EVALUASI PELAKSANAAN RUJUKAN IBU BERSALIN PENGGUNA KARTU SEHAT OLEH BIDAN DI RUMAH SAKIT UMUM DAERAH PRAYA KABUPATEN LOMBOK TENGAH
Eis Sulastri, Prof. dr. Mohammad Hakimi, Sp.OG(K), Ph.D
2012 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar belakang: Rujukan ibu bersalin dilakukan dengan tujuan memberikan perawatan yang lebih baik bagi pasien, tetapi juga membawa risiko terutama pada pasien dalam keadaan kritis, justru akan menambah morbiditas dan mortalitas. Untuk melaksanakan pedoman rujukan sesuai standar yang telah ditetapkan untuk bidan yaitu standar BAKSOKU. Pada Profil Dinas Kesehatan Kabupaten Lombok Tengah terdapat ibu hamil sebanyak 21.357, ibu hamil yang memiliki kartu sehat sebanyak 8.800, ibu hamil yang di rujuk ke RSUD Praya menggunakan kartu sehat sebanyak 1.157. Khusus ruang bersalin melayani persalinan sebanyak 1.260, 818 adalah kasus rujukan oleh bidan 715 (87,4%) kasus rujukan menggunakan kartu sehat. Tujuan: Untuk mengetahui pelaksanaan rujukan ibu bersalin pengguna kartu sehat oleh bidan di Rumah Sakit Umum Daerah Praya Kabupaten Lombok Tengah. Metode: Penelitian ini adalah penelitian evaluasi dengan rancangan cross-sectional. Teknik pengambilan sampel dengan consecutive sampling. Sampel dari penelitian ini yaitu ibu bersalin pengguna kartu sehat yang di rujuk ke Ruang Bersalin Rumah Sakit Umum Daerah Praya berjumlah 70. Pada penelitian ini evaluasi dilakukan terhadap aspek input, proses, output. Penelitian ini dilakukan di Rumah Sakit Umum Daerah Praya. Analisis data secara kuantitatif menggunakan analisa univariabel, bivariabel menggunakan uji statistik Chi-square, dan analisa multivariabel menggunakan uji statistik Regresi logistik. Hasil: Variabel input rujukan ibu bersalin dengan resiko tinggi mempunyai hubungan bermakna dengan kesesuaian standar BAKSOKU pada nilai p = 0,009, nilai RP = 3,35, CI 95% = 1,18-9,50. Variabel input lainnya yang memiliki hubungan dengan kesesuaian standar BAKSOKU yaitu pendidikan bidan, pelatihan APN dan masa kerja bidan. Kesimpulan: Proses rujukan ibu bersalin pengguna kartu sehat yang sesuai standar BAKSOKU masih rendah. Faktor kondisi ibu, pelatihan APN, pendidikan dan masa kerja berhubungan dengan pelaksanaan rujukan standar BAKSOKU
Background: Maternal referral is conducted with the aim of providing better care for patients; however, it also presents risks, especially in a patient’s critical condition since it can increase maternal morbidity and mortality. It is important to carry out the referrals guidelines according to the standards for midwives, that is, BAKSOKU standards. In the Profile of Central Lombok District Health Office, there are as many as 21,357 pregnant women. Yet, there are 8,800 pregnant women who have a health card (health insurance for the poor) in which, of the number mentioned, 1,157 pregnant women have been referred to Praya District Hospital using the health card. In particular, the maternity room has served as many as 1,260 deliveries, 818 of which were referral cases by the midwife and 715 (87.4%) of 818 patients were referral cases using the health card. Objective: To find out the maternal referral implementation for health card users by midwives at Praya Local Hospital of Central Lombok District. Methods: This was an evaluation study with a cross-sectional design. The sampling technique was with consecutive sampling. Samples were maternal health card users referred to the Maternity Room at Praya Local Hospital as many as 70. In this study, an evaluation was carried out to the aspects of input, process, and output. Quantitative data analysis used Univariable analysis, Bivariabel analysis with Chi-square statistical test, and Multivariable analysis with logistic regression statistical test. Results: The input variable of high-risk maternal referral had a significant relationship with the BAKSOKU standards suitability on the value of p = 0.009 and the value of RP = 3.35, CI95% = 1.18 to 9.50. Other input variables that had a relationship with the BAKSOKU standards were midwives’ education, Normal Maternity Care training and years of service. Conclusion: The process of maternal referral in accordance with the BAKSOKU standard was still low. The factors of maternal condition, Normal Maternity Care training, education and years of service were related to the implementation of the BAKSOKU standards
Kata Kunci : Evaluasi, Sistem Rujukan, Standar.
