Dental and Oral Hospital Health Service System in Indonesia

Background: Oral and Dental Hospital provides health services, namely individual dental and oral health services for treatment and recovery services without neglecting health promotion and disease prevention services which are carried out through out-patient, emergency and medical treatment services. Purpose: to introduce the public to the health service system at the Dental and Oral Hospital, where people still do not understand about Dental and Oral Hospitals, especially in Indonesia. Methods: This literature study uses the narrative review method by analyzing various journals from the PubMed, Ebsco and Google Scholar databases from the last 5 years related to Oral and Dental Hospital. Conclusion: Oral and Dental Hospital provides facilities to improve the quality of service, education, research in the field of dental and oral health from basic to specialist levels in accordance with the demands of the community and developments in Medical and Dentistry Science and Technology, as well as being a means of referral efforts


INTRODUCTION
According to the Decree of the Minister of Health Number 1173/MENKES/PER/2004 in article 1 Dental and Oral Hospital (RSGM) is a health service facility that organizes individual dental and oral health services for treatment and recovery services without neglecting health promotion and disease prevention services carried out through outpatient services, emergency services and medical action services. Meanwhile, according to the Indonesian Ministry of Health (2003) Educational Dental and Oral Hospital (RSGMP) is a special hospital that provides dental and oral health services, and is a means of education and research for academic (S1) and professional level dental health workers (dentists and doctors). dental specialist) as well as master (S2) and doctoral (S3) education.
Outpatient services One type of health services in the hospital. The number of outpatients is usually more much compared to other treatments so that hospital management is more concerned with outpatient care. Health services in a good hospital will be a superiority of the hospital and become a consumer attraction.
In general, the quality of health services is measured by patient satisfaction so that patient satisfaction is an indicator of the quality of hospital services. Health service providers in all countries in the world consider patient satisfaction as the main concern in providing health services so that the measurement of patient satisfaction is one aspect of the overall evaluation of service quality. Patient satisfaction is also an indicator to assess the quality of care in a hospital. The quality of service and care of a good hospital can generate customer satisfaction, consumers will continue to seek treatment at the hospital in question, there are new customers, and can reduce costs so that the hospital will get big profits.

METHODOLOGY
This literature review uses the narrative review method. Journals and references were collected through the BMC Oral Health online database and website, PubMed and Google Scholar. References were also selected through reference analysis in the form of research, articles and systematic reviews for the last 5 years.

RESULTS AND DISCUSSION
Dental and Oral Hospital is the leading dental and oral health service facility in Indonesia that provides dental and oral health services for the community, as well as dental health providers to restore patients' oral health to a better level to meet patient satisfaction. According to the Decree of the Minister of Health Number 1173/MENKES/PER/2004 in article 1 Oral and Dental Hospital, hereinafter abbreviated as RSGM is a health service facility that organizes individual dental and oral health services for treatment and recovery services without neglecting health promotion services and prevention of diseases that carried out through outpatient services, emergency services and medical action services. Teaching dental and oral hospital is a hospital that provides dental and oral health services, which is also used as a means of learning, education and research for the dental health profession and other health workers. Oral and dental hospitals must collaborate with dental faculties.
The implementation of the Oral and Dental Hospital aims to provide facilities to improve the quality of service, education, research in the field of dental and oral health from basic to specialist levels in accordance with community needs, referral facilities and development of Dentistry technology. The function of the dental and oral hospital is to provide: Basic, specialist and sub-specialty dental medical services.
Supporting services; such as pharmaceutical services, laboratories, dental radiology, anesthesia services. Referral services, emergency dental and oral health services, education, research, and development.
Regulation of the Minister of Health Num-ber1173/MENKES/PER/2004 concerning Oral and Dental Hospitals is a minimum mandatory standard that must be met for every RSGM that will be built or that has already been built. The following are some important reviews of the contents of the PerMenKes that need attention: A. Requirements for building facilities and infrastructure as well as dental and oral hospital equipment, namely: outpatient rooms, emergency rooms, recovery rooms, operating rooms, pharmaceuticals and dental materials, clinical laboratories, dental engineering laboratories, central sterilization rooms, radiology, waiting room, administrative room, and infrastructure which includes electricity, clean water supply, waste disposal installation, communication equipment, fire extinguisher and parking area. B. Types of dental and oral hospital service components, namely: general and dental health consultation, hospital administration, diagnostic support, operative medical procedures, non-operative medical procedures, radiology, pharmacy, ambulance and hospital services, materials and equipment consumables, clinical laboratories, dental technical laboratories, services for education and research, for RSGM Education.
According to PMK no.1173 of 2004, there are dentistry medical personnel at RSGM in Indonesia, namely: Dentists and Dental Specialists, including:

a. Oral Surgery
This specialist field covers a wide range of management of diseases, disorders, and conditions of the soft and hard tissues of the oral and jaw cavities that require a surgical approach, including tooth extraction here.

b. Orthodontia
This specialist area treats patients with problems with growth, development, facial, jaw and dentition variations and abnormalities of the dental and facial relationships as well as their corrective treatment.

c. Dental Conservation
This specialist area deals with the treatment of dental restorations (eg dental fillings). There is an Endodontics section, namely root canal treatment. All efforts are aimed at maintaining the teeth as long as possible in the mouth, one of which is by making restorations for each tooth that needs it.

d. Prostodontia
This specialist field deals with the replacement of one or several natural teeth and their missing tissues with dentures.

e. Pediatric Dentistry
This specialist field deals with growth and development problems in the teeth and mouth of pediatric patients. This is distinguished from adult patients because pediatric patients have different types of teeth from adult teeth, where pediatric patients still have milk teeth while adult patients have permanent teeth. In children, they are in a period of growth and development that requires special attention.

f. Periodontia
Specialist field that treats patients with the treatment of gums and tooth supporting tissues.

g. Oral Medicine
This specialist field deals with the patient's oral health, including non-surgical diagnosis and treatment of infectious and non-infectious disorders in the oral cavity and its surroundings.

h. Dental Radiology
This specialist area can help make a diagnosis, determine a treatment plan, evaluate during treatment, and evaluate the results of treatment radiologically.
Dental and oral health services are any form of dental and oral health services or programs aimed at individuals or collectively within an organization with the aim of maintaining or improving the degree of dental and oral health. According to The Andersen Model of Health Services Utilization, utilization of health services is used to identify predispositions and characteristics that influence the use of dental and oral health services. According to Newsome and Wright (2010), five issues that affect patient satisfaction with dental care are technical competence, interpersonal factors, convenience, costs, and facilities, but according to Al Johara et al, on his research categorized into five factors namely: access, availability/convenience, cost, illness experience and quality which are the main sources of satisfaction or dissatisfaction with dental and oral health services.
In hospital management, good management is closely related to efficient administration. Hospital administration includes several activities that are categorized as follows: preparation of hospital legislation, implementation of hospital legalization, and daily hospital activities managed by administration staff in internal, financial, and technical services, including reservation aspects. Outpatient services at the dental and oral hospital have standard operating procedures for patient queue flow during outpatient care. This rule was stipulated in 2018 with letter number B07-014.
Hospitals as service providers for the wider community, are required to provide good service and according to established standards. Efforts to improve the quality of health services are the most important step to provide better services to patients. Quality hospital services can increase patient satisfaction and encourage these patients to come back to the hospital. The factors that determine patient satisfaction with dental and oral health services can be assessed based on the fulfillment of several indicators of the quality of health services. According to Parasuraman (2003) and Zeithaml (2006), there are several indicators for assessing service quality that can be considered to improve services at dental and oral hospitals, including indicators of empathy, assurance, reliability, tangibles, and responsiveness. According to Zeithaml, Lovelock, and Tjiptono, they divided service quality indicators based on several component aspects. The service components are then divided into five and are known as Service Quality, where the five indicators include: a. Empathy: Indicators of empathy are assessments including special attention, attention to patient complaints, Medical personnel's understanding of patient needs and medical personnel's communication with patients can affect patient satisfaction. Good or bad dimensions of empathy can affect the level of patient satisfaction.
b. Assurance: Knowledge, courtesy, and the ability of the company's employees to foster consumer trust in the company. For dentists, the ability to build trust in patients is an indicator of assurance. This assessment is because medical personnel have sufficient knowledge, skills, courtesy, and foster patient trust.
c. Reliability: The dimension of reliability on indicators of dentists in providing information to patients before service is given and after treatment. The dentist providing an explanation of the procedure before treatment is carried out is an important aspect of the dentist and patient relationship. According to Mahrous (2012) who stated that 78% of patients were satisfied with the doctor's explanation before treatment. According to Rankin and Haris, patients do not like dentists who start treatment without explanation. Explanation to patients regarding treatment options will increase satisfaction with dental and oral health services.
d. Physical Evidence: Physical evidence of services, including physical facilities, tools, and equipment used to produce services. Physical evidence indicators (tangibles) are important as a measure of service. Patients will use their sense of sight as a service quality attribute of physical evidence indicators. Good physical evidence will affect the patient's perception. At the same time this dimension is also a source that can influence patient expectations. Due to good physical evidence, patient expectations are higher.
e. Responsiveness: An indicator of responsiveness which includes the dentist's willingness to respond to patient complaints, the dentist's ability to act quickly and precisely, and the dentist's ability to respond to patient complaints can affect the level of patient satisfaction. The good and bad dimensions of responsiveness can affect the high or low level of patient satisfaction.

CONCLUSION
Dental and Oral Hospital is a health service facility that organizes community dental and oral health services for treatment and recovery services, disease prevention which is carried out through outpatient services, emergency services and medical treatment services. Oral and dental hospitals also always maintain the quality of service and care for the community. The implementation of the Dental and Oral Hospital aims to provide facilities to improve the quality of service, education, research in the field of dental and oral health from basic to specialist levels in accordance with the demands of society and developments in Medical and Dentistry technology, as well as being a means of referral efforts. The function of the dental and oral hospital is to provide: Basic, specialist and sub-specialty dental medical services.