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"Tesis ini membahas tentang kelayakan rujukan oleh bidan Puskesmas Poned Kota di RSUD Pirngadi Medan Tahun 2012. Penelitian ini adalah penelitian kuantitatif dengan desain cross sectional. Sampel pada penelitian ini adalah seluruh kasus rujukan yang dirujuk ke RSUD Pirngadi berjumlah 136 kasus rujukan, dan dilengkapi dengan informasi dari 17 orang bidan di 6 Puskesmas Poned. Data primer diambil dengan wawancara menggunakan kuesioner, daftar ceklist dan data sekunder menggunakan data rekam medis RSUD Pirngadi Medan. Ada 75,7% kasus rujukan persalinan yang layak dirujuk dan 24,3% kasus rujukan persalinan yang tidak layak dirujuk.

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This study analyzed the referral feasibility by Poned Health Centres midwives in Pirngadi Medan Hospital in 2012. This is a quantitative research using cross sectional design. Sample in this study are all referral cases referred to Pirngadi Hospital 136 cases and supplemented by information from 17 midwives in 6 Poned Health Centre. Data used a questionnaire, checklist, and medical record. There were 75,7% of the cases referred to decent referral and 24,3% of cases referral is not feasible referenced."

"Considers what can be done to improve the quality of urban health services and make them more accessible to residents in low-income areas and slums. Noting that a shortage of resources for urban health is a problem everywhere, the report concentrates on organizational and administrative changes that can upgrade the quality of health centres, extend coverage to underserved populations, and reduce the inefficiencies that occur when hospitals are overburdened by patients suffering from minor complaints. The objective is to help health administrators and municipal authorities analyse the weaknesses in urban health systems, appraise options for strengthening primary health care, and introduce interventions that help obtain the maximum health gains from restricted budgets. Throughout the report, experiences in different cities around the world are used to illustrate both the shortcomings of many urban health systems and the specific changes that have brought improvements. The opening sections identify key issues in the organization of urban health systems and review the extent to which health systems in the worlds cities are providing primary health care, particularly for low-income communities. Details range from a list of mistakes frequently made by municipal and public health authorities, through an explanation of methods for collecting basic data, to a series of 10 questions to be asked when moving from an analysis of problems to a programme of action. Noting that almost half of the residents of cities in developing countries live in conditions of extreme poverty and squalor, the report cites evidence of an impending health crisis as urban populations continue to grow and the incidence of chronic diseases rises alongside traditional health problems and the added burdens of HIV infection and AIDS, alcohol and drug abuse, and injuries caused by violence and road accidents. The report also identifies weaknesses in urban health centres and health posts, which frequently suffer from a low standard of services and lack of credibility, and are often bypassed, resulting in an overloading of hospital services. Against this background, the report introduces the concept of reference health centres that would provide an extended range of high-quality, round-the-clock health services in defined catchment areas and link with hospitals for referral support. According to this concept, an urban reference health centre aims to support and strengthen local health centres in their role as providers of primary health care and to bring comprehensive medical care to local communities, making health services accessible to all city-dwellers on a more equitable basis. A review of experiences to date in developing such centres in various urban settings underscores the potential contribution that reference health centres can make to urban public health."

"Seiring dengan semakin meningkatnya pengetahuan dan kebutuhan masyarakat khususnya dalam hal pelayanan kesehatan, yang diikuti oleh adanya tuntutan masyarakat terhadap kualitas pelayanan kesehatan yang Iebih balk, maka institusi pelayanan kesehatan dituntut untuk selalu merespon perubahan yang terjadi. Kebijakan Pemerintah Propinsi DKI Jakarta memberikan kesempatan kepada rumah sakit daerah menjadi unit swadana adalah sebagai upaya pemerintah daerah dalam memperhatikan pelayanan kesehatan di rumah sakit. Hal ini dimaksudkan agar rumah sakit daerah dapat dikelola secara mandiri dan profesional sesuai dengan perkembangan tuntutan masyarakat. Salah satu indikator keberhasilan rumah sakit sebagai unit swadana adalah berdasarkan tingkat kepuasan pelanggan terhadap pelayanan kesehatan yang mereka berikan. Berdasarkan hal tersebut, maka penulis akan mengadakan penelitian tentang tingkat kepuasan pelanggan yaitu masyarakat sebagai pengguna jasa layanan kesehatan terhadap pelayanan kesehatan poliklinik rawat jalan di Rumah Sakit Umum Daerah ( RSUD) Budhi Asih. Penelitian ini akan difokuskan kepada persepsi atau tanggapan pengguna jasa terhadap layanan yang diberikan dan harapan pengguna jasa terhadap layanan yang berkualitas. Untuk mengetahui tingkat kepuasan pelanggan adalah dengan Cara membandingkan antara tingkat kinerja dan harapan dari pelanggan dengan menggunakan metode Analisis Tingkat Kepentingan dan Kinerja. Sementara untuk rekomendasi tentang faktor atau atribut yang mempengaruhi kepuasan pelanggan dipetakan dalam diagram kartesius. Metode penelitian yang digunakan adalah metode survai terhadap 100 pasien poliklinik rawat jalan yang diambil secara acak dengan menggunakan teknik sampling aksidental. Tingkat kepuasan pelanggan terhadap pelayanan kesehatan di RSUD Budhi Asih ini, didasarkan pada dimensi kualitas pelayanan yang terdiri dan : reliability, responsiveness, assurance, empathy dan tangible.Berdasarkan hasil penelitian maka dapat disimpulkan bahwa Persepsi pasien terhadap tingkat pelayanan di poliklinik rawat jalan RSUD Budhi Asih sebagian besar berada pada kontinum cukup memuaskan, demikian pula berdasarkan rata-rata untuk setiap dimensi juga berada pada kontinum cukup memuaskan. Sementara dari 18 indikator yang dinilai, maka berdasarkan hasil analisis sebagaimana tergambar pada diagram kartesius berkenaan dengan faktor-faktor yang mempengaruhi kepuasan pasien, terlihat bahwa terdapat 4 faktor yang berada di kuadran A yang berarti faktor tersebut dinilai sangat penting oleh pelanggan, akan tetapi tingkat pelaksanaannya masih belum memuaskan. Dikuadran B terdapat 7 faktor, hal tersebut menggambarkan bahwa antara tingkat pelaksanaan dengan harapan pelanggan sudah sesuai. Sementara dikuadran C terdapat 5 faktor, artinya bahwa faktor-faktor tersebut dianggap kurang penting oleh pelanggan sementara tingkat kualitas pelaksanaannya dianggap biasa. Terdapat 2 faktor yang berada dikuadran D, hal ini menunjukkan bahwa faktor-faktor tersebut dianggap tidak terlalu penting oleh pelanggan sementara pelaksanaannya dilakukan dengan balk oleh rumah sakit. Hasil penelitian ini kiranya dapat dijadikan sebagai salah satu masukan bagi pihak manajemen rumah sakit dalam upaya meningkatkan kualitas pelayanan di masa yang akan datang.

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Along with the advancement of knowledge and needs of the society with particular reference to health services, followed by society's demands on better health service quality, health service institution is forced to keep responding to these changes. The policy of the Provincial Government of the Special Territory of the Capital City of Jakarta. allowing the Local General Hospitals to transform themselves to be a self-funded unit, is the manifestation of the provincial government's concern on health services in the hospital. The intention is to enable the Local General Hospitals to manage independently and professionally in congruence with the development of societies' demands. One of the success indicators of the hospital as a self-funded unit is based on the customers satisfaction towards the health services they provide. Based on this, the writer conducts a research on customers' satisfaction level as service users towards on coming-basis polyclinic health services in Budhi Asih Local General Hospital. The research will focus on the customers' perceptions or responses towards the services provided and their expectations towards quality services.

To find out the customer's satisfaction level the writer uses a method of performance and interest analysis by way of comparing between performance level and customer's expectations. As for the recommendations on factors or attributes which influence the customer's satisfaction is outlined in Cartesius diagram. The method of the research uses survey method towards a hundred on coming-basis patients of polyclinic which were randomly taken by using accidental sampling technique. The customer's satisfaction level towards health services in Budhi Asih Local General Hospital is based on service quality dimension comprising of reliability, responsiveness, assurance, emphaty and tangible. Based on the research findings it can be concluded that the patient's perceptions towards health services level in on coming-basis polyclinic of Budhi Asih Local General Hospital the majority stands in the continuum of relatively satisfactory, it is also the case for each dimension based on average. From 18 measured, based on analysis result as illustrated in Cartesius diagram in terms of factors that influences patient's satisfaction, it can been seen that there are four factors in A quadran meaning those factors is considered very important by the customers, however the implementation level remains not yet satisfactory. In B quadran there are seven factors that ilustrated between implementation level and customer's expectations already appropriate. As in C quadran there are five factors meaning that those factors are considered less important by the customers whereas the implementation quality level is considered ordinary. In B quadran there are two factors which show that those factors are considered not too important by the customers whereas the hospital has done it well. The research findings can be considered as an input for the hospital management in an effort to improve service quality in the future."