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FOKUS MASALAH

KULIAH PKP

DR. ROBIANA MODJO, MKES

DEFINISI MASALAH

Kesenjangan Realitas:
Antara SEHARUSNYA dg. KENYATAAN

Kesenjangan hasil
Medical

check up Assessment risiko kesehatan Biaya kesehatan Produktivitas

SUMMARY CARDIAC CASES COMPANY X


50 45 40 35 30 25 20 15 15 10 5 0
Total Patient Angiography Pos Angiography Neg Treatment with Drugs Treatment with Stent Treatment with Surgery Refer to JKT Refer to SBY Refer to Other

34

26 23 22 17 14 11 7 4 6 8 8 5 2 12 16 16 13 88 5 6 2 12 3 0 1 0 0 0 1 000 11 8 22 19 15 14 20 14 13

1999

2000

2001

2002

2003

KUNJUNGAN BEROBAT CDC JAN-NOV 2004


90 80
JML KUNJUNGAN

70 60 50 40 30 20 10 0 DM CAD HT JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV 24 25 24 22 41 28 40 39 44 37 39 24 45 39 40 38 41 34 BULAN 37 43 38 72 71 67 78 84 77 70 78 74 66 71 61 DM CAD HT

KASUS CDC 2003 VS 2004 (NOV, 30)


180 160 140

2003 2004
92 72 55 11 NIDDM
KASUS CAD

169

JML KASUS

120 100 80 60 40 20 0

90

HIPERTENSI

Step dalam Manajemen Program Promosi Kesehatan di Perusahaan

Rekognisi Analisis Perencanaan Komunikasi Persiapan Implementasi Evaluasi Kontinuitas

Table Degree of Employee Participation in the Design Process


top management directs process and makes all decisions top management directs process and makes all decisions but seeks input top management retains decisions making but shares direction of process top management shares decision making and direction of process employees direct process and direction making

If the management goal of reducing medical care costs the following process might be followed:

Analyze past, current, and projected health care expenditures for patterns and high-cost areas. Determine current and projected future health conditions of employees as they relate to health care expenditures. This is done through health screenings and by reviewing medical insurance and workers compensation records. Determine which health conditions have the greatest impact on cost and which can be successfully addressed by health promotion programs.

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Perform a cost/benefit analysis to determine which programs product benefits that are greater than their cost. Investigates methods to correct or prevent the highcost health conditions that cannot be affected by health promotion. Develop methods to track the impact of the program on health care cost. Develop health promotion programs that will have the greatest impact on medical care cost. These will probably include special programs for employees with the highest medical care cost, smoking cessation, hypertension control, prevention of lower back problems, auto safety, and general injury prevention programs.

If the goal is a health goal, such as reducing the incidence of heart attacks, the following might be followed:

Determine causes of heart attacks. Determine which of these causes can be affected by health promotion programs. Conduct screening of employees to identify cardiac risk factors. Determine which programs are most effective in reducing the cardiac risk factors in the employee population.

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Investigate methods to correct the cardiac risk factor that cannot be reduced by the health promotion program. Develop methods to track the impact of the programs on cardiac risk factor. Develop the programs that will have the greatest impact on cardiac risk factor. These will probably include nutrition, smoking cessation, fitness, stress management, hypertension control, and social support enhancement.

If the goal is a management goal to enhance the image of the organization, the following process would be followed:

Determine the groups and individuals whose perception the organization is most important. Determine the components of a health promotion program most likely to shape this groups perception and develop this programs. Develop mechanisms to capitalize on the image value of the program.

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Investigate methods to enhance image other than the health promotion program. Develop methods to track the impact of the program on image. Develop other nonhealth promotion programs that will have the greatest impact on image.

Teknik Multivoting
Melibatkan pekerja identifikasi masalah Menentukan prioritas seluruh pekerja Membicarakan program yang ditetapkan (jadwal & komitmen)

INDIKATOR KEBERHASILAN PROGRAM PKP

Participant rate tinggi Jenis Pelatihan beragam Jumlah Pelatihan

DAFTAR MASALAH
Masalah Olah Raga Masalah Penggunaan Obat2an terlarang/Narkotika Masalah tingginya kecelakaan kerja Masalah Stress pada pekerja Masalah Gizi Pekerja Masalah Berat Badan Masalah Pengendalian Darah Tinggi

DAMPAK MASALAH PKP (1)


Kolesterol darah meningkat Berat Badan berlebih Tekanan Darah tinggi

Kebugaran jasmani menurun


Moral kerja/kesehatan mental menurun Hubungan dan dukungan sosial menurun

DAMPAK MASALAH PKP (2)

Morbiditas/mortalitas meningkat

Jantung koroner Stroke Kanker Diabetes Mellitus Tuli/Kebisingan Penyakit Akibat Kerja lain

DAMPAK MASALAH PKP (2)

Cacat dan disability meningkat

Morbiditas penyakit umum meningkat


Flu/ISPA Bronkhitis Pnemonia

ANALISIS MASALAH (1)

Tentukan yang ingin diketahui


Pengetahuan

faktor timbulnya masalah perilaku Mengapa ada masalah Distribusi masalah Siapa ( umur, pendidikan, dll) Kapan Dimana Untuk menjawab, cari strategi I. Prilaku Pendekatan apa Apakah Model memadai

What Why
Who When Where

How

ANALISIS MASALAH (2)


Kumpulkan data/fakta
Jenis data

lapangan

: angka, kata, gambar Teknik sampling : random, sistematik, stratified Teknik : Survey, model epidemiologi Kuesioner : apa yg diperkirakan/dirasakan Output : data dasar & pola masalah

LANGKAH PROGRAM PROMOSI KESEHATAN


Inventarisasi permasalahan Penyampaian program pimpinan Menetapkan prioritas program Mengevaluasi kegiatan periodik Melaporkan hasilnya