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Biaya Kesehatan di Indonesia cenderung meningkat yang disebabkan oleh berbagai faktor. diantaranya adalah pola penyakit degeneratif. Orientasi pada pembiayaan kuratif, pembayaran out of pocket secara individual, service yang dilentukan oleh provider. teknologi canggih, perkembangan (sub) spesialisasi ilmu kedokteran, dan tidak lepas juga dari tingkat inflasi. Jika dibandingkan dengan negara - negara tetangga di Asia Tenggara tingkat kesehatan penduduk Indonesia masih relatif rendah. Angka kernatian ibu masih sekitar 390 per 100,000 kelahiran hidup. sementara di Philipina 170, Vietnam 160, Thailand 44 dan Malaysia 39 per 100.000 kelahiran hidup. Hal ini berkaitan secara langsung maupun tidak langsung dcngan besarnya biaya yang dikeluarkan oleh pemerinlah ataupun masyarakat untuk kesehatan dan besarnya cakupan asuransi kesehatan. Komplikasi persalinan sangat berpengaruh dengan kematian maternal/perinatal. Kebuluhan akan pelayanan kesehatan bagi seorang wanita akan meningkat dan mencapai puncaknya pada saat kehamilan dan menjelang persalinan. Kelerkaitan nasib ibu dan bayi nienggambarkan suatu kesatuan yang dimulai pada masa kehamilan. persalinan, sampai dengan awal kehidupan pertama bayi sandal mernbutuhkan perhatian yang cukup besar. kejadian komplikasi obstetric terdapat pada sekitar 20% dari seluruh kehainilan, namun yang lerlangani masih kurang dari 10%, yang nmempengaruhi kematian maternal/perinatal adalah: terlambat mengenali bahaya dan mengambil keputusan merujuk, terlambat mencapai fasilitas rujukan, dan terlambat memperoleh fasilitas rujukan yang adekuat. (Litbang Depkes, 2003) Upaya yang perlu dilakukan untuk mengendalikan biaya pelayanan kesehatan adalah peralihan dari bentuk FFS ke bentuk Prospective Payment System (PPS). System pembayaran prospektif makin banyak diterapkan. balk pada pelayanan rawat jalan berupa system pra-upaya yang berbentuk paket maupun pelayanan rawat inap yang menggunakan system pengelompokan penyakit berdasarkan diagnosa terkait. (Diacrpnosis Related group?sl DRG?s). Cost of DRGs alau cost of treatment merupakan keseluruhan biaya mulai dari pasien masuk mclakukan pendaftaran. penegakan diagnosa. pre partus. partus. post partus. puking dan berohal jalan semuanva terangkum dalam suatu alur perawatan atau Integrated Clinical Pathway, Tujuan dari penelitian ini adalah untuk mengetahui bagaimana clinical pathway dan cost of treatment Partus Pervaginam berdasarkan DRGs di RSIA Budiasih tahun 2007.
Health expense at Indonesia tending increase because of various factor, amongst those is degeneratif diseased pattern, orientation on kuratif's finances, payment out of pocket individual, service that prescribed by provider. sophisticated technology developing (sub) medical science specialization. and doesn't take down also of inflation rate. In comparison with neighbouring states at healths level South-east Asia. Indonesia still low relative. Mother mortality is still around 390 about 100.000 natal live, while at Philipina 170. Vietnam 160, Thailand 44 and Malaysia 39 about 100.000 natal live. It gets straightforward bearing and also indirect with outgrows it cost that issued by government or society even for health and outgrows it health insurance range. Complication about ascendant with maternal / perinatal's death. Requirement that take care of health for a woman will increase and peaks it upon pregnancy and drawing near about cope. Mothers fated relevance and baby figure an unity that started in by pregnancy term, about copy until with first life startup baby really need sizable attention. obstetric's complication instance exists on vicinity 20% of all pregnancies. but one most handles to be still less than 10%. one that regard death maternal 1 perinatal is: behind schedule recognize danger and taking a decision refers, behind schedule reach reference facility. and slowing to get reference facility that adekuat. ( Litbang Depkes. 2003 ) Effort that needs to be done to restrain health care cost is transition of Fee For Service form goes to to form Prospective Payment System (PPS), System is prospektifs payment gets a lot of be applied, well on roads nursed service as system pre effort which gets package form and also nurse service lodge that utilizes system disease agglomeration bases to diagnose relates( Related's diagnosis Group s / DRGs). Cost o/-DRGs or cost of treatment constitute entirely cost begins from input patient do registration. straightening of diagnosa, pre partus. partus. post partus, go home and get street drug every thing to hold in clinical pathway or Integrated Clinical Pathway . To the effect of observational it is subject to be know how clinical pathway and cost of treatment Vaginal delivery bases DRGs at RSIA Rudiasih year 2007.
ABSTRAK Penelitian ini dilakukan untuk melihat clinical pathway dan perhitungan cost of treatment hemodialisa serta melihat gambaran benefisitas biaya hemodialisa dengan sistem KSO dan dikelola sendiri di RSUD Subang tahun 2013. Cost of treatment hemodialisa dengan sistem KSO dan dikelola sendiri adalah hasil perhitungan biaya langsung dan tidak langsung dengan kombinasi metode Activity Based Costing (ABC) dan Simple Distribution sesuai dengan clinical pathway hemodialisa. Cost diperoleh dengan menjumlahkan hasil perkalian antara cost of treatment masing-masing penjamin dengan jumlah tindakannya dalam satu bulan. Pendapatan diperoleh dengan menjumlahkan hasil perkalian antara tarif rumah sakit kepada masing-masing penjamin dengan jumlah tindakan dalam satu bulan. Hasil analisis benefisitas biaya hemodialisa ternyata sistem KSO lebih menguntungkan dibandingkan dengan dikelola sendiri.
ABSTRACT This study was conducted to look at clinical pathways, calculation of cost of treatment of hemodialysis and to figure of the level of benefits of cost of hemodialysis either by the KSO and self-managed system in Subang District Hospital in 2013. Cost of hemodialysis treatment both by the KSO and self-managed system is the calculation of direct and indirect costs with a combination of Activity Based Costing (ABC) and Simple Distribution, according to clinical pathways of hemodialysis. Cost obtained it by summing the results of multiplying the cost of treatment of each guarantor with the number of actions in a single month. Revenues obtained by summing the multiplication of hospital rates for each guarantor with the amount of action in a single month. The results of the analysis of the level of benefits of cost of hemodialysis appeared the KSO system was more profitable than the self-managed.
Indonesia with a disaster risk level of 43.50% ranks 2nd out of 193 countries in the world. Hospitals have an important role in preventing disasters and emergencies. This research aims to look at hospital preparedness in dealing with disasters and emergencies as well as explain the findings of low scores and provide input for improvements related to disasters and hospital emergencies.This research method is a mixed method sequential explanatory design. The quantitative method was carried out by analyzing secondary data from HSI Hospital, and the qualitative methode carried out by deep interview. The research location at Hospital X in Semarang City with the most complete services, apart from being a reference place in Central Java, it is also a teaching hospital. The research results found that several elements in emergency management need attention and improvement, including responsibilities and training of committee members, because not all staff receive training; appointment of emergency and disaster management coordinators, because the tasks assigned to the staff are not the main tasks; emergencies and disaster planning, sub-planning regarding hazard specifications in hospitals, SOP for activation and deactivation planning, training, evaluating and correcting the implementation of disaster emergency planning, hospital recovery planning, low because audits and evaluations were not carried out within the last 1 year; communication procedures with the public and the media, low because there have been no updates in the last 1 year; staff contact lists due to no updates in 3 months and no written contact list; clarity of staff duties in handling emergencies and disasters and their recovery, because not all staff receive written assignments and training; psychosocial services, low because there are no special staff to provide psychosocial services; prevention of chemical and biological hazard contamination, personal protective equipment and isolation against infectious diseases and epidemics, some of which are low because staff training and testing is not carried out annually. Therefore, there is a need to improve comprehensive emergency and disaster management in hospitals.
