PERBANDINGAN PERSEPSI KUALITAS PELAYANAN ANTENATAL PASIEN RUJUKAN DAN NON RUJUKAN DI UNIT RAWAT JALAN BAGIAN OBSTETRI DAN GINEKOLOGI RSUP DR. SARDJITO

SRI SUMARSI, Prof. dr. H. Moh. Hakimi, Ph.D., Sp.OG(K).

2011 | Tesis | S2 Ked.Klinik/MS-PPDS

Latar belakang: Pelayanan antenatal yang berkualitas adalah pelayanan yang sesuai dengan standar, tetapi ada asumsi terdapat perbedaan pelayanan antara pasien rujukan dan non rujukan. Obyektif: Untuk mengetahui adakah perbedaan persepsi kualitas pelayanan antenatal di unit rawat jalan Bagian Obstetri Ginekologi RS Dr.Sardjito antara pasien rujukan dan non rujukan berdasar standar minimal dan kualitas total pelayanan serta mengetahui adakah pengaruh karakteristik responden terhadap persepsi kualitas pelayanan antenatal. Cara penelitian: Deskriptif analitik dengan pendekatan cross sectional survey. Responden ibu hamil rujukan dan non rujukan yang melakukan ANC di unit rawat jalan Bagian Obstetri Ginekologi RSUP Dr.Sardjito, sesuai kriteria inklusi dan eksklusi yang dilakukan pada Januari-Juli 2010. Kedua kelompok responden diberi kuesioner tentang penilaian responden terhadap kualitas pelayanan antenatal. Hasil: Komparabilitas karakteristik pasien rujukan dan non rujukan menghasilkan gambaran perbedaan bermakna. Persentase persepsi kualitas standar minimal rujukan dan non rujukan adalah 72,79% dan 71,21% sehingga dikategorikan tidak sesuai standar. Begitu pula pada persentase persepsi kualitas total rujukan dan rujukan adalah 71,54% dan 67,84% sehingga dikategorikan rendah. Analisis multivariat dengan regresi logistik menunjukkan karakteristik responden yang paling berpengaruh terhadap persepsi kualitas standar minimal pelayanan antenatal dipengaruhi oleh jenis kunjungan p=0,082 (OR: 0,164, 95% CI: 0,022- 1,255), jumlah kunjungan p=0,013 (OR: 0,075, 95% CI: 0,010-0,579) dan pekerjaan p=0,030 (OR: 1,083, 95% CI: 1,083-4,849). Sedangkan persepsi kualitas total pelayanan antenatal adalah jenis kunjungan p=0,041 (OR: 0,092, 95% CI: 0,009-0,905), jumlah kunjungan p=0,006 (OR: 0,041, 95% CI: 0,004- 0,404) dan alamat p=0,000 (OR: 4,039, 95% CI: 2,375-6,868). Kesimpulan: Tidak terdapat perbedaan persepsi kualitas standar minimal dan kualitas total pelayanan antenatal antara responden rujukan dan non rujukan di unit rawat jalan Bagian Obstetri Ginekologi RSUP Dr. Sardjito. Persepsi kualitas standar minimal pelayanan antenatal dipengaruhi oleh jenis kunjungan, jumlah kunjungan dan pekerjaan. Sedangkan persepsi kualitas total pelayanan antenatal dipengaruhi oleh jenis kunjungan, jumlah kunjungan dan alamat.

Background: The quality of antenatal services is the service in accordance with the standards, but it is assumed there is a difference between patient referral and service of non-referral. Objective: To know is there any difference in perceived quality of antenatal care in the outpatient unit of the Department of Obstetrics Gynecology Sardjito Hospital between patient referral and non referral based on minimum standards and total quality service and to know is there any influence of respondent characteristics on perceived quality of ANC. Methods: Descriptive cross sectional analytic survey. Respondents pregnant women referral and non-referral to the ANC in the outpatient unit of the Department of Obstetrics Gynaecology of Sardjito Hospital, according to inclusion and exclusi on criteria conducted in January till July 2010. Both groups of respondents were given a questionnaire about the respondents' assessment of quality of antenatal care. Results: The comparability of the characteristics of the patient referral and non referral produce meaningful picture differences. Percentage of minimum standards of quality perception referral and non referral was 72.79% and 71.21%, thus not categorized according to the standard. Similarly, the percentage of the total quality perception referral and referral are 71.54% and 67.84% so categorized low. Multivariate analysis with logistic regression showed that the most influential characteristics of respondents to a minimum standard of quality perception is influenced by the type of antenatal care visits p = 0.082 (OR: 0.164, 95% CI: 0.022 to 1.255), number of visits p = 0.013 (OR: 0.075, 95 % CI: .010 to .579) and job p = 0.030 (OR: 1.083, 95% CI: 1.083 to 4.849). While the total quality perception is a type of antenatal care visits p = 0.041 (OR: 0.092, 95% CI: .009 to .905), number of visits p = 0.006 (OR: 0.041, 95% CI: .004 to .404) and addresses p = 0.000 ( OR: 4.039, 95% CI: 2.375 to 6.868). Conclusion: There were no differences in the perception of minimal standards of quality and total quality of antenatal care among respondents in the referral and non referral outpatient Department of Obstetrics Gynecology Sardjito H ospital. Minimum standard of quality perception is influenced by the type of antenatal care visits, number of visits and jobs. While the total quality perception is influenced by the type of antenatal care visits, number of visits and addresses.

Kata Kunci : persepsi kualitas pelayanan antenatal, rujukan, non rujukan, poliklinik