Analisis pengelolaan obat di instalasi farmasi Rumah Sakit PKU Muhammadiyah Temanggung Tahun 2006, 2007 dan 2008

FAKHRIADI, Akhmad, Prof. Dr. Marchaban, DESS.,Apt

2010 | Tesis | S2 Ilmu Farmasi

Pengelolaan obat di rumah sakit meliputi tahap selection, procurement, distribution, dan use. Ketidakefisienannya dapat berdampak negatif secara medik, sosial maupun ekonomi. Hasil observasi pendahuluan menunjukkan sejumlah permasalahan pengelolaan obat di IFRS PKU Muhammadiyah Temanggung. Untuk itu, perlu upaya perbaikan pengelolaan obat beserta pendukung manajemennya di IFRS tersebut. Rancangan penelitian deskripsi data diambil secara retrospektif dan concurrent, dengan tujuan mengetahui gambaran efisiensi pengelolaan obat dan pendukung manajemennya di IFRS PKU Muhammadiyah Temanggung. Data berupa kualitatif dan kuantitatif disertai wawancara dengan pihak terkait. Seluruh tahap pengelolaan obat diukur efisiensinya menggunakan indikator WHO, Pudjaningsih, dan Depkes RI kemudian dibandingkan dengan nilai terbaik hasil penelitian terpilih. Hasil pada tahap pengelolaan obat adalah : 1. Selection, kesesuaian item obat yang tersedia dengan DOEN 2005 belum efisien di tahun 2006, 2007 dan 2008; 2. Procurement, belum efisien pada frekuensi pengadaan obat di tahun 2006, 2007 dan 2008; jumlah item obat diadakan di tahun 2006, 2007 dan 2008, namun sudah efisien pada alokasi dana obat di tahun 2006, 2007 dan 2008; serta ketertundaan pembayaran faktur di tahun 2006, 2007, dan 2008; 3. Distribution, belum efisien pada ketepatan data kartu stok; dan nilai kadaluwarsa obat di tahun 2008, sedangkan nilai TOR sudah efisien di tahun 2006, 2007 dan 2008; 4. Use, belum efisien pada jumlah item perlembar resep rawat inap di tahun 2007 dan 2008; peresepan obat generik rawat inap dan jalan; peresepan antibiotika di rawat jalan; peresepan injeksi di rawat inap dan jalan; peresepan sesuai standar obat rumah sakit di rawat inap dan jalan; serta persentase obat yang diserahkan di rawat inap, namun sudah efisien pada jumlah item perlembar resep rawat inap di tahun 2006 dan rawat jalan di tahun 2006, 2007 dan 2008; peresepan antibiotika di rawat inap; kecepatan pelayanan sediaan; persentase obat yang diserahkan di rawat jalan; dan kelengkapan label obat. Hasil pengamatan pada pendukung manajemennya adalah : 1. IFRS belum memiliki visi dan misi tersendiri, 2. IFRS sudah berfungsi sebagai revenue center bagi rumah sakit, 3. Manajemen informasi IFRS sudah terkomputerisasi, 4. Sudah ada upaya dalam meningkatkan kualitas sumber daya manusia di IFRS.

Drug management consisted stages of selection, procurement, distribution, and use. Its inefficiency can induce bad condition for medical, social and economical. From preliminary observation in Pharmacy Departement of PKU Muhammadiyah Temanggung Hospital, it was found some problems in its drug management. Therefore, it needs investigation to fix drug management along with its management support in this pharmacy departement. This study was conducted by a descriptive observational design using retrospective and concurrent analysis. It was aimed to know the profile of drug management efficiency and its management support in Pharmacy Departement of PKU Muhammadiyah Temanggung Hospital. Qualitative and quantitative data was obtained as well as interview data from relevance department. Efficiency in all of drug management stages were measured using indicators from WHO, Pudjaningsih, and Health Department, then compared with the the best result of different researches. The result in each drug management stage is as follows: 1. Selection, availability adjustment of drug with NEDL (National Essential Drug List) item is inefficient in 2006, in 2007, and in 2008; 2. Procurement, inefficient yet in frequency of drug purcahsing in 2006, in 2007, and in 2008; and sum of item of drug supplied in 2006, in 2007, and in 2008; whereas it was efficient in drug funding allocation in 2006, in 2007, and in 2008; and delay in invoice payment, in 2006, in 2007, and in 2008; 3. Distribution, has not efficient yet in accuracy of stock card and percentage of expired drug in 2008; whereas value of TOR was efficient in 2006, in 2007, and in 2008; 4. Use, has not efficient yet in average number of drugs per encounter for inpatient in 2007 and in 2008; percentage of prescribing in generic name for inpatient and outpatient; percentage of antibiotic encounters for outpatient; percentage of injection encounters for inpatient and outpatient; percentage of drug prescribed from hospital drug list for inpatient and outpatient; and percentage of drugs dispensed for inpatient, but it was efficient for average number of drugs per encounter for inpatient in 2006 and outpatient in 2006, in 2007, and in 2008; percentage of antibiotic encounters for inpatient; average dispensing time; percentage of drugs dispensed for outpatient; and percentage of drugs actually labeled for outpatient. Observation result for management supports are: 1. Pharmacy department has not build its vision and mission yet; 2. Positions of pharmacy department is as revenue center for the hospital; 3. Information management in pharmacy department has computerized; 4. There are actions to improve the quality of human resources in pharmacy department.

Kata Kunci : Pengelolaan obat,Indikator,Instalasi farmasi rumah sakit, Drug management, indicator, efficiency, hospital’s pharmacy departement