MERZISTYA, Aufiena Nur Ayu and Adi, M. Sakundarno and Sutiningsih, Dwi (2022) PENILAIAN PADA RISIKO KUALITAS PELAYANAN TUBERKULOSIS BERDASARKAN QUOTE TB LIGHT TERHADAP KEJADIAN DROPOUT TUBERKULOSIS DI KOTA SEMARANG. Masters thesis, School of Postgraduate Studies.

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Abstract

Latar Belakang: Kasus dropout Tuberkulosis (TB) sebagai penyebab tidak tercapainya success rate pengobatan TB di Kota Semarang. Namun, fasilitas kesehatan belum melakukan penilaian risiko pada kualitas pelayanan TB berdasarkan QUOTE TB Light terhadap kejadian dropout pengobatan TB.
Tujuan: Untuk menilai dan menganalisis besar risiko kualitas pelayanan TB berdasarkan QUOTE TB Light terhadap kejadian dropout TB di Puskesmas Kota Semarang.
Metode: Penelitian case control ini melibatkan 40 pasien dropout TB dan 40 pasien tidak dropout TB di 14 Puskesmas Kota Semarang melalui teknik random sampling. Variabel independen yaitu kualitas pelayanan TB. Variabel dependen yaitu kejadian dropout TB, merupakan pasien yang tidak mengambil/meminum obat selama 2 bulan berturut-turut dan diketahui dari rekam medik. Diduga adanya variabel perancu yaitu umur, jenis kelamin, jenis pekerjaan, tingkat pendapatan, dan tingkat pendidikan. Pengambilan data kualitas pelayanan TB melalui wawancara langsung menggunakan instrumen QUOTE TB Light. Data dianalisis deskriptif dengan penilaian Importace Score (I), Performance Score (P), dan Quality Impact (QI). Analisis bivariat dengan uji Chi-square dan analisis multivariat Uji Regresi Logistik untuk mengontrol perancu.
Hasil Penelitian: Dari sembilan dimensi pelayanan TB berdasarkan QUOTE TB Light, pasien dropout menganggap dimensi dukungan uang dan makanan yang paling penting (I=83,06%) serta sangat kurang baik didapatkan selama pengobatan (P=100%), perlu ditingkatkan kualitasnya (QI=8,83). Interaksi dan konseling menjadi dimensi paling penting bagi pasien tidak dropout (I=80,28%) dan kurang baik diterima (P=50%). Perlu adanya peningkatan kualitas, utamanya cara petugas mengatasi masalah (QI=4,01). Pasien yang menilai kualitas pelayanan TB kurang baik 2,911 (95% CI:1,093–7,755) kali lebih berisiko melakukan dropout pengobatan TB, setelah mengontrol perancu.
Kesimpulan: Sembilan dimensi pelayanan TB, terutama dukungan serta interaksi dan konseling dinilai kurang baik oleh pasien, sehingga perlu adanya peningkatan kualitas. Pasien yang menilai pelayanan TB kurang baik berisiko melakukan dropout pengobatan TB. Puskesmas perlu mempertimbangkan perspektif pasien dalam menilai kualitas pelayanan TB dengan instrumen QUOTE TB Light.
Kata Kunci: Tuberkulosis, QUOTE TB Light, dropout, penilaian risiko

Background: Tuberculosis (TB) dropout cases are the cause of not achieving the treatment success rate in the Semarang. Health facilities have not carried out a risk assessment on the TB services quality based on QUOTE TB Light on the incidence of TB treatment dropout.
Objective: To assess and analyze the risk of TB service quality based on QUOTE TB Light towards TB dropout at the Semarang Public Health Centers (PHC).
Methods: This case-control study involved 40 dropout and 40 non-dropout patients at 14 PHCs through random sampling. The independent variable was the TB services quality. The dependent variable was TB dropout incidence. Confounding variables were age, gender, type of work, income level, and education level. TB service quality data collection through interviews using QUOTE TB Light instrument. The data were analyzed descriptively with the Importance Score (I), Performance Score (P), and Quality Impact (QI) assessment. Bivariate analysis used Chi-square test and to control for confounding variables used Logistic Regression Test.
Results: Of the nine dimensions of TB services based on QUOTE TB Light, dropout patients considered money and food supports were most important (I=83.06%) and very lacking during treatment (P=100%), need for improvement (QI=8.83). Interaction-counseling became the most important dimensions for non-dropout patients (I=80.28%) and were not well received (P=50%). So, need for improvement, especially in officers solve problems (QI=4.01). Patients who rated poor TB services quality 2,911 (95% CI:1,093–7,755) were more at risk of dropping out of TB treatment, after controlling for confounders.
Conclusion: Nine dimensions of TB services, especially support and interaction-counseling are considered poor by patients, so need for improvement in quality. Patients who rated poor TB services quality were more at risk of dropping out of TB treatment. PHCs need to consider the patient's perspective in assessing the TB services quality using QUOTE TB Light.
Keywords: Tuberculosis, QUOTE TB Light, dropout, risk assessment

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