Dimulai akhir Desember 2019 terjadi wabah virus baru di dataran china terkhusus di daerah Wuhan, yang secara cepat menyebar diluar China bahkan dalam waktu 2 bulan hampir seluruh dunia terinfeksi COVID-19, sehingga WHO menyatakan Outbreak COVID-19 Global Pandemic. Pada tanggal 2 maret 2020 Indonesia mengumumkan dimulainya kejadian wabah di wilayah Jakarta, Jawa Barat, dan Bali, dalam waktu singkat kurang 1 bulan, 34 provinsi terdeteksi COVID-19. Oleh karena Presiden RI menyatakan bencana nasional non alam, maka dibentuklah Gugus Tugas Percepatan Penanganan COVID-19 yang diawali oleh BNBP dari tingkat pusat hingga wilayah provinsi. Dengan adanya beberapa korban dokter gigi yang meninggal dunia akibat COVID-19, maka Kepala BNPB dan Kementerian Kesehatan menghimbau agar dokter gigi yang berisiko tinggi tertular COVID-19 saat memberikan pelayanan kesehatan gigi dan mulut, untuk sementara menghentikan pemberian pelayanan kecuali untuk kasus-kasus emergensi. Hampir 4 bulan para dokter gigi tidak praktik, tidak memberikan pelayanan langsung ke pasien, dan tidak dapat mengamalkan ilmu dan kompetensi dalam bentuk pengabdian kepada masyarakat. Banyak permintaan dan keluhan dari masyarakat, klinik, rumah sakit dan institusi pelayanan kesehatan agar para dokter gigi segera dapat berpraktik kembali, karena masyarakat kesulitan mendapatkan perawatan. Seiring dengan wacana Pemerintah menerapkan Kehidupan Normal Baru, atau Adaptasi Kebiasaan Baru yang dikenal dengan sebutan era New Normal, PB-PDGI memberikan kesempatan kepada dokter gigi seluruh Indonesia untuk memulai praktik kembali dengan berbagai ketentuan yang harus ditaati. Ketentuan-ketentuan ini dimaksudkan untuk melindungi dokter gigi dan tenaga kesehatan pendukung agar tidak tertular COVID-19, serta menghindari adanya infeksi silang di ruang tempat praktik. Dengan diterbitkan dan diberlakukannya Buku Panduan Dokter Gigi Dalam Era New Normal, maka dimulailah para dokter gigi Indonesia untuk berpraktik kembali. Buku ini memuat panduan secara lengkap, selain ketentuan berpraktik kembali di era new normal, tetapi juga tentang manajemen pembiayaan dan upaya promotif Kesehatan Gigi dan Mulut, yang didukung oleh literatur ilmiah yang kuat, sehingga dapat menjadi referensi bagi siapapun untuk penulisan ilmiah maupun penelitian. iv Ketua umum PB-PDGI memberikan apresiasi yang setinggi-tingginya kepada tim penulis buku Panduan Dokter Gigi Di Era New Normal, dengan dedikasi yang tinggi pula dan jerih payahnya mencari literatur, siang dan malam menyusun kata demi kata yang dirangkai menjadi kalimat-kalimat hingga terwujudnya buku ini yang menjadi pedoman bagi dokter gigi se-Indonesia untuk berpraktik di era new normal. Dengan penuh harapan, agar dokter gigi Indonesia dapat menggunakan buku ini secara bijak dan tidak menjadi keterpaksaan. Semoga Allah SWT selalu melindungi kita semua dan memberikan yang terbaik.. Aamiin...Aamiin… Ya Robbal 'alamin. Demikian terima kasih.
Background: Adopting Universal Health Coverage for implementation of a national health insurance system [Jaminan Kesehatan Nasional (JKN)/Badan Penyelenggara Jaminan Sosial or the Indonesian National Social Health Insurance Scheme (BPJS)] targets the 255 million population of Indonesia. The availability, accessibility, and acceptance of healthcare services are the most important challenges during implementation. Referral behavior and the utilization of primary care structures for underserved (rural/remote regions) populations are key guiding elements. In this study, we provided the first assessment of BPJS implementation and its resulting implications for healthcare delivery based on the entire insurance dataset for the initial period of implementation, specifically focusing on poor and remote populations.Methods: Demographic, economic, and healthcare infrastructure information was obtained from public resources. Data about the JKN membership structure, performance information, and reimbursement were provided by the BPJS national head office. For analysis, an ANOVA was used to compare reimbursement indexes for primary healthcare (PHC) and advanced healthcare (AHC). The usage of primary care resources was analyzed by comparing clustered provinces and utilization indices differentiating poor [Penerima Bantuan Iur (PBI) membership] and non-poor populations (non-PBI). Factorial and canonical discrimination analyses were applied to identify the determinants of PHC structures.Results: Remote regions cover 27.8% of districts/municipalities. The distribution of the poor population and PBI members were highly correlated (r2 > 0.8; p < 0.001). Three clusters of provinces [remote high-poor (N = 13), remote low-poor (N = 15), non-remote (N = 5)] were identified. A discrimination analysis enabled the >82% correct cluster classification of infrastructure and human resources of health (HRH)-related factors. Standardized HRH (nurses and general practitioners [GP]) availability showed significant differences between clusters (p < 0.01), whereas the availability of hospital beds was weakly correlated. The usage of PHC was ~2-fold of AHC, while non-PBI members utilized AHC 4- to 5-fold more frequently than PBI members. Referral indices (r2 = 0.94; p < 0.001) for PBI, non-PBI, and AHC utilization rates (r2 = 0.53; p < 0.001) were highly correlated.Conclusion: Human resources of health availability were intensively related to the extent of the remote population but not the numbers of the poor population. The access points of PHC were mainly used by the poor population and in remote regions, whereas other population groups (non-PBI and non-Remote) preferred direct access to AHC. Guiding referral and the utilization of primary care will be key success factors for the effective and efficient usage of available healthcare infrastructures and the achievement of universal health coverage in Indonesia. The short-term development of JKN was recommended, with a focus on guiding referral behavior, especially in remote regions and for non-PBI members.
(NHI) for oral health needs to be evaluated by observing the dental disease patterns and dental therapy patterns from community health centers (CHCs) in the rural area, suburban area, and urban area. The aim of the study is to describe the characteristics of dental services in rural, suburban, and urban areas after the implementation of NHI on CHCs in the Special Region of Yogyakarta in 2014. Materials and methods: This is an observational study with a cross-sectional research design. The study used quantitative data obtained from dental records at selected CHCs. Using a purposive sampling method, 30 CHCs as unit analysis were collected from rural, suburban, and urban areas. The data were collected from January 2014 to December 2014. Results: Data from 26,554 patients were collected from dental records of dental clinics at CHCs. There were 5829 patient dental records from rural areas, 12,327 from suburban areas, and 8938 from urban areas. The primary dentist tends to provide services without clinical intervention on periodontal problems, abscesses, and lesions. Clinical interventions were mostly provided for prolonged retention and deposits on teeth. Primary dentists in suburban areas tend to provide clinical intervention on caries disease compared to those in rural and urban areas. Statistically significant differences (p < 0.05) were observed among locations in the pattern of providing clinical interventions on caries, abscess, lesion, prolonged retention, deposits on teeth, and other problems. No difference was recorded only on periodontal disease. Discussion: This study found that each area has different characteristics of dental disease and dental therapy patterns. Each area has a significant difference in the pattern of the clinical intervention of dental disease except in periodontal problems.
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