Abstrak: Waktu tunggu proses pelaksanaan CT Scan kepala pasien stroke iskemik di Intalasi Gawat Darurat RSUP Dr. Moh Hoesin belum standar. Tujuan penelitian adalah menerapkan manajemen lean terhadap proses pelaksanaan CT Scan kepala pasien stroke iskemik di IGD. Penelitian ini menggunakan metode operational research. Hasil penelitian didapatkan lead time Current Visual Stream Map (VSM) adalah 175,41 menit. Pada Simulated VSM didapatkan penurunan lead time yang signifikan menjadi 30,09 menit, peningkatan persentase Value Added Activities dan penurunan Non Value Added activites. Disimpulkan bahwa penerapan manajemen lean telah berhasil memperbaiki waktu tunggu proses pelaksanaan CT Scan kepala pasien stroke iskemik di IGD. Kata kunci: lean, value added, non value added but neccessary, non value added, current, lead time value streaming map, simulated value streaming map The waiting time of head CT Scan prosess of ischemic stroke patient in Emergency Departement of Mohammad Hoesin Hospital Palembang has not been standard yet. The objectives was to apply lean management in this process by operational research. We found that lead time of Current Visual Stream Map is 175,41 minutes and in Simulated VSM, there were a significant decrease of lead time to 30,09 minutes, increase of Value added Activites percentage and decrease of Non Value Added Activites. Lean management has been successfully improved the waiting time of head CT Scan proses of ischemic stroke patient in ED. Key word: lean, value added, non value added but neccessary, non value added, current, lead time value streaming map, simulated value streaming map

Abstrak: Jaminan Kesehatan Nasional (JKN) yang diselenggarakan oleh Badan JaminanSosial (BPJS) Kesehatan telah mulai dilaksanakan dari 1 Program AsuransiKesehatan di Indonesia Januari 2014. Pelaksanaan program asuransi nasionalmenemukan risiko. Risiko kejadian fraud (kecurangan) di Indonesia sangat tinggitetapi masih sulit untuk mengidentifikasi risiko kejadian fraud. Hal tersebutdidukung oleh kurangnya kesadaran semua pihak baik dari pasien, provider danperusahaan asuransi walaupun tindakan tersebut sangat terasa adanya. Penipuankesehatan merupakan ancaman serius bagi seluruh dunia, yang menyebabkanpenyalahgunaan keuangan sumber daya yang langka dan dampak negatif padaakses kesehatan, infrastruktur, dan determinan sosial kesehatan. Penipuankesehatan dikaitkan dengan meningkatnya biaya kesehatan yang terjadi diAmerika Serikat. Penelitian ini untuk menganalisis tentang pengaruh dimensifraud triangle dalam kebijakan pencegahan fraud terhadap program JaminanKesehatan Nasional yang merupakan alasan untuk penipuankesehatan.Penelitianini menggunakan pendekatan kualitatif. Tehnik pengumpulan data berupapedoman wawancara, alat perekam, arsip tertulis dan dokumen. Hasil penelitianmendapatkan analisis tekanan, kesempatan, dan rasionalisasi terhadap risikokejadian fraud dan menyajikan contoh bagaimana kebijakan telah berdampak diRSUP Nasional DR Cipto Mangunkusumo. Tesis ini kemudian akan memberikansaran tentang bagaimana mencegah penipuan kesehatan masa depan untukmengurangi pengeluaran kesehatan dan penggunaan sumber daya untukkepentingan RSUP Nasional DR Cipto Mangunkusumo.
Kata kunci : kecurangan, segitiga kecurangan, kebijakan pencegahan fraud,jaminan kesehatan nasional

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The National Health Insurance (JKN) held by the Social Security Agency (BPJS)Health has started to be implemented from 1 Indonesia's Health InsuranceProgram in January 2014. The implementation of a national insurance programfound the risk. The risk of occurrence of fraud (fraud) in Indonesia is very highbut it is still difficult to identify fraud risk events. This is supported by the lack ofawareness of all parties, both from patients, providers and insurance companiesalthough such actions are felt presence. Health fraud is a serious threat to theentire world, which led to financial abuse of scarce resources and the negativeimpact on access to health care, infrastructure, and social determinants of health.Health fraud associated with increased health care costs in the United States. Thisstudy was to analyze the influence of the dimensions of the fraud triangle in fraudprevention policies towards the National Health Insurance program which is thereason for health fraud. This study used a qualitative approach. Data collectiontechniques such as interview guides, recorders, written records and documents.The results of a study reported stress analysis, opportunity, and rationalization ofthe risk of fraud incident and presents examples of how policy has an impact onthe National Hospital Dr. Cipto Mangunkusumo. This thesis will then provideadvice on how to prevent future fraudulent health to reduce health spending anduse of resources for the benefit of the National Hospital Dr. CiptoMangunkusumo.
Keywords : Fraud, fraud triangle, fraud prevention policies, national healthinsurance

Abstrak: PENELITIAN INI BERTUJUAN UNTUK MEGEVALUASI PENULISAN ASESMEN DAN REASESMEN PADAHARI LIBUR OLEH DOKTER PENANGGUNG JAWAB PASIEN (DPJP) DAN HUBUNGANNYA DENGAN KONTINUTAS PELAYANAN MENGGUNAKAN CLINICAL PATHWAY DENGAN RENCANA HARI RAWAT ≤5 HARI. DESIGN YANG DIGUNAKAN ADALAH CROSSSECTIONAL DENGAN PENDEKATAN KUANTITATIF.DATA DIKUMPULKAN MELALUI TELAAH DATA SEKUNDER REKAM MEDIS 368 PASIEN SECARA REALTIME DENGAN KERANGKA WAKTU SESUAI DENGAN KETENTUAN PENGISIAN ASESMEN YAITU 1 X 24 JAM SETELAH PASIEN MASUK RAWAT INAP DAN SETIAP HARI UNTUK PENGISIAN REASESMEN. 31,7% ASESMEN DAN 13,5 % ASESMEN DAN REASESMEN DITULIS OLEH DOKTER PENANGGUNG JAWAB PASIEN (DPJP) PADA HARI LIBUR. TIDAK DITEMUKAN ADANYA HUBUNGAN ANTARA PENULISAN ASESMEN/REASESMEN DENGAN PEMERIKSAAN LABORATORIUM, RADIOLOGI DAN PEMBERIAN TERAPI OBAT. PENULISAN ASESMEN/REASESMEN SECARA SIGNIFIKAN BERHUBUNGAN DENGAN LAMA HARI RAWAT PASIEN, P VALUE = 0,049. KATA KUNCI : ASESMEN, KONTINUITAS, CLINICAL PATHWAY THIS RESEARCH AIM TO EVALUATE THE IMPLEMENTATION OF ASSESSMENT AND REASSESSMENT WRITTEN BY PRIMARY RESPONSIBLE PHISYCIAN AT DAYS OFF INCLUDING WEEKEND AND THEIR ASSOCIATION TO CONTINUITY OF CARE USING CLINICAL PATHWAYS WITH ≤ 5 DAYS LENGTH OF STAY. CROSSECTIONAL STUDY WITH KUANTITATIVE APPROACHES WAS USED TO 368 MEDICAL RECORD. 31,7% ASSESSMENT COUNTED AS WRITTEN BY THE PRIMARY RESPONSIBLE PHISYCIAN DUE TO THE TIME FRAME, 1 X 24 HOURS IN PATIENT ADMITTED ON DAYS OFF AND ONLY 13,5% REASSESSMENT WRITTEN AT DAYS OFF INCLUDING WEEKEND. ASSESSMENT/REASSESSMENT IS NOT A SIGNIFICANT FACTORS ASSOCIATED TO THE CONTINITY OF CARE MEASURED BY NUMBERS OF APPROPRIATE DIAGNOSTIC WORK UP (RADIODIAGNOSTIC AND LABORATORY TEST), AND THERAPY BY CLINICAL PATHWAYS. ASSESSMENT/REASSESSMENT ON DAYS OFF WAS SIGNIFICANTLY ASSOCIATED WITH IN PATIENT LENGTH OF STAY, P VALUE = 0, 049. KEYWORD : ASSESSMENT, CONTINUITY OF CARE, CLINICAL PATHWAY

Abstrak:

Penelitian ini bertujuan untuk menilai besarnya biaya akibat stroke pada penderita stroke yang mengalami kejadian stroke pertama kalinya pada periode 1 Januari – 31 Maret 2011 di Rumah Sakit Umum Pusat Fatmawati Jakarta. Penelitian ini merupakan penelitian dengan desain studi cost of illness crosssectional retrospektif, menggunakan pendekatan insiden kasus dan metode estimasi biaya dengan pendekatan ”bottom up”. Sampel populasi penderita stroke diambil berdasarkan purposive sampling sebanyak 100 responden. Untuk melihat faktor-faktor yang mempengaruhi biaya stroke digunakan uji Kai Kuadrat dan untuk melihat derajat hubungan menggunakan Odds Rasio dengan CI 95%. Berdasarkan hasil penelitian ditemukan bahwa estimasi rata-rata biaya akibat stroke per pasien pada tahun pertama adalah Rp18.872.561, dari total biaya ini rata-rata besar biaya langsung adalah Rp. 15.110.241 dan rata-rata biaya tidak langsung adalah Rp 3.762.360. Faktor-faktor yang mempengaruhi biaya akibat stroke antara lain Lama Hari Rawat, Status Neurologis saat masuk pertama kali ke rumah sakit, kondisi pasien saat keluar RS serta perbedaan kelas perawatan, tingkat pendidikan, status pekerjaan, tingkat pendapatan serta mekanisme pembayar. Hasil penelitian ini menyarankan kepada Kementerian Kesehatan dan Rumah Sakit untuk menata ulang perhitungan tarif dari semua penjamin baik Askes, Jamkesda, Jamkesmas dan TM DKI supaya banyak provider yang mau ikut serta dalam mekanisme pembiayaan ini. Kata kunci : Stroke, biaya, RSUP Fatmawati.

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 This study aimed to estimate the cost of stroke among stroke patients who experienced the first stroke acute  in the period of 1 January to 31 March 2011 at the Fatmawati Public Hospital Jakarta. This research is design by cost of illness study of cross-sectional retrospective, using incident cases and the approach to cost estimation methods with a "bottom up". Sample population of stroke patients will be taken based on purposive sampling as much as 100 respondents. Factors that influence the cost of stroke in tests using the Kai Squares test and to see the degree of relationship using the Odds Ratio with 95% CI. The results showed that the estimated average cost per patient of a stroke in the first year is Rp18.872.561, the average of direct cost is Rp. 15.110.241 of total cost and the average of indirect cost is Rp 3.762.360. Factors that affect the cost of a stroke include the Length Of Stay (LOS), Neurological status at first time admission to the hospital, condition when patient’s discharge and treatment of class differences. In the present study also found that the cost of a stroke is indirectly affected by education level, employment status, income and method payment. These results suggest to the Ministry of Health and Hospitals to conduct the rate calculation of all method payment so many providers are willing to participate in this financing mechanism. Key words: Stroke, cost, Fatmawati Public Hospital Jakarta.

Abstrak: Dalam pengelolaan berkas klaim BPJS Kesehatan di RSUD kabupaten Bulungan, ditemukan beberapa kesalahan yang dapat menyebabkan penundaan pembayaran. Penelitian ini bertujuan untuk mengetahui bagaimana proses administrasi klaim pada pasien rawat inap dilaksanakan dan apa faktor hambatan manajerial yang dapat menyebabkan permasalahan dan penundaan pembayaran di RSUD kabupaten Bulungan. Studi kasus ini menggunakan pendekatan kualitatif. Berkas klaim rawat inap BPJS Kesehatan pada periode tersebut dianalisis untuk mengetahui adanya ketidak sesuaian. Ini termasuk faktor dalam proses selama pengisian resume medis, mengumpulkan berkas penunjang klaim, pengkodingan diagnosa dan tindakan medis, dan pengentrian data/grouping INA-CBGs. Hasil penelitian menunjukkan bahwa beberapa berkas klaim masih belum tepat dikelola sesuai dengan kelengkapan administrasi klaim BPJS Kesehatan, berdasarkan pengisian resume medis hingga pengentrian data/grouping INA-CBGs. Permasalahan yang ditemukan disebabkan oleh berbagai faktor: jumlah dan kompetensi sumber daya manusia (man), terbatasnya kemampuan finansial (money), kebijakan manajemen (method), fasilitas yang terbatas untuk mendukung berkas dan proses elektronik (material), serta keterbatasan sumber daya (machine). RSUD kabupaten Bulungan diharapkan melakukan pemantauan berkala dan evaluasi terhadap proses administrasi klaim rawat inap BPJS Kesehatan dan meningkatkan proses manajemen klaimnya
Kata kunci: kesesuaian dan ketidak sesuaian, berkas klaim, rawat inap, BPJS Kesehatan

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In managing claim documents for the BPJS Kesehatan in Bulungan District hospital, there are some errors have been found that may lead to delays in payment. This study aims to determine how claim administration process among inpatients is implemented and what are managerial bottleneck factors that may cause problem and delay in paymentt in Bulungan district hospital. This case study was using qualitative approach. The inpatient claim documents of BPJS Kesehatan on that period was analyzed to learn any discrepancies. This included factors in the process during medical resume filling, collecting the supporting claim documents, diagnose and procedures coding, and data entry/INA-CBGs grouping. The study revealed that some claim documents were still not appropriately administered in accordance with BPJS Kesehatan claim equired procedures, based on medical resume filling to the data entry/INA-CBGs grouping. Problems were found caused by various factors: number and competence of human resources (man), financial constrained (money), the management policies (method), limited facilities to support e-file and e-process (material), as well as limited resources (machine). Bulungan District Hospital is expected to have a regular monitoring and evaluation for the inpatient claim administration process of BPJS Kesehatan and improve its claim management process
Keywords: conformity and discrepancies, claim documents, inpatient, BPJS Kesehatan

Abstrak:

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Abstrak: Student Centered E-Learning (SCeLE) merupakan media pembelajaran online yang mulai digunakan pada tahun 2008. Penggunaan SCeLE pada Rumpun Sosial dan Humaniora paling rendah dibandingkan dengan Rumpun Sains dan Teknologi serta Rumpun Ilmu Kesehatan di Universitas Indonesia. Penelitian ini bertujuan untuk mengetahui faktor penerimaan teknologi yang memengaruhi tingkat kepuasan mahasiswa sosial humaniora dalam menggunakan SCeLE. Penelitian ini menggunakan penggabungan antara teori information success model DeLone & McLean dan Technology Acceptance Model (TAM) dengan analisis menggunakan SEM-PLS. Hasil penelitian dari 9 hipotesis terdapat 7 hipotesis diterima dan 2 hipotesis yang ditolak. Hipotesis yang ditolak yaitu service quality berpengaruh terhadap perceived usefulness, dan system quality berpengaruh terhadap perceived usefulness. Hipotesis yang diterima adalah Service quality berpengaruh terhadap perceived ease of us, Information quality berpengaruh terhadap perceived ease of use, Information quality berpengaruh terhadap perceived usefulness, System quality berpengaruh terhadap perceived ease of use, perceived ease of use berpengaruh terhadap behavioural intention, perceived usefulness berpengaruh terhadap behavioural intention, behavioural intention berpengaruh terhadap user satisfaction.
Kata Kunci : SCeLE, SEM-PLS, Universitas Indonesia, information success model, dan Technology Acceptance Model (TAM)

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Student Centered E-Learning (SCeLE) is an online learning media that was used in 2008. The use of SCeLE in the Social and Humanities Cluster was the lowest compared to the Science and Technology Cluster and the Health Sciences Cluster at the University of Indonesia. This study aims to determine the technology acceptance factors that affect the level of satisfaction of social humanities students in using SCeLE.This study uses a merger between DeLone & McLean's information success model and Technology Acceptance Model (TAM) with analysis using SEM-PLS. The results of the study of 9 hypotheses there are 7 hypotheses accepted and 2 hypotheses rejected. The rejected hypothesis is that service quality has an effect on perceived usefulness, and system quality has an effect on perceived usefulness. The most accepted hypothesis is Service quality affect the perceived ease of us, Information quality affect the perceived ease of use, Information quality affect the perceived usefulness, System quality affect the perceived ease of use, perceived ease of use influence on behavioral intention, perceived usefulness influential to behavioral intention, behavioral intention effect on user satisfaction.
Keywords : SCeLE, SEM-PLS, University of Indonesia, information success model, dan Technology Acceptance Model (TAM)