Analisis Pengelolaan Logistik Obat Program Antiretroviral (ARV) di Provinsi Sumatera Utara (Studi Kasus: RSUD Dr. Pirngadi Medan dan RSU HKBP Balige)

Abstract

Background: Proper drug management including planning, procurement, storage, distribution, destruction, recording, and reporting is one of the tasks of the Department of Health Province of Sumatera Utara. Insufficiency of antiretroviral drug stock has a bad impact on the quality of HIV-AIDS health services. Objective: to analyze the management of antiretroviral drug program in Installation of Pharmacy (IP) Department of Health Province of Sumatera Utara, IP Dr. Pirngadi General Hospital Medan, and IP HKBP General Hospital Balige. Method: This retrospective descriptive quantitative and qualitative study was conducted to evaluate the management of antiretroviral drug in IP Department of Health Province of Sumatera Utara, IP Dr. Pirngadi General Hospital Medan, and IP HKBP General Hospital Balige period 2019-2020. Quantitative data of management aspects including planning, procurement, storage/distribution, and supporting management of antiretroviral drug were assessed from the 3 healthcare facilities. Qualitative data were obtained from observation and interview with the informan. Indicators of management aspects were analyzed and compared with the standard parameters. Result: five indicators including percentage of planning accuracy, percentage of planning deviation, level of drug availability, unavailability of drug (in average number of day) in 2020, Result of Inventori Turn Over Ratio have not been complied with the standard of antiretroviral drug management in IP Department of Health Province of Sumatera Utara. Four indicators that consisted of level of drug availability, Persentage of drugs expired year 2020, number of drug stock-outs, result of Inventory Turn Over Ratio 2019 have not been complied with the management standard in Pirngadi General Hospital Medan, and no indicators were complied with the standard in HKBP General Hospital Balige. Conclusion: Management of antoretroviral drugs in Department of Health Province of Sumatera Utara, Dr. Pirngadi General Hospital Medan, and HKBP General Hospital Balige have not been in accordance with the standard.

Latar Belakang: Pengelolaan obat yang baik meliputi perencanaan, pengadaan, penyimpanan, pendistribusian, pemusnahan, pencatatatan dan pelaporan merupakan salah satu tugas Dinas Kesehatan (Dinkes) Provinsi Sumatera Utara. Kekurangan stok obat antiretroviral memberikan dampak yang buruk terhadap mutu pelayanan kesehatan HIV-AIDS. Tujuan: untuk menganalisis pengelolaan obat program Antiretroviral di Instalasi Farmasi Dinkes Provinsi Sumatera Utara, Instalasi Farmasi Rumah Sakit Umum Daerah (RSUD) Dr. Pirngadi Medan, dan Instalasi Farmasi Rumah Sakit Umum (RSU) HKBP Balige. Metode: Penelitian retrospektif deskriptif kuantitatif dan kualitatif ini dilakukan untuk mengevaluasi pengelolaan antiretroviral di Instalasi Farmasi Dinkes Provinsi Sumatera Utara, Instalasi Farmasi RSUD Dr. Pirngadi Medan, dan Instalasi Farmasi RSU HKBP Balige periode 2019-2020. Data kuantitatif tentang pengelolaan yaitu perencanaan, pengadaan, penyimpanan/distribusi, dan pendukung managemen antiretroviral diakses dari ke 3 sarana pelayanan kesehatan tersebut. Data kualitatif diperoleh melalui observasi dan wawancara terhadap informan. Indikator dari setiap aspek pengelolaan dianalisis dan dibandingkan dengan parameter standar. Hasil: Lima indikator yaitu Persentase Ketepatan Perencanaan, Persentase Penyimpangan Perencanaan, Tingkat ketersediaan obat, Jumlah rata-rata hari kekosongan obat tahun 2020, Hasil Inventori Turn Over Ratio belum memenuhi standar Pengelolaan antiretroviral di Instalasi Farmasi Dinkes Provinsi Sumatera Utara. Empat indikator yaitu Tingkat Ketersediaan obat, Persentase Obat Kedaluwarsa/rusak Tahun 2020, Jumlah Stok Obat Mati Hasil Inventori Turn Over Ratio 2019 belum memenuhi standar pengelolaan di RSUD Pirngadi Medan dan di RSU HKBP Balige tidak ada indicator yang memenuhi standar. Kesimpulan: Pengelolaan antoretroviral di Dinkes Provinsi Sumatera Utara, RSU Dr. Pirngadi, dan RSU HKBP Balige belum memenuhi standar.