Study of Diabetes Mellitus Management Policies Using a Systems Approach in Surge Capacity

Siti Badriah, Peni Cahyati, Lia Nurcahyani, Arief Tarmansyah Iman, Ristrini Ristrini, Athanasia Budi Astuti
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Abstract

Background: The prevalence of Diabetes Mellitus (DM) in Indonesia continues to increase, even though DM control policies and programs have been implemented. According to existing policies, the family has not been involved in diabetes control. This study evaluates diabetes mellitus management policies by designing family-based community empowerment model interventions with a systems approach to surge capacity.   Methods: The design of this study used a cross-sectional operational analysis conducted in Cirebon City with 26 participants. Data collection was carried out using Focus Group Discussion (FGD) and in-depth interviews using interview guidelines from the surge capacity component. Inclusion criteria were Non-Communicable Diseases program holders at the Cirebon City Health Office and Community Health Centers with the highest and lowest prevalence, and DM sufferers and their families representing each age and gender category. Data analysis was performed using open code.   Results: The non-communicable disease program has not been integrated between the health office and the hospital; funds for the DM prevention program have not met the needs; there are limited human resources with multiple tasks and an excessive workload, so it is not optimal for DM health services; and there is a lack of family involvement in diabetes control, so the incidence of DM is still not usually controlled.   Conclusion: Policy studies using a system approach in surge capacity have been able to dig up various information on DM control efforts in terms of policy, organizational structure, DM surveillance, information systems, integrated services, case screening, budgeting, and community empowerment.
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利用系统方法研究突增能力下的糖尿病管理政策
背景:尽管已经实施了糖尿病控制政策和计划,但印度尼西亚的糖尿病(DM)发病率仍在持续上升。根据现有政策,家庭并未参与糖尿病控制。本研究通过设计以家庭为基础的社区赋权模式干预措施,采用系统方法来提高能力,从而对糖尿病管理政策进行评估。方法:本研究在井里汶市进行了横断面操作分析,共有 26 人参与。数据收集采用焦点小组讨论(FGD)和深入访谈的方式进行,访谈采用突增能力部分的访谈指南。纳入标准包括井里汶市卫生局和发病率最高和最低的社区卫生中心的非传染性疾病项目负责人,以及代表各个年龄和性别类别的 DM 患者及其家属。数据分析采用开放代码进行。结果卫生局和医院之间没有整合非传染性疾病项目;DM预防项目的资金不能满足需要;人力资源有限,任务繁多,工作量过大,因此DM医疗服务并不理想;缺乏家庭对糖尿病控制的参与,因此DM的发病率通常仍得不到控制。结论在能力激增的情况下,采用系统方法进行的政策研究能够从政策、组织结构、DM 监测、信息系统、综合服务、病例筛查、预算编制和社区赋权等方面挖掘出有关 DM 控制工作的各种信息。
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