Mutu penggunaan dan tingkat kecukupan obat di 10 Puskesmas Kota Ambon

LINTHIN, Sandra M.P, dr. Iwan Dwiprahasto, MMed.Sc.,PhD

2001 | Tesis | S2 Kesehatan Masyarakat

Penggunaan obat yang tidak rasional merupakan masalah yang banyak dialami oleh negara berkembang yang akan menimbulkan dampak yang cukup besar terhadap penurunan mutu pelayanan kesehatan dan peningkatan anggaran pemerintah yang dialokasikan untuk obat-obatan. Penelitian ini bertujuan untuk mendapatkan gambaran tentang mutu penggunaan dan tingkat kecukupan obat di 10 Puskesmas kota Ambon. Penelitian ini merupakan penelitian non eksperirnentallobservasional dengan metode kuantitatif dan kualitatif, menggunakan rancangan cross-sectional, data dianalisis secara deskriptif. Data peresepan dikumpulkan secara retrospektif pada periode 1 Januari sampai dengan 31 Desember 1998. Data dipaoleh dari buku register harian pasien, kertas resep dan status pasien, meliputi data peresepan terhadap 3 jenis diagnosis yaitu diagnosis ISPA non pneumonia pada balita dan dewasa, Diare akut non spesifik pada balita dan dewasa serta Myalgia. Jumlah kasus yang diambil sebanyak 2349. Tingkat kecukupan obat di GFK dan Puskesmas diperoleh melalui observasi dokumen persediaan obat di GFK dan LPLPO di Puskesmas. Wawancara mendalam dilakukan kepada kepala GFK kota Ambon, 2 orang dokter kepala Puskesmas dan 1 orang perawat yang menjabat sebagai kepala Puskesmas. Hasil penelitian menunjukkan bahwa rata-rata jumlah item obat yang diterima pasien di Puskesmas adalah 3,8 — 5,1 item; penggunaan antibiotika di Puskesmas bervariasi dari 9,9% - 80,4%; penggunaan injeksi di Puskesmas bervariasi dari 0% - 34,70%; penggunaan obat dengan nama generik bervariasi dari 93,7% - 99,2% ; peresepan yang sesuai dengan Pedoman Pengobatan Dasar di Puskesmas bervariasi dari 6,8% - 18%; tingkat kecukupan obat di GFK bervariasi dari 5 — 67 bulan, sedangkan tingkat kecukupan obat di Puskesmas bervariasi dari 3 — 40 bulan. Dari hasil penelitian dapat disimpulkan bahwa peresepan obat di Puskesmas belum rasional; perencanaan dan pengelolaan obat di kota Ambon belum efisien.

Inappropriate use of drugs is a problem experienced by developing countries that results in big problem of decreasing quality of health service and increasing government's state budget allocated for drugs. This study was aimed to find out the quality and level of drugs availability in 10 health service centers in Ambon. This study was non experimental/observational, quantitative and qualitative method was used, cross-sectional design, data were analyzed descriptively. Prescription data were collected retrospectively fi-om January 1 to 31 December 1998. The data gathered from daily patient registration records, prescription sheets, and patient status, which included prescription data of 3 diagnosis, non-pneumonia acute respiratory infection among under-five-year-old children and adults, non-specific acute diarrhea among under-five-year-old children and adults, and myalgia. There were 2349 cases. The drugs availability level in the pharmacy and health service centers was found out by observing the documents of drugs availability in the pharmacy and drugs prescription unit in the health service centers. Depth interviews were conducted with the pharmacy head, 2 head doctors of the health service centers, and 1 nurse who was the head of a health service center. The result showed that in average the number of drugs that a patient received were 3,8 — 5,1 items; use of antibiotics in the health service centers were varied from 9.9 to 80.4%; use of injection in the health service centers was varied from 0% to 34.70%; use of generic drugs were varied from 93.7% to 99.2%; prescriptions relevant with the basic guidelines at the health service centers were varied fi-om 6.8% to 18%; the level of drugs availability in the pharmacy was varied from 5 to 67 months; while the level of drugs availability in the health service centers was varied from 3 to 40 months. From the study it could be concluded that drugs prescription in the health service centers has not been rational; planning and management of drugs at the health service centers and pharmacy in Ambon has not been efficient.

Kata Kunci : mutu penggunaan obat, pola peresepan, kecukupan obat, quality control of drugs, prescription pattern, drug management