Hasil swaperiksa di situs PDSKJI adalah 69% responden memiliki masalah psikologis: cemas 68%, depresi 67% dan trauma psikologis 77%, serta sebanyak 49% responden yang mengalami depresi juga memiliki ide untuk mengakhiri hidupnya. Sebanyak 48% pasien dengan positif COVID-19 mengalami stress psikologis saat memasuki ruang isolasi. Alokasi anggaran kesehatan jiwa tahun 2019 sebesar Rp. 44.554.492.000. Rasio Psikiater di Indonesia adalah 1:278.000, penyebaran Psikiater belum merata. Terjadi beberapa situasi dimana pasien COVID-19 menerjunkan diri dari ruang lantai perawatan pada beberapa rumah sakit di Indonesia, yang terjadi pula di RS UI. Tujuan dari penelitian ini untuk memperoleh pemodelan sistem dinamik yang menjadi opsi strategi pelayanan kesehatan mental COVID-19 di RS UI. Penelitian ini merupakan penelitian kualitatif dan kuantitatif (mix method) non-eksperimental/observasional design sequential exploratory dengan studi literatur, telaah dokumen (30 rekam medis), observasi, wawancara mendalam dan pemodelan sistem dinamik. Hasil penelitian adalah kelima unsur input memiliki pengaruh terhadap seluruh proses pelayanan kesehatan mental COVID-19 di RSUI, yaitu kebijakan (sosialisasi skrining status mental belum menyeluruh), sumber daya manusia (jumlah kurang dan tidak ada pelatihan psikiatri), sarana prasarana (keamanan ruangan belum sesuai syarat), logistik (persediaan obat rawat jalan yang belum memenuhi) dan anggaran (belum spesifik dicantumkan di rencana anggaran). Pemodelan sistem dinamik digunakan untuk memotret dinamika sistem pelayanan kesehatan mental COVID-19 di RSUI dan melakukan simulasi skenario-skenario yang dikembangkan untuk kondisi yang akan datang. Dari simulasi yang dilakukan dengan kondisi Business As Usual, akan terjadi peningkatan jumlah pasien cemas-depresi sebanyak 3795 pasien di bulan Juni 2021 jika RSUI tidak melakukan intervensi apapun. Skenario Moderat akan memprediksi jumlah pasien cemas-depresi sebanyak 2875 pasien, sedangkan dengan skenario Optimis jumlah pasien cemas-depresi sebanyak 2300 pasien. Di setiap skenario, manajemen RSUI dapat mengantisipasi peningkatan tersebut
The results of self-examination on the PDSKJI website were 69% of respondents had psychological problems: 68% anxiety, 67% depression and 77% psychological trauma, and as many as 49% of respondents who experienced depression also had the idea of ending their life. As many as 48% of patients who tested positive for COVID-19 experienced psychological stress when entering isolation rooms. The mental health budget allocation for 2019 is Rp. 44,554,492,000. The ratio of psychiatrists in Indonesia is 1: 278,000, the distribution of psychiatrists is not evenly distributed. There have been several situations where COVID-19 patients have dropped themselves from the treatment floor rooms at several hospitals in Indonesia, which also happened at UI Hospital. The purpose of this study was to obtain dynamic system modeling as an option for the mental health service strategy for COVID-19 at UI Hospital. This research is a qualitative and quantitative research (mix method) non-experimental / observational sequential exploratory design with literature study, document review (30 medical records), observation, in-depth interviews and dynamic systems modeling. The results showed that the five elements of input had an influence on the entire process of mental health services for COVID-19 at RSUI, namely policies (socialization of mental status screening was not comprehensive), human resources (insufficient number and no psychiatric training), infrastructure (room security was not yet according to requirements), logistics (inadequate outpatient medicine supplies) and budget (not specifically included in the budget plan). Dynamic system modeling is used to capture the dynamics of the COVID-19 mental health service system at RSUI and simulate developed scenarios for future conditions. From the simulations carried out with Business As Usual conditions, there will be an increase in the number of anxious-depressed patients by 3795 patients in June 2021 if RSUI does not intervene. The Moderate scenario will predict the number of anxious-depressed patients as much as 2875 patients, while with the Optimistic scenario the number of anxious-depression patients is 2300 patients. In each scenario, RSUI management can anticipate this increase. |
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