EVALUASI KERASIONALAN PENGGUNAAN OBAT DENGAN STANDAR PELAYANAN MEDIS SEBAGAI PENGENDALI PADA BEBERAPA PENYAKIT PASIEN RAWAT JALAN DI RSUD PANEMBAHAN SENOPATI BANTUL
Rahyanti Fitriah, Prof. Dr. Sri Suryawati
2012 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar belakang : Penggunaan obat yang rasional merupakan salah satu langkah untuk mendapatkan pelayanan kesehatan yang baik. Penggunaan obat rasional dapat diidentifikasi salah satunya diawali dengan peresepan obat. Peresepan obat yang baik dibutuhkan ketepatan diagnosis dan ketepatan dalam pemilihan obat. Hal tersebut dapat dilakukan dengan mengacu pada Standar Pelayanan Medis (SPM) yang telah dibakukan. Kerasionalan penggunaan obat dapat meningkatkan kualitas pelayanan kesehatan di rumah sakit, oleh karena itu perlu dilakukan evaluasi kerasionalan penggunaan obat yang fokus pada mutu pengobatan untuk tiap jenis penyakit dengan menggunakan SPM sebagai pengendali. Tujuan : Untuk mengetahui kerasionalan penggunaan obat dengan SPM sebagai pengendali pada beberapa penyakit (LBP, TB Paru, ISK) pasien rawat jalan di RSUD Panembahan Senopati Bantul. Metode : Penelitian ini merupakan penelitian dengan rancangan studi kasus jenis deskriptif analitik, dengan menggunakan data kualitatif dan kuantitatif. Pengumpulan data dilakukan dengan wawancara mendalam untuk data kualitatif dan observasi dokumen secara retrosfektif menggunakan rekam medik dan resep pasien. Hasil : Penyakit LBP: rata-rata item obat per lembar resep 2,66 item, persentase generik 74,3%, persentase antimikroba 1,7%, persentase injeksi 72,7%, persentase formularium rumah sakit 88,2%, persentase DOEN 18,5%, persentase pedoman pengobatan 71%, persentase psikotropika 12,7%, persentase steroid sistemik 6,3%. Penyakit TB Paru: rata-rata item obat per lembar resep 3,15 item, persentase generik 56,4%, persentase antimikroba 100%, persentase injeksi 0%, persentase formularium rumah sakit 100%, persentase DOEN 71,9%, persentase pedoman pengobatan 71,8%, persentase psikotropika 0%, persentase steroid sistemik 0%. Penyakit ISK: rata-rata item obat per lembar resep 1,75 item, persentase generik 69,5%, persentase antimikroba 92%, persentase injeksi 0%, persentase formularium rumah sakit 94,3%, persentase DOEN 33,4%, persentase pedoman pengobatan 54,8%, persentase psikotropika 1,3%, persentase steroid sistemik 1,3%. Kesimpulan : Pola peresepan obat di RSUD Panembahan Senopati Bantul dengan SPM sebagai pengendali pada beberapa penyakit (LBP, TB Paru, ISK) belum rasional. Penggunaan obat agar dikendalikan dengan menggunakan SPM sebagai instrumen pengendali dan kualitas SPM itu sendiri perlu dilakukan perbaikan secara periodik.
Background: To achieve satisfactory medical services, good prescription is important. Good prescription requires diagnostic accuracy and appropriateness in medicine choice. To ensure the quality of therapy, standard treatment guideline essential towards rational use of medicine. Thus, evaluation on rational use of medicine should be carried to focus on quality of therapy. Aim: To analyze the appropriateness of medicine use with standard treatment as guideline for Low back pain, Pulmonary Tuberculosis, Urinary Tract Infections in outpatient department in Panembahan Senopati Regency Hospital, Bantul. Methods: Descriptive case study design was applied, using qualitative and quantitative data. Qualitative data were obtained by in-depth interview while quantitative data were gathered from document observation. Data collected by conducting in-depth interviews for qualitative data, and for quantitative data were gathered from documents observation. Results: On LBP, average number of drugs per prescription was 2.66 items, percentage of generic drugs was 74.3%, percentage of antimicrobial was 1.7%, percentage of injection was 72.7%, percentage of hospital formulary was 88.2%, percentage of DOEN was 18.5%, percentage of therapeutic guideline was 71%, percentage of psychotropic drugs was 12.7%, percentage of systemic steroid was 6,3%. While Pulmonary TB, average number of drugs per prescription was 3.15 items, percentage of generic drugs 56.4%, percentage of antimicrobial was 100%, percentage of injection was 0%, percentage of hospital formulary was 100%, percentage of DOEN was 71.9%, percentage of therapeutic guideline was 71.8%, percentage of psychotropic drugs was 0%, percentage of systemic steroid was 0%. For UTI, average number of drugs per prescription was 1.75 items, percentage of generic drugs 69.5%, percentage of antimicrobial was 92%, percentage of injection was 0%, percentage of hospital formulary was 94.3%, percentage of DOEN was 33.4%, percentage of therapeutic guideline was 54.8%, percentage of psychotropic drugs was 1.3%, percentage of systemic steroid was 1.3%. Conclusion : Pattern of drug prescription in Panembahan Senopati regency hospital, Bantul with medical standard service as guideline for Low Back Pain, Pulmonary Tuberculosis, Urinary Tract Infections was not yet rational. Usage of medical service standard as controlling instrument and the quality of medical service standard itself should be periodically improved.
Kata Kunci : Penggunaan obat rasional, Standar pelayanan medis, Low Back Pain, Tuberculosis Paru, Infeksi Saluran Kemih.
