scholarly journals Upaya Pencegahan Perbedaan Diagnosis Klinis Dan Diagnosis Asuransi Dengan Diberlakukan Program Jaminan Kesehatan Nasional (JKN) Dalam Pelayanan Bpjs Kesehatan Studi Di Rsud Kota Semarang

2016 ◽  
Vol 4 (2) ◽  
pp. 84-90
Author(s):  
Faik Agiwahyuanto ◽  
Sudiro Sudiro ◽  
Inge Hartini
Keyword(s):  
Qualitative Study ◽  
Social Security ◽  
Medical Treatment ◽  
Emergency Room ◽  
Medical Record ◽  
Clinical Pathway ◽  
Public Hospital ◽  
Medical Service ◽  
Hospital Director ◽  
Social Security Agency

Percentage of clinical and insurance diagnosis differences at Semarang City Public Hospital tended to increase. If this condition remained, it would lead to upcoding (fraud). The aim of this study was to explain a process of clinical and insurance diagnosis at a hospital in the implementation of Healthcare and Social Security Agency (Health BPJS). This was a qualitative study. Main informants consisted of doctors at an emergency room, surgeons, and internists. Informants for triangulation purpose consisted of a Hospital Director, a hospital verifier, and a head of Medical Record Unit. Data were analysed using content analysis.The results of this research showed that there were any differences in clinical and insurance diagnosis at Semarang City Public Hospital. The cause of these differences was due to differences in diagnosis and medical treatment between medical service standard of doctors at the hospital and a standard of INA-CBGs. To prevent the differences of clinical and insurance diagnosis, the Semarang City Public Hospital had formed an internal verifier team of the hospital and a Clinical Micro System team. A medical committee had a role to minimise the occurrence of upcoding by multiplying kinds of Clinical Pathway as a reference for doctors in diagnosing and determining kinds of treatments for patients.The differences of clinical and insurance diagnosis must be equated to prevent the occurrence of upcoding and disadvantage of the hospital. Efforts to prevent these differences are by adding officers, training coding, making and multiplying algorithm of clinical pathway, forming a team of Clinical Micro System, and monitoring and evaluating medical services.

scholarly journals Avaliação da qualidade dos registros de enfermagem em um hospital do Norte do Brasil.

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Natalia Bianchini Dodo ◽  
Josimeire Cantanhêde De Deus ◽  
Priscilla Perez da Silva Pereira ◽  
José Juliano Cedaro
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Medical Record ◽  
Quality Of Health Care ◽  
Medical Records ◽  
Public Hospital ◽  
Northern Region ◽  
Nursing Team ◽  
Quality Of Nursing

Objetivo: avaliar a qualidade dos registros de enfermagem realizados em prontuário de pacientes internados num hospital público municipal da região norte brasileira. Método: estudo quanti-qualitativo, tipo documental, em prontuários de pacientes que permaneceram internados no mínimo 48 horas. O instrumento de coleta avaliava a qualidade dos registros, conforme definição pelo Conselho Federal de Enfermagem. Foram realizadas análises descritivas por meio do Stata®13.0. Resultados: do total de 248 prontuários, 25,9% foram considerados completos, 67,1% incompletos, 6,7% incorretos e 0,3% não estavam preenchidos. Em mais de 90% dos registros estudados se verificou que não havia uma escrita sequencial e concisa, emprego de terminologias técnicas e descrição dos cuidados prestados. Conclusões: Os registros de enfermagem foram considerados com qualidade insatisfatória. Como possíveis caminhos a serem experimentados tem-se o uso de formulários específicos para a Sistematização da Assistência de Enfermagem, implementação do prontuário eletrônico e padronização de siglas.Descritores: Registros de Enfermagem; Equipe de Enfermagem; Qualidade da Assistência à Saúde. EVALUATION OF THE QUALITY OF NURSING RECORDS IN THE HOSPITAL IN NORTHEN BRAZILObjective: to evaluate the quality of nursing records carried out in patients' records in a municipal public hospital in the northern region of Brazil. Method: quantitative-qualitative study, documentary type in medical records of patients who remained hospitalized at least 48 hours. The collection instrument evaluated the quality of the records, as defined by the Federal Nursing Council. Descriptive analyzes were carried out using Stata®13.0. Results: Of the total of 248 medical records, 25.9% were considered complete, 67.1% were incomplete, 6.7% were incorrect and 0.3% were not filled. In more than 90% of the studied registers it was verified that there was no sequential and concise writing, use of technical terminologies and description of the care provided. Conclusions: Nursing records were considered of unsatisfactory quality. As possible ways to be tried it is suggested the use of specific forms for the Systematization of the Nursing Assistance, implantation of the electronic medical record and standardization of acronyms.Descriptors: Nursing Records; Nursing Team; Quality of Health Care. EVALUACIÓN DE LA CALIDAD DE LOS REGISTROS DE ENFERMERÍA EN UN HOSPITAL EN EL NORTE DE BRASILObjetivo: evaluar la calidad de los registros de enfermería realizados en los registros de pacientes en un hospital público municipal en la región norte de Brasil. Método: estudio cuantitativo-cualitativo, tipo documental en registros médicos de pacientes que permanecieron hospitalizados al menos 48 horas. El instrumento de recolección evaluó la calidad de los registros, según lo define el Consejo Federal de Enfermería. Los análisis descriptivos se llevaron a cabo utilizando Stata®13.0. Resultados: Del total de 248 registros médicos, 25.9% se consideraron completos, 67.1% estaban incompletos, 6.7% eran incorrectos y 0.3% no se llenaron. En más del 90% de los registros estudiados se verificó que no había una escritura secuencial y concisa, el uso de terminologías técnicas y la descripción de la atención prestada. Conclusiones: los registros de enfermería fueron considerados de calidad insatisfactoria. Como posibles formas de ser juzgado, se sugiere el uso de formularios específicos para la Sistematización de la Asistencia de Enfermería, la implantación del registro médico electrónico y la estandarización de acrónimos.Descriptores: Registros de Enfermería; Registros; Grupo de Enfermería; Calidad de la Atención de Salud.

scholarly journals BPJS Kesehatan dalam Perspektif Hukum Islam (Studi Fatwa Majelis Ulama Indonesia dan Fatwa Nahdlatul Ulama)

2018 ◽  
pp. 141
Author(s):  
Mughni Labib
Keyword(s):  
Health Insurance ◽  
Qualitative Study ◽  
Social Security ◽  
National Health Insurance ◽  
Islamic Law ◽  
Formal Aspect ◽  
Islamic Jurisprudence ◽  
Nahdlatul Ulama ◽  
Sociological Approaches ◽  
Social Security Agency

This paper elaborates the fatwa of the Healthcare and Social Security Agency (BPJS Kesehatan) issued by the Indonesian Ulema Council (MUI) and Nahdlatul Ulama (NU), Indonesia’s largest Muslim organization. The MUI and NU declared their own fatwa on BPJS Kesehatan. The MUI labeled that BPJS Kesehatan contravened Islamic law, whereas the NU promoted that the national health insurance aligns with the law. These two fatwas trigger polemic in the country. A qualitative study was designed by employing usul al-fiqh (Islamic jurisprudence) and sociological approaches. The study used documentation and interviews to collect data concerning the MUI and NU fatwas on BPJS Kesehatan. The interactive model of Miles & Huberman was adopted to analyze the data. The results reveal that the issuance of the MUI and NU contradictory fatwas against BPJS Kesehatan was due to the use of different Islamic sources (dalil) and overlooks in drafting the edicts. The MUI emphasized more on several elements involved in the health insurance that were inconsistent with sharia law such as riba (interest), gharar (uncertainty), and maisir (gambling). Conversely, the NU highlighted a formal aspect stipulating that BPJS Kesehatan represented a social agency that benefited lots of people. This study also points out that some factors causing the variety of fatwas on BPJS Kesehatan between the MUI and NU covered the understanding and application of the dalil in relation to the edict formulation and the influence of socio-political atmospheres at the time of fatwa issuance.

scholarly journals Penetrating Neck Injuries Treated at a U.S. Role 3 Medical Treatment Facility in Afghanistan During Operation Resolute Support

2020 ◽  
Author(s):  
John Breeze ◽  
William G Gensheimer ◽  
Joseph J DuBose
Keyword(s):  
Medical Treatment ◽  
Emergency Room ◽  
Neck Region ◽  
Neck Injuries ◽  
Treatment Facility ◽  
Medical Treatment Facility ◽  
Trauma Registries ◽  
Neck Wound ◽  
Major Injury ◽  
High Negative Predictive Value

ABSTRACT Introduction Military trauma registries can identify broad epidemiological trends from neck wounds but cannot reliably demonstrate temporal casualty from clinical interventions or differentiate penetrating neck injuries (PNI) from those that do not breach platysma. Materials and Methods All casualties presenting with a neck wound to a Role 3 Medical Treatment Facility in Afghanistan between January 1, 2016 and September 15, 2019 were retrospectively identified using the Emergency Room database. These were matched to records from the Operating Room database, and computed tomography (CT) scans reviewed to determine damage to the neck region. Results During this period, 78 casualties presented to the Emergency Room with a neck wound. Forty-one casualties underwent surgery for a neck wound, all of whom had a CT scan. Of these, 35/41 (85%) were deep to platysma (PNI). Casualties with PNI underwent neck exploration in 71% of casualties (25/35), with 8/25 (32%) having surgical exploration at Role 2 where CT is not present. Exploration was more likely in Zones 1 and 2 (8/10, 80% and 18/22, 82%, respectively) compared to Zone 3 (2/8, 25%). Conclusion Hemodynamically unstable patients in Zones 1 and 2 generally underwent surgery before CT, confirming that the low threshold for exploration in such patients remains. Only 25% (2/8) of Zone 3 PNI were explored, with the high negative predictive value of CT angiography providing confidence that it was capable of excluding major injury in the majority of cases. No deaths from PNI that survived to treatment at Role 3 were identified, lending evidence to the current management protocols being utilized in Afghanistan.

EMTALA: Screening Can Satisfy EMTALA, Despite Misdiagnosis

2003 ◽  
Vol 31 (1) ◽  
pp. 169-170 ◽  
Author(s):  
Hemanth Gundavaram
Keyword(s):  
Blood Pressure ◽  
Medical Treatment ◽  
Emergency Room ◽  
Urinary Retention ◽  
Court Of Appeals ◽  
Statutory Duty ◽  
Active Labor ◽  
Summary Judgment ◽  
De Medicina ◽  
The U.S

In Del Carmen Guadalupe v. Agosto, the U.S. Court of Appeals for the First Circuit held that a hospital fulfills its statutory duty to screen patiens in is emergency room if it provides for a “screening examination reasonably calculated to identify critical medical conditions” that may be afflicting symptomatic patients and if it “provides that level of screening uniformly to all those who present substantially similar complaints.” The First Circuit affirmed the lower court's decision to grant summary judgment to the hospital in a claim raised under the Emergency Medical Treatment and Active Labor Act (EMTALA).Maria del Carmen Guadalupe brought her husband, Narciso Figueroa, to the Hospital Interamericano De Medicina Avanzada, Inc., (HIMA) on October 3, 1998, with symptoms of urinary retention, edema in the legs, high blood pressure, pain, increased respiratory difficulty, a dry cough, fever, and drowsiness.

scholarly journals Patients' experience with a diabetes support programme based on an interactive electronic medical record: qualitative study

BMJ ◽  
2004 ◽  
Vol 328 (7449) ◽  
pp. 1159 ◽  
Author(s):  
James D Ralston ◽  
Debra Revere ◽  
Lynne S Robins ◽  
Harold I Goldberg
Keyword(s):  
Qualitative Study ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Support Programme ◽  
Patients Experience

scholarly journals Dokter Tunggu, A Hospital Application for Patient of Healthcare and Social Security Agency

2021 ◽  
Vol 8 (8) ◽  
pp. 450-458
Author(s):  
Muhammad Riyadi ◽  
Rhian Indradewa ◽  
Tantri Yanuar Rahmat Syah
Keyword(s):  
Social Security ◽  
Real Time ◽  
Health Facilities ◽  
Referral Hospital ◽  
Capital City ◽  
Business Planning ◽  
Level I ◽  
A Company ◽  
Social Security Agency

PT. Zaps Technology is a company engaged in technology and information by producing application products with the name Dokter Tunggu (Doku). The application was created to eliminate queues that often occur in Healthcare and Social Security Agency patient services at level I Hospitals and Health Facilities. Place of company at Bekasi Jawa Barat, The location is said to be chosen because Bekasi is one of the supporting areas for the capital city and has a variety of complete business facilities. This company's strategy is to create innovations in Healthcare and Social Security Agency patient services where the application made has various features that are able to eliminate queues. The application has an online referral menu on the application so that Hospitals, Level I Facilities and Healthcare and Social Security Agency patients are easier to take advantage of BPJS services. The waiting doctor application will display real time conditions at the referral hospital so that BPJS users can monitor the condition of BPJS services at the destination Hospital. Keywords: Dokter Tunggu, Hospital, Online Sevice, Business Planning.

scholarly journals Probing strategy-project alignment: The case of the South African Social Security Agency

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Gerrit Van Der Waldt
Keyword(s):  
Social Security ◽  
Strategic Management ◽  
South African ◽  
Systems Thinking ◽  
Empirical Investigation ◽  
Public Institutions ◽  
The South ◽  
Project Failures ◽  
Organisation Management ◽  
Social Security Agency

Public institutions, such as the South African Social Security Agency (SASSA) increasingly function in multi-project environments to translate strategies successfully into service-delivery initiatives. However, this ‘projectification’ often causes projects to be designed and executed haphazardly. This can lead to budget and schedule overruns, and the general wastage of an organisation’s resources. Project failures often occur where organisations do not ensure that specific projects are aligned with their core strategies. The purpose of this article is to combine the theories and principles of organisation, management, strategic management, and project management in an effort to pinpoint core determinants that can help establish the extent to which an organisation manages the alignment of its strategic projects. In the present study, the author applied the principles of interdisciplinarity, systems thinking, and organisational integration. The combined core determinants that were uncovered were then used in an empirical investigation of SASSA. The purpose of this investigation is to identify particular challenges the organisation faces in aligning their strategies and projects successfully. Thereafter, a number of recommendations follow to address these challenges.

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