Upaya perbaikan perencanaan obat melalui tim perencanaan obat terpadu di Kabupaten Barito Timur Propinsi Kalimantan Tengah

KRISELINA, Anda, dr. Sulanto S. Danu, SpFK

2007 | Tesis | S2 Ilmu Kesehatan Masyarakat (Manaj. dan Kebijakan

Latar Belakang: Kabupaten Barito Timur adalah Kabupaten Baru yang memiliki permasalahan dalam pengelolaan obatnya terutama dalam perencanaan. Berdasarkan studi pendahuluan yang dilakukan tahun 2004 dan didukung hasil audit oleh Badan Pemeriksa Keuangan dan Pembangunan (BPKP) ditemukan bahwa sering terjadi kekosongan obat, dana untuk pengadaan obat kecil, belum adanya Tim Perencanaan Obat Terpadu Kabupaten (TPOTK) dan keterbatasan sumberdaya manusia. Perencanaan obat oleh Dinas Kesehatan dikerjakan oleh Seksi Pelayanan Kesehatan Khusus Farmasi dan Akreditasi. Perencanaan dilakukan belum sesuai dengan teori perencanaan yang benar. Tujuan penelitian: Untuk mengetahui apakah perencanaan obat oleh TPOTK menghasilkan perencanaan obat yang lebih baik dibandingkan sebelum adanya TPOTK dengan indikator-indikator sebagai berikut: 1). Indikator Perencanaan yaitu: ketepatan perencanaan obat, kesesuaian ketersediaan dengan DOEN, kesesuaian ketersediaan obat dengan pola penyakit, tingkat ketersediaan obat ,persentase rata-rata waktu kekosongan obat, persentase obat kedaluwarsa, alokasi dana pengadaan obat, persentase dana pengadaan obat dan biaya obat perkapita penduduk. 2). Rencana kebutuhan obat yang masuk di dalam Rencana Anggaran Belanja (RAB) obat dengan menghitung: jumlah item obat, persentase (%) item obat, total dana dan persentase (%) dana termasuk obat-obatan yang bersifat Vital, Esensial, Non Esensial dan obat non Program Kesehatan Dasar (PKD). Metode Penelitian: Penelitian ini dirancang sebagai penelitian quasi eksperimental dengan pre-post test tanpa kelompok kontrol diberlakukan pada satu kelompok (One group pretest-posttest design), dengan mengukur indikator perencanaan sebelum dan setelah adanya TPOTK dan membandingkan hasil perencanaan obat sebelum dan setelah TPOTK, data disajikan dalam bentuk tabel dan grafik dan dianalisis secara deskriptif. Hasil Penelitian: Hasil perencanaan obat setelah pertemuan TPOTK lebih baik dibandingkan sebelum TPOTK dapat dilihat dari hasil pengukuran terhadap pengukuran indikator perencanaan sebagai berikut: Ketepatan perencanaan, kesesuaian obat yang tersedia dengan DOEN naik, kesesuaian ketersediaan obat dengan pola penyakit naik, rata-rata waktu kekosongan obat turun menjadi nol, tingkat Ketersediaan naik, persentase obat kedaluwarsa tidak ada obat yang kedaluwarsa, alokasi dana pengadaan obat, persentase alokasi dana pengadaan obat dan biaya Obat perpenduduk naik. Jenis dan jumlah item obat yang bersifat vital naik, obat esensial, obat non esensial dan obat diluar PKD turun. Persentase item obat untuk obat Vital naik, esensial turun, obat non esensial dan obat di luar PKD turun. Jumlah dana yang dialokasikan untuk perencanaan obat-obatan Vital, obat esensial, non esensial dan obat bukan PKD meningkat. Persentase dana untuk obat-obatan Vital naik, obat esensial, non esensial dan obat bukan PKD turun. Kesimpulan: Perencanaan Obat yang dilakukan melalui pembentukan dan pertemuan TPOTK menghasilkan perencanaan obat yang lebih baik dibandingkan dengan perencanaan sebelum terbentuknya TPOTK

Background: East Barito Regency is a new regency that has problem in drug management especially in the planning part. Based on the preliminary study which was conducted in the year of 2004 and which was supported the audit result by Financing and Development Examination Board, it was found that there was often drug unavailability, funding for the providence of minor drug, the inexistence of integrated drug planning team in the regency and limited human resources. Drug planning which was conducted in the health office was implemented by health service section specifically in pharmaceutical and accreditation. The planning was not yet suitable with appropriate planning theory. The objective: to find out whether the drug planning by team of integrated drugs planning in the regency (TPOTK) created a better drug planning compared than before the existence of TPOTK with indicators such as: 1) Planning indicator that was appropriateness of drug planning, availability adjustment with DOEN (list of national essential drugs), suitability of drug availability with disease method, level of drug availability, percentage of drug unavailability time average, percentage of expired drug, allocation of drug providence funding, percentage of drug providence funding and the cost of drug in community per capita, 2) The planning of the needed drug which is included in the Planning of Shopping Budget (RAB) of drug was conducted by calculating the number of drug item, percentage (%) of drug item, total funding and percentage (%) of funding including drugs that are vital, essential, non essential and drugs of non basic health program (PKD). Method: This was a quasi experimental research that used pre-post test without control group which was implemented in one group pretest-posttest design, by measuring the planning indicator before and after the TPOTK and compared the result of drug planning before and after the TPOTK, and the data was presented in the form of table and graphic and analyzed descriptively. Result: The result of this research showed that drug planning after forming and meeting of TPOTK created the drug planning which was better than drug planning before forming the TPOTK, it from the calculation result of planning indicator such as: appropriateness of drug planning and drugs adjustment item with DOEN were decreased, drugs adjustment with disease method and average percentage of drug unavailability were decreased, level of drug availability was increased, expired drugs was none; funding allocation of drugs providence, percentage of drugs funding allocation, and the cost of drug per community were increased. The number and various of vital drugs item was increased; essential, non essential, and non PKD drug were decreased, percentage of vital drug item was increased; essential, non essential, and drugs beside PKD were decreased. The number and various of vital drugs funding, the essential drugs, non essential, non PKD, percentage of vital funding, and the essential were increased; non essential and non PKD were decreased. Conclusion: The drug planning which was conducted through forming and meeting with TPOTK created drug planning which was better than planning before TPOTK.

Kata Kunci : Pengelolaan Obat,Perencanaan,Drugs Planning, Team of Integrated Drug Planning in the Regency (TPOTK), Cost Budget Planning (RAB)