HEALTH CARE QUALITY INPATIENTS OF DIABETES MELLITUS IN THIRD CLASSES MOHAMMAD HOESIN HOSPITALS PALEMBANG A. Faisal Rizal ABSTRACT The quality of inpatient health care 3rd classes Diabetes Mellitus is still low or has not met the expectations of the sociaty. The hospital has a very strategic role in efforts to accelerate the improvement of the degree of public health, the expected patterns of health services is a quality service, research is meant to learn, know and analyze the quality of inpatient healthcare thirdclass Diabetes Mellitus which subsequently found a new concept in order to enrich the culture of public administration science about the development of quality public services.This research uses Qualitative Research Methods.Collecting data using a literature study, the documents study, observation, and interviews. Through this design gained a phenomenal relationship nature and facts about the quality of health services so do categorisation and answers to the formulation of hypotheses of work as research findings.The result of research and discussion show that the quality of Inpatient health care Diabetes Mellitus in third classes Hospitals Mohammad Hoesin Palembang based on aspects of comfort, safety, reliability, attention to the person, problemsolving approach, justice, financial responsibility, influence the community, not to walk with, whether unaccompanied. As for the concepts of the bare that can result from this research were raised is open procedure and service quality Keywords: Open Procedure, Quality and Service 1. INTRODUCTION Palembang city health development as part of national health development efforts are directed at achieving awareness, willingness and ability to live a healthy life for every resident in order to realize optimal health status . Health efforts were originally put emphasis on efforts to cure people gradually been evolving towards health promotion and prevention efforts . laid vision of health development in Palembang Healthy , 2012. The significance of this vision contains the expectation of the people of Palembang in 2012 to live in the environment and healthy behavior , have the ability to reach health services grade fairly and equitably , and has a level of hIn realizing the ideals in the health sector Palembang city government has ealth that is as high as that in parallel with advancing the surrounding area . To realize this vision , set of 4 ( four ) main mission of the health development of Palembang , namely : 1) Maintain and enhance the excellent health services , equitable and affordable . 2) Cultivating a clean and healthy living behavior . 3) Maintaining and improving the health of individuals , families and communities and their environment. 4) Moving the development vision of health Dr Dr.Mohammad Hoesin Palembang , formerly known as General Hospital Palembang , which was founded in 1953 on the initiative of the Minister of Health Dr.Mohammad Ali ( Dr.Lee Kiat Teng ) and began operational from the date of January 3, 1957 with simple facilities . Serving Outpatient Services , Inpatient Services with 78 beds dei and complete laboratory services , a pharmacy, Radiology , Emergency and other supporting equipment . Dr These Palembang airport communities throughout southern Sumatra that includes Sumatra , Riau, Jambi , Bengkulu and Bangka Belitung Hospital official Palembang using the name Dr Dr.Mohammad Hoesin Palembang on October 4, 1997 , based on the Minister of Health No: 1297 / Menkes / SK / XI / 1997 .
In RSMH organizational structure has been amended several times , among others : 1) In 1993 the department of Palembang by SK Menkes RI No: 1134 / Menkes / SK / 1993 changed the status of the vertical Hospital ( Hospital of the receiving State Non-Tax ) becomes Hospital Swadana . 2) In 2000 under Regulation No: 122/2000 , Dr Dr.Mohammad Hoesin Palembang set as Hospital Bureau Company ( Perjan ) . 3) In 2005 the government policy against 13 Hospital Dr Dr.Mohammad Hoesin Vertical including Palembang , by decree of the Minister of Health Decree No: 1243 / Menkes / SK / VIII / 2005 concerning the establishment of 13 Ex- RS Perjan Applying Financial Management General Services Agency The hospital has a strategic role in the effort to accelerate the improvement of public health degree . The new paradigm of health care requires hospitals provide quality services according to the needs and wishes of patients to adhere to the code of professional conduct and medical . In the rapid technological developments and increasingly fierce competition , the hospital is required to upgrade the quality of its service The main problem as an institution of health services is the increasing number of competitors . Therefore , hospitals are required to always maintain consumer confidence by improving the quality of services in order to increase consumer satisfaction . The hospital authorities need to carefully determine the needs of consumers in an effort to fulfill the wishes and improve satisfaction with the services provided (John, 1992:57). Providing services with the best quality , not something that is easy for managers of hospitals for the services provided by the hospital concerning the quality of life of their patients when an error occurs in the medical action can be bad for patients . Such impacts may be ill patient is getting worse, disability and even death ( Jacobalis , 1995: 68 ) . " Hospital as part of the national health system is required to improve the quality of provision of facilities, services and independence . Thus the hospital is one of several actors competitive health care should be managed by actors who have an entrepreneurial spirit capable of creating efficiency, excellence in quality and service , excellence in innovation as well as excel in responding to the needs of the patient " ( Jacobalis , 1995: 77 ) . Diabetes mellitus ( DM ) is a chronic metabolic disease that generally affects lifetime ( PERKENI, 2006: 1-21 ) . In the United States , approximately 15 million people suffer from diabetes , and half are undiagnosed . There is the growing number of patients as many as 800,000 people every year and 54,000 died by causes related to diabetes . Terminal kidney disease , adult blindness , and lower limb amputations in the United States is most commonly caused by diabetes mellitus ( Maitra , 2005: 37-49 ) . DM not only interfere with the quality of life of patients , but also interfere with the patient's social and economic functions . The prevalence of diabetes in the world in 2000 is 171 million and is expected in 2030 will reach 366 million . Indonesia was ranked second highest after India in the prevalence of DM for the Asian region . The prevalence of DM in Indonesia in 2000 was 8.5 million and in 2030 is expected to reach 21.3 million ( WHO , 2008 26: 4174-176 . ) . Indonesian Central Statistics Agency (2003 ) states that the prevalence of diabetes in urban areas was 14.7 % and rural areas by 7.2 % , ( Perkeni , 2006: 1-21 ) . The above facts show how serious disease DM in Indonesia . DM treatment is important to prevent the complications of diabetes , but unfortunately , only two- thirds of patients who have undiagnosed diabetes who undergo treatment ( non -pharmacologic and pharmacologic treatment ) and only the third well-controlled ( Perkeni , 2006: 1-21 ) . DM is a chronic disease that lasts a lifetime . DM treatment should be done lifetime of the patient certainly exhausting and financial patient , let alone to buy the latest generation of drugs that are quite expensive .
In accepting and serving inpatients as consumers with a variety of characteristics , the hospital must equip themselves in order to continue to listen to the voice of consumers , and has the ability to respond to every whim , consumer expectations and demands of service users of health care facilities . This is closely related to the health professionals who always accompany and serve patients as consumers. The foregoing is in line with the opinions expressed Waworuntu (1997 : 19 ) that : Professional person in the world to master the state administration and the public needs to know how to satisfy and meet the needs of the community . Society needs to be satisfied by fulfilling their needs. So that people feel as a king , then it should be served well . The human factor as the service provider to the public in the organization is considered very crucial in a quality service . According Thoha (2002 : 181 ) " quality of service to the community is dependent on the individual actors and the system used " . Doctors , nurses and medical support personnel as well as non-medical duty at the hospital must understand how to serve customers well, particularly to patients and their families , for patients and their families is a major consumer in the hospital . The ability of hospitals to meet patient needs can be measured from the level of patient satisfaction. In general, patients who are dissatisfied will complain to the hospital. Citizens who take medication to hospital of course expect superior service and excellence. It is given also that the Government has always campaigned for their excellent service by government officials for citizens who need the service (in this case health care). According to data from RSMH Party in 2013 that people who are satisfied receive health care in general RSMH amounted to 86.27% of the total stakeholders (stakeholders) in the hospital, but in accordance with the Minimum Service Standards / SOP (Standard Operating Procedure) there , the number of customer satisfaction in a hospital at least 90% of the total stakeholders (stakeholders) in the hospital. The high number of patient deaths that occurred after a period of 48 hours after an inpatient hospital admission. Complaints are not treated immediately will result in reduced patient satisfaction with health care capabilities at the hospital , customer satisfaction has become a central concept in the discourse of business and management . Consumers generally expect the product in the form of goods or services consumed can be accepted and enjoyed with good service or satisfactory ( Assauri , 2003: 28 ). Consumer satisfaction can shape perceptions and can further position the company's products in the eyes of consumers . In conjunction with the satisfaction of consumers / patients and quality of care Hospitals Mohammad Hoesin ( RSMH ) of Palembang , the people of Palembang several times to make a complaint against the service RSMH Palembang through local media , in particular the quality of service in Inpatient Class III patients with Diabetes Mellitus . Complaints for hospital services are also delivered through a suggestion box in RSMH Palembang. It thus provides an indication that the RSMH Palembang built with adequate facilities and infrastructure have not been able to provide services that meet the expectations , desires and demands of the public as consumers . Based on the above description , the need for research related to the study of public administration studies of the quality of inpatient care in patients D.M RSMH Palembang. The title is defined in this study are in accordance with the foregoing is the Quality of Health Care Inpatient Class III Diabetes Mellitus in Hospitals Mohammad Hoesin Palembang 2. THE RESEARCH METHODOLOGY In this study, researchers used qualitative research methods . because as the title of Quality of Health Care inpatients class III Diabetes Mellitus in Hospitals Mohammad Hoesin Palembang . This study is more appropriate to use qualitative methods for the study revealed comprehensively the problems are complex relating to inpatient care kualias class III DM Hospital in Mohammad Hoesin Palembang .
The number of informants are as follows: Informants Status Inpatients class III DM Families of patients Kep. Midwives Nursing Physician experts DM Responsible for the health of one person Number No. 1. 2. 3. 4. 5.
Number 3 3 1 1 1 9
processing data by: a) Make a transcript , the field notes on observations and interviews. b) Make a display for example a table , matrix , photographs and sketches Kambar . Processing and anatisis data were simultaneously and continuously repeated - again following completion of the interviews and observations . In this process once performed data reduction is done selectively as possible for data to be true - really not necessary , so that the work would be more efficient . This process continues until the data required is collected . By using this process , each stage of data collection is quite unified , so that observation and interviews later became more focused , narrowed and dived in The analysis of the data obtained in the field menggunakahn stages as proposed by Miles and Huberman (1992 : 16 ) a. The first stage: Categorization and data reduction, that did the collection of all the important information related to this research problem, then the data was grouped according to subject matter. Categorization and data reduction is performed on data from interviews with informants, such as the purpose of implementation, coordination of work, availability of resources both human resources, facilities and finance. Thus poula well as on the interpretation of programs, labor standards, the clarity of proposal ADD, clear work objectives and implementation activities, monitoring, evaluation and priority allocation of funds. b. The second stage: Data were grouped further arranged in the form of narratives, so that the data in sets of meaningful information according to research issues relating to the implementation kebiajakan village allocation fund is based on the organization, interpretation and application. c. The third stage: Conducting the interpretation of the data, ie to interpret what has been given and interpreted informants against the problems examined regarding the implementation kebiajakan village allocation fund is based on the organization, interpretation and application. d. The fourth stage: Making conclusions based on the arrangement of the narrative that has been arranged in the third stage, so that it can provide answers to issues related to the research related to the implementation of the allocation of funds kebiajakan village in Minahasa e. Phase five : To verify the results of data analysis with the informant , which is based on the conclusion of the fourth stage . This phase is intended to avoid misinterpretation of the results of interviews with a number of research informants that could obscure the meaning of the real issue from the focus on the implementation kebiajakan village allocation fund is based on the organization , interpretation and application . The study was conducted at Hospital Mohammad Hoesin Palembang . Being in the middle of the city of Palembang in South Sumatra province . 3. RESULTS According to Carlson and Schwarz (1995: 29) in Denhardt and Denhardt (2003: 61) covering aspects: Convenience (convenience) are: the size of the degree to which government services easily available and much people include ease of equipment, neatness medical personnel, cleanliness, beauty and neatness ward, complete facilities, and medical equipment.
The provision of services can not be separated by the availability of facilities in connection with the implementation of physical appearance in the embodiment of comfort that can be seen on the availability of equipment and state of personal relationships. Availability of facilities are the responsibility of management Mohammad Hoesin Palembang Hospital as a health care provider in meeting the needs for facilities and infrastructure. Though it must be admitted that the current Hospital Mohammad Hoesin Palembang has tried to make some breakthroughs in service as well as the absence of traders, hawkers who roam the area hospitals, office management started well ordered, supported the readiness of forces, but the lack of access for the public in meeting the health care needs are still many untapped apparatus properly. In connection with this case of course the patient has hope against the uniform appearance of doctors and hospital staff, office locations, the location of hospitals, facilities that seems interesting and convenient, real-time and sophisticated equipment to provide health services. But the reality in the field findings are: a. Almost every day in class III inpatient room Irina B is always in a state of full and all the beds are used. b. III overcrowded classrooms making it difficult for patients to rest well Limitations of the room, especially classrooms III, often give rise to a speculation that the third class room facility as if traded. To resolve this issue is already the hospitals should be more transparent, it helps display it on the monitor as a computer or a television or affixed in places billboards. It does require a little extra work, but it must be done to fulfill the comfort aspect Based on observations conducted by researchers Hospital Mohammad Hoesin Palembang showed that Irina B Lounge observed when it is full. Seeing the exposure mentioned above are clearly visible not meet the comfort aspect related to the physical facilities, equipment and form personal relationships or circumstances. This is certainly the responsibility of the hospital Mohammad Hoesin Palembang means RSMH did not fully play a role in running a social function. According to the provisions in the implementation of the National Social Security Health, all hospitals, both private and government must provide inpatient facilities Class III proportionally. To the government hospital at least 25 percent and private hospitals at least 10 percent of the total number of inpatient beds provided for the service class III. This means that people who use health services JAMKESMAS the memorandum benenya identical to the poor is not accommodated or their rights to health services is not being met. This means that now more and more people are poor levels of life. 4. CONCLUSION Based on the results of research and discussion that has been done, the researchers concluded that the quality of the waitress keshatan inpatients class III at the Hospital Mohammad Hoesin in the achievement has not been effective, especially in patients with Diabetes Mellitus. This is because the service activities that are not fully based on the following aspects: comfort, safety, keahandalan, attention to the person (patient), problem-solving approach, justice, financial responsibility, the influence of society.
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