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"Latar Belakang:Kegawatan onkologi pada pasien kanker paru berhubungan dengan angka kesintasan pasien kanker paru. Pasien kanker paru yang memiliki kegawatan akan meningkatkan angka morbiditas dan angka mortalitas. Penelitian ini bertujuan memberikan data angka kesintasan pada penderita kanker paru dengan kegawatan di RS Wahidin Sudirohusodo Makassar.Metode:Studi kohort retrospektif dengan menggunakan data sekunder rekam medis di RS Wahidin Sudirohusodo dari Januari 2016 sampai Agustus 2017. Semua data penderita kanker paru di ambil melaluielectronic medical record. Perhitungan angka kesintasan menggunakan analisis Kaplan Meier beserta kurva kesintasan. Uji kemaknaan menggunakan uji Mantel-Cox log-rank-test. Kriteria inklusi pada penelitian ini adalah pasien yang sudah tegak diagnosis kanker paru tanpa disertai dengan keganasan primer di organ lain.Hasil:Subjek penelitian 182 pasien kanker paru (122 laki-laki dan 60 perempuan). median. 135 pasien dengan kegawatan onkologi (74.18%). Usia median 55 (18-91 tahun). Jenis kegawatan pada pasien kanker paru yang paling sering ditemukan adalah efusi pleura masif. Angka kesintasan pasien kanker paru dengan tamponade jantung memiliki kesintasan paling rendah; angka tengah tahan hidup 0.6 bulan, dan angka kesintasan 1 tahun sebesar 0% (p<0.005). Pasien kanker paru yang memiliki lebih dari satu jenis kegawatan memiliki angka kesintasan yang lebih rendah dibandingkan dengan pasien kanker paru yang hanya memliki satu jenis kegawatan onkologi dengan nilai (p=0.002). Kesimpulan:Penderita kanker paru dengan kegawatan, terutama tamponade jantung dan jenis kegawatan lebih dari satu kegawatan memiliki angka kesintasan yang rendah.

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Background:

Oncological emergencies affect morbidity and mortality in lung cancer patients, which ultimately affects their survival. This study aims to estimate the survival rates of lung cancer patients with oncological emergencies treated at a general hospital in Indonesia.

Methods:

This retrospective study analyzed a cohort of lung cancer patients with oncological emergencies treated at Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia, between January 2016 and August 2017. Subjects were patients without any primary malignancies in the other organs. Their survival rate was estimated from the Kaplan-Meier survival curve and was analyzed using the Mantel-Cox log-rank test.

Results:

This study involved 182 lung cancer patients (122 males and 60 females) as subjects, in which 135 subjects (74.18%) presented with oncological emergencies. Their median age was 55 (18-91) years old. Massive pleural effusion was the most common oncological emergency found (53%). The subject presented with a cardiac tamponade had the lowest survival rate; their median survival rate was 0.6 months, and their 1-year overall survival rate was 0% (p<0.005). Subjects presented with more than one oncological emergency had a lower survival rate compared to subjects with only one type of oncological emergency (p=0.002).

Conclusion:

Lung cancer patients with oncological emergencies, mainly presented with cardiac tamponade and more than one emergency, had a lower survival rate."

"Kanker ovarium adalah salah satu kanker ginekologi yang paling umum terjadi dan menempat urutan ketiga setelah kanker serviks dan kanker uterus. Sebagian besar kasus kanker ovarium (60%) ditemukan pada stadium lanjut sehingga hasil pengobatan tidak seperti yang diharapkan. Penelitian ini bertujuan untuk mengetahui ketahanan hidup pasien kanker ovarium berdasarkan stadium di Rumah Sakit Umum Pusat Dr. Wahidin Sudirohusodo Makassar Tahun 2014-2018. Desain Penelitian ini menggunakan kohort retrospektif. Pasien yang merupakan kasus baru dan mendapatkan perawatan hanya di rumah sakit masuk ke dalam penelitian. Sampel terdiri dari 295 pasien, 142 pasien dengan stadium awal dan 153 pasien dengan stadium akhir yang didapatkan dari sistem informasi rumah sakit pada periode Januari 2014 – Desember 2018. Pasien diamati dari waktu diagnosis hingga event (meninggal) dalam kurun waktu 57 bulan. Hasil analisis Kaplan Meier menunjukkan probabilitas ketahanan hidup pasien kanker ovarium stadium awal (84%) lebih tinggi dibandingkan pasien kanker ovarium stadium akhir (81%). Rata-rata ketahanan hidup pasien kanker ovarium stadium awal selama 15 bulan sedangkan pasien kanker ovarium stadium akhir selama 9 bulan. Hasil analisis cox regression didapatkan bahwa risiko kematian pasien kanker ovarium stadium akhir 1,4 kali lebih tinggi dibandingkan dengan pasien kanker ovarium stadium awal setelah dikontrol dengan umur, derajat diferensial sel, dan keadaan umum.

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Ovarian cancer is one of the most common gynecological cancers and ranks third after cervical cancer and uterine cancer. Most cases of ovarian cancer (60%) are found at an advanced stage so the treatment results are not as expected. This study aims to determine the survival of ovarian cancer patients based on the stadium at Rumah Sakit Umum Pusat Dr. Wahidin Sudirohusodo Makassar in 2014-2018. Design This study uses a retrospective cohort. Patients who are new cases and get treatment only at the hospital were included in the study. The sample consisted of 295 patients, 142 patients with early stage and 153 patients with final stage obtained from the hospital information system in the period January 2014 - December 2018. Patients were observed from the time of diagnosis to event (death) in a period of 57 months. Kaplan Meier's analysis showed that the probability of survival of patients with early-stage ovarian cancer (84%) was higher than that of end-stage ovarian cancer patients (81%). The average survival of patients with early stage ovarian cancer for 15 months while patients with late stage ovarian cancer for 9 months. The results of cox regression analysis found that the risk of death of end-stage ovarian cancer patients was 1.4 times higher compared to patients with early-stage ovarian cancer after being controlled with age, grade, and performance status. "

"Chemotherapy is one of the cancer treatment that could provide many side effects and decrease the functional status and quality of life cancer patients. Progressive muscle relaxation (PMR) training is one of the nursing intervention that leads to decreased physical and phsycological effect from chemotherapy. The purpose of this study was to identify 'the effect of progressive muscle relaxation training on functional status in the context of the nursing care for cancer patients with chemotherapy'. This study was a quasi experimental using a nonequivalent control group with pretest and posttest design. The sample was cancer patients who received chemotherapy and inpatient in RS Dr. Wahidin Sudirohusodo Makassar. A concecutive sampling was used as the sample collection method and 48 subjects were obtained this study, divided into two groups, each group consisted of twenty four subjects as intervention group who were given PMR training twice a day for seven days, and twenty four subjects as control group who were not given PMR training. The instrument that used in this study were demography form and Functional Living Index-Cancer to measure functional status which consisted 22 questions with 7-point Likert-Type linear analog scale. A T test was used to examine the differences of the mean of functional status scores and each dimension. The finding showed that there was a significant increased of the mean of functional status after PMR training in intervention group (p=0,000). It means that PMR training has an effect in increasing level of functional status in cancer patients with chemotherapy. It is recommended to apply PMR training as a nursing intervention to cancer patients with chemotherapy and suggested to conduct futher research using more samples."

"ABSTRAKKepatuhan merupakan hal penting bagi wanita dengan kanker payudara karena dapat menjadi penentu efektivitaspengobatan dan manfaat klinis yang optimal. Tujuan penelitian ini adalah untuk mengetahui hubungan umur, pekerjaan,pendidikan, keikutsertaan dalam asuransi, depresi, dukungan sosial, efikasi diri dan pengetahuan dengan kepatuhankemoterapi pada pasien kanker payudara. Peneltian cross sectional ini melibatkan 89 responden yang dipilih denganteknik consecutive sampling. Hasil penelitian menunjukan adanya hubungan yang bermakna antara kepatuhankemoterapi dengan pendidikan (p value 0,001), pekerjaan (p value 0,002), depresi (p value 0,001), dukungan sosial (pvalue 0,03), efikasi diri (p value 0,002), dan pengetahuan (p value 0,001). Hasil multivariat menujukan bahwaresponden yang memiliki pengetahuan baik berpeluang 16 kali lebih patuh terhadap kemoterapi dibandingkan denganresponden yang memiliki pengetahuan buruk, setelah dikontrol oleh variabel pendidikan,depresi, dukungan sosial, danefikasi diri. Rekomendasi dari penelitian adalah memberikan edukasi sesuai karakteristik pasien dan sesuai denganpenilaian tingkat depresi, dukungan sosial, dan efikasi diri.

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ABSTRACT

Adherence is the important thing for the woman with breast cancer as it determines the effectiveness of the medical

treatment and optimal clinical benefits. This research aims to find out the correlation of age, job, education,

involvement in insurance, depression, social support, self-efficacy, and the knowledge of chemotheraphy adherence for

the breast cancer patients. This cross sectional research involved 89 respondents selected through consecutive

sampling technique. The research result shows that there is meaningful correlation between the chemotheraphy

adherence with education level (p value 0,001), job status (p value 0,002), depression level (p value 0,002) social

support (p value 0,03), self-efficacy (p value 0,002), and knowledge (p value 0,001). The multivariate result shows that

the respondents havinggood knowledge have the possibility 16 times to be more obedient to the chemotheraphy than

those having poor knowledge. Theresult is obtained after being controlled by the variable of education, depression,

social support, and self-efficacy. This research suggests to give the education based on the patients characteristics and

the assessment of depression level, social support, and patients'self-efficacies."

"Kepala ruangan pada unit rawat inap RS merupakan penanggung jawab ruangan dan menjadi manajer di garis depan yang harus mampu menjadi urat nadi dari segala proses pendayagunaan sumber-sumber keperawatan di ruangan sehingga dapat menciptakan iklim kerja kondusif yang mampu memberi kesempatan dan kemudahan kepada staf keperawatan yang manjadi tanggung jawabnya untuk tumbuh, berkembang dan berprestasi dalam suasana iklim organisasi yang dinamis.RSUP Dr. Wahidin Sudirohusodo Makassar, sebagai RS tipe A dan pusat rujukan kawasan timur Indonesia memiliki 15 ruang rawat inap dengan jenis pelayanan kesehatan yang kompleks, namun demikian tenaga perawat pelaksana yang bertugas di ruang rawat inap mayoritas tenaga non profesional (69,%) sehingga diharapkan para kepala ruangannya mampu menjadi seorang pemimpin yang efektif yang dapat menciptakan iklim organisasi ruang rawat inap yang kondusif.Berdasarkan hal tersebut rumusan masalah dalam penelitian ini adalah bagaimana hubungan antara kepemimpinan efektif kepala ruangan dengan iklim organisasi di ruang rawat inap RSUP Dr. Wahidin Sudirohusodo Makassar dengan asumsi ada hubungan kepemimpinan efektif kepala ruangan dengan iklim organisasi yang dipersepsikan oleh perawat pelaksana, dimana persepsi ini dapat dipengaruhi oleh beberapa karakteristik demografisnya seperti usia, jenis kelamin, pendidikan dan lama kerja.Penelitian ini merupakan penelitian kuantitatif dengan disain deskriptif korelasi yang bersifat "Cross Sectional" dengan tujuan untuk melihat hubungan antar variabel yakni kepemimpinan efektif, iklim organisasi dan karakteristik demografis perawat pelaksana.Berdasarkan analisis data univariat, bivariat dan multivariate hasil penelitian menggambarkan ada hubungan yang signifikan antara kepemimpinan efektif kepala ruangan dengan iklim organisasi_ Dari enam komponen kepemimpinan efektif maka empat diantaranya yakni komunikasi, energi, tujuan dan tindakan masing-masing berhubungan secara signifikan dengan iklim organisasi, sedangkan karakteristik responden, tidak ada satupun yang berhubungan secara signifikan dengan kepemimpinan efektif. Tetapi antara karakteristik responden dengan iklim organisasi mama umur dan lama kerja berhubungan secara signifikan. Dari model regresi ganda maka komponen komunikasi energi dan tindakan masing-masing memberikan kontribusi pengaruhnya terhadap iklim organisasi, diantara ketiganya komponen energi memberikan kontribusi terbesar.Berdasarkan hasil penelitian tersebut ada beberapa saran yang dapat disampaikan yakni : bahwa dalam proses rekruitmen, promosi jabatan kepala ruangan para pengambil kebijakan di RSUP Dr. Wahidin Sudirohusodo sangat penting mempertimbangkan aspek kemampuan energi, kemampuan komunikasi dan kemampuan bertindak yang dapat terjaring melalui wawancara dan observasi.Perawat yang berusia muda dan perawat yang mempunyai lama kerja kurang dari 10 tahun dapat didistribusikan merata pada 15 ruang rawat inap. Dalam meningkatkan kemampuan kepemimpinan maka kepala ruangan dapat melakukan learning by doing atau on the job training. Demikian juga agar senantiasa meningkatkan energi yang dimiliki, kemampuan berkomunikasi dan dapat bertindak sesuai batas kewenangan dengan mengaplikasikan komponen kepemimpinan efektif didalam kepemimpinannya.Daftar Pustaka 51 (1968 - 2000)

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The relation between the effective leadership of the charge nurse and the organisational climate at the Central Public Hospital Dr. Wahidin Sudirohusodo in Makassar, 2001 The charge nurse of a hospital long ward stay department is a person in responsibility to a ward and a manager in front line, who must have capability to become a nerve root of all process in making efficient use of nursing sources in the ward. The charge nurse can create a conducive working climate, allowing nursing staffs as her subordinate to have an opportunity and ease to develop and gain their achievement on the dynamic organisational climate.The Central Public Hospital Dr. Wahidin Sudirohusodo in Makassar is a type A hospital having a role as a central reference in eastern Indonesia - posses 15 long ward stay departments with variety of complex health services. Nevertheless, the nurse staff in duty at long ward stay department is non-professional in majority or almost 69 %. Thus, the charge nurse is expected to have an effective leadership who is able to create a conducive long ward stay department.Based on those reasons above, the problem formulation at this research poses how the relationship between an effective leadership and the organisational climate at long ward stay department at Central Public Hospital Dr. Wahidin Sudirohusodo in Makassar, with the assumption that there is an effective leadership of the charge nurse with the organisational climate perceived by the nurse in duty, which this perception can be affected by some demographic character such as age, sex, education, and duration of working.This research is a quantitative study with correlation of descriptive design "Cross Sectional" in nature. This research aims at finding out the relation intervariable of effective leadership organisational climate and demographic character of nurses in duty. Based on the analytical data of univariate, bivariate, and multivariate, the research outcome shows that there is a significant relation between effective leadership of the charge nurse and organisational climate. Of these six components of effective leadership, four of them are communication, energy, purpose and action of each have interrelationship with organisational climate, while at the respondent characteristic, none of them has significantly relationship to effective leadership. However, the age and duration of working have a significant relationship between respondent characteristic and organisational climate. From multiple-regression linear model, the energy communication component and action on each give its influential contribution against organisational climate, energy component gives the greatest contribution in comparison with those three components.Lining with the outcome research, there are some suggestion being able to be conveyed That ; the decision maker of the Central Public Hospital Dr. Wahidin Sudirohusodo must consider the energy, communication, behaviour capacity in recruiting, promoting the post of the charge nurse that can be select through observation and interview. The young nurse and nurses who have duration of working less than 10 years can be distrubuted in flat into 15 long ward stay department. To improve the leadership capacity, the charge nurse is able to carry out "learning by doing or job training". So then to improve their owned energy, the ability to communicate, and act on in accordance with their own authority border by applying an effective leadership components in their leadership are very necessary.Bibliography = 51 (1968 - 2000)"

"Pembayaran dengan sistem paket seringkali menimbulkan terjadinya selisih antara tarif paket INA-CBG dengan biaya pelayanan rumah sakit yang dianggap tidak mencukupi. Pembiayaan terbesar BPJS kesehatan terhadap penyakit katastropik adalah penyakit jantung dengan biaya sebesar 8,6T dan merupakan kasus terbanyak dibandingkan dengan kasus katastropik lainnya. RSWS merupakan rumah sakit rujukan tertinggi di Kawasan timur Indonesia dan menaungi sebuah instalasi pusat jantung terpadu. Pada tahun 2019, dr. Khalid Saleh, selaku Dirut di RSUP Wahidin Sudirohusodo, di dalam jumpa persnya menyatakan bahwa terjadi tunggakan oleh pihak BPJS Kesehatan yang mencapai ratusan miliar rupiah. Besarnya tunggakan tentunya akan memengaruhi proses pelayanan dan penangan pada pasien. Penelitian ini bertujuan untuk mengetahui besar selisih yang terjadi antara biaya pelayanan penyakit jantung koroner dengan tarif INA-CBGs di RSWS dan faktor-faktor yang mempengaruhi terjadinya selisih. Penelitian ini adalah penelitian mix method dengan observasional analitik menggunakan pendekatan crosssectional. Sampel yang digunakan dalam penelitian ini sebanyak 112 data pasien PJK yang menjalani rawat inap di RSWS. Hasil penelitian menunjukkan adanya selisih positif sebesar 171.908.682 jika dihitung secara keseluruhan namun jika dilihat perkasus terhadap selisih negatif pada kasus angina pektoris. Faktor yang mempengaruhi terjadinya selisih biaya pelayanan dan tari INA-CBG pada penyakit jantung koroner adalah Tingkat keparahan (p-value = 0,000), lama hari rawat (p-value = 0,001), dan pelayanan medis (p-value = 0,002). Hasil wawancara menunjukkan bahwa faktor yang paling berpengaruh terhadap terjadinya selisih biaya adalah adanya tindakan operasi. Upaya yang dilakukan untuk mengatasi selisih biaya yang terjadi di rumah sakit dengan melakukan subsidi silang, menginformasikan kepada pihak-pihak tertentu, mengadakan pertemuan dengan DPJP, dan membatasi tindakan-tindakan yang melebihi tarif rumah sakit pada kasus yang sifatnya tidak urgent. Rumah sakit perlu mengendalikan biaya agar tidak terjadi selisih negatif yang lebih besar antara pelayanan rumah sakit dengan tarif yang ditentukan BPJS dengan tetap memperhatikan kualitas pelayanan. Terus melakukan kendali mutu pelayanan yang efektif sebagaimana panduan praktik klinis.

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Payment with a package system often result in a difference between the INA-CBG package rates and hospital service cost, which are considered insufficient. The largest BPJS health financing for catastrophic diseases is heart disease, with a cost of 8.6T, and it is the most common case compared to other catastrophic cases. RSWS is the highest referral hospital in Eastern Indonesia and houses an integrated heart center installation. In 2019, Dr. Khalid Saleh, as the President Director of RSUP Wahidin Sudirohusodo, stated in a press conference that there were arrears from BPJS Health reaching hundreds of billions of rupiah. The large amount of arrears will certainly affect the service and handling process for patients. This study aims to determine the magnitude of the difference between the cost of coronary heart disease services and the INA-CBGs rates at RSWS and the factors that influence the occurrence of the difference. This research is a mixed-method study with observational analytics using a cross-sectional approach. The sample used in this study was 112 data of CHD patients who underwent inpatient treatment at RSWS. The results showed a positive difference of 171.908.682 when calculated as a whole, but when viewed per case, there was a negative difference in cases of angina pectoris. Factors that influence the difference in service costs and INA-CBG rates in coronary heart disease are the severity level (p-value = 0.000), length of stay (pvalue = 0.001), and medical services (p-value = 0.002). Interview result indicated that the most influential factor in the cost difference is the presence of surgical procedures. Efforts are made to overcome the cost difference that occurs in hospitals by conducting crosssubsidies, informing certain parties, holding meetings with DPJP, and limiting actions that exceed hospital rates in cases that are not urgent. Hospitals need to control costs so that there is no greater negative difference between hospital services and the rates determined by BPJS while still paying attention to the quality of service. Continue to carry out effective quality control of services as guided by clinical practice guidelines."

"Latar Belakang: Kanker paru adalah penyakit dengan ancaman serius di Indonesia. Progresifitas massa tumor merupakan salah satu faktor yang mempengaruhi kesintasan hidup pasien kanker paru. Karsinoma sel kecil (KPKSK) menunjukkan progresifitas yang lebih tinggi daripada karsinoma bukan sel kecil (KPKBSK). Beberapa studi menunjukkan bahwa pasien KPKBSK memiliki tingkat kesintasan hidup yang lebih baik daripada pasien KPKSK. Penelitian ini bertujuan untuk menilai perbedaan kesintasan antara pasien KPKSK dan KPKBSK di Rumah Sakit Kanker "Dharmais" (RSKD) dengan mengontrol variabel umur, jenis kelamin, stadium klinis, dan penatalaksanaan.Metode: Studi kohort retrospektif ini melibatkan 949 partisipan (KPKSK dan KPKBSK) di RSKD dari tahun 2013 hingga 2017, dengan follow-up hingga tahun 2021. Tingkat kesintasan dianalisis menggunakan metode Kaplan-Meier, dan efek prediktor dinilai dengan model Cox proportional hazard.Hasil: Kesintasan pasien KPKSK di RSKD pada periode 2013-2017 lebih rendah dibandingkan dengan pasien KPKBSK. Kesintasan di tahun pertama pada pasien KPKSK adalah 31,21%, dan pada tahun ketiga, keseluruhan pasien KPKSK meninggal. Pada pasien KPKBSK, kesintasan di tahun pertama, ketiga, dan kelima berturut-turut adalah 45,19%, 23,62%, 15,92%. Median waktu kesintasan pasien KPKSK adalah hari ke-172, lebih pendek dibandingkan dengan pasien KPKBSK (hari ke-272). Setelah mengontrol variabel-variabel kovariat, tidak terdapat perbedaan kesintasan yang bermakna secara statistik antara pasien KPKSK dan KPKBSK (p > 0,05).Kesimpulan: Studi menunjukkan bahwa kesintasan pasien KPKSK lebih rendah dibandingkan dengan pasien KPKBSK di RSKD; namun secara statistik tidak menunjukkan perbedaan signifikan setelah mengontrol variabel umur, jenis kelamin, stadium klinis, dan penatalaksanaan.

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Background: Lung cancer is a disease with a serious threat in Indonesia. Tumor mass progression is one of the factors influencing the survival of lung cancer patients. Small cell carcinoma (SCLC) shows higher progression compared to non-small cell carcinoma (NSCLC). Several studies have shown that NSCLC patients have a better survival rate than SCLC patients. This study aims to assess the difference in survival rates between SCLC and NSCLC patients at Dharmais Cancer Hospital while controlling for age, gender, clinical stage, and management.

Method: This retrospective cohort study involved 949 participants (SCLC and NSCLC) from 2013 to 2017, with follow-up until 2021. Survival rates were analyzed using the Kaplan-Meier method, and the predictor effect was assessed using the Cox proportional hazard model.

Results: The survival rate of SCLC patients at Dharmais Cancer Hospital during the period 2013-2017 was lower compared to NSCLC patients. The survival rate in the first year for SCLC patients was 31.21%, and by the third year, all SCLC patients had passed away. For NSCLC patients, the survival rates in the first, third, and fifth years were 45.19%, 23.62%, and 15.92%, respectively. The median survival time for SCLC patients was day 172, which was shorter compared to NSCLC patients (day 272). After controlling for covariate variables, there was no statistically significant difference in survival between SCLC and NSCLC patients (p > 0.05).

Conclusion: The study shows that the survival rate of SCLC patients is lower than NSCLC patients at Dharmais Cancer Hospital , but statistically, there is no significant difference after controlling for age, gender, clinical stage, and management."

"Sejak tahun 2000 berdasarkan PP No. 125 / 2000 tentang Perusahaan Jawatan (PERJAN), Rumah Sakit DR Wahidin Sudirohusodo (RSWH) selain sebagai rumah sakit pendidikan juga sudah menjadi Rumah Sakit Perusahaan Jawatan (PERJAN). Berarti dengan status ini RSWSH diberi kewenangan penuh untuk menyelenggarakan kegiatan pelayanan rumah sakit dengan mengutamakan efisiensi, efektivitas juga mutu layanannya.Unit Rawat Jalan adalah unit fungsional yang memberikan sumbangan pendapatan paling rendah dibandingkan unit lainnya. Selain itu, dari tahun ketahun juga peningkatan pendapatannya masih lebih rendah dari unit lain. Dengan demikian kinerja Unit Rawat Jalan RSWSH perlu segera merespon-nya dengan memperbaiki kinerjanya selama ini dengan mengaplikasikan Konsep Manajemen Strategis dengan membuat Perencanaan Pengembangan Unit Rawat jalan menjadi Unit Bisnis Strategis.Penelitian ini bertujuan untuk mendapatkan strategi yang paling baik dan paling cocok/relevan untuk Pengembangan Unit Rawat jalan RSWSH di masa yang akan datang sehingga dapat menjadi Unit Bisnis Strategis di Rumah Sakit Wahidin Sudirohusodo dengan pendekatan penelitian operasional.Hasil penelitian menunjukkan bahwa ; (1) faktor-faktor lingkungan eksternal dan internal yang mendukung pengembangan unit rawat jalan menjadi unit bisnis strategis di RSWSH adalah : demografi, ekonomi, peraturan/regulasi, pelanggan, pemasok, teknologi, sumber daya manusia, produk/jasa, keuangan, manajemen, organisasi dan pemasaran. (2) faktor-faktor yang lingkungan eksternal dan internal menghambat pengembangan unit rawat jalan menjadi unit bisnis strategis di RSWSH adalah : sosial pendidikan, pesaing, sarana dan prasarana, sistem informasi manajemen. (3) strategi yang paling cocok dan aplikatif untuk digunakan unit rawat jalan dalam upaya pengembangannya menjadi unit bisnis strategis di RSWSH adalah : strategi integrative dengan memperluas pangsa pasar, meningkatkan efisiensi, memberikan insentif dokter, penelitian dan pengembangan, dan strategi intensif dengan memberikan pelayanan berorientasi mutu, optimalisasi kapasitas, pemasaran aktif dan SIMRS berbasis komputer.Melihat hasil ini maka Unit Rawat Man RSWSH disarankan untuk melaksanakan strategi yang menjadi prioritas berdasarkan hasil analisis matriks QSPM dan rencana operasionl yang ada sampai tahun 2009.

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The Ambulatory Care Development Planning to Become Strategic Business Unit in Dr Wahidin Sudirohusodo Hospital, Makassar 2005 - 2009Since the year of 2000 based on "PP No.125/2000" about the state enterprise (PERJAN). The DR Wahidin Sudirohusodo Hospital ( RSWSH ) beside as a education hospital also become a state enterprise (PERJAN). With this status the hospital is given full authority to do the hospital service activities with efficiency, effectively, and service quality as priorities.

Ambulatory Care is a functional unit that give the lowest revenue comparing the other unit. The Ambulatory Care year revenue also lower than the other unit. We need to response this by applying a strategic management concept by making the Ambulatory Care plan become a strategic business unit.

The purpose of this research is to get the best strategy for the Wahidin Sudirohusodo Hospital (RSWSH) Ambulatory Care development in years to come, so it can become a strategic business unit in Wahidin Sudirohusodo Hospital (RSWSH) with an operational research approach.

The research shows that; (1) The external and internal factors that supporting the development of Ambulatory Care to become a strategic business unit is: demography, economic, regulation, customers, supplier, technology, human resources, product, finance, management, organization and marketing. (2) The external and internal factors that stagnant the development of Ambulatory Care to become a strategic business unit is: social education, competitor, infrastructure, and management information system (SIMRS)_ (3) The best strategy to use in the Ambulatory Care development for becoming a strategic business unit in Wahidin Sudirohusodo Hospital is: integrative strategies by expanding the market, increase the efficiency, giving doctor incentives, research and development, and intensive strategies by giving services that orientated on quality, capacity optimally, active market and SIMRS based on computer.

The result shows that the Wahidin Sudirohusodo Hospital Ambulatory Care is suggested to apply the strategy that become the priority based on the result of Quantitative Strategic Planning Matrix (QSPM) and operational planning that exist into the year of 2009."

"Uremic Stomatitis can be happened by effect of improvement of concentration of ureum in saliva of effect of height of level of ureum blood. The aim of this cross sectional research to know influence of rate of ureum of blood with the happening of uremic stomatitis at patients chronic renal failure (CRF). As much 36 sample taken away from patient of CRF in RS. Wahidin Sudirohusodo Makassar. Rate of Ureum of blood known from result of inspection of laboratory enclosed at card of patient status, while stomatitis conducted by a direct inspection at patient of persuant to location, type of stomatitis. Analyzed data with of X2 test, t test, Logistic Regression and Simple Linear regression at a=0.05 contructively Program SPSS/PC(-) version 9. Result of research that mean of rate of ureum blood = 170.3889 mg/dL, there relation and influence have a meaning between rate of ureum of blood to the happening of uremic stomatitis at patients CRF (p=0.05). Conclusion that height of ureum of blood can be happened in oral cavity like the happening of uremic stomatitis."