Jurnal Administrasi Kesehatan Indonesia Fakultas Kesehatan Masyarakat | Universitas Airlangga (original) (raw)

Papers by Jurnal Administrasi Kesehatan Indonesia Fakultas Kesehatan Masyarakat

Indonesian Journal of Health Administration (IJHA), 2021

Background: Healthcare resources are limited therefore, adequate, appropriate and timely allocati... more Background: Healthcare resources are limited therefore, adequate, appropriate and timely allocation of resources are important. Decision to invest on health care program can be made from the analysis of the information obtained on the cost and consequences of the various alternative health programs, often known as economic evaluation of health interventions. Aims: This write-up emphasizes on the importance of evidence driven policy of health intervention whereby economic evaluation should be performed to indicate whether investment on health intervention would benefit the country. Methods: Literature review on economic evaluation studies conducted by the first author during her 14 years tenure as academician had been performed. Various studies which applied the cost-effectiveness analysis tools to economically evaluate health interventions and programs in Malaysia and other countries are shared. Results: The economic evaluation studies cut across different programs such as disease prevention and treatment, public health monitoring and control, and implications of health issues to the healthcare system. Many of the findings have been used for advocacy to shape the delivery of more effective health intervention programs in the country. Conclusion: The country will benefit from economic evaluation studies which could provide evidence to assist in policy making on health programs for the country.

Indonesian Journal of Health Administration (IJHA), 2021

Background: The patient safety incident reporting systems is designed to improve the health care ... more Background: The patient safety incident reporting systems is designed to improve the health care by learning from mistakes to minimize the recurrence mistakes, however the reporting rate is low. Aims: Integrative literature review was chosen to identify and analyze the barriers of reporting patient safety incidents by health care workers (HCWs) in hospital. Methods: Searching for articles in electronic database consisting of Medline, CINAHL and Scopus resulted in 11 relevant articles originating from 9 countries. Results: There are differences but similar in barriers to reporting patient safety incident among HCWs. The barriers that occur are the existence of shaming and blaming culture, lack of time to report, lack of knowledge of the reporting system, and lack of support from the management. Conclusion: Each hospital has different barriers in reporting incident and the interventions carried out must be in accordance with the existing barriers.

Indonesian Journal of Health Administration (IJHA), 2021

Background: One of the nurse's roles is to provide nursing care regards of patient safety, consis... more Background: One of the nurse's roles is to provide nursing care regards of patient safety, consistently and timely. The availability of nurses and equipment can be considered as a primary constraint contributing to acute missed nursing care. Aims: This study aimed to determine the correlation between the availability of nurses and equipment with incidences of acute missed nursing care in medical and surgical wards at hospitals. Methods: This study used quantitative research with a cross sectional approach. This research was conducted at six private hospitals in Malang from October 2020 to November 2020. The population in this study were selected using consecutive sampling, and the study sample consisted of 206 nurses. The acute MISSCARE Survey was used to collect data. The relationship between the availability of the number of nurses and equipment with acute missed nursing care was analyzed by applying SPSS version 26 with the Spearman test. Results: The relationship between the availability of nurses and acute missed nursing care yielded results of ρ = 0.016 (<0.05) and R =-0.168. Equipment availability and acute missed nursing care had values of ρ = 0.026 (<0.05), and R =-0.155. This shows correlation between the availability of the number of nurses and equipment with incidences of acute missed nursing care. Conclusion: The availability of the number of nurses and equipment are the reasons for the incidence of acute missed nursing care. Therefore, nursing managers are needed in managing and allocating the necessary number of nurses and equipment.

Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia), 2021

Background: As a health service institution, hospitals have characteristics and management comple... more Background: As a health service institution, hospitals have characteristics and management complexities which have an impact on their financing aspects. Controlling the supply of pharmaceutical supplies aims to create a balance between supply and demand in order to realize effective and efficient health services. Aims: This study aimed to design a method for controlling the optimal supply of disposable medical materials at the Bali Mandara Eye Hospital, Bali. Methods: This is a qualitative study based on in-depth interviews with three informants, and involving 11 doctors (users) to determine the critical value of disposable medical materials. Results: ABC analysis was used to classify all types of goods based on their importance to determine priorities based on the value of use. The budget allocation was dominated by only a small portion or only a few types of pharmaceutical supplies. The results show that there was a decrease in the total cost of inventory by 19.14% after the application of the EOQ method. The application of the reorder point (ROP) method can anticipate the occurrence of stock outs or vacancies. Conclusion: The EOQ method is more efficient than the conventional method applied at the Bali Mandara Eye Hospital Pharmacy Installation. The EOQ and ROP methods greatly affect the efficiency and effectiveness of controlling the inventory of medical disposable materials at the Bali Mandara Eye Hospital.

Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia), 2021

Background: Pharmacy managers will make various efforts to increase their income. In spite of thi... more Background: Pharmacy managers will make various efforts to increase their income. In spite of this, pharmacies that have the same facilities can generate greatly varied incomes. Aims: The purpose of this study was to determine the difference between high sales turnover pharmacies and low sales turnover pharmacies as observed through employee motivation, organizational culture, and patient satisfaction. Methods: This study used an analytical design with a questionnaire and checklist. Consumers were selected using the purposive sampling system to assess patient satisfaction. All employees were sampled to assess work motivation and organizational culture. Data analysis was performed using descriptive, bivariate, and multivariate testing. Results: Direct observation of pharmaceutical services from the two outlets shows that there were differences in the time it takes for pharmacist to retrieve the drug, the time for providing drug information, collecting information from patients, and the type of drug information provided, as well as employee motivation, organizational culture, and patient satisfaction. Conclusion: Services at pharmacies with high sales turnover are different from pharmacies with low sales turnover. Empathy has the greatest effect on sales turnover, followed by reliability, responsiveness, assurance, and tangible dimensions. Outlets that have high sales turnover have better organizational culture and higher employee motivation when compared to outlets that have low sales turnover.

Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia), 2021

Background: Treatment variations have been considered as a sign of an inappropriate healthcare se... more Background: Treatment variations have been considered as a sign of an inappropriate healthcare service whether due to the underuse or the overuse of resources. To reduce these variations, establishing and implementing well-developed standardized operating procedures (SOPs) and evidence-based standardized clinical guidelines is required. A rehabilitation unit for children with disabilities in Makassar did not implement any SOPs or standardized clinical guidelines in their service and treatment. This conduct may have an adverse effect on physiotherapists' professionalism. Aims: The study aimed to explore the possible impact of community-based rehabilitation (CBR) practice with no SOPs and evidence-based standardized clinical guidelines on the physiotherapists. Method: This study was a qualitative case study. The CBR unit was observed for 278-hours and the study conducted three semistructured interviews. Three physiotherapists voluntarily participated in the study. Open, axial, and selective coding were conducted to encode the interview findings. The findings from observation encoded interview, field, and self-reflective notes were triangulated, analyzed thematically, and illustrated by the explorative model. Results: Working with no SOPs and guidelines was associated with variations in procedures by physiotherapists, irregularity in their treatment choices, liability feeling toward errors making, and Low self-confidence in their professionalism. Conclusion: Working without SOPs and guidelines was associated with psychological exertion of the physiotherapists. They showed uncertainty in their professional capabilities as a physiotherapist. It is recommended for YPAC Makassar city to develop SOPs and evidence-based standardized clinical guidelines for their organization.

Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia), 2021

Background: The COVID-19 pandemic has constituted concurrent public health and economic crises. A... more Background: The COVID-19 pandemic has constituted concurrent public health and economic crises. An inter-correlation between economic and public health impacts due to the COVID-19 pandemic needs to be studied to improve mitigation measures. Aims: This study identified a correlation of the economic insecurity and perceived stress with adherence to recommended preventive behaviours Methods: This across-sectional analytic study was conducted to adults in the working areas of East Denpasar Primary Healthcare Center I. Respondents were selected using consecutive sampling and given a self-administered questionnaire. The research variables included demographic characteristics, economic insecurity indicators, perceived stress, and adherence to handwashing, mask-wearing, physical distancing, and limitation on the social gathering. Correlations, linear regressions, and path analyses were conducted using IBM SPSS 23.0. Results: As many as 161 respondents of which 34.2% males were involved had a mean age of 36.31 (± 7.16) years. Sex, job insecurity, income insecurity, and perceived stress were found as independent determinants in females. Female sex and job insecurity was associated with better preventive behaviours with an adjusted β value of 0.276 and 0.306, while income insecurity and perceived stress had the opposite association with a β value of-0.247 and-0.224. Conclusion: There are correlations between economic insecurity and preventive behavioural practices during COVID-19. It is suggested that public health policies against COVID-19 cover measures of economic safety nets to improve adherence

Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia), 2021

Background: Hand hygiene is the simplest practical method of preventing cross-infection. Knowledg... more Background: Hand hygiene is the simplest practical method of preventing cross-infection. Knowledge of hand hygiene plays a vital role in determining adherence to hand hygiene. Nosocomial infection is an infection that occurs in patients in hospital. Aims: This study aims to analyze the knowledge of health workers regarding hand hygiene in Palembang hospitals during Covid-19 era. Methods: This study used a cross-sectional design with 300 health workers who worked in hospitals in Palembang. They are selected by simple random sampling. Data were collected using online questionnaire during October 2020. Results: The majority of respondents were female (88.67%), with the majority age group 30-39 years (43.67%), the majority of respondent came from nurses (63%), work in inpatient rooms (27.33%). A total of 80.67% of respondents have received formal training related to hand hygiene. 96% used alcohol-based hand rub. About 15.33% of respondents indicated good knowledge, moderate knowledge (80.33%), and less knowledge (4.3%) regarding hand hygiene. The difference in health workers' profession was significantly related to the level of knowledge about hand hygiene (p <0.05). Conclusion: There are differences in the level of knowledge about hand hygiene in each type of health worker profession

Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia), 2021

Background: The world is in the grip of an unprecedented novel COVID-19 pandemic. These have resu... more Background: The world is in the grip of an unprecedented novel COVID-19 pandemic. These have resulted in massive impacts on humans as well as on economies invariably. Hence, planning for a future pandemic is vital in minimizing deleterious effects. Aims: The current review aimed to derive common policy perspectives that are important in future planning of a pandemic. Methods: A narrative review was conducted by searching published articles from PubMed, Medline, Scopus, CINAHL, and Google Scholar. Forty-eight articles were selected for the review. Results: The policy perspectives derived under mitigation were rearranged into surveillance, epidemiology, and lab activities. The policy perspectives under recovery derived were related to economy, supply chain management, sustainable and green concept, and health system. Conclusion: Understanding common policy perspectives is important in the mitigation and recovery planning of a pandemic with similar nature in the future. The spillover effects in response to the mitigation measures are deemed vital in planning mitigation and recovery measures for future pandemics. Global and regional resource sharing mechanisms are vital when a universal shortage of healthcare resources occurs.

Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia), 2021

Background: Interprofessional collaboration for patient care is integrated cooperation between he... more Background: Interprofessional collaboration for patient care is integrated cooperation between health workers in ensuring optimally consecutive patient care. Interprofessional decisions should be made in two ways between professional caregivers. Aims: This study aimed to analyze communication between professional caregivers in establishing interprofessional collaboration at Meuraxa District General Hospital in Banda Aceh. Method: This study was qualitative research and used a phenomenological approach. In-depth interviews and FGD were conducted with professional caregivers consisting of doctors in charge, nurses, pharmacists, and dietitians. All of the in-depth interviews and FGD were recorded and transcribed. Data obtained were analyzed thematically. Results: Communication between professional caregivers in establishing interprofessional collaboration at the hospital had not been well-performed. Overall, they had not optimally utilized integrated patient progress records as they focused on taking care of their patients individually. They also lacked literacy about the information in the records. Inadequate time in serving patients and the insufficient number of human resources were presumed to hamper interprofessional communication. Conclusion: Promoting interprofessional collaboration and effective communication regularly is required by the hospital management. They also need to evaluate the sufficiency of human resources, especially pharmacist positions. Besides, they can formulate supervision and evaluation systems of interprofessional communication between professional caregivers.

Indonesian Journal of Health Administration, 2021

Background: Drug misuse is a global threat, including in Indonesia. Solving issues of drug use i... more Background: Drug misuse is a global threat, including in Indonesia. Solving issues of drug use is by understanding the drug patterns. One of the important concepts related to public policy in drug addiction is the gateway hypothesis. However, not all researchers support this theory as the initation of drug use is debatable in terms of how a person starts to consume tobacco and alcohol, marijuana, and then other drugs.

Aim: This study identified a initiation sequence of drug use, particularly the gateway from soft to hard drugs and its reverse from hard to soft drug patterns.

Methods: This study employed a dataset of drug user patients aged 14–67 years from the Rehabilitation Center of National Narcotics Board in 2014-2018. The dataset was assessed using the Addiction Severity Index (ASI). Purposive sampling was utilized in the sample selection. The dataset was divided into three subsamples to identify the pattern. The subsamples included regular soft-drug users, regular intermediate-drug users, and regular hard-drug users. This study used a quantitative method and cross-tabulation approach along with descriptive statistics.

Results: Most of the drug users began consuming intermediate drugs and then soft drugs. Only early users followed the gateway pattern, while those in the intermediate and hard drug pattern mostly did not have the gateway pattern.

Conclusion: A policy about prevention of soft drug use (marijuana) in early use may be effective to reduce harder drug use in the future.

Indonesian Journal of Health Administration, 2021

Wearing a universal face mask is recommended by most health authorities during the COVID-19 pande... more Wearing a universal face mask is recommended by most health authorities during the COVID-19 pandemic. This commentary elaborates directives given in relation to the use of face masks and identify the underlying principles for public health recommendations by the government authorities of Australia, Canada, China, Hong Kong, Singapore, the United Kingdom and the United States of America. Key data were considered from official government websites by a team of healthcare management experts. It was argued that the directives recommended by the governments were based on the principles addressing the different facets of COVID-19 pandemic, population dynamics, resource availability and scarcity, and the fact that how the proposed standard of practices would be translated into compulsory obligations in the community. The principles involved regulations versus voluntary compliance of the population, transmission scenario, protection from sick or asymptomatic people, special needs and vulnerable groups, synergistic versus substitute/alternative, occupational health risk, adverse effects on usage, types of masks which depend on the risk or context, change in use practices depending on demand, scarcity and quality assurance. Recommendations of the use of face masks were found to be heterogeneous and apparently inconstant. Within the dynamic situation of the COVID-19 pandemic, the directives on community use of face masks were issued based on certain dominant principles and interplayed between principles that should be deeply explored by the healthcare decision makers.

Indonesian Journal of Health Administration, 2021

Background: The assessment from the patient's perspective is the assurance of TB service’ quality... more Background: The assessment from the patient's perspective is the assurance of TB service’ quality to achieve the "End TB" target. The information regarding TB services’ quality assessment in the dimensions of QUOTE TB Light is not widely found.
Aims: The study aims to review TB services' quality from the patients’ perspective in the 7 dimensions of QUOTE TB Light.
Methods: This literature review study searched from 3 databases, namely PubMed, Science-Direct, and Google Scholar since July - October 2020. The inclusion criteria were research on TB services quality, patients’ perspective, and patient assessment of 7 dimenssion. Articles assessed the other health services’ quality and published before January 2015 was excluded.
Results: A total of 7 from 89 articles found were selected for review. The patients’ assessments are based on their experiences or satisfactions. Most of the studies are satisfied with service availability, communication, patient-provider interactions, competence, and affordability. The patients’ dissatisfactions about infrastructure and stigma acquired during treatment.
Conclusion: Infrastructure and stigma are assessed negatively. The continously evaluation and training for health workers need to be improved so they can serve patients well. The patients’ perspectives can be the major consideration for providers to enhance the TB services’ quality.

Indonesian Journal of Health Administration, 2021

Background: Career ladder is given to nurses to encourage and maintain professional development a... more Background: Career ladder is given to nurses to encourage and maintain professional development and practice of nursing. Career ladder has an impact on raising clinical levels, promotion opportunities, competency complexity, rewards and recognition. In this study, the career ladder has started by mapping and conducting, credentials and competency assessment at the levels of pre Nurse Clinicians, Nurse Clinicians Level I and Nurse Clinicians Level II. Almost half of the nurses were dissatisfied (47.2%) with their career development.

Aims: This study was to analyzed the relationship between the career ladder and nurses’ job satisfaction.

Methods: This study was a quantitative correlational study with a cross-sectional approach. There were 108 nurses as samples selected using consecutive sampling techniques. These respondent who met the inclusion criteria came from Inpatient Room, (i.e VVIP, VIP, Class I, Class 2/3, Ophthalmology Inpatient), Polyclinic, Chemotherapy Unit, NICU (Neonatal Intensive Care Unit), ICU (Intensive Care Unit), Hemodialysis, Emergency room and COT (Centra Operation Theater). Data were analyzed using the Spearman test.

Results: There was a significant relationship between career ladder (p=0.000) and nurse’ job satisfaction. The nurse were satisfied with her career development related to implementation of career ladder. Besides, career ladder allowed to be promoted as the heads of the rooms. Rewards and recognition of nurses’ competencies through job promotion affected nurses’ satisfaction.

Conclusion: Career ladder affects nurse satisfaction. Nurses can advance their careers through a career promotion, competencies, rewards and recognition from other health professionals. Support from nurse manager is needed as a form of mentoring and evaluation of nurse performance in the career ladder.

Indonesian Journal of Health Administration, 2021

Background: Error rate in medical laboratories is very low. Only one error is identified every 33... more Background: Error rate in medical laboratories is very low. Only one error is identified every 330–1,000 events. The goal of laboratory services should outweigh patient safety in a well-structured manner. Healthcare Failure Mode and Effect Analysis (HFMEA) is a proactive preventive method for identifying and evaluating potential failure.

Aims: This study identified factors affecting patient safety in hospital laboratories and described potential risk identification process using the HFMEA.

Methods: This study was conducted between March-July 2020 and retrieved data from PubMed, Scopus, and Google Scholar. The data were generalized and extracted into Table 2 based on factors dealing with patient safety in hospital laboratories. This study performed a risk identification design based on the steps of HFMEA.

Results: Out of 4,062 articles collected, only 8 articles between 2013–2020 were included for analysis. The highest error rate in laboratories occurred in the pre-analytic phase (49.2%–84.5%). The errors included clotted and inadequate specimen volume, and thus the specimens were rejected. Factors related to patient safety in laboratories were patient condition, laboratory staff performance (including training, negligence, and burnout), facilities, and accreditation.

Conclusion: The HFMEA process used the result of hazard analysis with severity and probability criteria categorized into health sector. Decision tree analysis could determine the next step of the work process. The HFMEA must be adjusted to the equipment and technologies in each hospital laboratory. Leader’s commitment in monitoring and evaluation is required to maintain patient safety culture. More comprehensive data from Indonesian hospital laboratories are needed to generate more representative and applicable results.

Indonesian Journal of Health Administration, 2021

Background: Hospital is a health care institution that provides public services for patients. It ... more Background: Hospital is a health care institution that provides public services for patients. It needs computerized information technology, for example, a hospital information management system.

Aims: This study was aimed at analyzing the implementation of hospital management information system using the human organization fit model at the Outpatient Department of Sabang General Hospital.

Methods: This study was conducted from March-June 2020 using a cross sectional design. The study’s population was the hospital managers, administration staff and health workers at the hospital. The study’s sample size was 106 respondents selected using a purposive sampling. This study used a quantitative design in which the data analysis was done using a spearman correlation test with P-value of =<0.05. The independent variables were the quality of system, quality of information, and quality of care. While the dependent variables included system user, user satisfaction and organization. The data were collected through questionnaire distributed to the respondents.

Results: The quality of system did not have a relationship with the system user (P=0.585), user satisfaction (P=0.541), and organization (P=0.256). The quality of information had a relationship with the system user(P=0.004) and user satisfaction (P=0.000), but it did not have a relationship with organization (P=0.132). The quality of care had a relationship with the system user(P=0.000), user satisfaction (P=0.000) and organization (P=0.000).

Conclusion: The Sabang General Hospital, Aceh, needs to improve the hospital management information system with the HOT-fit model, especially the quality of system. They can conduct training for users and provide applicable and attractive manuals.

Indonesian Journal of Health Administration, 2021

Background: The implementation of the National Health Insurance (JKN) program has created a trans... more Background: The implementation of the National Health Insurance (JKN) program has created a transformation in the health care system in Indonesia. Many hospitals were stuttering and unable to adapt to the new payment system. Some hospitals complained about INA-CBG rates that were lower than the real rates, so that hospitals suffered losses.

Aims: This research aims to take the best practice from one government hospital and one private hospital that is able to thrive in the JKN era.

Methods: This study used qualitative research methods through in-depth interviews.

Results: The similarity of strategies carried out by the two best practice hospitals to thrive in JKN era are efficiency in business process, investment in human resources, customer relationship management, and stakeholders collaboration.

Conclusion: The results of this study can be used as a reference for government and private hospitals in Indonesia to be able to thrive in the JKN era.

Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia), 2021

The health system in Indonesia is facing the persistent burden of maternal mortality and infectio... more The health system in Indonesia is facing the persistent burden of maternal mortality and infectious diseases (including COVID-19) and an increasing burden of non-communicable diseases. Thus, health system reform and innovations at all levels are needed, including through lessons learned from other countries. There are at least five lessons from primary health care in the United Kingdom: easy access, digital and online services, continuity of care, managing chronic conditions, and referral and counter-referral system. There are lessons that policymakers and stakeholders at the national and local (city/district) level could potentially learn from. Despite the differences between the UK and Indonesia (e.g. country income level, national health systems), these lessons could be adapted or piloted in some settings.

Jurnal Administrasi Kesehatan Indonesia, 2020

Background: The most essential aspect to reduce the number of maternal and newborn mortality is m... more Background: The most essential aspect to reduce the number of maternal and newborn mortality is midwife competence. Midwives have a great role to be able to handle variety of health services (antepartum, intrapartum, and postpartum) to avoid or decrease the maternal and infant mortality rate. Performance of health workers, particularly midwives, is the most crucial in affecting the quality and quantity of midwives' services to enhance the national health development. Aim: This study analyzed factors affecting village midwife performance for reducing maternal and infant mortality in seek for achieving Bone Bolango cemerlang or bright Bone Balango as the vision of Bone Bolango District in 2021. Methods: This study was an analytical survey with a cross-sectional approach. It was conducted from March to June 2019 in the working area of Bone Bolango District Health Office. There were 227 people from 19 primary healthcare centers as the population, and the sample size was 227 selected by using the total sampling technique. The data were collected by distributing questionnaires to the respondents and using secondary data. The data processing was done through chi-square test and multiple logistic regression with backward wald method. Results: Midwife performance in Bone Bolango District was assessed based on several variables. Most of them were ≥ 25 years old (80.6%); worked for ≥ five years (58,6%); mostly had not participated in any normal childbirth care training (76.7%); had a good competence (96.5%); had good resources/equipment (79.7%); had a good reward (92.5%); had a good attitude (76.2%); had a good motivation (90.7%). There were 12 maternal mortalities from 2017 to 2019 handled by only 11 midwives (4.8%). On the other hand, infant mortality rate (IMR) reached 25 cases in the same years; of 227 midwives, these cases were handled by only 21 midwives (9.3%). Conclusion: A midwife as a part of the health workers has an important role to increase the quality of maternal and child well-being program. Some variables that became indicators of midwife performance and had an effect on reducing the MMR and IMR included work period, reward, and motivation. This study recommends that all midwives have to be provided with a normal childbirth care training in the working area and increased rewards in the process of labor and delivery.

https://e-journal.unair.ac.id/JAKI/article/view/19708, 2020

Background: The fluctuated patient satisfaction level shows the need to improve nursing performance.

Indonesian Journal of Health Administration (IJHA), 2021

Background: Healthcare resources are limited therefore, adequate, appropriate and timely allocati... more Background: Healthcare resources are limited therefore, adequate, appropriate and timely allocation of resources are important. Decision to invest on health care program can be made from the analysis of the information obtained on the cost and consequences of the various alternative health programs, often known as economic evaluation of health interventions. Aims: This write-up emphasizes on the importance of evidence driven policy of health intervention whereby economic evaluation should be performed to indicate whether investment on health intervention would benefit the country. Methods: Literature review on economic evaluation studies conducted by the first author during her 14 years tenure as academician had been performed. Various studies which applied the cost-effectiveness analysis tools to economically evaluate health interventions and programs in Malaysia and other countries are shared. Results: The economic evaluation studies cut across different programs such as disease prevention and treatment, public health monitoring and control, and implications of health issues to the healthcare system. Many of the findings have been used for advocacy to shape the delivery of more effective health intervention programs in the country. Conclusion: The country will benefit from economic evaluation studies which could provide evidence to assist in policy making on health programs for the country.

Indonesian Journal of Health Administration (IJHA), 2021

Background: The patient safety incident reporting systems is designed to improve the health care ... more Background: The patient safety incident reporting systems is designed to improve the health care by learning from mistakes to minimize the recurrence mistakes, however the reporting rate is low. Aims: Integrative literature review was chosen to identify and analyze the barriers of reporting patient safety incidents by health care workers (HCWs) in hospital. Methods: Searching for articles in electronic database consisting of Medline, CINAHL and Scopus resulted in 11 relevant articles originating from 9 countries. Results: There are differences but similar in barriers to reporting patient safety incident among HCWs. The barriers that occur are the existence of shaming and blaming culture, lack of time to report, lack of knowledge of the reporting system, and lack of support from the management. Conclusion: Each hospital has different barriers in reporting incident and the interventions carried out must be in accordance with the existing barriers.

Indonesian Journal of Health Administration (IJHA), 2021

Background: One of the nurse's roles is to provide nursing care regards of patient safety, consis... more Background: One of the nurse's roles is to provide nursing care regards of patient safety, consistently and timely. The availability of nurses and equipment can be considered as a primary constraint contributing to acute missed nursing care. Aims: This study aimed to determine the correlation between the availability of nurses and equipment with incidences of acute missed nursing care in medical and surgical wards at hospitals. Methods: This study used quantitative research with a cross sectional approach. This research was conducted at six private hospitals in Malang from October 2020 to November 2020. The population in this study were selected using consecutive sampling, and the study sample consisted of 206 nurses. The acute MISSCARE Survey was used to collect data. The relationship between the availability of the number of nurses and equipment with acute missed nursing care was analyzed by applying SPSS version 26 with the Spearman test. Results: The relationship between the availability of nurses and acute missed nursing care yielded results of ρ = 0.016 (<0.05) and R =-0.168. Equipment availability and acute missed nursing care had values of ρ = 0.026 (<0.05), and R =-0.155. This shows correlation between the availability of the number of nurses and equipment with incidences of acute missed nursing care. Conclusion: The availability of the number of nurses and equipment are the reasons for the incidence of acute missed nursing care. Therefore, nursing managers are needed in managing and allocating the necessary number of nurses and equipment.

Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia), 2021

Background: As a health service institution, hospitals have characteristics and management comple... more Background: As a health service institution, hospitals have characteristics and management complexities which have an impact on their financing aspects. Controlling the supply of pharmaceutical supplies aims to create a balance between supply and demand in order to realize effective and efficient health services. Aims: This study aimed to design a method for controlling the optimal supply of disposable medical materials at the Bali Mandara Eye Hospital, Bali. Methods: This is a qualitative study based on in-depth interviews with three informants, and involving 11 doctors (users) to determine the critical value of disposable medical materials. Results: ABC analysis was used to classify all types of goods based on their importance to determine priorities based on the value of use. The budget allocation was dominated by only a small portion or only a few types of pharmaceutical supplies. The results show that there was a decrease in the total cost of inventory by 19.14% after the application of the EOQ method. The application of the reorder point (ROP) method can anticipate the occurrence of stock outs or vacancies. Conclusion: The EOQ method is more efficient than the conventional method applied at the Bali Mandara Eye Hospital Pharmacy Installation. The EOQ and ROP methods greatly affect the efficiency and effectiveness of controlling the inventory of medical disposable materials at the Bali Mandara Eye Hospital.

Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia), 2021

Background: Pharmacy managers will make various efforts to increase their income. In spite of thi... more Background: Pharmacy managers will make various efforts to increase their income. In spite of this, pharmacies that have the same facilities can generate greatly varied incomes. Aims: The purpose of this study was to determine the difference between high sales turnover pharmacies and low sales turnover pharmacies as observed through employee motivation, organizational culture, and patient satisfaction. Methods: This study used an analytical design with a questionnaire and checklist. Consumers were selected using the purposive sampling system to assess patient satisfaction. All employees were sampled to assess work motivation and organizational culture. Data analysis was performed using descriptive, bivariate, and multivariate testing. Results: Direct observation of pharmaceutical services from the two outlets shows that there were differences in the time it takes for pharmacist to retrieve the drug, the time for providing drug information, collecting information from patients, and the type of drug information provided, as well as employee motivation, organizational culture, and patient satisfaction. Conclusion: Services at pharmacies with high sales turnover are different from pharmacies with low sales turnover. Empathy has the greatest effect on sales turnover, followed by reliability, responsiveness, assurance, and tangible dimensions. Outlets that have high sales turnover have better organizational culture and higher employee motivation when compared to outlets that have low sales turnover.

Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia), 2021

Background: Treatment variations have been considered as a sign of an inappropriate healthcare se... more Background: Treatment variations have been considered as a sign of an inappropriate healthcare service whether due to the underuse or the overuse of resources. To reduce these variations, establishing and implementing well-developed standardized operating procedures (SOPs) and evidence-based standardized clinical guidelines is required. A rehabilitation unit for children with disabilities in Makassar did not implement any SOPs or standardized clinical guidelines in their service and treatment. This conduct may have an adverse effect on physiotherapists' professionalism. Aims: The study aimed to explore the possible impact of community-based rehabilitation (CBR) practice with no SOPs and evidence-based standardized clinical guidelines on the physiotherapists. Method: This study was a qualitative case study. The CBR unit was observed for 278-hours and the study conducted three semistructured interviews. Three physiotherapists voluntarily participated in the study. Open, axial, and selective coding were conducted to encode the interview findings. The findings from observation encoded interview, field, and self-reflective notes were triangulated, analyzed thematically, and illustrated by the explorative model. Results: Working with no SOPs and guidelines was associated with variations in procedures by physiotherapists, irregularity in their treatment choices, liability feeling toward errors making, and Low self-confidence in their professionalism. Conclusion: Working without SOPs and guidelines was associated with psychological exertion of the physiotherapists. They showed uncertainty in their professional capabilities as a physiotherapist. It is recommended for YPAC Makassar city to develop SOPs and evidence-based standardized clinical guidelines for their organization.

Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia), 2021

Background: The COVID-19 pandemic has constituted concurrent public health and economic crises. A... more Background: The COVID-19 pandemic has constituted concurrent public health and economic crises. An inter-correlation between economic and public health impacts due to the COVID-19 pandemic needs to be studied to improve mitigation measures. Aims: This study identified a correlation of the economic insecurity and perceived stress with adherence to recommended preventive behaviours Methods: This across-sectional analytic study was conducted to adults in the working areas of East Denpasar Primary Healthcare Center I. Respondents were selected using consecutive sampling and given a self-administered questionnaire. The research variables included demographic characteristics, economic insecurity indicators, perceived stress, and adherence to handwashing, mask-wearing, physical distancing, and limitation on the social gathering. Correlations, linear regressions, and path analyses were conducted using IBM SPSS 23.0. Results: As many as 161 respondents of which 34.2% males were involved had a mean age of 36.31 (± 7.16) years. Sex, job insecurity, income insecurity, and perceived stress were found as independent determinants in females. Female sex and job insecurity was associated with better preventive behaviours with an adjusted β value of 0.276 and 0.306, while income insecurity and perceived stress had the opposite association with a β value of-0.247 and-0.224. Conclusion: There are correlations between economic insecurity and preventive behavioural practices during COVID-19. It is suggested that public health policies against COVID-19 cover measures of economic safety nets to improve adherence

Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia), 2021

Background: Hand hygiene is the simplest practical method of preventing cross-infection. Knowledg... more Background: Hand hygiene is the simplest practical method of preventing cross-infection. Knowledge of hand hygiene plays a vital role in determining adherence to hand hygiene. Nosocomial infection is an infection that occurs in patients in hospital. Aims: This study aims to analyze the knowledge of health workers regarding hand hygiene in Palembang hospitals during Covid-19 era. Methods: This study used a cross-sectional design with 300 health workers who worked in hospitals in Palembang. They are selected by simple random sampling. Data were collected using online questionnaire during October 2020. Results: The majority of respondents were female (88.67%), with the majority age group 30-39 years (43.67%), the majority of respondent came from nurses (63%), work in inpatient rooms (27.33%). A total of 80.67% of respondents have received formal training related to hand hygiene. 96% used alcohol-based hand rub. About 15.33% of respondents indicated good knowledge, moderate knowledge (80.33%), and less knowledge (4.3%) regarding hand hygiene. The difference in health workers' profession was significantly related to the level of knowledge about hand hygiene (p <0.05). Conclusion: There are differences in the level of knowledge about hand hygiene in each type of health worker profession

Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia), 2021

Background: The world is in the grip of an unprecedented novel COVID-19 pandemic. These have resu... more Background: The world is in the grip of an unprecedented novel COVID-19 pandemic. These have resulted in massive impacts on humans as well as on economies invariably. Hence, planning for a future pandemic is vital in minimizing deleterious effects. Aims: The current review aimed to derive common policy perspectives that are important in future planning of a pandemic. Methods: A narrative review was conducted by searching published articles from PubMed, Medline, Scopus, CINAHL, and Google Scholar. Forty-eight articles were selected for the review. Results: The policy perspectives derived under mitigation were rearranged into surveillance, epidemiology, and lab activities. The policy perspectives under recovery derived were related to economy, supply chain management, sustainable and green concept, and health system. Conclusion: Understanding common policy perspectives is important in the mitigation and recovery planning of a pandemic with similar nature in the future. The spillover effects in response to the mitigation measures are deemed vital in planning mitigation and recovery measures for future pandemics. Global and regional resource sharing mechanisms are vital when a universal shortage of healthcare resources occurs.

Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia), 2021

Background: Interprofessional collaboration for patient care is integrated cooperation between he... more Background: Interprofessional collaboration for patient care is integrated cooperation between health workers in ensuring optimally consecutive patient care. Interprofessional decisions should be made in two ways between professional caregivers. Aims: This study aimed to analyze communication between professional caregivers in establishing interprofessional collaboration at Meuraxa District General Hospital in Banda Aceh. Method: This study was qualitative research and used a phenomenological approach. In-depth interviews and FGD were conducted with professional caregivers consisting of doctors in charge, nurses, pharmacists, and dietitians. All of the in-depth interviews and FGD were recorded and transcribed. Data obtained were analyzed thematically. Results: Communication between professional caregivers in establishing interprofessional collaboration at the hospital had not been well-performed. Overall, they had not optimally utilized integrated patient progress records as they focused on taking care of their patients individually. They also lacked literacy about the information in the records. Inadequate time in serving patients and the insufficient number of human resources were presumed to hamper interprofessional communication. Conclusion: Promoting interprofessional collaboration and effective communication regularly is required by the hospital management. They also need to evaluate the sufficiency of human resources, especially pharmacist positions. Besides, they can formulate supervision and evaluation systems of interprofessional communication between professional caregivers.

Indonesian Journal of Health Administration, 2021

Background: Drug misuse is a global threat, including in Indonesia. Solving issues of drug use i... more Background: Drug misuse is a global threat, including in Indonesia. Solving issues of drug use is by understanding the drug patterns. One of the important concepts related to public policy in drug addiction is the gateway hypothesis. However, not all researchers support this theory as the initation of drug use is debatable in terms of how a person starts to consume tobacco and alcohol, marijuana, and then other drugs.

Aim: This study identified a initiation sequence of drug use, particularly the gateway from soft to hard drugs and its reverse from hard to soft drug patterns.

Methods: This study employed a dataset of drug user patients aged 14–67 years from the Rehabilitation Center of National Narcotics Board in 2014-2018. The dataset was assessed using the Addiction Severity Index (ASI). Purposive sampling was utilized in the sample selection. The dataset was divided into three subsamples to identify the pattern. The subsamples included regular soft-drug users, regular intermediate-drug users, and regular hard-drug users. This study used a quantitative method and cross-tabulation approach along with descriptive statistics.

Results: Most of the drug users began consuming intermediate drugs and then soft drugs. Only early users followed the gateway pattern, while those in the intermediate and hard drug pattern mostly did not have the gateway pattern.

Conclusion: A policy about prevention of soft drug use (marijuana) in early use may be effective to reduce harder drug use in the future.

Indonesian Journal of Health Administration, 2021

Wearing a universal face mask is recommended by most health authorities during the COVID-19 pande... more Wearing a universal face mask is recommended by most health authorities during the COVID-19 pandemic. This commentary elaborates directives given in relation to the use of face masks and identify the underlying principles for public health recommendations by the government authorities of Australia, Canada, China, Hong Kong, Singapore, the United Kingdom and the United States of America. Key data were considered from official government websites by a team of healthcare management experts. It was argued that the directives recommended by the governments were based on the principles addressing the different facets of COVID-19 pandemic, population dynamics, resource availability and scarcity, and the fact that how the proposed standard of practices would be translated into compulsory obligations in the community. The principles involved regulations versus voluntary compliance of the population, transmission scenario, protection from sick or asymptomatic people, special needs and vulnerable groups, synergistic versus substitute/alternative, occupational health risk, adverse effects on usage, types of masks which depend on the risk or context, change in use practices depending on demand, scarcity and quality assurance. Recommendations of the use of face masks were found to be heterogeneous and apparently inconstant. Within the dynamic situation of the COVID-19 pandemic, the directives on community use of face masks were issued based on certain dominant principles and interplayed between principles that should be deeply explored by the healthcare decision makers.

Indonesian Journal of Health Administration, 2021

Background: The assessment from the patient's perspective is the assurance of TB service’ quality... more Background: The assessment from the patient's perspective is the assurance of TB service’ quality to achieve the "End TB" target. The information regarding TB services’ quality assessment in the dimensions of QUOTE TB Light is not widely found.
Aims: The study aims to review TB services' quality from the patients’ perspective in the 7 dimensions of QUOTE TB Light.
Methods: This literature review study searched from 3 databases, namely PubMed, Science-Direct, and Google Scholar since July - October 2020. The inclusion criteria were research on TB services quality, patients’ perspective, and patient assessment of 7 dimenssion. Articles assessed the other health services’ quality and published before January 2015 was excluded.
Results: A total of 7 from 89 articles found were selected for review. The patients’ assessments are based on their experiences or satisfactions. Most of the studies are satisfied with service availability, communication, patient-provider interactions, competence, and affordability. The patients’ dissatisfactions about infrastructure and stigma acquired during treatment.
Conclusion: Infrastructure and stigma are assessed negatively. The continously evaluation and training for health workers need to be improved so they can serve patients well. The patients’ perspectives can be the major consideration for providers to enhance the TB services’ quality.

Indonesian Journal of Health Administration, 2021

Background: Career ladder is given to nurses to encourage and maintain professional development a... more Background: Career ladder is given to nurses to encourage and maintain professional development and practice of nursing. Career ladder has an impact on raising clinical levels, promotion opportunities, competency complexity, rewards and recognition. In this study, the career ladder has started by mapping and conducting, credentials and competency assessment at the levels of pre Nurse Clinicians, Nurse Clinicians Level I and Nurse Clinicians Level II. Almost half of the nurses were dissatisfied (47.2%) with their career development.

Aims: This study was to analyzed the relationship between the career ladder and nurses’ job satisfaction.

Methods: This study was a quantitative correlational study with a cross-sectional approach. There were 108 nurses as samples selected using consecutive sampling techniques. These respondent who met the inclusion criteria came from Inpatient Room, (i.e VVIP, VIP, Class I, Class 2/3, Ophthalmology Inpatient), Polyclinic, Chemotherapy Unit, NICU (Neonatal Intensive Care Unit), ICU (Intensive Care Unit), Hemodialysis, Emergency room and COT (Centra Operation Theater). Data were analyzed using the Spearman test.

Results: There was a significant relationship between career ladder (p=0.000) and nurse’ job satisfaction. The nurse were satisfied with her career development related to implementation of career ladder. Besides, career ladder allowed to be promoted as the heads of the rooms. Rewards and recognition of nurses’ competencies through job promotion affected nurses’ satisfaction.

Conclusion: Career ladder affects nurse satisfaction. Nurses can advance their careers through a career promotion, competencies, rewards and recognition from other health professionals. Support from nurse manager is needed as a form of mentoring and evaluation of nurse performance in the career ladder.

Indonesian Journal of Health Administration, 2021

Background: Error rate in medical laboratories is very low. Only one error is identified every 33... more Background: Error rate in medical laboratories is very low. Only one error is identified every 330–1,000 events. The goal of laboratory services should outweigh patient safety in a well-structured manner. Healthcare Failure Mode and Effect Analysis (HFMEA) is a proactive preventive method for identifying and evaluating potential failure.

Aims: This study identified factors affecting patient safety in hospital laboratories and described potential risk identification process using the HFMEA.

Methods: This study was conducted between March-July 2020 and retrieved data from PubMed, Scopus, and Google Scholar. The data were generalized and extracted into Table 2 based on factors dealing with patient safety in hospital laboratories. This study performed a risk identification design based on the steps of HFMEA.

Results: Out of 4,062 articles collected, only 8 articles between 2013–2020 were included for analysis. The highest error rate in laboratories occurred in the pre-analytic phase (49.2%–84.5%). The errors included clotted and inadequate specimen volume, and thus the specimens were rejected. Factors related to patient safety in laboratories were patient condition, laboratory staff performance (including training, negligence, and burnout), facilities, and accreditation.

Conclusion: The HFMEA process used the result of hazard analysis with severity and probability criteria categorized into health sector. Decision tree analysis could determine the next step of the work process. The HFMEA must be adjusted to the equipment and technologies in each hospital laboratory. Leader’s commitment in monitoring and evaluation is required to maintain patient safety culture. More comprehensive data from Indonesian hospital laboratories are needed to generate more representative and applicable results.

Indonesian Journal of Health Administration, 2021

Background: Hospital is a health care institution that provides public services for patients. It ... more Background: Hospital is a health care institution that provides public services for patients. It needs computerized information technology, for example, a hospital information management system.

Aims: This study was aimed at analyzing the implementation of hospital management information system using the human organization fit model at the Outpatient Department of Sabang General Hospital.

Methods: This study was conducted from March-June 2020 using a cross sectional design. The study’s population was the hospital managers, administration staff and health workers at the hospital. The study’s sample size was 106 respondents selected using a purposive sampling. This study used a quantitative design in which the data analysis was done using a spearman correlation test with P-value of =<0.05. The independent variables were the quality of system, quality of information, and quality of care. While the dependent variables included system user, user satisfaction and organization. The data were collected through questionnaire distributed to the respondents.

Results: The quality of system did not have a relationship with the system user (P=0.585), user satisfaction (P=0.541), and organization (P=0.256). The quality of information had a relationship with the system user(P=0.004) and user satisfaction (P=0.000), but it did not have a relationship with organization (P=0.132). The quality of care had a relationship with the system user(P=0.000), user satisfaction (P=0.000) and organization (P=0.000).

Conclusion: The Sabang General Hospital, Aceh, needs to improve the hospital management information system with the HOT-fit model, especially the quality of system. They can conduct training for users and provide applicable and attractive manuals.

Indonesian Journal of Health Administration, 2021

Background: The implementation of the National Health Insurance (JKN) program has created a trans... more Background: The implementation of the National Health Insurance (JKN) program has created a transformation in the health care system in Indonesia. Many hospitals were stuttering and unable to adapt to the new payment system. Some hospitals complained about INA-CBG rates that were lower than the real rates, so that hospitals suffered losses.

Aims: This research aims to take the best practice from one government hospital and one private hospital that is able to thrive in the JKN era.

Methods: This study used qualitative research methods through in-depth interviews.

Results: The similarity of strategies carried out by the two best practice hospitals to thrive in JKN era are efficiency in business process, investment in human resources, customer relationship management, and stakeholders collaboration.

Conclusion: The results of this study can be used as a reference for government and private hospitals in Indonesia to be able to thrive in the JKN era.

Indonesian Journal of Health Administration (Jurnal Administrasi Kesehatan Indonesia), 2021

The health system in Indonesia is facing the persistent burden of maternal mortality and infectio... more The health system in Indonesia is facing the persistent burden of maternal mortality and infectious diseases (including COVID-19) and an increasing burden of non-communicable diseases. Thus, health system reform and innovations at all levels are needed, including through lessons learned from other countries. There are at least five lessons from primary health care in the United Kingdom: easy access, digital and online services, continuity of care, managing chronic conditions, and referral and counter-referral system. There are lessons that policymakers and stakeholders at the national and local (city/district) level could potentially learn from. Despite the differences between the UK and Indonesia (e.g. country income level, national health systems), these lessons could be adapted or piloted in some settings.

Jurnal Administrasi Kesehatan Indonesia, 2020

Background: The most essential aspect to reduce the number of maternal and newborn mortality is m... more Background: The most essential aspect to reduce the number of maternal and newborn mortality is midwife competence. Midwives have a great role to be able to handle variety of health services (antepartum, intrapartum, and postpartum) to avoid or decrease the maternal and infant mortality rate. Performance of health workers, particularly midwives, is the most crucial in affecting the quality and quantity of midwives' services to enhance the national health development. Aim: This study analyzed factors affecting village midwife performance for reducing maternal and infant mortality in seek for achieving Bone Bolango cemerlang or bright Bone Balango as the vision of Bone Bolango District in 2021. Methods: This study was an analytical survey with a cross-sectional approach. It was conducted from March to June 2019 in the working area of Bone Bolango District Health Office. There were 227 people from 19 primary healthcare centers as the population, and the sample size was 227 selected by using the total sampling technique. The data were collected by distributing questionnaires to the respondents and using secondary data. The data processing was done through chi-square test and multiple logistic regression with backward wald method. Results: Midwife performance in Bone Bolango District was assessed based on several variables. Most of them were ≥ 25 years old (80.6%); worked for ≥ five years (58,6%); mostly had not participated in any normal childbirth care training (76.7%); had a good competence (96.5%); had good resources/equipment (79.7%); had a good reward (92.5%); had a good attitude (76.2%); had a good motivation (90.7%). There were 12 maternal mortalities from 2017 to 2019 handled by only 11 midwives (4.8%). On the other hand, infant mortality rate (IMR) reached 25 cases in the same years; of 227 midwives, these cases were handled by only 21 midwives (9.3%). Conclusion: A midwife as a part of the health workers has an important role to increase the quality of maternal and child well-being program. Some variables that became indicators of midwife performance and had an effect on reducing the MMR and IMR included work period, reward, and motivation. This study recommends that all midwives have to be provided with a normal childbirth care training in the working area and increased rewards in the process of labor and delivery.

https://e-journal.unair.ac.id/JAKI/article/view/19708, 2020

Background: The fluctuated patient satisfaction level shows the need to improve nursing performance.