Analisis Pengelolaan Obat Dan Faktor-Faktor Yang Mempengaruhinya: Studi Di Puskesmas Kabupaten Maluku Tengah Dan Garut

UN TUALEKA, Pembimbing Pertama Dr. Satibi, M.Si.,Apt ; Pembimbing Pendamping Prof. Dr.Achmad Fudholi, DEA.,Apt

2020 | Tesis | MAGISTER ILMU FARMASI

Pengelolaan obat di Puskesmas dilakukan untuk menjamin kelangsungan ketersediaan dan keterjangkauan pelayanan obat yang efisien, efektif, dan rasional. Tujuan penelitian ini: untuk mengetahui gambaran pengelolaan obat, mengetahui hasil pengendalian obat serta untuk mengidentifikasi faktor-faktor yang mempengaruhi pengelolaan obat di Puskesmas Kabupaten Maluku Tengah dan Garut. Penelitian ini merupakan penelitian deskriptif menggunakan desain cross-sectional dengan metode kombinasi, yang dilakukan di Puskesmas Kabupaten Maluku Tengah dan Garut dengan menggunakan purposive sampling. Sumber informasi pada penelitian ini adalah Pengelola Obat Puskesmas dan Kepala Seksi Farmasi dan Alat Kesehatan Dinas Kesehatan Kabupaten. Data yang diperoleh berupa data kualitatif dengan menggunakan lembar observasi daftar tilik dan wawancara mendalam kepada informan, serta data kuantitatif diperoleh dianalisis secara deskriptif dengan menghitung masing-masing indikator, kemudian dibandingkan dengan nilai standar pengelolan obat di Puskesmas. Hasil penelitian menunjukkan bahwa pengelolaan obat di Puskesmas Kabupaten Maluku Tengah dan Garut belum dilakukan dengan baik. Tingkat ketersediaan obat Puskesmas Kabupaten Maluku Tengah sebesar 51,95 ± 37,93 bulan, stok kosong dan stok kurang 0%, stok aman 44,99% ± 12,28%; stok lebih 55,01% ± 12,28%; ITOR 1,02 kali/tahun; nilai obat kadaluwarsa 1,54% ± 1,43%; nilai obat rusak 0%; stok mati 14,09% ± 6,41%. Sedangkan tingkat ketersediaan obat Puskesmas Kabupaten Garut sebesar 19,72 ± 5,45 bulan; stok kosong 0,18% ± 0,60%; stok kurang 2,53% ± 4,27%; stok aman 68,19% ± 8,77%; stok lebih 29,10% ± 7,94%; ITOR 6,70 kali/tahun; nilai obat kadaluwarsa 0,12% ± 0,16%; nilai obat rusak 0%; stok mati 11,17% ± 6,60%. Faktor yang mempengaruhinya, antara lain: Perencanaan dan administrasi, organisasi, SDM, SIM, akreditas Puskesmas dan pola peresepan. Kesimpulan dari penelitian ini adalah pengelolaan obat di Puskesmas Kabupaten Maluku Tengah dan Garut belum sepenuhnya dilakukan dengan baik, hasil pengendalian obat yang diperoleh adalah tingkat ketersediaan obat dalam jumlah berlebih yang dipengaruhi oleh faktor perencanaan dan permintaan, organisasi, SDM, SIM, akreditas Puskesmas dan pola peresepan. Rekomendasi yang perlu dilakukan, antara lain: menigkatkan pengetahuan dan ketrampilan pengelola obat, perencanaan kebutuhan SDM kefarmasian, pengadaan SIM obat, melakukan pendekatan dengan penulis resep agar patuh terhadap Fornas.

Drug management at the health centers was carried out to ensure the continuity of availability and affordability of drug services which is efficient, effective, and rational. The purpose of this study: to determine the condition of drug management, know the results of drug control, and to identify the factors that influence drug management of health centers in the district of Central Maluku and Garut. This research was a descriptive study using a cross-sectional design with a combination method that was conducted at health centers in the district of Central Maluku and Garut by using purposive sampling. The sources of information in this study were from the Health Center Drug Management and the Head of the Pharmacy and Medical Devices Section of the District Health Office. The data obtained were in the form of qualitative data which was collected using observation sheet checklist and in-depth interviews with informants, and quantitative data obtained were analyzed descriptively by calculating each indicator, then they were compared with the standard value of drug management in the health centers. The findings showed that the management of drugs in health centers in the district of Central Maluku and Garut has not been properly managed. The level of drugs availability in health centers in the district of Central Maluku was 51.95 ± 37.93 months, empty stock and less stock 0%, safe stock 44.99% ± 12.28%; more stock 55.01% ± 12.28%; ITOR 1.02 times/year; the expiry value of the drug is 1.54% ± 1.43%; damaged drug value 0%; dead stock 14.09% ± 6.41%. While the level of drugs availability in health centers in the district of Garut was 19.72 ± 5.45 months; empty stock 0.18% ± 0.60%; less stock 2.53% ± 4.27%; safe stock 68.19% ± 8.77%; more stock 29.10% ± 7.94%; ITOR 6.70 times/year; the expiry value of the drug is 0.12% ± 0.16%; damaged drug value 0%; dead stock 11.17% ± 6.60%. Some factors that influence, include: planning and administration, organization, human resources, driving license, health centers' accreditation, and prescribing patterns. The conclusion of this study was that the management of drugs in health centers in the district of Central Maluku and Garut has not been fully carried out properly, the results of drug control which were obtained showing that the level of drug availability was in excessive amounts which were influenced by planning and demand factors, organization, human resources, driving license, health centers� accreditation, and prescribing patterns. Recommendations that need to be made include: increasing the knowledge and skills of drug management, planning the pharmacy HR needs, making procurement of drug licenses, as well as making approaches with prescription writers to comply with the national formulary (Fornas).

Kata Kunci : Kata kunci : Pengelola Obat, Ketersediaan, Puskesmas, Kabupaten Maluku Tengah, Kabupaten Garut / Keywords : Drug Management, Availability, Health Center, Central Maluku District, Garut District.