Pandemi COVID ? 19 menjadi tantangan dalam kapasitas sistem kesehatan dimana sistem kesehatan yang ada harus memastikan pasien COVID ? 19 dapat mengakses layanan kesehatan sekaligus menangani pandemi di masyarakat. Rekomendasi yang dikeluarkan WHO dalam menghadapi tantangan kapasitas sistem kesehatan diantaranya menambah jumlah rumah sakit rujukan dan mengupayakan sistem rujukan yang memadai terhadap lonjakan kasus COVID ? 19. Di Indonesia, pemerintah menggunakan Sistem Informasi Rujukan Terintegrasi (SISRUTE) dalam rujukan kasus COVID ? 19, meski dalam praktiknya masih bervariasi di berbagai daerah. Penggunaan SISRUTE sebelum COVID ? 19 dinilai masih belum optimal, sementara saat pandemi sangat sedikit pasien COVID ? 19 yang diterima melalui SISRUTE. Oleh karena itu, penelitian ini bertujuan memperoleh gambaran terkait efektivitas penggunaan SISRUTE dalam kasus COVID ? 19 di Semen Padang Hospital sebagai rumah sakit swasta pertama di Kota Padang yang menjadi rumah sakit rujuikan COVID ? 19 selama periode April 2020 hingga Oktober 2021. Penelitian ini merupakan penelitian kualitatif dengan proses pengumpulan data dilakukan dengan analisis data sekunder, wawancara mendalam kepada tujuh orang informan yang dipilih secara purposive sampling dan telaah dokumen. Dari penelitian ditemukan bahwa SISRUTE digunakan oleh dokter umum di UGD dan isolasi COVID ? 19 dan terdapat penggunaan SISRUTE berulang pada pasien yang sama karena penolakan dan rujukan yang tidak direspon. Respon time rujukan via SISRUTE sangat lama disebabkan tidak adanya dokter yang khusus bertugas mengecek SISRUTE dan panjangnya alur konsultasi penerimaan rujukan. Banyaknya penolakan rujukan via SISRUTE disebakan oleh penuhnya ruangan, tidak tersedianya fasilitas seperti kamar operasi dan persalinan khusus COVID, ventilator mekanik dan alat hemodialisa. Kendala dari kualitas SISRUTE yang tidak menampilkan kapasitas dan fasilitas yang tersedia, aplikasi berbasis web sulit dibuka di handphone, perlunya penambahan beberapa fitur serta belum tersedianya pencarian otomatis menyulitkan dalam melakukan rujukan. Penggunaan SISRUTE dalam kasus COVID ? 19 tidak efektif karena kemungkinan pasien diterima lewat SISRUTE jauh lebih kecil dibandingkan dengan pasien datang sendiri ke UGD, respon time yang lama, banyaknya rujukan yang ditolak dan dikaitkan dengan kapasitas yang tidak mampu menghadapi lonjakan kasus COVID-19.
COVID ? 19 pandemic is a challenge in the capacity of the health system where the existing health system must ensure that COVID ? 19 patients can access health services as well as handle the pandemic in the community. Recommendations issued by WHO in facing health system capacity challenges include increasing the number of referral hospitals and seeking an adequate referral system for spikes in COVID-19 cases. In Indonesia, the government uses the Integrated Referral Information System (SISRUTE) in referring cases of COVID-19, even though in practice still varies in different regions. The use of SISRUTE before COVID-19 was considered not optimal, while during the pandemic very few COVID-19 patients were accepted through SISRUTE. Therefore, this study aims to obtain an overview regarding the effectiveness of using SISRUTE in cases of COVID-19 at Semen Padang Hospital as the first private hospital in Padang City to become a referral hospital for COVID-19 during the period April 2020 to October 2021. This research is a qualitative, data collection process was carried out by secondary data analysis, in-depth interviews with seven informants selected by purposive sampling and document review. From the study it was found that SISRUTE was used by general practitioners in the ER and COVID-19 isolation and there was repeated use of SISRUTE in the same patient due to rejection and referrals that did not respond. The response time for referrals via SISRUTE was very long due to the absence of a doctor who was specifically tasked with checking SISRUTE and the length of the consultation flow for receiving referrals. Many rejections of referrals via SISRUTE are caused by full rooms, unavailability of facilities such as special COVID operating and delivery rooms, mechanical ventilators and hemodialysis equipment. Constraints from the quality of SISRUTE which does not display available capacities and facilities, web-based applications are difficult to open on mobile phones, the need to add several features and the unavailability of automatic search makes it difficult to make referrals. The use of SISRUTE in cases of COVID-19 is not effective because the possibility of patients being accepted via SISRUTE is much smaller than patients coming alone to the ER, the response time is long, the number of referrals rejected and is associated with the capacity to be unable to deal with the surge in COVID-19 cases.
Pratiwi-Tesis-FKM-Full Text-2023.pdf ::