ABSTRAK Nama : Nur Annisa Program Studi : Ilmu Kesehatan Masyarakat Judul : Pengaruh Fasilitas Pelayanan Kesehatan Terhadap Keberhasilan Pengobatan Pasien Tuberkulosis Resisten Obat di Indonesia Tahun 2014 - 2016 Pembimbing : Dr. Sutanto Priyo Hastono., M. Kes Resistensi obat merupakan masalah baru dalam program eliminasi TB yang disebut TB resisten obat. Pengobatan TB resisten obat di Indonesia dilakukan di fasilitas pelayanan kesehatan rujukan dan fasilitas pelayanan kesehatan satelit. Penelitian ini bertujuan untuk mengetahui pengaruh fasilitas pelayanan kesehatan terhadap keberhasilan pengobatan pasien TB resisten obat di Indonesia. Penelitian ini dilaksanakan pada bulan Mei 2019 di Subdit-TB, Direktorat P2PML, Kementerian Kesehatan RI. Desain studi penelitian ini adalah kohort restrospektif. Jumlah sampel sebanyak 4288 orang, diseleksi menggunakan teknik total sampling. Hasil penelitian menunjukkan bahwa pasien yang menyelesaikan pengobatan di fasilitas pelayanan kesehatan satelit sebanyak 97,20% dan di fasilitas pelayanan kesehatan rujukan sebanyak 2,8%. Proporsi keberhasilan pengobatan sebesar 53,2% dengan kumulatif hazard keberhasilan pengobatan sebesar 5,43 di akhir pengamatan selama 36 bulan pengamatan. Hazard rate keberhasilan pengobatan 36,42/1000 orang-bulan. Hasil analisis multivariat menggunakan regresi cox timeindependet menunjukkan bahwa pasien yang menyelesaikan pengobatan di fasilitas pelayanan kesehatan satelit meningkatkan kecepatan terjadinya keberhasilan pengobatan sebesar 54% (HR 2,17; 95% CI 1,66 – 2,82) dengan kondisi riwayat pengobatan sama. Penambahan fasilitas pelayanan kesehatan satelit dan tenaga ahli dibutuhkan untuk membantu proses pengobatan berjalan lebih baik. Peran serta masyarakat dan kesadaran pasien perlu ditingkatkan dengan melakukan promosi kesehatan tentang TB resisten obat secara rutin. Kata Kunci: Fasilitas Pelayanan Kesehatan; Keberhasilan Pengobatan; TB Resisten Obat
ABSTRACT Name : Nur Annisa Study Program : Public Health Title : The Effect of Health Care Unit on The Success in Treatment of Drug Resistant-Tuberculosis Patient in Indonesia, 2014 - 2016 Counsellor : Dr. Sutanto Priyo Hastono., M. Kes Drug resistant is a new problem in TB elimination program, it’s called Drug-Resistat TB. Treatment of drug-resistant TB in Indonesia is carried out in rujukan health care and satelite health care. The aims of this study is increasing the successful treatment of Drug- Resistant TB patients in Indonesia by health care unit. This research was conducted in May 2019 at the TB Sub-Directorate, Directorate of P2PML, Ministry of Health of the Republic of Indonesia. The design of this study is a retrospective cohort. Total sample were 4288 patient, selected by using total sampling technique. The results showed that patients who completed treatment in satelit health care were 97.20% and 2.8% in the rujukan health care. The proportion of treatment success was 53.2% with a cumulative hazard of treatment success 5.43 at the end of the observation for 36 months observation. Treatment success rate was 36.42/1000 person-month. The results of multivariate analysis using cox time-independent regression showed that patients who completed treatment at satelit health care increased the speed of treatment success 54% (HR 2.17; 95% CI 1.66 - 2.82) with the same treatment history. The addition of satellite health service facilities and experts is needed to help the treatment process run better. Community participation and patient awareness need to be improved by conducting routine health promotion about Drug-Resistant TB. Key words: Drug-Resistant Tuberculosis; Health Care Unit; Treatment Success. |