Analisis Pengaruh Faktor-Faktor Manajemen terhadap Komitmen Dokter dalam Pengisian Dokumen Rekam Medis Rawat Inap di RSUD Sunan Kalijaga Kabupaten Demak

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi Rumah Sakit 2011 ABSTRAK Nani Amrin Analisis Pengaruh Faktor-Faktor Manajemen terhadap Komitmen Dokter dalam Pengisian Dokumen Rekam Medis Rawat Inap di RSUD Sunan Kalijaga Kabupaten Demak 105 halaman + 34 tabel + 4 gambar + 5 lampiran Di RSUD Sunan Kalijaga Kabupaten Demak pada tahun 2010 masih ditemukan dokumen rekam medis dokter yang tidak terisi lengkap sebanyak (24,99%). Hal ini merupakan permasalahan penting yang harus ditangani oleh pihak manajemen RSUD Sunan Kalijaga Kabupaten Demak. Tujuan penelitian adalah untuk mengetahui faktor-faktor manajemen yang berpengaruh terhadap komitmen dokter dalam pengisian dokumen rekam medis rawat inap. Penelitian ini merupakan penelitian observasional metode survei analitik dengan pendekatan cross sectional. Populasi penelitian adalah dokter yang terlibat dalam pelayanan rawat inap RSUD Sunan Kalijaga Kabupaten Demak. Analisis statistik yang digunakan analisis bivariat dengan uji Chi-Square dan analisis multivariat dengan uji regresi logistik. Hasil uji univariat sebanyak (50%) dari responden mempersepsikan faktor-faktor manajemen mengenai kejelasan jasa medis yang sesuai, ketanggapan pemimpin yang baik, tindakan dukungan pemimpin yang baik, kondisi lingkungan kerja yang baik, dan (65%) dari responden mempersepsikan faktor-faktor manajemen mengenai kesesuaian jasa medis yang sesuai, dan kesempatan promosi yang baik, komitmen dokter dalam mengisi dokumen rekam medis rawat inap di RSUD Sunan Kalijaga Kabupaten Demak secara lengkap dan tidak lengkap sama besar (50%). Analisis bivariat variabel yang berhubungan dengan komitmen dokter dalam mengisi dokumen rekam medis rawat inap di RSUD Sunan Kalijaga Kabupaten Demak adalah kejelasan jasa medis (p value = 0,025 < α), pembuatan keputusan pemimpin (p value = 0,002 < α), tindakan dukungan pemimpin (p value = 0,025 < α), dan kondisi lingkungan kerja (p value = 0,005 < α). Variabel yang tidak berhubungan dengan komitmen dokter dalam pengisian dokumen rekam medis rawat inap di RSUD Sunan Kalijaga Kabupaten Demak adalah kesesuain jasa medis (p value = 1,000 > α), ketanggapan pemimpin (p value = 0,170 > α), dan kesempatan promosi (p value = 1,000 > α). Uji multivariat metode stepwise hanya ada satu variabel bebas yang berpengaruh yaitu pembuatan keputusan pemimpin dengan nilai p < 0,05 dan Exp(B) = 81. Disarankan transparansi, keadilan dan ketepatan waktu pemberian jasa medis, pemberian penghargaan bagi dokter yang mengisi dokumen rekam medis rawat inap secara lengkap, memantau secara berkesinambungan prosedur kerja panitia rekam medis melalui komite medis, dan lebih berhati-hati dalam membuat keputusan yang adil dalam upaya peningkatan pengisian dokumen rekam medis. Kata Kunci : Kepemimpinan, Pengisian Dokumen Rekam Medis, Rawat Inap Kepustakaan : 51 (1992 – 2010) Diponegoro University Postgraduate Program Master’s Program in Public Health Majoring in Hospital Administration 2011 ABSTRACT Nani Amrin Analysis on the Influence of Management Factors towards Physician Commitment in the Completion of Inpatient Medical Record Documents at Sunan Kalijaga District General Hospital, Demak 105 pages + 34 tables + 4 figures + 5 enclosures At Sunan Kalijaga district general hospital (RSUD), Demak district, in 2010, there was still found incomplete physician medical record documents (24.9%). This was a significant problem that needed to be solved by managerial division of RSUD Sunan Kalijaga Demak district. The objective of this study was to identify management factors that influenced physician commitment in the completion of inpatient medical record documents. This was an observational study using analytical survey method with cross sectional approach. Study population was physicians who were involved in inpatient service at RSUD Sunan Kalijaga Demak district. Bivariate analysis using Chi-Square test and multivariate analysis using logistic regression were applied for data analysis. Results of univariate test showed that 50% of respondents had the right perception on management factors especially in the clarity of medical cost, good responsiveness of the leader, good support from the leader, good work environment. Sixty five percentages of respondents had the right perception on management factors especially in the appropriateness of medical cost and promotion opportunity. Physician commitment in the completion of inpatient medical record document at RSUD Sunan Kalijaga Demak district was in equal percentage between those who completely and incompletely filling the documents (50%). Result of bivariate analysis showed that clearness of medical cost (p value = 0,025 < α), decision made by the leader (p value = 0,002 < α), leader support (p value = 0,025 < α) and work environmental condition (p value = 0,005 < α) were associated with physician commitment to complete inpatient medical record at RSUD Kalijaga Demak district. Appropriateness of medical cost (p value = 1,000 > α), leader responsiveness (p value = 0,170 > α), promotion opportunity (p value = 1,000 > α) were not associated with physician commitment in the completion of inpatient medical record at RSUD Kalijaga Demak district. Result of multivariate analysis using stepwise method showed only one independent variable that influenced physician commitment in the completion of inpatient medical record at RSUD Kalijaga Demak district. That factor was leader decision making (p<0.05 and Exp (B) = 81). It was suggested to do transparency, fairness and time punctuality in giving medical services, to give rewards to physician who completely filled inpatient medical record document, to continuously monitor work procedure of medical record team via medical committee and to be more careful in making fair decision to improve medical record document completion. Key words : Leadership, Medical record document completion, inpatient Bibliography : 51 (1992 – 2010)