Kajian rujukan pasien GAKIN di RSUD Kabupaten Buleleng Singaraja Provinsi Bali

EKSASILA, I Wayan, Prof.dr. Hari Kusnanto J., DrPH

2005 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Rumah Sakit Umum Daerah Kabupaten Buleleng merupakan rumah sakit type B non pendidikan, rumah sakit dengan status swadana daerah dan merupakan rumah sakit rujukan di wilayah kabupaten Buleleng. Rata-rata rasio rujukan dari puskesmas ke rumah sakit di kabupaten Buleleng tergolong rendah yaitu 8,91%, pasien rawat darurat yang datang ke rumah sakit hanya 4,9% dari 6149 kasus yang merupakan kasus rujukan. Ini menunjukkan adanya kesenjangan dalam sistem rujukan. Rujukan rumah sakit gakin rawat inap di didapatkan persentase yang jauh lebih banyak dibandingkan dengan rawat jalan. Tujuan penelitian ini untuk mengidentifikasi masalah sistem rujukan pasien gakin yang berkaitan dengan pemahaman pasien, petugas puskesmas dan petugas rumah sakit serta menilai kesesuaian pelaksanaan prosedur rujukan dengan pedoman. Metode: Penelitian ini merupakan studi kasus dengan metode kualitatif dan kuantitatif, lokasi penelitian di RSUD Kabupaten Buleleng. Populasi dan sampelnya adalah pasien rujukan gakin rawat inap, metode pengambilan sampel dengan sampling waktu. Subyek penelitian adalah pasien gakin, petugas rumah sakit, tim verifikasi gakin dan kepala puskesmas se Kabupaten Buleleng. Alat ukur penelitian dengan menggunakan kuesioner, pedoman wawancara dan ceklis. Hasil: Didapatkan kurangnya pemahaman pasien gakin tentang kartu sehat, pasien gakin mencari kartu sehat setelah dirawat di rumah sakit, petugas puskesmas dan rumah sakit tidak melaksanakan prosedur sesuai pedoman , diantaranya merujuk dan menerima rujukan tidak sesuai dengan kriteria jenis penyakit sesuai pedoman. Kesimpulan: Pemahaman pasien gakin tentang kartu sehat masih kurang, Pelaksanaan prosedur rujukan di puskesmas dan di rumah sakit tidak sesuai dengan pedoman.

Background: Kabupaten Buleleng District Public Hospital in Singaraja is a type B non teaching hospital with a self-sufficient status and still becomes a referral hospital in the area of Buleleng district. The percentage of the referral of poor patients for inpatient treatment was 36,7%, was more than outpatient visits with only 2,11%. This research was aimed to identify the problem of referral system of poor families, associated with patient’s understanding, the perceptions of health care providers of primary health care and health care providers in the hospital and to evaluate the implementation of referral procedure guidelines Method: This was a case study with qualitative and quantitative method. The location of the research was in District Public Hospital Kabupaten Buleleng in Singaraja. The population and the sample were patients treated in the inpatient treatment wards. The subjects of the research were patients of poor families who experienced inpatient treatment, administration officer and hospital medical recor d administration, head of verification team of poor families and head of primary health centers in the district of Buleleng. The measuring instruments were questionnaires, in-depth interview guidelines and checklist. Result: It was known that there was a lack of understanding among patients regarding health card. Patients looked for health card after being treated in the hospital, health care provider in the primary health care and hospital did not implement procedures as they were stated in the guidelines, such as referring and accepting referral that is not suitable according to with criteria of type of the disease according to the guidelines. Conclusion: Understanding of poor family patient regarding health card was still unsatisfactory. The implem entation of referral procedures in the primary health care and in the hospital did not comply the guidelines.

Kata Kunci : Manajemen Rumas Sakit,Sistem Rujukan,Pasien Keluarga Miskin, poor families, understanding and referral procedure