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Sterilization and Laundry Installation in Fatmawati General HospitalJakarta has a very important role in controlling and preventing Health care-AssociatedInfections. At present, all work which consists of recording andreporting is done manually by one of the staff and thus creates some problems, asfollows: (1) No recall recording and reporting format, therefore data needed forrecall process is not available on time, and (2) Medical instrument sterilizationactivity recording takes a lot of time, therefore the report cannot be submitted ontime. The research goal is to develop a model of Medical Instrument Recordingand Reporting System, resulting in a prototype which can create medicalinstrument sterilization document properly so that medical instrument sterilestatus can be monitored and create medical instrument sterilization report in shorttime and provide data for recall process. The research phases are system analysis,system design by using System Development Life Cycle, coding and testing. Thedata were collected by using interview, flow observation and document study. Thedevelopment of Medical Instrument Sterilization Recording and Reporting Systemmodel resulting in prototype is able to support problem solving in medicalinstrument recording and reporting, especially regarding recall. The research canbe developed by integrating the system with existing information system inFatmawati General Hospital.Keywords: Recording, Reporting, Sterilization, System.
Tantangan yang dihadapi RSU GMC dalam mengelola biaya pelayanan kesehatan, khususnya pada tindakan operasi pterygium yang memiliki variasi rawat inap dan rawat jalan pada pelayanannya, di tengah sistem pembayaran berbasis INA-CBGs BPJS Kesehatan yang seringkali tidak mencerminkan biaya riil pelayanan. Penelitian ini bertujuan untuk menganalisis biaya satuan dan tingkat pemulihan biaya (Cost Recovery Rate/CRR) pada layanan operasi pterygium di RSU GMC, Pesawaran Lampung tahun 2024. Metode penelitian yang digunakan adalah studi kasus dengan pendekatan kuantitatif melalui analisis biaya menggunakan metode Double Distribution dan Relative Value Unit (RVU), serta pendekatan kualitatif melalui wawancara mendalam dengan informan kunci di rumah sakit. Data yang dikumpulkan meliputi biaya investasi, operasional, dan pemeliharaan untuk seluruh unit terkait selama tahun 2024, baik biaya langsung maupun tidak langsung. Hasil penelitian menunjukkan bahwa total biaya yang dikeluarkan RSU GMC untuk seluruh pelayanan rumah sakit pada tahun 2024 mencapai Rp18,4 miliar, dengan proporsi terbesar dialokasikan untuk biaya operasional (74%), diikuti investasi (25%) dan pemeliharaan (1%). Biaya satuan tindakan operasi pterygium rawat inap bervariasi menurut kelas, mulai dari Rp8.393.130 (VVIP) hingga Rp5.758.508 (kelas 3), sedangkan estimasi jika dilakukan rawat jalan sebesar Rp3.222.238 untuk metode konjungtival graft dan Rp2.680.442 untuk metode bare sclera. Terdapat selisih negatif yang signifikan antara unit cost aktual dan tarif INA CBGs, dengan tingkat pemulihan biaya (CRR) pada rawat inap hanya 80-87% dan rawat jalan 49-58%. Rekomendasi penelitian yaitu evaluasi ulang terhadap perjanjian KSO alat operasi, pengkajian ulang jasa medis, serta optimalisasi utilitas SDM dan ruang operasi. Kesimpulan dari penelitian ini adalah bahwa tarif INA CBGs belum mampu menutupi biaya riil pelayanan operasi pterygium di RSU GMC, baik pada layanan rawat inap maupun rawat jalan, sehingga diperlukan evaluasi biaya rumah sakit dan efisiensi internal agar keberlanjutan dan mutu pelayanan tetap terjaga.
The main challenge faced by RSU GMC in managing healthcare service costs is related to providing pterygium surgery, which includes both inpatient and outpatient care, within the limitations of the INA-CBGs payment system under BPJS Kesehatan that often does not reflect the actual service costs. This study aims to analyze the unit cost and cost recovery rate (CRR) of pterygium surgery services at RSU Gladish Medical Center (GMC) Pesawaran, Lampung, in 2024. The research applies a case study method with a quantitative approach using cost analysis based on the Double Distribution and Relative Value Unit (RVU) methods, supported by a qualitative approach through in-depth interviews with key hospital informants. The data collected include investment, operational, and maintenance costs for all related units in 2024, covering both direct and indirect costs. The results show that the total hospital expenditure in 2024 reached IDR 18.4 billion, with the majority allocated to operational costs (74%), followed by investment (25%) and maintenance (1%). The unit cost of inpatient pterygium surgery varied by class, from IDR 8,393,130 for VVIP to IDR 5,758,508 for Class 3. For outpatient procedures, the estimated cost was IDR 3,222,238 for the conjunctival graft method and IDR 2,680,442 for the bare sclera method. There is a significant negative gap between the actual unit cost and the INA-CBGs tariff. The CRR for inpatient care ranges from 80% to 87%, while for outpatient care it is lower, between 49% and 58%. Based on these findings, it is recommended that the hospital conduct a comprehensive review of the surgical equipment partnership agreement, reassess medical service fees, and optimize the use of human resources and operating room capacity. This study concludes that the INA-CBGs tariff does not sufficiently cover the actual costs of pterygium surgery at RSU GMC, for both inpatient and outpatient services. Therefore, regular cost evaluation and internal efficiency improvements are crucial to maintain the sustainability and quality of healthcare services.