Potensi Partisipasi Masyarakat Menuju Pelaksanaan Jaminan Kesehatan dalam Rangka Universal Coverage di Kota Bandung

Background: Community is one of the components that mustbe prepared to participate on funding the health insuranceaccording to their ability. The main problem in Indonesia is thatthere are many informal workers who have unsteady incomeand are not the target of Jamkesmas, but they have the abilityfunding for their health insuranceMethod: The study aim was to asses the ability and willingnessof informal workers funding for health insurance in BandungCity. A survey with multy stage random sampling wasconducted using questionnaire for 700 respondents.Descriptive analysis technique was performed.Result: The results were average nonfood expenditure was1.62 times greater than average food expenditure, averagenonprimary expenditure such as personal expenditure,arisan, recreation and saving, was 2.13 times greater thanaverage health expenditure. 94.4% of respondents did nothave any health saving, 87.1% of respondents would like toparticipate funding their health insurance.Conclusions: In Bandung City, the informal workers have theability and willingness to participate on funding their healthinsurance, so that the policy of free health care should bereconsidered. On the other hand, there are some actions stillneed to be developed, those are socialization; the collectingmethod; motivating this group to save money for health as theyhave an unsteady income.Keywords: community participation, health insurance, freehealth car

POTENSI PARTISIPASI MASYARAKAT MENUJU PELAKSANAAN JAMINAN KESEHATAN DALAM RANGKA UNIVERSAL COVERAGE DI KOTA BANDUNG

Background: Community is one of the components that mustbe prepared to participate on funding the health insuranceaccording to their ability. The main problem in Indonesia is thatthere are many informal workers who have unsteady incomeand are not the target of Jamkesmas, but they have the abilityfunding for their health insuranceMethod: The study aim was to asses the ability and willingnessof informal workers funding for health insurance in BandungCity. A survey with multy stage random sampling wasconducted using questionnaire for 700 respondents.Descriptive analysis technique was performed.Result: The results were average nonfood expenditure was1.62 times greater than average food expenditure, average“nonprimary” expenditure such as personal expenditure,“arisan”, recreation and saving, was 2.13 times greater thanaverage health expenditure. 94.4% of respondents did nothave any health saving, 87.1% of respondents would like toparticipate funding their health insurance.Conclusions: In Bandung City, the informal workers have theability and willingness to participate on funding their healthinsurance, so that the policy of “free health care” should bereconsidered. On the other hand, there are some actions stillneed to be developed, those are socialization; the collectingmethod; motivating this group to save money for health as theyhave an unsteady income.Keywords: community participation, health insurance, “free”health car

Patients' Perceptions of Drug Abuse Rehabilitation Services in Psychiatric Hospital

Drug abuse is a very complex and serious problem in the international community, including Indonesia. It needs adequate handling in rehabilitation services program. The study aims to describe the patient's perception of drug abuse patient rehabilitation services. We used qualitative research with an analytic descriptive approach. Collected data by in-depth interviews, Focus Group Discussion (FGD), observation, and document. A total of 14 participants consisted of drug addict patients, nurses, head of mental planning, head of the polyclinic, a doctor, assessor, and patient's family. Analyses were performed using content analysis in stages, namely: transcript text, meaning unit, coding, and theme. The results showed that the utilization of service quality from the availability of health facilities was adequate and medical costs were still affordable. It's just a need continuous improvement of training for health workers skill. Meanwhile, another aspect that the patient needs is family support which major role in the recovery process. The main conclusion of this study, it is necessary to develop the quality of service by making the Family Support Group a forum for families to share experiences and obstacles

PROTON PUMP INHIBITORS FOR STRESS ULCER BLEEDING PROPHYLAXIS IN CRITICALLY ILL PATIENTS: A COST ANALYSIS STUDY

Objective:Stress ulcer prophylaxis is generallyadministered for the prevention stress-related mucosal disease (SRMD) in critically ill patients. Proton Pump Inhibitors (PPIs) are most commonly prescribed in preventing bleeding from SRMD. Pantoprazole iv and omeprazole iv are the most effective, but clinically effective is not always efficient. Thisstudy aimed to investigate whether the most efficient PPIs for prophylaxis in ICU settings.Methods:An observational study was conducted on June 2014 with comparative design by using medical records in January 2012−November 2014 in a private hospital in Bandung City. Both retrospective and prospective data collection was performed in this study. Paired t-test analysis was used to compare average cost of the drugs with significant level p<0.05.Results:The results showed average cost of pantoprazole iv 458.142 IDR/patient and omeprazole iv 575.573 IDR/patient, there were significant differences of average drug cost between pantoprazole iv and omeprazole iv (p=0.0085).Conclusion:Both pantoprazole iv and omeprazole iv were effective but pantoprazole ivhad been found more efficient

Comparison of Maternal Health Service Satisfaction Level of National Health Coverage and Non National Health Coverage Patients in Bandung Mother and Child Hospital

Background: Healthcare is financially inaccessible to some people. This results in deterioration of patients’ condition or even death, which is proven by the high level of Maternal Death Rate in Indonesia. The government implemented the National Health Coverage (NHC) system to ensure the provision of quality health care for the entire community. This study aimed to examine the NHC and non-NHC patients’ perception to quality maternal healthcare services.Methods: This study was an analytic cross-sectional study conducted from August–October 2014. One hundred and twenty six respondents from Kota Bandung Mother and Child Hospital were included. The tool used in this study was a validity and reliability-tested questionnaire encompassing five dimensions of service quality: tangibles, reliability, responsiveness, assurance, and empathy. The Kolmogorov-Smirnov test was used to test the hypothesis.Results: The study showed that the majority of NHC(75%) and non-NHC patients (89%) ware unsatisfied with the maternal healthcare services. Most patients felt unsatisfied towards the reliability dimension which involved complicated referral procedures and examination time that failed to comply with what was promised.Conclusions: There is no difference between NHC and non-NHC patients’ level of satisfaction of maternal health care service in Bandung Mother and Child Hospital. [AMJ.2016;3(3):425–29]DOI: 10.15850/amj.v3n3.86

Role of Satisfaction with Health Care Services in Increasing Patient Loyalty: an Ambulatory Setting

Background: Health care providers must be able to provide services that can satisfy the patient. This encourages patient loyalty so that competitiveness can be preserved. This study aimed to examine the correlation of patients’ satisfaction to their loyalty towards health care facilities.Methods: An analytic cross-sectional study was conducted on 50 respondents from Anggrek Specialist Polyclinic at Dr. Hasan Sadikin General Hospital Bandung (ambulatory setting) who met the inclusion criteria during the period of September to October 2014. Questionnaires that had been validated and tested for reliability were used. Rank Spearman test was used to analyze the correlation between patient satisfaction and patient loyalty. This study used five dimensions of service quality to measure patient satisfaction, i.e. tangibles, reliability, responsiveness, assurance, and empathy.Results: The study showed that most (84%) patients felt unsatisfied and only 14% was loyal towards the health care services they received. Satisfaction and loyalty showed positive correlation with p=0.001 (p<0.05) and r=0.439, which showed a moderate correlation.  Conclusions: There is significant correlation between patient satisfaction and loyalty in Anggrek Specialist Polyclinic at Dr. Hasan Sadikin Hospital. This study can be an evaluative material for health care providers to encourage improvement of service quality as to increase patient satisfaction and loyalty.

Social Determinant Factors of Elderly as an Input in Enhancing Primary Health Care in Indonesia

Objective: To analyze the differences of social determinant factors among elderly according to gender, in urban and rural areas in Indonesia. Indonesia is one of the most populated countries in the world,  faces an increased number of elderly. This situation leads to the increase of degenerative diseases and demands of caregivers as well. The identification of social determinant factors of elderly has an important role in enhancing primary health care. Methods: A comparative study was carried out in 33 provinces in Indonesia using secondary data from Statistics Indonesia 2013. The variables included in this study were percentage of elderly according to  education, marital status, occupation, income and living arrangements, divided in gender, urban and rural areas.  The normally distributed data were analyzed using unpaired T test and not normally distributed data were analyzed using Mann-Whitney test.  Results: This study showed that there were differences in education, occupation and income between urban and rural areas. In urban area, most of the elderly worked in industry and trade and in rural area they worked in agricultural, indicated huge risks of occupational haxards.  Most of them were poor, still married, lived with spouses and family of three generations. Conclusions: It can be concluded that there were differences of social determinant factors (education, occupation and income) in elderly who live in urban and rural areas that can contribute to the risks of disease in elderly and these situations must be considered as an input  to enhance the primary health care. Keywords: Elderly, gender, rural, social determinants, urba

Ability and Willingness to Pay Premium in the Framework of National Health Insurance System

Background: The National Health Insurance is one of the government’s efforts to improve community access to health services. The government has fixed the premiums to be paid by community, except for underprivileged community. The aim of the study was to identify Ability to Pay (ATP) and Willingness to Pay (WTP) of the national health insurance premium.Methods: A descriptive study which involved 210  housewives who were chosen by rapid survey method was conducted from September to November 2013 in Cipacing village, Jatinangor, Sumedang, West Java. Data collection was using questionnaire to obtain level of ability and willingness to pay the health insurance premium. The results were compared to the required premium by the government (Rp 22,000,-).Results: Most of the respondents were only housewives, but there were still respondents who were private workers. Most of them were 20–39 years old. About 57.6% of the respondents were able to pay for the required premium, but Only 17.4% of the them were willing to pay according to the required premium.Conclusions: The ATP of the respondents are higher compared to the WTP, meaning that most of the respondents are able to pay the requires premium but are not willing to pay it. [AMJ.2015;2(4):502–5] DOI: 10.15850/amj.v2n4.63

Cyanosis as Mortality Risk among Children with Severe Pneumonia

Background: Pneumonia is the second leading cause of infant death in Indonesia. The mortality of pneumonia in children is associated with cyanosis, malnutrition, and age less than 4 months. The aim of this study was to determine the relationship between cyanosis, malnutrition, and age less than 4 months with the mortality of infant patients with severe pneumonia at Dr Hasan Sadikin General hospital.Methods: A case-control study has been conducted using medical records of 80 patients with pneumonia at Dr. Hasan Sadikin General Hospital, period January 2007 to December 2013. The inclusion criteria were medical records consisting of information about infants with severe pneumonia, without comorbid diagnoses, who died during hospitalization. While controls were infants who have been discharged from hospital. The independent variables of this study were cyanosis, malnutrition, and age less than 4 months, while the dependent variable was the mortality. Data were analyzed by using univariate and bivariate analysis.Results: The study reported that only cyanosis was associated with mortality. Malnutrition and age less than 4 months were not associated with mortality.Conclusions: Cyanosis is known to be the only factor that has affected the mortality of infants with pneumonia who are hospitalized at Dr. Hasan Sadikin General Hospital. [AMJ.2016;3(2):186–9]DOI: 10.15850/amj.v3n2.79