Analisis pengelolaan obat di instalasi farmasi RSUD Brigjend. H. Hasan Basry Kandangan Provinsi Kalimantan Selatan

FARDIYANNOOR, Muhammad, Prof. Dr. Marchaban, DESS, Apt

2008 | Tesis | S2 Ilmu Farmasi

Pengelolaan obat di apotek umum / pelengkap RSUD Brigjend H. Hasan Basry Kandangan mengalami permasalahan dalam menentukan mekanisme pengadaan dan sistem anggaran obat. Pembelian obat secara tender dengan jumlah yang besar, proses pengadaan yang lama dan frekuensi pembelian 1-2 kali setahun membawa dampak penumpukan obat, obat tidak diresepkan dan ditemukan obat yang kadaluwarsa. Pendapatan obat tidak bisa digunakan secara langsung sehingga proses pengadaan obat mengikuti mekanisme pengadaan barang dan jasa pemerintah. Tujuan penelitian adalah untuk menganalisis pengelolaan obat di RSUD Brigjend H. Hasan Basry Kandangan dengan mengidentifikasi faktor pendukung pengelolaan obat, meliputi; sumber daya manusia, sistem informasi pengelolaan obat, struktur organisasi, dan dana / biaya obat. Penelitian dirancang sebagai penelitian non eksperimental bersifat deskriptif dan eksploratif. Data diambil secara retrospektif. Pengumpulan data dengan observasi dokumen dan wawancara mendalam dengan pelaku yang terkait pengelolaan obat, kemudian dilakukan analisis deskriptif. Data kuantitatif disajikan dalam bentuk tabel dan data kualitatif disajikan dalam bentuk tekstual berupa narasi. Hasil penelitian menunjukkan bahwa perencanaan obat belum berdasarkan metode konsumsi secara komprehensif, persentase anggaran yang tersedia untuk belanja obat tahun 2005, 2006, dan 2007 menurun dari 97,56 %, 91,46 %, dan 90,24 %. Perbandingan jumlah item obat direncanakan dengan kenyataan pakai pada tahun 2005 terjadi selisih sebesar 15 %. Untuk tahun 2006 dan 2007 tidak ada perencanaan obat. Pengadaan obat dengan tender antara 1-2 kali setahun, sedangkan pembelian langsung antara 9 – 69 kali dalam setahun. Frekuensi kesalahan faktur dan tertundanya pembayaran obat tidak terjadi. Persentase nilai kadaluwarsa sebesar 3,52 % , jumlah stok mati apotek umum/pelengkap antara 25-27 item obat. Persentase jumlah pelayanan resep yang terlayani tahun 2005, 2006, dan 2007 sebesar 99,90 %, 98,60 %, dan 74,80 %. Persentase penggunaan obat generik tahun 2005, 2006, dan 2007 sebesar 37,60 %, 36,10 %, dan 35,30 %. Sumber daya manusia yang terlibat dalam pengelolaan obat belum memenuhi kualitas dan kuantitas yang dibutuhkan, struktur organisasi instalasi farmasi belum ada, sistem informasi pengelolaan obat belum memadai dan bersifat konvensional. Anggaran kebutuhan obat belum berdasarkan kondisi riil kebutuhan rumah sakit. Hasil penelitian dapat disimpulkan bahwa sistem pengelolaan obat di instalasi farmasi RSUD Brigjend H. Hasan Basry Kandangan belum memadai, dan swakelola serta otonomi penggunaan dana obat mendukung efektivitas dan efisiensi pengadaan obat.

Drug management in public / supplementary pharmacy in RSUD Brigjend H. Hasan Basry Kandangan, South Kalimantan Province, has suffered problems in determining a drug procurement mechanism and a drug budgeting system. A large number of drug purchases by tender, a long process of procurement and purchases with a frequency of 1-2 times a year adversely lead the excessive storage of drug, more non-prescribed drugs, and expired drugs. Drug-based income cannot be used directly, so the drug procurement process should follow the mechanism of goods and service procurement by government. Main purpose of this study is to analyze the drug management in RSUD Brigjend H. Hasan Basry Kandangan, South Kalimantan Province, by identifying factors that support the drug management including human resources, information system for the drug management, organizational system, and drug fund/costs. It is designed as the non-experimental study with a descriptive, analytical, explorative approach in the drug management in RSUD Brigjend H. Hasan Basry Kandangan, South Kalimantan Province, with retrospective data. The data are collected by the techniques of documentary observation and in-depth interview with some subjects closely related to the drug management, then processed by using descriptive and content analyses. Quantitative data are presented in tables, while qualitative ones are in a textual format of narration. Result of the study indicates that the planning of drug procurement has not been based yet on the comprehensive method of consumption, and the percentages of budget available for drug expenses from 2005, 2006, and 2007 have decreased from 97.56%, 91.46%, to 90.24%, respectively. A comparison of the planned and actual numbers of drug items on 2005 has resulted in a gap of 15%. For 2006 and 2007, there was no drug planning. The drug procurement by tender was 1-2 times a year, while direct purchases 9-69 times a year. The frequency of facture errors and the delayed payment of drugs have not existed. The percentage of value in expired drugs was 3.52% and number of idle stocks in the public/supplementary pharmacy was from 25 to 27 drug items. The percentage of prescription services delivered on 2005, 2006, and 2007 was 99.9%, 98.6%, and 74.8%, respectively. The percentage of generic drug uses on 2005, 2006, and 2007 was 37.6%, 36.1%, and 35.3%, respectively. Human resources involved in the drug management have not fulfilled the requirements of quality and quantity of drugs, the organizational structures of pharmacy installation have not existed yet, and the information system of drug management has not been adequate yet and still conventional. The budget for drug procurement has not been based on the real conditions of hospital needs. From the result of the study, it can be concluded that the drug management system in the pharmacy installation of the RSUD Brigjend H. Hasan Basry Kandangan has actually been inadequate, and that self-management and autonomy in spending the drug funds can support the effectiveness and efficiency of the drug procurement.

Kata Kunci : Pengelolaan obat,Instalasi farmasi,Faktor pendukung pengelolaan obat, drug management, pharmacy installation, factors supporting the drug management