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Dalam tesis ini akan dihitung rata-rata biaya pelayanan (average cost), nilai karakteristik, nilai kapitasi untuk pembiayaan layanan rawat inap bagi pasien JPK Gakin di rumah sakit pemerintah dan swasta wilayah Jakarta Timur. Studi ini bertujuan untuk mendapatkan informasi tentang besaran biaya kapitasi pelayanan rawat inap di rumah sakit wilayah Jakarta Timur, termasuk menganalisis faktor-faktor yang mempengaruhi biaya kapitasi tersebut. Penelitian deskriptif-analitik dengan menggunakan pendekatan kuantitatif. Data yang digunakan terdiri dari laporan bulanan klaim biaya rawat inap pasien JPK Gakin dari rumah sakit Jakarta Timur. Hasil penelitian menunjukkan bahwa Total biaya untuk pelayanan RITL di rumah sakit wilayah Jakarta Timur diperkirakan sebesar Rp 33,6 milyar dengan nilai kapitasi sebesar Rp 191.063 per orang per tahun atau sebesar Rp 15.922 per orang per bulan. Average claim cost untuk RS Jakarta Timur adalah Rp 3.359.799 dan tingkat utilisasi RITL rata-rata 7. Peneliti menyarankan untuk : (1) memperluas penelitian dan analisis untuk seluruh rumah sakit dan puskesmas yang ada di DKI Jakarta, (2) menggunakan sistem kapitasi dalam mekanisme pembayaran di RS, (3) penerapan DRG guna mendukung penerapan Tarif Paket Pelayanan Essensial, (4) adanya pendataan ulang yang akurat tentang jumlah penduduk miskin DKI yang perlu mendapat kartu gakin, renovasi dan evaluasi sistem/program senantiasa dilakukan agar realisasi program JPK-Gakin semakin optimal dan sesuai tujuan, (5) Diagnosa penyakit dengan pembiayaan terbesar, perlu dilakukan langkah-langkah pengendalian baik oleh RS maupun dinas kesehatan agar beban anggaran dapat dikurangi.
This thesis calculated the average cost of care, characteristic value, the value of capitation for in-patient health services payment of the program of health service assurance for the poor family (HAS-PF) in hospitals government and the private area of East Jakarta. The Study purposed to obtain information about amount of capitation cost of in-patient health service at east Jakarta hospitals, and the analysis of factors that affect the capitation cost. Descriptive-analytic study using quantitative approaches. Data used consisted of monthly reports expense claim of the in-patient of HAS-PF programs at the east Jakarta hospitals. The results showed that the total cost of the in-patient health services at the hospital east Jakarta area is estimated at Rp 33.6 billion with a value of capitation Rp 191.063 per person per year, or Rp 15.922 per person per month. Average claim cost for the Hospital, East Jakarta is Rp 3,359,799, and the utilization rate of in-patient 7. The study suggested to: (1) expand research and analysis for all hospitals and puskesmas in Jakarta, (2) using a capitation system of payment mechanisms in hospitals, (3) application of DRG in order to support the implementation of Essential Service Package Rates (PPE), (4 ) the existence of accurate data about the number of repeated poor DKI people who need to get a gakin card, the renovation and evaluation systems / programs are constantly maintained so that the realization of program-Gakin JPK more optimal and appropriate objectives, (5) Diagnosis of the disease with the largest financing, needs to be done step- control measures by both the hospital and health department so that the budget burden can be reduced.
Dalam era globalisasi tumbuhnya rumah sakit menyebabkan terjadinya kompetisi antar rumah sakit yang makin keras untuk dapat merebut pasar yang semakin terbuka lebar. Hal ini mendorong pihak rumah rumah sakit maupun stakeholder untuk menghitung secara riil berapa biaya pelayanan yang dibutuhkan sehingga dapat menjadi alat dalam pembiayaan pelayanan kesehatan tanpa mengurangi mutu pelayanan yang diberikan, yaitu dengan melakukan analisis perhitungan biaya. Penelitian ini bertujuan untuk mengetahui besaran biaya satuan tindakan appendiktomi akut di kamar operasi rumah sakit X dengan menghitung biaya langsung dan tidak langsung yang terjadi. Penelitian ini merupakan penelitian operational research dan bersifat deskriptif analisis dengan menggunakan data sekunder rumah sakit tahun 2010 di RS X Jakarta. Metode perhitungan biaya menggunakan metode ABC (Activity Based Costing) dan distribusi sederhana. Metode ABC untuk mengalokasikan biaya langsung dengan menghitung biaya dari kegiatan yang terjadi menggunakan cost driver berdasarkan waktu kegiatan. Metode distribusi sederhana untuk mengalokasikan biaya tidak langsung yang secara tidak langsung terlibat dalam pelayanan appendiktomi dengan melakukan pendistribusian biaya dari unit penunjang ke unit produksi (kamar operasi). Biaya satuan aktual appendiktomi sebesar Rp. 5.344.551,48,- dan biaya satuan normatif sebesar Rp. 5.312.912,-. Biaya operasional jasa medis dan paramedis merupakan biaya yang terbesar.
In an era of growing globalization of the hospital which led to competition among hospitals is increasingly more difficult to capture the wide open market. This prompted the hospital as well as the stakeholders to quantify how much the real cost of services is needed, and could be a reference tool in health care financing without reducing the quality of service provided by analyzing the cost calculation. The objective of this study is to determine the amount of unit cost in acute appendectomy surgery at operating room of hospital X by calculating the direct costs and indirect costs. This research type is operational research and descriptive analysis by using secondary data from hospital X Jakarta for the year 2010. Methods of cost calculation are ABC (Activity Based Costing) and simple distribution. ABC method is used for allocating direct costs by calculating the cost of activities that occur using time-based cost driver activity. Simple distribution method is used for allocating indirect costs that are not directly involved in appendectomy service by distribution of unit costs which supports the production unit (operating room). Actual unit cost of appendectomy surgery is Rp. 5.344.551,48, - and normative unit cost is Rp. 5.312.912, -. Operational costs of medical and paramedical consumable materials become the largest consumption.
The results of self-examination on the PDSKJI website were 69% of respondents had psychological problems: 68% anxiety, 67% depression and 77% psychological trauma, and as many as 49% of respondents who experienced depression also had the idea of ending their life. As many as 48% of patients who tested positive for COVID-19 experienced psychological stress when entering isolation rooms. The mental health budget allocation for 2019 is Rp. 44,554,492,000. The ratio of psychiatrists in Indonesia is 1: 278,000, the distribution of psychiatrists is not evenly distributed. There have been several situations where COVID-19 patients have dropped themselves from the treatment floor rooms at several hospitals in Indonesia, which also happened at UI Hospital. The purpose of this study was to obtain dynamic system modeling as an option for the mental health service strategy for COVID-19 at UI Hospital. This research is a qualitative and quantitative research (mix method) non-experimental / observational sequential exploratory design with literature study, document review (30 medical records), observation, in-depth interviews and dynamic systems modeling. The results showed that the five elements of input had an influence on the entire process of mental health services for COVID-19 at RSUI, namely policies (socialization of mental status screening was not comprehensive), human resources (insufficient number and no psychiatric training), infrastructure (room security was not yet according to requirements), logistics (inadequate outpatient medicine supplies) and budget (not specifically included in the budget plan). Dynamic system modeling is used to capture the dynamics of the COVID19 mental health service system at RSUI and simulate developed scenarios for future conditions. From the simulations carried out with Business As Usual conditions, there will be an increase in the number of anxious-depressed patients by 3795 patients in June 2021 if RSUI does not intervene. The Moderate scenario will predict the number of anxious-depressed patients as much as 2875 patients, while with the Optimistic scenario the number of anxious-depression patients is 2300 patients. In each scenario, RSUI management can anticipate this increase
ABSTRAK Nama : Weny Rinawati Program Studi : Kajian Administrasi Rumah Sakit Judul : Analisis biaya perawatan stroke berdasarkan Clinical Pathway di Rumah Sakit Pusat Otak Nasional Jakarta dalam pelayanan pasien Jaminan Kesehatan Nasional Latar belakang. Masalah yang sering dihadapi pada pelayanan pasien Jaminan Kesehatan Nasional adalah kesenjangan biaya perawatan pasien stroke dengan tarif INA-CBGs. Hal ini terkait dengan biaya perawatan dan Clinical Pathway. Tujuan. Mengetahui biaya perawatan pasien stroke di Rumah Sakit Pusat Otak Nasional. Metoda. Penelitian kuantitatif deskriptif mengikutsertakan 277 subjek penyakit stroke yang diperoleh di Rumah Sakit Pusat Otak Nasional Jakarta selama Januari – Juni 2015. Biaya perawatan stroke dihitung berdasarkan biaya satuan (unit cost) dengan menggunakan metode activity based costing dan Clinical Pathway. Hasil. Biaya satuan perawatan stroke iskemik dan stroke hemoragik berdasarkan Clinical Pathway, dengan memperhitungkan biaya investasi dan biaya gaji, tanpa memperhitungkan jasa medis berturut-turut adalah Rp 311,860,860.83 dan Rp 585,083,610.01; dengan memperhitungkan biaya investasi, biaya gaji, dan jasa medis berdasarkan tarif rumah sakit adalah Rp 321,682,940.73 dan Rp598,929,450.01; dengan memperhitungkan biaya investasi, biaya gaji, dan jasa medis berdasarkan tarif IDI adalah Rp 318,360,860.73 dan Rp 594,333,610.01; tanpa memperhitungkan biaya investasi, biaya gaji, dan jasa medis adalah Rp30,361,681.00 dan Rp25,698,199.46; tanpa memperhitungkan biaya investasi dan biaya gaji, tetapi memperhitungkan jasa medis berdasarkan tarif rumah sakit adalah Rp 40,183,761.00 dan Rp 39,544,199.46; tanpa memperhitungkan biaya investasi dan biaya gaji, tetapi memperhitungkan jasa medis berdasarkan IDI adalah Rp 36,861,681.00 dan Rp 34,948,199.46. Simpulan: Dijumpai selisih biaya perawatan berdasarkan biaya satuan dan Clinical Pathway, baik yang memperhitungkan biaya investasi, gaji, dan jasa medis, maupun tanpa memperhitungkan biaya investasi, gaji, dan jasa medis, dengan tarif layanan existing dan tarif INA-CBGs Kata kunci : biaya, Clinical Pathway, INA-CBGs, stroke
ABSTRACT Name : Weny Rinawati Study Program : Hospital Administration Title : Cost of stroke treatment based on Clinical Pathway in National Brain Center Hospital, Jakarta Background. Problem often encountered in patient care National Health Insurance is the gap between the cost of stroke treatment with INA-CBGs tariff. This is related to the cost of treatment and the Clinical Pathway. Aim. Knowing the cost of stroke treatment in the National Brain Center Hospital Jakarta. Methods. Descriptive quantitative study involving 277 subjects stroke obtained at the National Brain Center Hospital Jakarta during January - June 2015. The cost of stroke treatment are calculated based on the unit cost using activity-based costing method and Clinical Pathway. Results. The unit cost of ischemic stroke and hemorrhagic stroke treatment by Clinical Pathway, taking into account investment costs and salary costs, regardless of medical services is IDR 311,860,860.83 and IDR 585,083,610.01; taking into account investment cost, salary cost, and medical services tariff based hospital is IDR 321,682,940.73 and IDR 598,929,450.01; taking into account investment cost, salary cost, and medical services tariff based IDI is IDR 318,360,860.73 and IDR 594,333,610.01; without taking into account investment cost, salary cost, and medical services are IDR 30,361,681.00 and IDR 25,698,199.46; without taking into account the investment cost and salary cost, but taking into account medical services tariff based hospital is IDR 40,183,761.00 and IDR 39,544,199.46; without taking into account the investment cost and salary cost, but taking into account medical services tariff based IDI is IDR 36,861,681.00 and IDR 34,948,199.46. Conclusion. Found difference in the cost of stroke treatment is based on unit cost and Clinical Pathway, both of which take into account the investment, salaries, and medical services cost, and without taking into account investment, salaries, and medical services cost, with existing services and tariff rates INA-CBGs Keywords: Clinical Pathway, cost, INA-CBGs, stroke
Dalam menjawab keluhan perawat mengenai besarnya beban kerja di ruang rawat inap Cattleya B RSU Bhakti Yudha, perlu dilakukan analisis kebutuhan tenaga perawat dengan menggunakan beberapa formula yaitu, Workload Indicator Staff Needs (WISN), formula Gillies, PPNI, dan formula Ilyas. Penelitian dilakukan di ruang rawat inap Cattleya B menggunakan pendekatan kuantitatif dan kualitatif dengan melakukan observasi terhadap aktivitas perawat menurut metode work sampling serta in-depth interview pada 21-30 Mei 2012. Hasil penelitian menyatakan beban kerja perawat pada kategori produktif (80%) dengan hanya 33.98% yang merupakan aktivitas keperawatan langsung dan 47.4% merupakan aktivitas keperawatan tidak langsung. Penggunaan waktu untuk kegiatan pribadi dan non produktif perawatmasih di dalam standar ILO (14.98%) Formula Gillies dan PPNI, dan Ilyas tidak menggambarkan sejumlah kegiatan keperawatan tidak langsung dari perawat seperti administrasi dan pencatatan laporan, yang justru pada saat observasi membutuhkan proporsi yang lebih besar. Sebaliknya metode WISN yang menghasilkan jumlah perawat sebesar 35 orang ditambah dengan 1 kepala ruangan dianggap lebih tepat dan sesuai dengan RS karena menggambarkan beban kerja nyata. Diharapkan pihak manajemen dapat memberikan toleransi seperti pemberian hari kepelatihan bagi perawat, menambah jumlah tenaga baik perawat dan non perawat sesuai kebutuhan untuk meningkatkan mutu pelayanan.
In order to answer the concern of high workload nursing care at Cattleya B Ward of Bhakti Yudha Hospital, there is a need to analyze the requirement of nursing staff with some formulas:Workload Indicator Staff Needs (WISN), Gillies?, PPNI, and Ilyas? Formula. This Research was held in Cattleya B Ward of Bhakti Yudha Hospital on May 21st-30th 2012 using Quantitative and Qualitative approach with an observation to nursing activity based on work sampling method and also in-depth interview with some informants to gain any information for analysis. The result of this research proved that nursing workload is in productive state (80%) with only 33.98% are direct nursing care activities and 47.4% are indirect nursing care activities. The usage of time for individual activity and non-productive activity are still in the ILO Standard (14.98%) Gillies?, PPNI, and Ilyas? Formula did not described some of indirect activity like administration, and making nursing report which in observation need higher proportions than others. In the contrary, WISN, which results 35 nurses as staff with 1 additional nurse as the head of Cattleya B ward, is suitable with hospital because described the real work load in the ward. In the future, hopefully manager can give any tolerance like training day for nurse; add some staff both nursing staff and non-nursing staff as needs for service quality.
Saat era globalisasi ini rumah sakit harus mempersiapkan diri dengan membenahi semua lini. Titik berat pelayanan rumah sakit pada masa lampau adalah pada pelayanan rawat inap. Tetapi saat ini telah tcnjadi perubahan mengenai pclayanan di rumah sakit yaitu Iebih cendemng pada pclayanan rawatjalan. Sehingga fungsi unit rawat jalan merupakan primadona di masa yang akan datang. Karena hal tcrscbut maka pihak manajemen Rumah Sakit Penamina Jaya merasa perlu untuk mengoptimalkannya dengan membuka Unit Poli Sorc.Tingkat pemanfiuxtan poliklinik yang digambarkan dengan banyaknya kunjungan di poliklinik setiap harinya tidak terlalu berubah banyak dan justru ada kecendenmgan kunjungan poliklik sore yang kian menumn. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan utilisasi polikiinik sore Rumah Sakit Penamina Jaya dimana pemanfaatan poliklinik sore yang sam ini masih kurang memcnuhi harapan manajemen Rumah Sakit Pertamina Jaya. Variabcl dari penelitian ini adalah variabel bebas dan variabel terikat. Adapun variabel bebas adalah faktor karakteristik pasien yang meliputi usia, jenis kelamin, pendidikan, penghasilan, pengctahuan dan pekerjaan serta faktor persepsi pasien terhadap mutu layman yaitu faktor SDM, tarifl sarana dan prasarana. Pendekatan yang dipergunakan dalam penelitian ini adalah menggunakan pendekatan kuantitatif dcngan disain cross sccsional dari data primer yang diambil melalui kuisioner dengan membcrikan lembar kuesioner terhadap I02 responden Dari hasil penelitian didapatkan hubungan yang bemmkna dari utilisasi poliklinik sore: faktor usia, penghasilan dan faktor SDM. Adapun faktor yang paling dominan adalah faktor SDM dan usia. Hasil penclitian ini mcnunjukkan bahwa sebagian besar responden mempersepsikan baik pclayanan poliklinik sore. Tetapi hal ini masih belum diikuti dengan pemanfaatan yang optimal terhadap poliklinik sore. Oleh karena itu diharapkan pihak manajemcn Rumah Sakit Pertamina Jaya berusaha unluk lebih mengembangkan poliklinik sore ini dengan pnoaktif mcmberi informasi kepada konsumen tentang keberadaan poliklinik sore tersebut. Dengan memperhatikan hasil penelitian yang memperlihatkan responden terbanyak adalah wanita usia produktif maka di masa mendatang diharapkan dapat dibuka Poliklinik baru yaitu Poliklinik kandungan dan kebidanan, poliklinik anak, scrta poliklinik kulit dan kelamin.
In globalization era, hospital has to be prepared by adjusting all line. In the past, hospital service is emphasizing in inpatient service. However, recently there is alteration toward hospital services, which is likely to outpatient services. Therefore, outpatient unit function is a favorite for fixture period. Because of it, so management of Pertamina Jaya Hospital feels that they need to maximize it by opening Evening Polyclinic Unit. Polyclinic service level described by visitation rate in pclyclinic per day is not change too much and tendency of evening polyclinic visitations trend decreased. This research aim to know factors that related with evening polyclinic utilization of Pertamina Jaya Hospital where recent polyclinic evening benefit still less to fulfill Pertamina Jaya Hospital management expectation. Variable from this research is free variable and bond variable. Free variables are patient characteristic factors that include age, sex, education, earning, knowledge and occupation and patient perception factor toward service quality such as SDM, tariff, medium and infrastructure. Research conducted by quantitative method with cross sectional design from primary data that gathered from questioner by giving questioner sheet to 102 respondents. From research result obtained signiticant relation from evening polyclinic utilization: age factor, eaming and SDM factor. The most dominant factor is SDM and age. This research result shows that most of 'respondents toward evening polyclinic perception are well; however, it still not followed with optimal benefit toward evening polyclinic. Therefore, suggested to Pertamina Jaya Hospital management developing this evening polyclinic proactively to give information for consumer toward evening polyclinic existence. Suggestion submitted in this research considering the most patients are children and productive age women so that management reconsiders opening new polyclinics, which are a polyclinic of paediatrics, polyclinic of obstetric and gynaecology, and polyclinic of dermatology.