Penggunaan Obat Pada Pasien Ibu Hamil di Poliklinik Obstetri dan Ginekologi di RSUD Dr. Pirngadi Medan Tahun 2014
Lampiran 1. Tabel Pengumpulan Data
TABEL DATA PASIEN IBU HAMIL DI POLIKLINIK OBSTETRI DAN GINEKOLGI RSUD Dr. PIRNGADI MEDAN TAHUN 2014
1
00.94.33.98
Usia
Pasien
(tahun)
33
2
3
4
00.87.04.61
00.74.59.73
00.76.96.93
25
29
28
No. No. Rekam Medis
5
6
7
00.89.25.93
00.85.38.04
00.91.28.34
30
25
34
Usia
Kehamilan
(minggu)
39 -- 40
Paritas
Obat
Dosis
Metode Pembayaran
Multigravida
1x1
BPJS Kesehatan
34 -- 36
37 -- 38
19 -- 20
Secundagravida
Multigravida
Primigravida
Roborantia
Vitamin B
Complex
Roborantia
OBH syrup
Vitamin B
Complex
Vitamin C
Vitamin B6
Vitamin B
Complex
Lactos Calsicy
Roborantia
Roborantia
Vitamin B
Complex
Sulfa Ferrous
3x1
1x1
3x1C
Askes
Umum
Umum
1x1
1x1
1x1
PBI
2x1
1x1
1x1
1x1
Non PBI
Non PBI
32 -- 34
38 -- 40
33 -- 34
Multigravida
Secundagravida
Multigravida
36 -- 37
2x1
2x1
47
Universitas Sumatera Utara
8
00.61.92.74
37
9
10
11
12
00.89.18.89
00.77.76.99
00.54.03.16
00.90.81.55
27
31
31
30
13
14
15
16
00.83.09.95
00.79.79.79
00.93.43.69
00.92.16.55
25
32
31
29
24 -- 26
30 -- 32
38 -- 39
38 -- 39
34 -- 35
38 -- 40
8 -- 10
14 -- 16
23 -- 24
32 -- 34
32 -- 34
38 -- 40
38 -- 40
12 -- 13
Secundagravida
Primigravida
Multigravida
Multigravida
Primigravida
Multigravida
Secundagravida
Secundagravida
Multigravida
18 -- 20
24 -- 26
35 -- 36
17
00.92.00.36
26
38 -- 40
Primigravida
Vitamin B
Complex
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Vitamin B
Complex
Roborantia
Roborantia
Roborantia
Roborantia
Amoxicillin
Ranitidine
Roborantia
Roborantia
Roborantia
Sulfa Ferrous
Vitamin B
Complex
Roborantia
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
3 x 500 mg
3x1
3x1
1x1
1x1
1x1
1x1
1x1
Umum
Non PBI
Non PBI
Umum
Non PBI
Umum
Non PBI
Non PBI
PBI
Umum
48
Universitas Sumatera Utara
18
00.93.09.94
22
12 -- 14
22 -- 24
Primigravida
24 -- 26
30 -- 31
34 -- 36
19
00.93.95.85
24
20
00.93.00.45
31
21
00.93.82.45
31
22
23
24
00.92.88.15
00.91.75.35
00.93.30.22
37
21
24
36 -- 38
38 -- 40
34 -- 35
36 -- 38
30 -- 32
39 -- 40
32 -- 34
34 -- 36
34 -- 36
Primigravida
Secundagravida
Multigravida
Secundagravida
Secundagravida
Primigravida
Roborantia
Sulfa Ferrous
Vitamin B
Complex
Asam Folat
Obimin AF
Roborantia
Roborantia
Vitamin B
Complex
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Vitamin B
Complex
Nifedipin
Roborantia
Roborantia
Sulfa Ferrous
Vitamin B
Complex
Volavit
Roborantia
1x1
1x1
PBI
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
4 x 10 mg
1x1
1x1
1x1
1x1
1x1
1x1
Non PBI
Non PBI
PBI
Non PBI
Non PBI
Non PBI
49
Universitas Sumatera Utara
25
26
00.93.61.22
00.78.62.12
23
34
26 -- 28
4 -- 5
Primigravida
Multigravida
27
00.92.79.22
29
Primigravida
28
29
30
31
00.93.78.32
00.93.49.42
00.92.83.62
00.93.22.92
21
16
17
42
32 -- 34
35 -- 36
36 -- 38
38 -- 40
34 -- 36
38 -- 40
7 -- 8
Primigravida
Primigravida
Primigravida
Primigravida
32
33
34
35
36
37
38
39
40
41
00.83.25.62
00.82.73.61
00.93.98.41
00.92.27.71
00.93.45.31
00.78.63.69
00.93.53.39
00.94.25.59
00.82.78.17
00.93.03.57
34
38
13
22
27
22
22
33
31
29
18 -- 20
34 -- 35
36 -- 37
39 -- 40
36
28 -- 29
38 -- 40
16
37 -- 38
36 -- 38
Multigravida
Primigravida
Primigravida
Secundagravida
Secundagravida
Secundagravida
Primigravida
Multigravida
Multigravida
Multigravida
Roborantia
Cefadroxil
Transamin
Duphaston
Roborantia
Nifedipin
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Premaston
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Folavit
Roborantia
1x1
2 x 500 mg
1x1
2x1
1x1
3 x 10 mg
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
Non PBI
Umum
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
50
Universitas Sumatera Utara
42
43
44
45
00.93.33.67
00.84.74.77
00.94.80.06
00.93.77.06
19
41
35
27
46
47
48
49
50
51
00.94.58.26
00.94.49.36
00.15.83.06
00.94.13.76
00.80.36.86
00.81.09.96
52
53
00.93.69.96
00.73.45.45
54
55
56
57
58
59
00.56.01.75
00.93.72.15
00.79.66.04
00.63.80.13
00.93.08.38
00.82.45.89
29
29
43
29
36
24
40
38 -- 39
38 -- 39
38 --39
40
38 -- 39
38 -- 40
38 -- 39
38 -- 40
34 -- 36
26 -- 28
Secundagravida
Secundagravida
Multigravida
Secundagravida
Primigravida
Secundagravida
26
33
38 -- 40
30 -- 32
Multigravida
Multigravida
33
15
30
34
41
27
38 -- 40
38 -- 40
37 -- 38
37 -- 38
38 -- 39
36 -- 37
Primigravida
Primigravida
Multigravida
Secundagravida
Secundagravida
Primigravida
Primigravida
Secundagravida
Multigravida
Primigravida
Nifedipin
Roborantia
Roborantia
Roborantia
Lynoral
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Asam Folat
Roborantia
Roborantia
Sulfa Ferrous
Vitamin B
Complex
Amoxicillin
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
3 x 10 mg
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
3 x 500 mg
1x1
1x1
1x1
1x1
1x1
1x1
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Medan Sehat
Non PBI
51
Universitas Sumatera Utara
60
61
62
00.94.27.69
00.83.32.89
00.81.25.37
21
25
38
24 -- 25
Multigravida
Primigravida
44
34 -- 35
37 -- 38
Multigravida
63
64
65
00.94.80.06
00.93.86.28
00.94.53.36
35
23
30
36 -- 38
38 -- 39
6 -- 8
Multigravida
Primigravida
Primigravida
66
00.93.60.16
37
38 -- 39
Primigravida
67
68
69
70
71
72
73
74
00.93.97.70
00.94.08.16
00.92.40.16
00.93.55.70
00.75.16.20
00.93.50.40
00.77.14.90
00.90.16.27
40
26
26
24
27
24
30
24
38 -- 39
34 -- 35
38 -- 40
35 -- 36
36 -- 37
38 -- 40
38 -- 40
30 -- 32
Primigravida
Secundagravida
Secundagravida
Secundagravida
Primigravida
Primigravida
Primigravida
Primigravida
Roborantia
Flagystatin Ovula
Nifedipin
Obimin AF
Asam Folat
Vitamin B
Complex
Sulfa Ferrous
Roborantia
Roborantia
Asam Folat
Sulfa Ferrous
Nifedipin
Sulfa Ferrous
Vitamin B
Complex
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
1x1
1x1
1x1
1x1
2x1
2x1
2x1
1x1
1x1
1x1
1x1
1 x 10 mg
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Umum
Non PBI
Umum
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Umum
52
Universitas Sumatera Utara
75
76
77
78
79
80
81
82
83
84
85
86
00.94.58.97
00.91.83.40
00.83.03.07
00.92.13.37
00.92.20.98
00.92.80.67
00.93.33.88
00.81.73.68
00.86.19.18
00.83.20.17
00.81.11.27
00.81.53.56
24
18
37
32
32
24
39
28
23
29
31
31
24 -- 25
26 -- 27
32 -- 34
34 -- 36
36 -- 37
38 -- 40
37 -- 38
38 -- 40
28 -- 30
38 -- 39
39 -- 40
35 -- 36
36 -- 37
Primigravida
Primigravida
Multigravida
Multigravida
Secundagravida
Primigravida
Multigravida
Multigravida
Secundagravida
Primigravida
Primigravida
Secundagravida
Vibrion
Sohobion 5000
Ranitidine tab
Metoclopramide
tab
Ulsicral Syrup
Cotrimoxazole tab
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Nifedipin
Metildopa
Vitamin E
Vitamin C
1x1
1x1
2x1
2x1
3x1C
3 x 400 mg
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
4 x 10 mg
2x1
1x1
1x1
Umum
Non PBI
Non PBI
Umum
Non PBI
Non PBI
Non PBI
Non PBI
Umum
Non PBI
Non PBI
Non PBI
53
Universitas Sumatera Utara
Lampiran 2. Surat Permohonan Izin Pengambilan Data Penelitian
54
Universitas Sumatera Utara
Lampiran 3.Surat Izin Penelitian Di Ruang Rekam Medis RSUD Dr.Pirngadi
Medan
55
Universitas Sumatera Utara
Lampiran 4.Surat Keterangan Selesai Penelitian
56
Universitas Sumatera Utara
TABEL DATA PASIEN IBU HAMIL DI POLIKLINIK OBSTETRI DAN GINEKOLGI RSUD Dr. PIRNGADI MEDAN TAHUN 2014
1
00.94.33.98
Usia
Pasien
(tahun)
33
2
3
4
00.87.04.61
00.74.59.73
00.76.96.93
25
29
28
No. No. Rekam Medis
5
6
7
00.89.25.93
00.85.38.04
00.91.28.34
30
25
34
Usia
Kehamilan
(minggu)
39 -- 40
Paritas
Obat
Dosis
Metode Pembayaran
Multigravida
1x1
BPJS Kesehatan
34 -- 36
37 -- 38
19 -- 20
Secundagravida
Multigravida
Primigravida
Roborantia
Vitamin B
Complex
Roborantia
OBH syrup
Vitamin B
Complex
Vitamin C
Vitamin B6
Vitamin B
Complex
Lactos Calsicy
Roborantia
Roborantia
Vitamin B
Complex
Sulfa Ferrous
3x1
1x1
3x1C
Askes
Umum
Umum
1x1
1x1
1x1
PBI
2x1
1x1
1x1
1x1
Non PBI
Non PBI
32 -- 34
38 -- 40
33 -- 34
Multigravida
Secundagravida
Multigravida
36 -- 37
2x1
2x1
47
Universitas Sumatera Utara
8
00.61.92.74
37
9
10
11
12
00.89.18.89
00.77.76.99
00.54.03.16
00.90.81.55
27
31
31
30
13
14
15
16
00.83.09.95
00.79.79.79
00.93.43.69
00.92.16.55
25
32
31
29
24 -- 26
30 -- 32
38 -- 39
38 -- 39
34 -- 35
38 -- 40
8 -- 10
14 -- 16
23 -- 24
32 -- 34
32 -- 34
38 -- 40
38 -- 40
12 -- 13
Secundagravida
Primigravida
Multigravida
Multigravida
Primigravida
Multigravida
Secundagravida
Secundagravida
Multigravida
18 -- 20
24 -- 26
35 -- 36
17
00.92.00.36
26
38 -- 40
Primigravida
Vitamin B
Complex
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Vitamin B
Complex
Roborantia
Roborantia
Roborantia
Roborantia
Amoxicillin
Ranitidine
Roborantia
Roborantia
Roborantia
Sulfa Ferrous
Vitamin B
Complex
Roborantia
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
3 x 500 mg
3x1
3x1
1x1
1x1
1x1
1x1
1x1
Umum
Non PBI
Non PBI
Umum
Non PBI
Umum
Non PBI
Non PBI
PBI
Umum
48
Universitas Sumatera Utara
18
00.93.09.94
22
12 -- 14
22 -- 24
Primigravida
24 -- 26
30 -- 31
34 -- 36
19
00.93.95.85
24
20
00.93.00.45
31
21
00.93.82.45
31
22
23
24
00.92.88.15
00.91.75.35
00.93.30.22
37
21
24
36 -- 38
38 -- 40
34 -- 35
36 -- 38
30 -- 32
39 -- 40
32 -- 34
34 -- 36
34 -- 36
Primigravida
Secundagravida
Multigravida
Secundagravida
Secundagravida
Primigravida
Roborantia
Sulfa Ferrous
Vitamin B
Complex
Asam Folat
Obimin AF
Roborantia
Roborantia
Vitamin B
Complex
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Vitamin B
Complex
Nifedipin
Roborantia
Roborantia
Sulfa Ferrous
Vitamin B
Complex
Volavit
Roborantia
1x1
1x1
PBI
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
4 x 10 mg
1x1
1x1
1x1
1x1
1x1
1x1
Non PBI
Non PBI
PBI
Non PBI
Non PBI
Non PBI
49
Universitas Sumatera Utara
25
26
00.93.61.22
00.78.62.12
23
34
26 -- 28
4 -- 5
Primigravida
Multigravida
27
00.92.79.22
29
Primigravida
28
29
30
31
00.93.78.32
00.93.49.42
00.92.83.62
00.93.22.92
21
16
17
42
32 -- 34
35 -- 36
36 -- 38
38 -- 40
34 -- 36
38 -- 40
7 -- 8
Primigravida
Primigravida
Primigravida
Primigravida
32
33
34
35
36
37
38
39
40
41
00.83.25.62
00.82.73.61
00.93.98.41
00.92.27.71
00.93.45.31
00.78.63.69
00.93.53.39
00.94.25.59
00.82.78.17
00.93.03.57
34
38
13
22
27
22
22
33
31
29
18 -- 20
34 -- 35
36 -- 37
39 -- 40
36
28 -- 29
38 -- 40
16
37 -- 38
36 -- 38
Multigravida
Primigravida
Primigravida
Secundagravida
Secundagravida
Secundagravida
Primigravida
Multigravida
Multigravida
Multigravida
Roborantia
Cefadroxil
Transamin
Duphaston
Roborantia
Nifedipin
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Premaston
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Folavit
Roborantia
1x1
2 x 500 mg
1x1
2x1
1x1
3 x 10 mg
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
Non PBI
Umum
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
50
Universitas Sumatera Utara
42
43
44
45
00.93.33.67
00.84.74.77
00.94.80.06
00.93.77.06
19
41
35
27
46
47
48
49
50
51
00.94.58.26
00.94.49.36
00.15.83.06
00.94.13.76
00.80.36.86
00.81.09.96
52
53
00.93.69.96
00.73.45.45
54
55
56
57
58
59
00.56.01.75
00.93.72.15
00.79.66.04
00.63.80.13
00.93.08.38
00.82.45.89
29
29
43
29
36
24
40
38 -- 39
38 -- 39
38 --39
40
38 -- 39
38 -- 40
38 -- 39
38 -- 40
34 -- 36
26 -- 28
Secundagravida
Secundagravida
Multigravida
Secundagravida
Primigravida
Secundagravida
26
33
38 -- 40
30 -- 32
Multigravida
Multigravida
33
15
30
34
41
27
38 -- 40
38 -- 40
37 -- 38
37 -- 38
38 -- 39
36 -- 37
Primigravida
Primigravida
Multigravida
Secundagravida
Secundagravida
Primigravida
Primigravida
Secundagravida
Multigravida
Primigravida
Nifedipin
Roborantia
Roborantia
Roborantia
Lynoral
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Asam Folat
Roborantia
Roborantia
Sulfa Ferrous
Vitamin B
Complex
Amoxicillin
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
3 x 10 mg
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
3 x 500 mg
1x1
1x1
1x1
1x1
1x1
1x1
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Medan Sehat
Non PBI
51
Universitas Sumatera Utara
60
61
62
00.94.27.69
00.83.32.89
00.81.25.37
21
25
38
24 -- 25
Multigravida
Primigravida
44
34 -- 35
37 -- 38
Multigravida
63
64
65
00.94.80.06
00.93.86.28
00.94.53.36
35
23
30
36 -- 38
38 -- 39
6 -- 8
Multigravida
Primigravida
Primigravida
66
00.93.60.16
37
38 -- 39
Primigravida
67
68
69
70
71
72
73
74
00.93.97.70
00.94.08.16
00.92.40.16
00.93.55.70
00.75.16.20
00.93.50.40
00.77.14.90
00.90.16.27
40
26
26
24
27
24
30
24
38 -- 39
34 -- 35
38 -- 40
35 -- 36
36 -- 37
38 -- 40
38 -- 40
30 -- 32
Primigravida
Secundagravida
Secundagravida
Secundagravida
Primigravida
Primigravida
Primigravida
Primigravida
Roborantia
Flagystatin Ovula
Nifedipin
Obimin AF
Asam Folat
Vitamin B
Complex
Sulfa Ferrous
Roborantia
Roborantia
Asam Folat
Sulfa Ferrous
Nifedipin
Sulfa Ferrous
Vitamin B
Complex
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
1x1
1x1
1x1
1x1
2x1
2x1
2x1
1x1
1x1
1x1
1x1
1 x 10 mg
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
PBI
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Umum
Non PBI
Umum
Non PBI
Non PBI
Non PBI
Non PBI
Non PBI
Umum
52
Universitas Sumatera Utara
75
76
77
78
79
80
81
82
83
84
85
86
00.94.58.97
00.91.83.40
00.83.03.07
00.92.13.37
00.92.20.98
00.92.80.67
00.93.33.88
00.81.73.68
00.86.19.18
00.83.20.17
00.81.11.27
00.81.53.56
24
18
37
32
32
24
39
28
23
29
31
31
24 -- 25
26 -- 27
32 -- 34
34 -- 36
36 -- 37
38 -- 40
37 -- 38
38 -- 40
28 -- 30
38 -- 39
39 -- 40
35 -- 36
36 -- 37
Primigravida
Primigravida
Multigravida
Multigravida
Secundagravida
Primigravida
Multigravida
Multigravida
Secundagravida
Primigravida
Primigravida
Secundagravida
Vibrion
Sohobion 5000
Ranitidine tab
Metoclopramide
tab
Ulsicral Syrup
Cotrimoxazole tab
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Roborantia
Nifedipin
Metildopa
Vitamin E
Vitamin C
1x1
1x1
2x1
2x1
3x1C
3 x 400 mg
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1
4 x 10 mg
2x1
1x1
1x1
Umum
Non PBI
Non PBI
Umum
Non PBI
Non PBI
Non PBI
Non PBI
Umum
Non PBI
Non PBI
Non PBI
53
Universitas Sumatera Utara
Lampiran 2. Surat Permohonan Izin Pengambilan Data Penelitian
54
Universitas Sumatera Utara
Lampiran 3.Surat Izin Penelitian Di Ruang Rekam Medis RSUD Dr.Pirngadi
Medan
55
Universitas Sumatera Utara
Lampiran 4.Surat Keterangan Selesai Penelitian
56
Universitas Sumatera Utara