Uji Coba Pedoman Evaluasi Pengelolaan dan Pembiayaan Obat di 20 Puskesmas Jawa Timur

Azis, Sriana and Supardi, Sudibyo and Muktiningsih, S.R. (2006) Uji Coba Pedoman Evaluasi Pengelolaan dan Pembiayaan Obat di 20 Puskesmas Jawa Timur. Media Penelitian dan Pengembangan Kesehatan, 16 (1). pp. 20-28. ISSN 0853-9987

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Abstract

Drug financing is the biggest cost component of health care which is relatively easy to be intervened, especially the government sector. If key outcome indicators have been determined at the beginning of an intervention measuring whether the objectives of the intervention have been met through changes in these indicators makes it possible to assess the impact of an intervention. The obyective of the study is essential regarding the recent decentralization policy. Guidelines on Drug Management and Financiing at Puskesmas with indicators adopted from WHO-PAHO "Manual of Rapid Assessment Pharmaceutical Management, 1995" as well as indicators recently developed from a study in Pekalongan District in 1999/2000, i.e. cost recovery , real cost and ability to pay, is intended to increase efficiency, to assess the system and broaden knowledge of drug managing staff at District Health office, District (Dinkes kabupaten), Pharmaceutical Warehouse (GFK) and Health Centre (puskesmas). In this cross-sectional retrospective study training of data collector, S health provider (H.P) from Puskesmas, 1 H.P from GFK and I H.P from Dinkes Kabupaten, should prepare them for different situations. The design for this study to characterize drug use practices in a region would call for a sample of at least 20 health facilities, with at least 30 encounters being recorded in each facility. Studying 20 Puskesmas from 4 districts: Jombang, Lumajang, Malang and Pasuruan through their medical records ( 600 from each Puskesmas) will increase the reliability and generalizability of indicators. The results of this study shows that in all districts drug budget per capita increased during 1998-2001 for different reasons and patients' ability to pay was higher than the real treatment cost for certain diseases. On the other hand, the average drug budget per encounter was higher than the real cost and cost recovery was declining for all districts except for Jombang, More intensive socialization of rational prescribing for Puskesmas physician to achieve efficiency in drug budgeting and of this guidelines implementation is necessary, regional authority should better return all Puskesmas retribution entirely.

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