THE RELATIONSHIP OF PHARMACEUTICAL SERVICES TO PATIENT SATISFACTION AT THE PUSKESMAS TRADING BANDAR DISTRICT SIMALUNGUN DISTRICT

The research entitled The Relationship of Pharmaceutical Services to Patient Satisfaction at the Trading Health Center, Bandar District, Simalungun Regency was conducted in July - August 2019. The purpose of this study was to find out how the application of pharmaceutical service standards at the Puskesmas, the level of patient satisfaction and the effect of applying pharmaceutical service standards on satisfaction Patients This research is a descriptive survey research that is cross-sectional. Data collection was carried out by observation by researchers to find out the application of pharmaceutical service standards and to conduct interviews with patients to determine the level of satisfaction with pharmaceutical services. Data was collected from 170 respondents in July-August 2019 at the Trading Health Center, Bandar District, Simalungun Regency, The application of pharmaceutical service standards studied in this study is human resources, facilities and infrastructure for the management of drugs and medical consumables, clinical pharmacy services and service quality control. The criteria for measuring the level of satisfaction include five variables, namely reliability, responsiveness, confidence, empathy and tangible facilities. The results showed that the implementation of pharmaceutical service standards at the Commercial Health Center, namely the application of pharmaceutical service standards at the Commercial Health Center, was included in the less category. Based on the average value of total patient satisfaction, the level of patient satisfaction at the Jawa Maraja Health Center was included in the satisfied category. The application of pharmaceutical service standards at the Commercial Health Center to patient satisfaction with the Mann-Whiteney Test obtained a sig value of <0.05.


INTRODUCTION
Health efforts aim to maintain and improve health, as well as realizing optimal health status for the community, which is carried out with approaches, maintenance, health improvement, disease prevention, disease healing and health restoration, which are carried out in a comprehensive, integrated and sustainable manner (Surahman and Husen, 2011). The Community Health Center (Puskesmas) as a place for first-level health efforts has the responsibility of providing health services to all people who are administratively domiciled in their working area (Tanan, 2013). With the existence of a puskesmas, it is hoped that the community can obtain quality health services with the easiest access and affordable costs (Bappenas, 2009).
The government has not fully implemented effective, efficient and quality health development in accordance with the principles of good governance. The health information system became weak after implementing the decentralization policy. Health data and information for planning are not available on time. The facility-based National Health Information System (SIKNAS) has reached the district/city level, but has not been utilized. The decentralization process which was originally expected to be able to empower regions in implementing health development, in reality has not been fully implemented and has even created euphoria in the regions which has resulted in constrained health development (Ministry of Health, 2009). The vision of health development organized by the puskesmas is to achieve healthy sub-districts. A healthy sub-district includes 4 main indicators, namely a healthy environment, healthy behavior, coverage of quality health services and the health status of the population. The health development mission organized by the puskesmas is to support the achievement of the national health development mission in the context of creating an independent community with a healthy life. To achieve this vision, the puskesmas organizes individual health efforts and community health efforts so that it needs to be supported with prescription services. Therefore, puskesmas must organize individual health efforts (Menkes, 2004).

Formulation of the problem
Based on the background above, the research problem can be formulated as follows: a. Is the implementation of pharmaceutical service standards at the Trading Health Center in Bandar District, Simalungun Regency good? b. Is the level of patient satisfaction with pharmaceutical services at the Trading Health Center, Bandar District, Simalungun Regency very satisfying? c. Does the application of pharmaceutical service standards affect patient satisfaction at the Trade Center in Bandar District, Simalungun Regency?

Types of research
This research is included in a descriptive survey research that is cross-sectional in nature, namely a research design by measuring or observing at the same time the independent and dependent variables (Hidayat, 2010).

Population and Sample Research Data
The selection of the puskesmas as a research location was carried out using purposive sampling based on certain considerations made by the researchers themselves based on previously known characteristics or characteristics of the population (Notoatmodjo, 2012). The Trading Health Center of Bandar District, Simalungun Regency was obtained as a research location. The population in this study were respondents who came to the puskesmas. The sample who became research respondents were patients who received drug services through a prescription at the puskesmas and patients who were willing to be interviewed voluntarily. The number of samples in this study were 170 patients.

Application of Pharmaceutical Service Standards
Pharmacy service standards at puskesmas can be seen from human resources, facilities and infrastructure, management of drugs and medical consumables, clinical pharmacy services and quality control of pharmaceutical services.

Management of Drugs and Medical Consumables
Management of drugs and medical consumables is one of the pharmaceutical service activities starting from planning, requesting, receiving, storing, distributing, controlling, recording and reporting as well as monitoring and evaluation. The aim is to ensure the continuous availability and affordability of drugs and medical consumables that are efficient, effective and rational (Menkes, RI., 2014).

Clinical Pharmacy Services
Pharmaceutical services at the puskesmas are an integral part of the implementation of health efforts, which play an important role in improving the quality of health services for the community. Clinical pharmacy services are part of pharmaceutical services that are direct and responsible to patients related to drugs and medical consumables with the aim of achieving definite results to improve the quality of life of patients (Menkes, RL, 2014). Data on clinical pharmacy services obtained at the Trading Health Center.

Quality Control of Pharmaceutical Services
Pharmaceutical service quality control is an activity to prevent drug-related problems from occurring or prevent medication errors (medication errors), which aim at patient care (Menkes, RI., 2014). Pharmaceutical service quality control data obtained.

Calculation results of Pharmaceutical Service Standards at the Puskesmas
Pharmaceutical service standards at the health center are calculated based on human resources, facilities and infrastructure, management of drugs and medical consumables, clinical pharmacy services and quality control of pharmaceutical services. Then the total score obtained is calculated. Results of the total score for the Trading Health Center.

Distribution of Assessment of Variables Affecting Patient Satisfaction Levels
Based on the average value of the total value of patient satisfaction at the Trading Health Center, it obtained a value of 32.12. From this value it can be seen that the level of patient satisfaction at the Commercial Health Center is in the satisfied category. This happens because there are differences in the assessment of the variables that affect the level of patient satisfaction. Obtain data on the assessment of variables that affect the level of patient satisfaction.

The Influence of Application of Pharmaceutical Service Standards on Patient Satisfaction at Commercial Health Centers
Based on the results of statistical tests, the effect of applying pharmaceutical service standards on patient satisfaction at the Commercial Health Centers using the Mann-Whiteney Test showed a significant value <0.05, so there was a significant difference, where there was a significant effect on the results of the assessment of pharmaceutical service standards at the Commercial Health Centers on the level of patient satisfaction.

CLOSING Conclusion
Based on the results of the research that has been done, it can be concluded that: 1. The application of pharmaceutical service standards at the Commercial Health Center is included in the poor category. 2. Based on the average value of total patient satisfaction, the level of patient satisfaction at the Trading Health Center is in the satisfied category.

The application of pharmaceutical service standards at the Commercial Health
Center to patient satisfaction with the Mann-Whiteney Test obtained a sig. <0.05 This indicates that the application of pharmaceutical service standards has a significant effect on patient satisfaction, with a high standard of pharmaceutical services affecting a high level of patient satisfaction as well.