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This thesis discusses the evaluation of clinical pathway implementation, with the aim of knowing the implementation of Clinical Pathway and unit cost analysis of the Sectio Caesarea action at Bhakti Rahayu General Hospital Denpasar. The research design used is the mix method, namely quantitative and qualitative research designs, obtained from patient billing data and in-depth interviews. The study was conducted in April 2019 to July 2020. The results obtained are still variations in some of the services provided so that they get different costs between the total cost of action in accordance with the clinical pathway of Rp 1,920,000, - with the real cost of services provided at IDR 3,319,281, - which means there is still a difference of IDR 1,399,281, -.
This thesis discusses about the evaluation of the suitability of the clinical pathway application of clinical pathway diarrhea in infants, with the aim of obtaining the results of an evaluation of the implementation of Clinical Pathway diarrhea in infants and the calculation of unit cost in cases of diarrhea in infants in Bhakti Rahayu General Hospital Denpasar. The research design used is the mix method, namely quantitative and qualitative research designs. The study was conducted in May 2019 to June 2020. The results obtained are still getting some variations in the services provided to patients so that the total cost of action in accordance with clinical pathway is Rp. 675,281, - with the real cost of services provided at Rp. 1,045,212 , - which means there is still a difference of Rp. 369,931, -.
This thesis discusses the implementation of the clinical pathway for sectio caesarea that has been applied. Hospitals are challenged to improve services with an emphasis on quality control and cost control. The application of clinical pathways is new in the Udayana University Hospital environment. This research uses a qualitative case study. Data were collected by means of in-depth interviews aimed at policy makers and policy implementers using purposive sampling method. The results of the study revealed that the implementation of clinical pathway of caesarean section was not yet fully implemented where there were obstacles which could be seen from the interrelated factors of communication, resources, disposition and bureaucratic structure. This research shows that there is no effective communication between policy makers and policy implementation as well as between policy implementers, there is no socialization and education regarding the implementation of clinical pathways so that there is a lack of staff knowledge about the functions and benefits as well as their duties and authorities in implementing clinical pathways, there is no SOP related to the flow and filling. clinical pathway, and the absence of a case manager who plays an important role in the implementation of clinical pathways. It is recommended to policy makers to carry out socialization and training that is delivered clearly and consistently and delivered to all policy implementers, formulating a strategic plan in appointing case managers who play an important role in the process of implementing clinical pathways. As well as implementing policies, it is hoped that they can increase commitment in implementing better clinical pathways
Penelitian ini bertujuan untuk mengetahui besaran biaya satuan rumah sakit khususnya tindakan sectio caesarea agar pihak manajemen dapat melakukan berbagai upaya efisiensi kedepannya. Penelitian ini menggunakan metode kualitatif yang mengolah data sekunder pasien melalui telaah dokumen dan wawancara mendalam serta menggunakan pendekatan Activity Based Costing. Hasil penelitian menunjukkan bahwa biaya Tindakan sectio caesarea rata-rata sebesar Rp 14.697.705,- dimana biaya satuan untuk tindakan sectio caesarea setiap kelas rawatnya memiliki besaran yang berbeda-beda dan biaya Tindakan tersebut dilakukan sesuai dengan clinical pathway. Terdapat kesenjangan rata-rata sebesar Rp 8.327.328,- jika dibandingkan dengan biaya tindakan berdasarkan layanan aktual yang diberikan kepada pasien. Efisiensi yang dapat dilakukan dalam penelitian ini yaitu mengurangi tingginya variasi obat dan bahan medis habis pakai dengan evaluasi clinical pathway sectio caesarea. Untuk mengurangi besaran biaya dan biaya satuan untuk tindakan sectio caesarea efisiensi yang dapat dilakukan adalah dengan menaikkan jumlah kunjungan pasien ke RS LNG Badak Kota Bontang Kalimantan Timur.
Kata kunci:Biaya Satuan, Efisiensi, Sectio Caesarea
This research aims to quantify the unit cost of a hospital, particularly for cesarean section procedures, enabling management to implement various efficiency strategies. Employing a qualitative methodology, the study analyzes secondary patient data through document review and in-depth interviews, utilizing an Activity Based Costing approach. Findings reveal an average cesarean section cost of Rp 14.697.705,- with varying unit costs across different inpatient class rooms. The procedure aligns with the established clinical pathway. A significant disparity of Rp 8.327.328,- exists when compared to the cost based on actual patient procedures. To enhance efficiency, the study suggests reducing the high variability in drug and medical supply usage by evaluating the cesarean section clinical pathway. Increasing the number of patient visits to RS LNG Badak Kota Bontang, East Kalimantan, is proposed as a strategy to reduce both overall and unit costs for cesarean section procedures.
Diarrhea is a disease that is often found and causes 4% of all deaths in the world. Cases of acute diarrhea in children is a disease that includes high risk, high volume, and high cost. According to 2018 data, there were 938 cases of acute diarrhea and were in first place in the top 10 causes of hospitalization at Bhakti Yudha General Hospital. The implementation of clinical pathways is closely related to efforts to control the quality and cost of affordable and predictable health services. Cost control can be realized if the process of overall health services can be planned and standardized from the start. Clinical pathways if done properly and correctly can reduce the cost of health services, reduce the length of stay, and improve patient clinical outcomes. The existence of a mismatch in the application of clinical pathways can affect the number of billing patients. This study aims to determine the appropriateness of the application of clinical pathways of mild acute diarrhea - moderate inpatient children in Bhakti Yudha General Hospital. The mixed-method research design is quantitative descriptive and qualitative case studies. The results showed that doctor compliance was still lacking in the provision of medical management. There are still discrepancies between clinical pathways and services provided. These discrepancies include variations in drug therapy, supporting examinations, and nursing actions. This variation was made because the patient's condition needed different treatments. The biggest gap in the use of drugs is 145% wherein real billing is greater than the bill according to the clinical pathway due to the use of drugs that are not following the clinical pathway. The number of variants that do not fit the clinical pathway will affect the amount of the hospital bill.
