scholarly journals Analisis Beban Biaya Sendiri Pasien Rawat Inap Peserta Askes di RSUD dr. Achmad Diponegoro, Putussibau, Kalimantan Barat

2008 ◽  
Vol 2 (4) ◽  
pp. 166
Author(s):  
Johanes Eko Kristiyadi
Keyword(s):  
Health Insurance ◽  
Length Of Stay ◽  
Influence Factor ◽  
Hospitalized Patients ◽  
Cross Sectional ◽  
West Kalimantan ◽  
Health Insurance Provider ◽  
Level 1 ◽  
Out Of Pocket Expenses ◽  
Interaction Test

PT. Askes asuradur yang mengelola asuransi wajib pegawai negeri sipil yang dalam peraturannya membolehkan peserta membayar beban biaya sendiri (out of pocket) karena perbedaan antara tarif rumah sakit dengan tarif paket Askes. Penelitian ini bertujuan untuk mengetahui berbagai faktor yang berpengaruh dan model prediksi beban biaya sendiri pasien rawat inap peserta Askes di RSUD dr. Achmad Diponegoro-Putussibau, Kabupaten Kapuas Hulu, Propinsi Kalimantan Barat, tahun 2005. Rancangan penelitian yang digunakan adalah survei dengan sampel sebesar 257 pasien rawat inap tahun 2005. Dfitemukan Rata-rata beban biaya sendiri sebesar Rp. 215.472atau 20,84 % dari rata-rata biaya perawatan sesuai tariff RSUD. Beban minimum dan maksimum adalah Rp. 25.000,- dan Rp. 2.784.000,- dipengaruhi oleh faktor lama hari rawat, penyakit penyulit, obat-obatan, peserta, peserta3(isteri), golongan pegawai, interaksi antara lama hari rawat dengan penyakit penyulit dan interaksi antara penyakit penyulit dengan obat-obatan. Interaksi antara lama hari rawat dengan penyakit penyulit merupakan faktor yang paling mempengaruhinya (nilai ? 0,624). Setelah dilakukan uji asumsi dan uji interaksi, maka diperoleh model prediksi beban biaya sendiri = 5,743 + 0,313*lama hari rawat - 0,785*tidak ada penyakit penyulit + 0,819*obat-obatan (Non DPHO) + 67,397*peserta + 0,179*istri + 1,489*golongan + 0,260*Interaksi penyakit penyulit dengan Obat-obatan + 37,353*Interaksi lama hari rawat dengan penyakit penyulit.Kata Kunci : Biaya sendiri, asuransi kesehatanAbstractPT Askes is the health insurance provider with mandatory membership for public officers in Indonesia. In reality, patient still have to cover some expenses from his or her pocket, due to the differences between hospital fare and the expenses that is covered by Askes. The objective of this research is to find out the determinant factors and the prediction model of out of pocket expenses among hospitalized patients with Askes membership at dr. Achmad Diponegoro Hospital in Putussibau, Kapuas Hulu District, West Kalimantan Province in 2005. This design used in this study is cross-sectional, using 257 samples of hospitalized patients in dr. Achmad Diponegoro Hospital in Putusibau, Kapuas Hulu District, West Kalimantan Province during the year of 2005. The average amount of out of pocket expenses of each patient is Rp 215,472.76 or 20.84 % out of the total expenses in the district hospital. the minimum fare is Rp 25,000.- and the maximum one is Rp 2,784,000.-, depend on the number of days in hospital, type of illness, medications, type of membership (member1=the person with the membership, member3=the spouse), level 1 employee, the interaction between length of stay with type of illness, and the interaction between complicated illness and drugs are the most influence factor ( the ? value are the highest, that is 0,624). The assumption and interaction test, resulted in the model: self expenses = 5,743 + 0,313*length of stay - 0,785*no complicated illness + 0,819*drugs (Non DPHO) + 67,397*member1 + 0,179*member3 + 1,489*employee1 + 0,260*interaction between complicated illness and drugs + 0,260*Interaction between length of stay and complicated illness.Key word : Out of pocket, health insurance

scholarly journals Variation Among Hospitals in the Continuity of Care for Older Hospitalized Patients: a Cross-sectional Cohort Study

2021 ◽  
Author(s):  
James S. Goodwin ◽  
Shuang Li ◽  
Jie Zhou ◽  
Yong-Fang Kuo ◽  
Ann Nattinger
Keyword(s):  
Logistic Regression ◽  
Length Of Stay ◽  
Regression Model ◽  
Continuity Of Care ◽  
Logistic Regression Model ◽  
Large Degree ◽  
Patient Characteristics ◽  
Hospitalized Patients ◽  
Cross Sectional ◽  
The Impact

Abstract Background: Little is known about how continuity of care for hospitalized patients varies among hospitals. We describe the number of different general internal medicine physicians seeing hospitalized patients during a medical admission and how that varies by hospital. Methods: We conducted a retrospective study of a national 20% sample of Medicare inpatients from 01/01/16 to 12/31/18. In patients with routine medical admissions (length of stay of 3-6 days, no Intensive Care Unit stay, and seen by only one generalist per day), we assessed odds of receiving all generalist care from one generalist. We calculated rates for each hospital, adjusting for patient and hospital characteristics in a multi-level logistic regression model. Results: Among routine medical admissions with 3- to 6-day stays, only 43.1% received all their generalist care from the same physician. In those with a 3-day stay, 50.1% had one generalist providing care vs. 30.8% in those with a 6-day stay. In a two-level (admission and hospital) logistic regression model controlling for patient characteristics and length of stay, the odds of seeing just one generalist did not vary greatly by patient characteristics such as age, race/ethnicity, comorbidity or reason for admission. There were large variations in continuity of care among different hospitals and geographic areas. In the highest decile of hospitals, the adjusted mean percentage of patients receiving all generalist care from one physician was >84.1%, vs. <24.1% in the lowest decile. This large degree of variation persisted when hospitals were stratified by size, ownership, location or teaching status. Conclusions: Continuity of care provided by generalist physicians to medical inpatients varies widely among hospitals. The impact of this variation on quality of care is unknown.

scholarly journals Variation among hospitals in the continuity of care for older hospitalized patients: a cross-sectional cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
James S. Goodwin ◽  
Shuang Li ◽  
Jie Zhou ◽  
Yong-Fang Kuo ◽  
Ann Nattinger
Keyword(s):  
Logistic Regression ◽  
Length Of Stay ◽  
Regression Model ◽  
Continuity Of Care ◽  
Logistic Regression Model ◽  
Large Degree ◽  
Patient Characteristics ◽  
Hospitalized Patients ◽  
Cross Sectional ◽  
The Impact

Abstract Background Little is known about how continuity of care for hospitalized patients varies among hospitals. We describe the number of different general internal medicine physicians seeing hospitalized patients during a medical admission and how that varies by hospital. Methods We conducted a retrospective study of a national 20% sample of Medicare inpatients from 01/01/16 to 12/31/18. In patients with routine medical admissions (length of stay of 3–6 days, no Intensive Care Unit stay, and seen by only one generalist per day), we assessed odds of receiving all generalist care from one generalist. We calculated rates for each hospital, adjusting for patient and hospital characteristics in a multi-level logistic regression model. Results Among routine medical admissions with 3- to 6-day stays, only 43.1% received all their generalist care from the same physician. In those with a 3-day stay, 50.1% had one generalist providing care vs. 30.8% in those with a 6-day stay. In a two-level (admission and hospital) logistic regression model controlling for patient characteristics and length of stay, the odds of seeing just one generalist did not vary greatly by patient characteristics such as age, race/ethnicity, comorbidity or reason for admission. There were large variations in continuity of care among different hospitals and geographic areas. In the highest decile of hospitals, the adjusted mean percentage of patients receiving all generalist care from one physician was > 84.1%, vs. < 24.1% in the lowest decile. This large degree of variation persisted when hospitals were stratified by size, ownership, location or teaching status. Conclusions Continuity of care provided by generalist physicians to medical inpatients varies widely among hospitals. The impact of this variation on quality of care is unknown.

scholarly journals Frequency of hospitalization of infants with bronchiolitis during 2017 in Puerto Madryn, Argentina

2021 ◽  
Author(s):  
Damián L. Taire ◽  
Bruno A. Pazos
Keyword(s):  
Length Of Stay ◽  
Hospital Readmissions ◽  
Basic Needs ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Place Of Origin ◽  
The Mean ◽  
Hospital Administrative

ABSTRACTIntroductionBronchiolitis is considered the most frequent disease in infants and still represents an important cause of morbidity and mortality worldwide. Despite its viral etiology, socioeconomic variables could influence the disease outcome. We aimed to determine the frequency of hospital discharge for bronchiolitis in a local Hospital in the city of Puerto Madryn, in the province of Chubut, Patagonia Argentina.Population and methodsWe performed a cross-sectional study that analyzed all hospitalized patients discharged for bronchiolitis in Hospital “Dr. Andrés R. Isola” during the year 2017 and based on data provided by the hospital administrative staff. The study variables were the length of stay, readmission rate and place of origin of hospitalized patients.ResultsA total of 120 patients were included. The median age was 4.45 months (3.9-5). The mean length-of-stay (LOS) was 7.30 days (5.52-9.08). Of the total number of patients, 24 (20%) had a LOS ≤3 days and 96 (80%) a >3 days. One hundred patients (88.33%) had no hospital readmissions and 10 patients (8.33%) had hospital readmissions. The median age of patients with readmissions was 4.2 months (2.69-5.71). The mean LOS during readmission was 17.3 days (5.25-29.35). Of the 120 hospitalized children, 100 infants (83.33%) live in areas identified as having “unsatisfied basic needs” in Puerto Madryn.ConclusionsThe overcrowding as a result of the demographic transformation on the frequency of hospitalization of infants with bronchiolitis was homogeneous within the Puerto Madryn population with “unsatisfied basic needs”.

scholarly journals Utilization, satisfaction, out of pocket expenditure and health seeking behaviour among the insured residents of rural field area: a cross sectional study

2020 ◽  
Vol 7 (3) ◽  
pp. 1047
Author(s):  
Netra G. ◽  
B. A. Varadaraja Rao ◽  
Prakash Kengnal
Keyword(s):  
Health Insurance ◽  
Cross Sectional Study ◽  
Health Seeking Behaviour ◽  
Health Seeking ◽  
Chi Square ◽  
Cross Sectional ◽  
Medical College ◽  
The Family ◽  
Field Practice ◽  
Out Of Pocket Expenses

Background: Health insurance is also called as medical insurance offering coverage that pays for unexpected medical and surgical expenses to the policyholder. A health insurance plan is one of the most secured and safest way to provide financial coverage to the insured family. Objective of this study was to assess utilization, satisfaction, out of pocket expenses and to determine the health seeking behaviour of the insured residents of the rural field practice area of SSIMS and RC, Davanagere.Methods: The study was done in the rural field practice area of the medical college, Davangere from January 2016 to December 2016. A sample of 600 families were studied by systematic random sampling and data was collected from the head of the family using structured questionnaire by house to house interview. Statistical analysis was carried out by SPSS v10, percentages, proportions and Chi-square tests were applied to find the association among the variables.Results: The utilization of health insurance in the present study was 50.2% and satisfaction regarding the health insurance schemes was 93.4%.Conclusions: The study reveals that the out of pocket expenses is high among the uninsured families compared to the insured families. The Insurance policies should be revived to do favour the patients so that more families will be encouraged to enrol and utilize so that the out of pocket expenses will be reduced.

scholarly journals Direct medical costs of hospitalized patients with idiopathic pulmonary fibrosis in China

2019 ◽  
Author(s):  
Xiaofen Zheng ◽  
Bingbing Xie ◽  
Yan Liu ◽  
Ming Zhu ◽  
Shu Zhang ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Economic Burden ◽  
Medical Costs ◽  
Hospitalized Patients ◽  
Cross Sectional ◽  
Direct Medical Costs ◽  
Hospitalization Costs ◽  
The Mean

AbstractBackgroundIdiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia of unknown cause. The incidence of IPF is increasing year by year, as well as the mortality rates, which is really a burden both for the family and the society. However few data concerning the economic burden of the patients with IPF is available, especially in China.ObjectiveThis study aimed to examine the direct medical costs of hospitalized patients with IPF and to determine the contributing factors.MethodsThis retrospective analysis used the cost-of-illness framework in order to analyze the direct medical costs of patients with IPF. The study used data from the pneumology department of Beijing Chao-Yang Hospital affiliated to Capital Medical University from year 2012 to 2015. The direct medical costs included drug fee, auxiliary examination fee, treatment fee and other fee. Patients’ characteristics, medical treatment, and the direct medical costs were analyzed by descriptive statistics and multivariable regression.ResultsThere were 219 hospitalized patients meeting the diagnosis of IPF, 91% male. The mean age was 65 years old. For the direct medical costs of hospitalized patients with IPF, the mean(SD) of the total costs per IPF patient per admission was 14882.3 (30975.8)CNY. The largest parts were the examination fee of 6034.5 (15651.2)CNY and the drug fee of 5048.9 (3855.1)CNY. By regression analysis we found that length of stay, emergency treatment, ventilator use and being a Beijing native were significantly (P<0.05) associated with total hospitalization costs, and the length of stay had the biggest impact. Complications or comorbidities contributated to the direct medical costs as follows: respiratory failure with 30898.3CNY (P=0.004), pulmonary arterial hypertension(PAH) with 26898.2CNY (P=0.098), emphysema with 25368.3CNY (P=0.033), and high blood pressure with 24659.4CNY (P=0.026). Using DLCO or DLCO% pred to reflect the severity of IPF, there was no significant correlation between DLCO or DLCO% pred and patients’ direct medical costs. While, the worse the diffusion function, the higher the drug fee.ConclusionThis study showed that IPF has a major impact on the direct medical costs. Thus, appropriate long-term interventions are recommended to lower the economic burden of IPF.Strengths and limitations of this studyIt was the first time in China to discuss the economic burden of diseases and its influencing factors in patients with IPF.The results of this study might be of reference for the establishment of IPF disease-related medical policies in future.The retrospective cross-sectional design does not allow for establishing any causal relationships.It was a a single-center study, resulting a slightly smaller sample size. A large sample of multicenter studies is needed to confirm this.

PARTICIPATING IN HEALTH INSURANCE AND FACTORS AFFECTING AMONG PERSONS WHOSE ENROLMENT IS VOLUNTARY IN THUA THIEN HUE PROVINCE

2015 ◽  
pp. 89-95
Author(s):  
Thi Hoai Thuong Nguyen ◽  
Hoang Lan Nguyen ◽  
Mau Duyen Nguyen
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Cross Sectional ◽  
Factors Affecting ◽  
The People ◽  
Universal Health Insurance Coverage ◽  
The Social

Background:To provide information helps building policy that meets the practical situation and needs of the people with the aim at achieving the goal of universal health insurance coverage, we conducted this study with two objectives (1) To determine the rate of participating health insurance among persons whose enrolment is voluntary in some districts of ThuaThien Hue province; (2) To investigate factor affecting their participation in health insurance. Materials and Methodology:A cross-sectional descriptive study was conducted in three districts / towns / city of ThuaThien Hue in 2014. 480 subjects in the voluntary participation group who were randomly selected from the study settings were directly interviewed to collect information on the social, economic, health insurance participation and knowledge of health insurance. Test χ2 was used to identify factors related to the participation in health insurance of the study subjects. Results:42.5% of respondents were covered by health insurance scheme. Factors related to their participation were the resident location (p = 0.042); gender (p = 0.004), age (p <0.001), chronic disease (p <0.001), economic conditions (p<0.001) and knowledge about health insurance (p <0.001). Conclusion: The rate of participating health insurance among study subjects was low at 42,5%. There was "adverse selection" in health insurance scheme among voluntary participating persons. Providing knowledge about health insurance should be one of solutions to improve effectively these problems. Key words: Health insurance, voluntary, Thua Thien Hue

Etiologies, Clinical Manifestations, and Factors Associated with Severe Symptomatic Hyponatremia among Hospitalized Hyponatremia Patients

2020 ◽  
Vol 103 (5) ◽  
pp. 465-471
Keyword(s):  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Sectional Study ◽  
Close Attention ◽  
Cross Sectional ◽  
Factors Associated ◽  
Present Cross Sectional Study ◽  
Important Health ◽  
Baseline Characteristics

Background: Hyponatremia is associated with unfavorable outcomes in many cases. The mainstay of hyponatremia treatment depends on its symptoms and etiology. However, etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia have been rarely reported. Objective: To analyze and report etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia. Materials and Methods: In the present cross-sectional study, the authors enrolled hospitalized patients with hyponatremia who had consulted a nephrologist between October 1, 2017, and October 31, 2018. Their baseline characteristics and clinical manifestations were recorded. Etiologies were confirmed by the attending nephrology staff. Factors associated with severe symptomatic hyponatremia were evaluated using logistic regression analysis. Results: One hundred patients were included in this study. The syndrome of inappropriate antidiuresis (SIAD), hypovolemia, and hydrochlorothiazide use were the leading hyponatremia etiologies. Hyponatremia etiologies differed between patients with community-acquired hyponatremia (n=50) and those with hospital-associated hyponatremia (n=50). Patients with communityacquired hyponatremia were older, presented with a higher frequency of severe symptomatic hyponatremia, and showed lower SNa-levels. Low SNa-levels were significantly associated with severe symptomatic hyponatremia (p=0.014). Conclusion: Hyponatremia remains an important health problem. SIAD, hypovolemia, and hydrochlorothiazide use are among the leading etiologies of hyponatremia. Low SNa-levels are associated with severe symptomatic hyponatremia; thus, physicians should pay close attention to low SNa-levels in hospitalized patients. Keywords: Hyponatremia, Symptomatic Hyponatremia, Community-acquired hyponatremia, Hospital-associated hyponatremia

scholarly journals Risk Factors for Undernutrition at Admission Among Adult Hospitalized Patients at a Referral Hospital in Indonesia

SAGE Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 215824402098331
Author(s):  
Nur Chandra Bunawan ◽  
Dwi Suseno ◽  
Drupadi H. S. Dillon ◽  
Ikhwan Rinaldi ◽  
Dyah Purnamasari
Keyword(s):  
Associated Factors ◽  
Multivariate Analyses ◽  
Gastrointestinal Disease ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
Initial Hospital ◽  
Comorbidity Index

Patients with undernutrition at admission have higher risks to worsen their nutritional status, which is linked to an increase in morbidity and mortality. This study investigated the prevalence of undernutrition at admission and its associated factors. A cross-sectional study was conducted on patients aged 18 to 59 years old in Internal Medicine ward at Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, between July and September 2019. Factors that might be associated with undernutrition at admission, such as age, sex, marital status, Charlson Comorbidity Index (CCI) and type of comorbidity, depression, and neutrophil–lymphocyte ratio (NLR), were assessed. Bivariate and multivariate analyses were used to determine the associated factors. Sixty hospitalized patients with median age of 42 years and 76.7% with married status joined the study. The most common reason for hospitalization was acute gastrointestinal disease with gallstones as the most common comorbidity. Undernutrition exists in 26.7% of subjects. High CCI score was observed among 11.7% subjects and half of subjects had NLR category ≥5. Bivariate analysis revealed that unmarried status, age ≥40 years, and malignancy were associated with undernutrition at admission. Logistic regression analysis showed malignancy as an independent predictor of undernutrition during the initial hospital admission (odds ratio [OR] = 11.8; 95% confidence interval [CI]: [1.1, 125.7]). The prevalence of undernutrition at admission was 26.7%. Factors associated with an increased prevalence of undernutrition at admission were age <40 years, unmarried status, and malignancy. Malignancy was an independent factor of the prevalence of undernutrition at admission.

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