Kompetensi dokter umum dalam menangani kasus bedah

IBRAHIM, Ismail, Prof.dr. Laksono Trisnantoro, MSc.PhD

2005 | Tesis | S2 Ilmu Kesehatan Masyarakat (Manajemen Rumah Saki

Latar belakang : Kebutuhan masyarakat akan pelayanan dokter spesialis bedah dan obsgin di daerah terpencil mendesak, terbukti dengan banyaknya kasus bedah dan obsgin ditangani oleh dokter umum di rumah sakit daerah yang tidak punya dokter spesialis bedah dan obsgin. Krisis dokter spesialis bedah dan obsgin disebabkan jumlah dokter spesialis bedah dan obsgin masih kurang, penyebaran belum merata. Dokter spesialis bedah dan obsgin di Indonesia cenderung berkumpul di perkotaan dan di pulau Jawa. Menarik dibicarakan kompetensi dokter umum menangani kasus bedah di rumah sakit daerah disaat gencarnya isu medical error. Tujuan : Melihat karakteritik penyebaran dokter spesialis bedah dan obsgin di Indonesia dan kompetensi dokter umum dalam menangani kasus bedah di RSUD Ampana. Metode : Penelitian menggunakan metode deskriptif rancangan case control dengan dua sub penelitian. Pertama, karakteristik penyebaran dokter spesialis bedah dan obsgin di Indonesia. Data dari Departemen Kesehatan RI, Ikabi dan Pogi pusat. Kedua, data rekam medik pasien di RSUD Ampana yang dibedah oleh dokter umum di bandingkan dengan dokter spesialis bedah. Hasil di analisis secara persentase kemudian dideskripsikan. Hasil : Jumlah dokter spesialis bedah dan dokter spesialis obsgin masih kurang untuk mengisi daerah-daerah terpencil masih memerlukan waktu yang lama dan penyebaran dokter spesialis bedah dan dokter spesialis obsgin di Indonesia tidak merata, kecenderungan di daerah perkotaan dan padat penduduk seperti pulau Jawa. Penelitian ini memperlihatkan kompetensi dokter umum menangani kasus bedah dan obsgin cukup efektif dan efisien karena hasilnya tidak jauh berbeda dengan yang dikerjakan oleh dokter spesialis bedah. Secara ekonomi kompetensi dokter umum menangani kasus bedah menguntungkan karena hanya 1 orang dokter umum dapat menangani kasus bedah dan kasus obsgin. Kesimpulan : Dokter spesialis bedah dan obsgin masih kurang, tidak merata, cenderung di perkotaan dan di pulau Jawa. Dokter umum di RSUD Ampana berkompetensi menangani kasus bedah

Background: The need of society for specialists’ doctor service, especially surgeon, obstetrician and gynecologist in isolated area was insisted. It was showed by many surgeries, obstetrics, and gynecological cases were handled by general doctor. Crisis of surgeon, obstetrician and gynecologist in district is caused by small number of surgeon, obstetrician and gynecologist and unevenly their distribution. Their distribution tended to concentrate in cities and Java. It is interesting to discuss general doctor’s competence in handling surgery cases in district hospital in medical error issue era. Objective: The study aimed to observe the distribution of surgeon, obstetrician, and gynecologist in Indonesia and their competence in handling surgery cases in Ampana district hospital. Method: The study used descriptive method and case control design, using two sub studies, i.e. 1) distribution characteristic of surgeon, obstetrician, and gynecologist in Indonesia in which data were collected from Health Department of Indonesia, Indonesian association of midwife, and Indonesian Society of Obstetrics & Gynecology, 2) medical record study of patients that were operated by general doctor compared to surgeon in Ampana district hospital. Data were analyzed based on proportion and then described. Result: There were lack of surgeon, obstetrician and gynecologist in isolated area because its distribution was not even and took long times to make it even. The study showed general doctor’s competence in handling operation, obstetric and gynecological cases were relative effective and efficient because the result of the operation was good enough as specialist did. Economically, general doctor’s competence in handling operation cases advantaged hospital because one general doctor could handle operation and obstetric and gynecological cases. Conclusion: Numbers of surgeon, obstetrician and gynecologist are small, unevenly, and tend to concentrate in the city and in Java. General Doctor in Ampana district hospital has competency in handling surgery case.

Kata Kunci : Manajemen Rumah Sakit,Kompetensi Dokter,Pembedahan, competency, specialists