masyarakat
u.p Uki, Dian, Yuni
Email : healtheconomics.ui@ui.ac.id
Telp : 021 – 7884 9036
0857 1666 7790

*) This seminar delivered in English

* UQ *
Humas FKMUI
Gd. B, Lt. 2
Kampus FKMUI Depok
T/F 021-786 4975

PROGRAM DOKTER KELUARGA DALAM PELAYANAN KESEHATAN RAWAT JALAN TINGKAT PERTAMA (RJTP) DI SUMATERA SELATAN

Ekowati Retnaningsih (eko_promkes2003@yahoo.com)

ABSTRACT

South Sumatra Province has launched family doctor program to provide health services for poor people in 2006. Government by APBN budged had paid the premium of health insurance for poor people by Askeskin program with capitation is Rp.1.000,- each person for the service of health take care of the first level health service (RJTP) in Puskesmas, on 2006. Meanwhile, province of South Sumatra by APBD budged have launch the program of family doctor which also give the service of health RJTP for poor people, its pay capitation is Rp.8.000,- each person. The objective of this research was to determine the application of family doctor program on membership, advantages of health service and financially aspects. This research is using policy analysis approach with qualitatively paradigm. The research design was a case study and explorative study. Results of this research were: 1) There was membership duplication of family doctor program and Askeskin program, 2) The family doctors hope all member of family doctor program was people non-poor, 3) There was duplication of the kind of family doctor program and Askeskin program health service, 4) The family doctors available to serve patient just at 2-4 hour, 5) There was budget duplication of family doctor program with Askeskin program, 6) The family doctor in puskesmas get double salary that can cause jealousy of another health provider.

Key words: family doctors, membership, health services, financing.

ABSTRACT
Indonesia is one of the countries that gives the biggest contribution of TB in the world. Until 2004, the Case Detection Rate (CDR) in Indonesia was low (51,8%). Many of TB suspects do not come and use the health facilities, so the free health facilities program provided by the government become useless. Presently, the TB Care program has been done by the same program at all province in Indonesia, although the characteristic of the community is different. Thes objective research of this to determine the different model of health seeking behavior of TB suspects at Java and outside Java. The research design used was cross sectional. The samples were 806 TB suspects in seven research location province. The result of the research showed that:1) there is a significant differences of utilisation in health services for TB suspects in Java and outside Java, and 2) the model of health seeking behavior of TB suspects in Java was influenced by the age of TB suspect, income per capita, suggestions, the distance and transport cost perception to the health facilities, but in outside Java was influenced by the quantity of the member of the family, suggestions, health cost perception, distance and transport cost perception to health facilities. It can be concluded that: 1) TB suspects in Java come and use the health facilities more often than TB suspects in outside Java, and 2) there are determinant differences that influence the model of health seeking behavior of TB suspects in Java and outside Java. It means that the TB care program must be designed by considering the characteristic and the local social culture. We can not make a single national program of TB care. At least there are differences programs between Java and outside Java. Further research is needed to develop the model of community based TB care that local specific.

Keywords; Health Seeking Behaviour, tuberculosis, utilizations, Java