Evaluasi penerapan daftar dan plafon harga obat (DPHO) PT Askes di bagian rawat inap RSUD Prof.Dr. Margono Soekarjo Purwokerto Jawa Tengah

SUNUSI, Muhammad, dr. Sulanto Saleh Danu, DSFK

2001 | Tesis | S2 Ilmu Kesehatan Masyarakat

Dari hasil perhitungan pemakaian obat Daftar dan Plafon Harga Obat (DPHO) selama 1999 di bagian rawat inap Rumah Sakit Margono Soekarjo Purwokerto, diketahui bahwa penerapan DPHO belum optimal. Oleh karena itu perlu dievaluasi ha1 apa yang mempengaruhi pola peresepan dan bagaimana kedudukan dan hngsi dari unsur manajemen Rumah Sakit Margono Soekarjo Purwokerto (RSMSP) terhadap penerapan DPHO. Tujuannya agar yang pengaruhi pola peresepan luar DPHO dan fbngsi/kedudb manajemen dapat diketahui untuk langkah perbaikan. Penelitian ini dilakukan dengan metode kualitatif dengan cara wawancara mendalam. Data yang dikumpulkan adalah data primer dari pelaku peresepan maupun dari pihak manajemen RSMSP. Subjek penelitian adalah 10 orang; 6 orang dari unsur pelaku peresepan, dan 4 orang unsur manajemen. Wawancara mendalam dengan pedoman wawancara, alat rekam suara, lembar kerja dan DPHO. Rekaman hasil wawancara mendalam dibuat dalam bent& transkrip lalu diidentifikasi serta dianalisis dan diinterpretasi dalam bentuk penulisan laporan. Hasil perhitungan penulisan resep luar DPHO selama 1999 dibagian rawat hap RSMSP rata-rata 22,55%, tertinggi 48,72%. Hasil wawancara mendalam dengan unsur palaku peresepan menunjukkan bahwa f'aktor yang menghambat penerapan DPHO adalah dokter kurang mengutmi isi DPHO, dokter kurang semangat menggunakan DPHO, dokter terpengad dengan industri obat nonJPJH0, dokter mengikuti keinginan/tuntutan pasien askes tentang obat non DPHO Selain itu adalah tidak adanya wadah organisasi khusus obat DPHO, pengelolaan obat secara khusus obat DPHO tidak ada, sosialisasi DPHO kurang, komunikasi-informasi-dan edukasi khusus DPHO belum optimal, serta evaluasi pengelolaan khusus DPHO kurang dan jasa medis askes tidak rasional dan tidak proporsional. Hal-hal yang dianggap dapat merupakan pendukung penerapan DPHO adalah; adanya wadah organisasi secara resmi, pelaku peresepan menyetujui adanya pedoman pengobatan seperti DPHO, pelaku peresepan bertindak rasional berdasarkan prosedur, sangat terbuka, bertanggung jawab, dan semuanya menghendaki adanya win-win solution. Dari hasil penelitian dapat disimpulkan bahwa penerapan DPHO di bagian rawat inap RSMSP belum optimal, karena pola peresepan dari unsur pelaku peresepan masih dipengaruhi oleh banyak faktor, kedudukan dan hngsi dari unsur manajemen, khususnya penerapan DPHO lemah dan sosialisasi oleh PT. Askes kurang, serta koordinasi dan persamaan persepsi tentang hak dan kewajiban dari tiga pihak kurang

Based on the use of drugs price and standard price (DPHO) in 1999 in the inpatient installation, Margono Soekarjo hospital, Purwokerto, it was found out that the application of drugs price (DPHO) was not optimum. Therefore, evaluation was required to determine factors affecting the prescription patterns and the position and hnction of hospital management at the Margono Soekarjo hospital in the drugs price application. This study was conducted using qualitative method by way of in depth interviews. Data obtained were primary data of prescription staff and the management of the hospital. The subjects were 10 persons; 6 were from prescription stafF and 4 from the management. The depth interviews were conducted using interview guideline, tape recorder, work sheet, and DPHO. The recording of these interviews were then transcripted, identified, analyzed, interpreted in the form of report. The results of prescription outside of the DPHO in 1999 in the inpatient installation showed that in average 22.55% and the highest was 48.72%. the results of depth interviews with the prescribers showed that the barrier factor was that the physicians did not understand the DPHO, and they did not have any idea of using DPHO. They were influenced by non-DPHO drugs industries. The physicians just filfilled the patients' interest. Besides there was not any organization of DPHO, the drugs management was not available. Communication, information and education on DPHO were not optimum, and evaluation on DPHO management showed that DPHO management was poor and Askes medical service was irrational and not proportional. The supporting facts of DPHO included the legal organization for DPHO, prescribers should agree with the treatment guidelines, and prescribers should be rational based on procedures, open, and responsible. There was even a very strong idea to implement the methods of DPHO and all expected win-win solution. It could be concluded that DPHO in the inpatient installation was not optimum as the prescription pattern in the inpatient installation was still affected by many factors. Prescribers were still affected by many factors including function, position of the management. The DPHO management, especially DPHO application was till weak and socialization of PT. Askes was also weak. Coordination of prescription was still poor.

Kata Kunci : Manajemen Rumah Sakit,Pelayanan Obat,DPHO,evaluation guideline, prescription pattern