Ditemukan 36822 dokumen yang sesuai dengan query :: Simpan CSV
Stroke is the leading cause of death and illness in Indonesia, according to Riskesdas data the prevalence continues to increase by 10.9 per mile in 2018. Non-hemorrhagic strokes are the most frequent inpatients cases at dr.Chasbullah Abdulmadjid Hospital. The hospital has made the clinical pathway, but no updates have been made after more than 3 years. This study aims to get an overview of the inputs, processes, outputs, and outcomes and challenges faced when implementing clinical pathways. This is retrospective research, uses quantitative and qualitative approaches in a system evaluation framework. The results showed that the input variables in terms of HR, funds, policies, infrastructure, drugs and medical equipment are available and ready to apply CP, the challenge is lies in the team coordination. Process variables are already running with challenges in team identification, team leader election and the CP socialization still not optimal. Output variables obtained an average LHR in accordance with CP, variants were obtained on the visit, supporting examinations, nursing services, drug consultations and medical devices. The outcome variable, there is a price difference between real and appropriate CP of Rp. 224,103 (5%), Positive difference in physiotherapy services Rp. 178,470 (143%), Visite Rp. 88,215 (26%), Nutrition Rp. 78,014 (18%), Accommodation Rp. 53,625 (10%), nursing services Rp. 45,805 (7%) and Consultation Rp. 6,750 (6%). A negative difference occurs in the drug service Rp. 123,911 (25%), Laboratory Rp. 92,465 (21%), Radiology Rp. 8,238 (1%) and Medical Devices Rp. 2,162 (1%).
Background : Osteoarthritis (OA) is the most common disease of joint disorders found in adults in the world, according to WHO in its report entitled The Burden of Musculoskeletal Conditions at The Start of the New Millennium, writing that osteoarthritis is one of the main causes of morbidity. in the world and has a major impact on the burden of health costs. Goal :Analyze factors related to cost variation Total action knee arthroplasty at dr. Chasbullah Abdulmadjid (RSCAM) Bekasi City Methode : The approach used in this research is quantitative and the ANOVA test is carried out on the influence between the independent variable and the dependent variable. The samples used were 29 patients who were taken according to the inclusion criteria which included age, gender, LOS, room class, severity level and treatment costs consisting of accommodation, doctor visits, consultations, medical support, medical procedures, drugs and medical equipment. Result : The frequency distribution of respondents based on age is 11 people (37.9%), old age 15 people (51.9%) and elderly people are 3 people (10.3%), with the majority of respondents being 24 women (82.8%). The highest number of treatment classes is in class 3 as many as 16 people (55.2%) and the highest severity level is severity level I as many as 16 people (55.2%), where the highest LOS during treatment is 5-10 days as many as 25 people (66.2%). The average total cost for accommodation is Rp.1,937.29.37, for doctor visits Rp.9,848.04, consultation Rp.5.8442.31, medical support Rp.118,834.96, medical treatment Rp. 508.153.50, medicine Rp. 36,554.39 and the average cost of medical equipment services is Rp. 650.165.39. In the ANOVA test results, age and length of stay have a significant relationship with treatment costs with a P value of 0.033 for age and a P value of 0.000 for LOS
The results showed that there was a significant relationship between triage assessment, emergency diagnosis, emergency intervention, investigations, doctor's consultation and doctor's disposition to the prolonged of EDLOS. The most influential factors are the triage tag factor, emergency intervention, type of diagnostic testing, type of doctor's consultation, and disposition. Other research is needed related to input and output factors to provide complete information on the causes of the prolongation of EDLOS in addition to the throughput factors in the ED. It is recommended to make a policy for physician compliance with clinical pathway, increasing the competency of emergency staff and evaluating EDLOS targets in the emergency room at RSUD dr Chasbullah Abdulmadjid Bekasi City.
Desentralisasi pelayanan kesehatan mendorong terjadinya perubahan System kelembagaan Rumah Sakit di suatu daerah. Adanya UU RI No.1 tahun 2004 tentang Perbendaharaan Negara akan member peluang bagi Pembahan Rumah Sakit pemerintah yang sebelumnya swadana menjadi Badan Layanan Umum. Badan Layanan umum melupakan suatu badan kuasi pemerintah yang tidak bertujuan mencari Iaba, meningkatkan kualitas pelayanan public dan memberikan Fleksibilitas manajemen rumah sakit. Pembahan system kelembagaan Rumah sakit memerlukan standadsasi dalam pengelolaan keuangan Sampai saat ini biaya pelayanan kesehatan bervariasi yang disebabkan oleh tidak adanya harga standar yang berdasarkan Unit Cost dari pelayanan tersebut. Hingga Diperlukan suatu perhitungan unit Cost menurut Diagnostic Related Groups yang tersusun dalam Clinical Pathway. Clinical Pathway merupakan suatu alat yang mampu untuk rneuinglcatkan mutu dan pengendalian biaya lcarena dapat menghindari tindakan yang tidak perlu dari suatu pelayanan di Rumah Sakit. Penelitian ini bertujuan untuk mengetahui Cost Of treatment Tonsilelctomi berdasarkan penyusunan Clinical Palhway di Rumah Sakit Umum Daerah Kota Bekasi tahun 2006. Tonsilektomi merupakan salah Satu tindakan pembedahan yang tertua, yang berupa tindakan pengangkatan jaringan tonsil palatine dari fossa tonsilaris_ Di inggris tahun 1987 - 1993 telah dilalcukan 70000 - 90000 tindakan tonsilelctomi dan adenodelctomi per tahun. Sedang dari catatan medis Rumah Salcit Umum Pusat Dipilihnya Tonsilektomi dalam penelitian ini dikarenakan Salah satu tindakan Pembedahan terbanyak di Rumah Sakit dan tidak membutuhkan pemanfaatan sumber daya yang bervariasi dan adanya penelitian yang menggambarkan biaya Bahan habis Pakai lebih diatas tarif yang ditentukan. Penelitian ini menggunakan metode studi kasus dengan rancangan penelitian survey kuantiuitifi Pelaksanaan penelitian ini dimulai pada bulan Maret 2007 sarnpai April 2007 dengan mempergunal-can data sekunder dari Rekam Medis pasien rawat inap dengan tindakan Tonsilektorni tahun 2006 dan data primer yang berasal dari Wawancara. Perhitungan biaya Unit Cost dihitung dengan metode Activity based Costing ( ABC ). Analisa data dilakukan secara uuivariat untuk melihat distribusi B-ekuensi dan proporsi masing - masing variable. Berdasarkan penelitian, pengelompokan menurut AR - DRG tidal: dapat diterapkan. Menurut pengelompolcan yang dilakukan di RSUD Kota Bekasi dihasilkan : Tonsilektomi murni, Tonsilektomi dengan penyakit penyerta, Tonsilelctomi dengan penyakit penyulit, Adenotonsilektomi rnurni dan Adenotonsilektomi dengan penyakit penyerta. Sedangkan penyusunan Episode Clinical Pathway didapatkan 6 tahapan yaitu Tahap pendaiizaran, Penegakkan diagnose, Pra Terapi, Terapi, Follow up dan Pulang. Hasil perhitungan Cost of Treatment Tonsilektomi di RSUD Kota Bekasi Tahun 2006 : ( 1 ). Tonsileldomi tanpa adenoidektami dengan penyakit penyulit 1 1.Kelas Perawatan Bougenvile VIP : Rp 760.582, 2.Bougenvile Utama : Rp 763.996,97, 3. WKI :Rp 577.2l0,14, 4. WKII : Rp 566.799,72, 5.WK HI I R.p s6o_o4o,'/2, 6. Mawar ; Rp 481.47102 dengan Lama hari mwar 2 hari. ( 2 ).Tonsilek1omi tanpa adenoidektomi dengan penyakit penyerta, Berdasarkan penyakit penyerta : 2.1 Anemia dan Observasi Febris ; 1. Kelas Perawatan Bougenvile VIP 1 Rp 2.096.988,08, 2.Bougcnvile Utama : Rp 2.l08.596,32, 3. WK I 2 Rp l.465.688,99, 4.WK [I I Rp l.463.302,56, 5. WK III 2 Rp 1.4-40.320,78, 6.Mawar : Rp l.164.5l8,35, 2.2 PKIB : 1. Kelas Perawatan Bougenvile VIP : Rp 762.384.46, 2. Bougenvile Utama : Rp 765.798,65, 3. WK I : Rp 553.821,90, 4, WK II : Rp 57O.16l,48, S. WK III : Rp 563.402, 6. Mawar : Rp 483.344,56, 2.3 Bronchopneumonia : 1. Kelas Perawatan Bougenvile VIP 1 Rp 767.828,46, 2 Bougenvile Utama : Rp 771.242,82, 3 WK I : Rp S59.266,07, 4. WK II: Rp 575.605,65, 5. WK III: Rp 568.846,31, 6. Mawar: Rp 488,768.71 2.4, Hipertensi siruasional ; 1. Kelas Perawatan Bougenvile VIP : Rp 765_564,12, 2. Bougenvile Un-una ; Rp 76s.97s,31, 3. WK 1 1 np 593_417,3, 4- WI( ll 1 Rp 6o9_756,ss, 5. WK III : Rp 602.997, 6. Mawar : Rp 524.433,94 (3) Tonsilekromi tanpa adenoidektomi mumi : 1.Ke1as Perawatan Bougenvile VIP : Rp 748.014, 08, 2. Bougenvile Utama : Rp 751.428,2, 3. WK I: Rp 564_641,43, 4. WK II: Rp 554.231, 5. WK IH: Rp 529.924,89, 6. Mawar : Rp 468.908,31 Median Lama hari rawat 2 hari. (4). Tonsilektomi dengan Adenodelctomi dengan penyakit penyerta : 1. Kelas Perawatan Bougenvile VIP : Rp 775,243,691 2. Bougenvile Utama : Rp 778.657,88, 3.WK I : Rp 59l.87l,05, 4. WK II : Rp 58l.460,63, 5. WK 111 : Rp 574_701,28, 6 Mawar : Rp 496.137,93Median Lama hari rawat 2 hart( 5 ) Torzsileldomi dengan Adenodektomi murni : l. Kelas Perawatan Bougenvile VIP : Rp 771.901,31, 2. Bougenvile Utama 2 Rp 775.315,50, 3. WK I 1 Rp 588,528,67, 4. WK II 1 Rp 578.l18,25, 5. WK III :Rp 571,358,90, 6. Mawar : Rp 492,795,S5. Median Lama hari rawat 2 hari. Berdasarkan hasil diatas maka diperlukan perhitungan biaya rawat inap berdasarkan penyusunan Clinical Pathway sebagai dasar penentuan tarif rumah sakit.
Decentralize in health treatment lead to some changes in Hospital institution within a certain region. Based on UU RI No. 1 year 2004 in relation of State Treasury will give opportunity to State Hospitals to change which was in self funding form to become Public Health Service. Public Health Service is a non- profit Government institution, improving public service quality and giving flexibility to Hospital management. There should be a standardization in every changes of Hospital Institution, especially in finance Sevior. Up to these days, health service fee are varies which is caused by no standardization which based on Unit Cost from its services. Therefore, Unit Cost calculation are needed according to Diagnostic Related Groups which are compiled in Clinical Pathway. Clinical Pathway is an instrument that will help to increase quality and cost control, as it can avoid tiom unnecessary actions of Hospital services. The aim of this research is to lind out Cost of treatment Tonsillectomy based on compiling Clinical Pathway in Bekasi City General Hospital in the year 2006. Tonsillectomy is one of the oldest surgery, which is a surgery of removing tonsil palatine tissue from Fossa tonsillitis. In England, within the year of 1987~ 1993 there had been 70000-90000 Tonsillectomy and Adenodektorny per year. Meanwhile, fiom the medical notes of RSUP Dr Sarjito, tonsillectomy are more then half of surgery actions in THT section. This research will use case study method with quantitative survey methodology. The implementation of this research started in March 2007 to April 2007, and using secondary data recorded hospitalized Patient with Tonsillectomy surgery action in the year 2006 and also using primary data which was based on direct interviews. Unit cost are calculated using Activity Based Costing (ABC) method. Data analysis is implemented as univariatly to see frequency distribution and proportion on each variable. Based on research grouping according AR-DRG can not be implemented. Based on grouping that had been implemented at Bekasi City General Hospital are as followed: Pure Tonsillectomy, Tonsillectomy with following disease, Tonsillectomy with complication disease, Pure Adeno Tonsillectomy and Adeno Tonsillectomy with following disease. In the meantime, compiling of Clinical Pathway episode is obtaining 6 steps which are: registration , established diagnose, pre-therapy, therapy, follow up then Horne. Final Clinical Pathway is needed to get clinical pathway concept as a tool to increase quality and cost control. The result cost of treatment tonsillectomy at Bekasi City General hospital in 2006 ( 1 ). Tonsillectomy with complication disease 1 1. Bougenvile VIP : Rp 760.582, 2.Bougenvile Utama : Rp 763.996,97, 3. WK I : Rp 577.2l0,l4, 4. WK II: Rp s66.799,72, 5_wK In ; Rp 560.040,72, 6. Mawar ; Rp 481.47102 with time length of stay 2 days. ( 2 ). T onsilectongr with following disease, Based on following disease : 2.1 Anenuh dan Observasi Fabris ; I. Bougenvile VIP : Rp 2.096.988,08, 2.Bougenvile Utama : Rp 2. 108.596,32, 3. WK I : Rp l_465.688,99, 4.WK II 1 Rp 1.463.3o2,s6, 5. WK III . Rp 1.440.320,78, 6.Mawar 1 Rp 1-164.51s,35, 2.2 PKYB : 1. Bougenvile VIP : Rp 762.384.46, 2. Bougenvile Utama 2 Rp '765.798,65, 3. WK I 2 Rp 553.82l,90, 4. WK 1] : Rp 570.161,48, 5. WK III : Rp 563.402, 6. Mawar : Rp 483.344,56, 2.3 Bronchopneumonia: 1. Bougenvile VIP : Rp 767.828,46, 2 Bougenvile Utama : Rp 77l.242,82, 3 WK I : Kp 559.266,07, 4. WK II: Rp 575.605,65, 5. WK III: Rp 568.846,3l, 6. Mawar: Kp 488.768.73, 2.4, Hiperteusi simasional ; 1. Bougenvile VIP : Rp 765.564,l2, 2. Bougenvile Utama 1 Rp 768.978,31, 3. WK I : Rp 593.417,3, 4. WK Il : Rp 609.756,88, 5. WK III : Rp 602.997, 6. Mawar 1 Rp 524.433,94 (3) Pure f0l|Si??L?f0I|Q?Z l. Bougenvile VIP : Rp 748.014, 08, 2. Bougenvile Utama ; Rp 751.42s,2, 3. WK 1; Rp 564.641,43, 4. WK II: Rp 554.231, 5. WK 111: Rp 529.924,89, 6. Mawar 1 Rp 468.908,3l with time length of stay 2 days. ( 4 ). Adenotonsilectongmy with following disease: l. Bougenvile VIP :Rp 775_243,69S, 2. Bougenvile Utama 1 Rp 778.657,88, 3.WK I 1 Rp 591.871,05, 4. WK II 1 Rp 58] .460,63, 5. WK HI 1 Rp 5?74.7Ol,28, 6 Mawar : Rp 496.l37,93 with time length of stay 2 days( 5 ) Pure Adenotonsileldomiz I. Bougenviie VIP : Rp 771_90l,3l, 2. Bougenvile Utama : Rp 775_3I5,S0, 3. WK I : Rp 588,528,67, 4. WK II : Rp 578.l18,25, 5. WK 111: Rp57l,358,90, 6. Mawar : Rp 492,795,55_ With time length of stay 2 days. Based on results above, therefore, we need calculation of hospitalised fee based on compiling Clinical Pathway as a benchmark to decide the hospital tariff.
Since turning into a hospital that fully serves COVID-19 patients, the Jati Padang Hospital has changed its governance and has a strategy by making several policies in the form of a director's decree, standard operating procedures, zoning arrangements, to changing the flow of services to prevent COVID-19 transmission in health workers. The purpose of this study was to find out what the governance of the Jati Padang Hospital has been in preventing the transmission of COVID-19 to its health workers. This research was conducted qualitatively through document review, observation, in-depth interviews, and finally a focus group discussion with the management of the Jati Hospital. field. The results of this study obtained changes that have occurred in the governance of the Jati Padang Hospital since serving COVID-19 patients. The strategy is carried out administratively, service flow to the fulfillment of the required facilities. There are still several things that need improvement, namely communication about internal policies between management and officers at the Jati Padang Hospital, officer discipline, and the fulfillment of facilities to increase the prevention of COVID-19 transmission to health workers. Follow-up that can be done in the short term is to improve communication related to existing policies, form a supervision team that is responsible to the leadership, improve coordination between units and formulate related policies that are not yet owned by the hospital. For the long-term follow-up related to the budget, namely the fulfillment of facilities and infrastructure and the provision of rewards and punishments for employees in improving their discipline
