No abstract

Schizophrenia is classified in severe mental disorders so that the possibility to recover from it is fairly minimal. Based on a study, 80% of schizophrenic patients experienced a relapse from schizophrenia and only about 20% of patients declared recovered on pre-morbid level (Arif, 2006). Many cases of relapse occurred when the patient returned to their family. Some studies suggest that the factor of interaction patterns within the family, such as parenting and emotional expression among the members of family, leads the patients to relapse. This study aims to determine the correlation between parenting and family emotional expression to the relapse of schizophrenic patients of Menur Mental Hospital, Surabaya. This study used a quantitative approach with a correlation method. The samples were 65 families of patients with schizophrenia who were treated at the Menur Mental Hospital, taken by purposive sampling technique. 35 samples are famillies of hospitalized patients and 30 samples are famillies of outpatient. Data analysed using binary logistic. The correlation between the variables measured using significant value of p <0.05 and the Odds Ratio (OR) with 95% Constant Interval (CI). The results shows a significant value of constant is 0.002,  a significant value of parenting is 0.001 and significant value of family emotional expression is 0.002. It means that there is a correlation between parenting and family emotional expression with relapse of schizophrenic patients. Family emotional expression was proven as the most variable responsible for the emergence of relapse which affect 16.9 times greater chance of relapse than other variable contribution.Abstrak: Skizofrenia digolongkan dalam gangguan mental berat, sehingga kemungkinan untuk sembuh terbilang kecil. Berdasarkan hasil sebuiah penelitian, sebanyak 80% pasien skizofrenia mengalami kekambuhan berulang dan hanya sekitar 20% pasien dinyatakan pulih pada tingkat premorbid (Arif, 2006). Banyak kasus kekambuhan terjadi ketika pasien dikembalikan kepada keluarga. Beberapa penelitian menyebutkan bahwa faktor pola interaksi didalam keluarga menyebabkan kekambuhan, seperti pola asuh dan ekspresi emosi. Penelitian ini bertujuan untuk mengetahui hubungan pola asuh dan ekspresi emosi keluarga  dengan kekambuhan pasien di Rumah Sakit Jiwa Menur Surabaya. Penelitian ini menggunakan pendekatan kuantitatif dengan metode korelasional. Sampel adalah 65 keluarga dari pasien skizofrenia yang dirawat di Rumah Sakit Jiwa Menur, diambil dengan teknik purposive sampling. Sebanyak 35 sampel merupakan keluarga dari pasien rawat inap dan 30 sampel merupakan keluarga dari pasien rawat jalan di Rumah Sakit Jiwa Menur Surabaya. Analisis data menggunakan uji regresi logistik biner. Adanya hubungan antara variabel diukur dengan menggunakan nilai signifikan p<0,05 dan Odds Ratio (OR) dengan interval kepercayaan (CI) 95%. Hasil penelitian diperoleh nilai signifikan konstanta sebesar 0,002, nilai signifikan pola asuh sebesar 0,001 dan nilai signifikan ekspresi emosi keluarga sebesar 0,002. Hal tersebut berarti bahwa ada hubungan pola asuh dan ekspresi emosi keluarga dengan kekambuhan pasien skizofrenia. Ekspresi emosi keluarga merupakan variabel yang paling berperan terhadap munculnya kekambuhan karena memiliki peluang 16,9 kali lebih besar memunculkan kekambuhan dibandingkan dengan variabel yang lain.

Drugs expenditure is the highest proportion in health services budget. financing for health services in National Universal Health Coverage era is carried out by BPJS payed to referral health facilities namely hospitals. The medicine cost at public service agency/District or Province public service agency is unknown certaintly. This descriptive study was advanced analyzes of the secondary data of 84 hospitals from health financing research in the year of 2016. The result showed that there were problems of drug availability in class B 94,6%, C 78,9% and A 77,8%. The highest proportion of generic drugs cost to total drug cost is class C hospital, followed by B class and A class hospitals i.e 40,57%, 37,83% dan 23,74% respectively. The cost of non generic drug compared to generic drugs at A, B and C class is 2,22 times, 1,15 times and 0,86 times respectively. The highest cost of generic drug is in outpatient specialist services in all class of hospitals. The cost of the drugs was increasing higher as well as the hospital class. Conclusion: The non generic drugs cost dominated in A and B class hospital while C class was generic drug cost. Generic drug use policy should be socialyzed by government and to be considered by management in order to be able to carried out cost efficiency.