Background: Medical services provided within the Indonesian National Health Insurance programme or Jaminan Kesehatan Nasional (JKN) have been continuously improving for the past several years. One of them is pharmaceutical service in the Pharmacy Store for JKN patients at one hospital with the highest number of visitors in Surabaya. However, one preliminary study points out that patient waiting time for prescription services in the Pharmacy Store for JKN patients is longer than the national standard.Aim: This study aims to investigate the causes for such delay in prescription services as one of pharmaceutical services in the Pharmacy Store for JKN patients at one hospital in Surabaya.Methods: This is an observational descriptive research with a reference to the Theory of Constraints. The research was conducted from August 2017 to February 2018. The data were obtained from observations, interviews with one pharmacist and four pharmacy technicians, and waiting time for prescription service. Results: The study finds that the longer waiting time is caused by inefficient division of jobs and workers and the lack of worker’s discipline to work on time. The behaviors and habits of pharmacist and pharmacy technicians in drug preparation greatly affect patient waiting time, since the services still highly depend on manual human labor.Conclusions: Patient experience in prescription drug services is significantly influenced by the time spent waiting for the service provider. This study provides useful insights about constraint identification in pharmaceutical services, especially waiting time.Keywords: Pharmaceutical service, Theory of Constraints, Patient waiting time.
Background: Although it has been globally reported that IMR and U5MR continue to decline every year, the rate disparities between urban and rural areas are still evident in various countries. The government is presumed to carry out efforts to reduce this disparity, such as by allocating the government’s health expenditure. Objectives: This study systematically identifies the effectiveness, best practices, and positive impacts of government health expenditure allocation for IMR and U5MR, specifically in rural areas. Methods: This systematic review study was conducted using the PICOS method to analyse data that were obtained from 3 online databases. Results: The government health expenditure could reduce the gap in mortality rate indicators between urban and rural areas. Programs specifically proposed for rural communities can help decrease the gap between urban-rural IMR and U5MR. The effectiveness of government health expenditure to reduce mortality rates was strongly influenced by various factors, including supporting policies, field implementation in regions, and the collaboration between the central and local governments. Conclusion: The local government plays a definitely crucial role in the implementation of the health program to ensure that the central government executes the program effectively in order to reduce IMR and U5MR in rural areas.
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