scholarly journals Penerapan Clinical Pathways sebagai Instrumen Pengendalian Biaya Pelayanan : Studi Penelitian Tindakan Penderita BPJS yang Menjalani Operasi Caesar dengan Sistem Pembayaran INA-CBG

2021 ◽  
Vol 4 (2) ◽  
pp. 593-599
Author(s):  
Annisa Fitria ◽  
Andri Sofa Armani ◽  
Thinni Nurul Rochmah ◽  
Bangun Trapsila Purwaka ◽  
Widodo Jatim Pudjirahardjo
Keyword(s):  
Action Research ◽  
Caesarean Section ◽  
Length Of Stay ◽  
Cesarean Section ◽  
Clinical Pathway ◽  
Average Length ◽  
Clinical Pathways ◽  
Hospital Costs ◽  
Average Length Of Stay ◽  
Length Of Hospitalization

This study aims to determine the effect of using clinical pathways to control total actual hospital costs for BPJS patients who undergo a cesarean section. The method used in this research is action research. The results showed that the average actual hospital costs were significantly higher after the application of CP with p = 0.019. The average length of stay, service costs, and hospital costs were significantly lower in the entire CP form group with p = 0.012, p = 0.013, and p = 0.012. In conclusion, this study shows that the application of clinical pathways can reduce the length of hospitalization and actual hospital costs for cesarean section patients and indicates that clinical pathways can make services more efficient.   Keywords: Hospital Costs, Clinical Pathway, Caesarean Section

scholarly journals Internações, óbitos e custos hospitalares pelas intercorrências dialíticas

2019 ◽  
Vol 13 ◽  
Author(s):  
Edison Vitório de Souza Júnior ◽  
Sarah Rodrigues Silva ◽  
Poliana Souza Lapa ◽  
Mariana Alves Soledade de Jesus ◽  
Michele Silva dos Santos ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Kidney Diseases ◽  
Average Length ◽  
Hospital Costs ◽  
Renal Dialysis ◽  
The Public ◽  
Average Value ◽  
Average Length Of Stay ◽  
Quantitative Descriptive ◽  
Dialysis Complications

Objetivo: descrever as internações, óbitos e custos hospitalares pelas intercorrências dialíticas em pacientes renais crônicos no Nordeste. Método: trata-se de um estudo quantitativo, descritivo e ecológico, voltado para a análise de dados do Sistema de Informações Hospitalares, organizados em frequências absolutas e relativas, a partir de tabelas construídas no software Excel. Resultados: notificaram-se 14.052 internações e 987 óbitos no Nordeste. Gerou-se, como consequência, um custo superior a R$ 19,6 milhões aos cofres públicos, com um valor médio de internação de R$ 1.543,09 e uma média de permanência de 9,1 dias. Destacaram-se os Estados de Alagoas, com a prevalência das internações (38,2%), e Bahia, em relação aos óbitos (40%), custos hospitalares (61,4%), média de permanência (14,4 dias) e valor médio de internação (R$ 2.794,42). Conclusão: aponta-se que as internações e óbitos pelas intercorrências dialíticas constituem um importante problema na Nefrologia, causando prejuízos diretos aos recursos financeiros públicos, especialmente, nos Estados da Bahia e Alagoas, por evidenciarem a maioria dos casos. Descritores: Saúde Pública; Nefrologia; Nefropatias; Diálise Peritoneal; Diálise Renal; Custos de Cuidados de Saúde.Abstract Objective: to describe hospitalizations, deaths and hospital costs due to dialysis complications in chronic renal patients in the Northeast. Method: this is a quantitative, descriptive and ecological study, focused on the analysis of data from the Hospital Information System, organized in absolute and relative frequencies, using tables built using Excel software. Results: 14,052 hospitalizations and 987 deaths were reported in the Northeast. As a result, the public coffers cost over R $ 19.6 million, with an average hospitalization value of R $ 1,543.09 and an average length of stay of 9.1 days. The states of Alagoas stood out, with the prevalence of hospitalizations (38.2%), and Bahia, in relation to deaths (40%), hospital costs (61.4%), average length of stay (14.4 days) and average value of hospitalization (R $ 2,794.42). Conclusion: it is pointed out that hospitalizations and deaths due to dialysis complications are an important problem in Nephrology, causing direct damage to public financial resources, especially in the states of Bahia and Alagoas, as they show the majority of cases. Descriptors:  Public Health; Nephrology; Kidney Diseases; Peritoneal Dialysis; Renal Dialysis; Health Care Costs. Resumen Objetivo: describir las hospitalizaciones, muertes y costos hospitalarios por las intercurrencias dialíticas en pacientes renales crónicos en el noreste. Método: se trata de un estudio cuantitativo, descriptivo y ecológico, destinado a analizar los datos del Sistema de Informaciones del Hospital, organizado en frecuencias absolutas y relativas, a partir de tablas construidas en el software Excel. Resultados: se reportaron 14.052 hospitalizaciones y 987 muertes en el noreste. Se generó como resultado de eso, un costo en exceso de R $ 19,6 millones para el gobierno, una hospitalización con costo promedio de R$1,543.09 y una estadía promedio de 9.1 días. Entre los estados, Alagoas tuvo una mayor prevalencia de hospitalizaciones (38,2%) y Bahía en las muertes (40%), costos hospitalarios (61,4%), duración media de la estancia (14,4 días) y media hospitalización (R $ 2.794,42). Conclusión: se observa que las hospitalizaciones y muertes debidas a las intercurrencias dialíticas se constituyen un problema importante en la nefrología, lo que implica directamente en los cofres públicos, especialmente en los Estados de Bahía y Alagoas, como evidencia de una mayor prevalencia de casos. Descriptores: Salud Pública; Nefrología; Enfermedades Renales; Diálisis Peritoneal; Diálisis Renal; Costos de la Atención en Salud. Descriptores: Salud Pública; Nefrología; Enfermedades Renales; Diálisis Peritoneal; Diálisis Renal; Costos de la Atención en Salud.  

scholarly journals Outcomes of a Clinical Pathway for Pleural Disease Management: “Pleural Pathway”

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Srinivas R. Mummadi ◽  
Peter Y. Hahn
Keyword(s):  
Length Of Stay ◽  
Clinical Pathway ◽  
Average Length ◽  
Clinical Pathways ◽  
Administrative Database ◽  
British Thoracic Society ◽  
Pleural Disease ◽  
Average Case ◽  
Community Healthcare ◽  
Pleural Diseases

Background and Objectives. Clinical pathways are evidence based multidisciplinary team approaches to optimize patient care. Pleural diseases are common and accounted for 3.4 billion US $ in 2014 US inpatient aggregate charges (HCUPnet data). An institutional clinical pathway (“pleural pathway”) was implemented in conjunction with a dedicated pleural service. Design, implementation, and outcomes of the pleural pathway (from August 1, 2014, to July 31, 2015) in comparison to a previous era (from August 1, 2013, to July 31, 2014) are described. Methods. Tuality Healthcare is a 215-bed community healthcare system in Hillsboro, OR, USA. With the objective of standardizing pleural disease care, locally adapted British Thoracic Society guidelines and a centralized pleural service were implemented in the “pathway” era. System-wide consensus regarding institutional guidelines for care of pleural disease was achieved. Preimplementation activities included training, acquisition of ultrasound equipment, and system-wide education. An audit database was set up with the intent of prospective audits. An administrative database was used for harvesting outcomes data and comparing them with the “prior to pathway” era. Results. 54 unique consults were performed. A total of 55 ultrasound examinations and 60 pleural procedures were performed. All-cause inpatient pleural admissions were lower in the “pathway” era (n=9) compared to the “prior to pathway” era (n=17). Gains in average case charges (21,737$ versus 18,818.2$/case) and average length of stay (3.65 versus 2.78 days/case) were seen in the “pathway” era. Conclusion. A “pleural pathway” and a centralized pleural service are associated with reduction in case charges, inpatient admissions, and length of stay for pleural conditions.

scholarly journals IMPACT OF CLINICAL PATHWAYS COMPLIANCE FOR REDUCING LENGTH OF STAY

2020 ◽  
Vol 8 (1) ◽  
pp. 79
Author(s):  
Michael Siswanto ◽  
Djazuly Chalidyanto
Keyword(s):  
Length Of Stay ◽  
Clinical Pathway ◽  
Acute Gastroenteritis ◽  
Pediatric Patients ◽  
Average Length ◽  
Clinical Pathways ◽  
Multidisciplinary Care ◽  
Care Plan ◽  
Cross Sectional ◽  
Therapy Compliance

Background: Clinical pathway is multidisciplinary care plan based on the best clinical practice for a group of patients with a particular diagnosis, designed to minimize care delay as well as maximize the quality of care and clinical outcomes. In 2017, average length of stay for pediatric patient with acute gastroenteritis was prolonged even clinical pathways had been implemented.Aim: Thid study determined the diagnostic examination and therapy compliance of clinical pathway related to the length of stay.Method: This study was cross sectional research through simple random sampling. Researchers analyzed pediatric patients whose clinical pathway were filled completely by doctors. The inclusion criteria were pediatric patients, admitted to hospitals during January to December 2018 as acute gastroenteritis patients. The data were analyzed using multiple classification analysis.Results: There were 197 patients with clinical pathway filled completely. As much as 60.91% of cases were compiled for diagnostic examination and 88.32% for therapy. There was no statistically significant correlation between diagnostic examination compliance (p > 0.05) and therapy compliance (p > 0.05) of clinical pathway with patients’ length of stay (combined = p > 0.05).Conclusion: Many factors could be related with the length of stay especially patients’ condition itself. In this study, clinical pathway compliance has no impact in reducing length of stay. Keywords: clinical pathway, compliance, length of stay, pediatric. 

scholarly journals Internações, óbitos e custos hospitalares por diabetes mellitus

2019 ◽  
Vol 13 ◽  
Author(s):  
Edison Vitório de Souza Júnior ◽  
Mariana Alves Soledade de Jesus ◽  
Poliana Souza Lapa ◽  
Jamille Sales da Cruz ◽  
Tayná Freitas Maia ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Length Of Stay ◽  
Public Hospital ◽  
Average Length ◽  
Hospital Costs ◽  
Northeastern Brazil ◽  
Slight Reduction ◽  
The Public ◽  
Average Length Of Stay ◽  
Public Health Epidemiology

Objetivo: descrever as internações, óbitos e custos públicos hospitalares por Diabetes Mellitus no Nordeste brasileiro entre 2013 e 2017. Método: trata-se de estudo quantitativo, descritivo e ecológico com levantamento de dados secundários do Sistema de Informações Hospitalares. Coletaram-se os dados referentes às internações, óbitos, custos hospitalares, valor médio de internação e média de permanência. Analisaram-se os dados mediante estatística descritiva simples, apresentando-os por meio de tabelas elaboradas no software Excel. Resultados: registraram-se 136.504 internações e 7.424 óbitos por Diabetes Mellitus no Nordeste brasileiro. Destacaram-se, além disso, os custos públicos hospitalares superiores a R$ 65 milhões, com valor médio de internação de R$ 545,08 e média de permanência de 5,4 dias. Conclusão: conclui-se que as internações, óbitos e os custos públicos hospitalares por Diabetes Mellitus apresentaram discreta redução e, mesmo assim, implicaram, de maneira expressiva, o orçamento público, além das repercussões pessoais e familiares impostas pela doença. Descritores: Saúde Pública; Epidemiologia; Endocrinologia; Custos de Cuidados de Saúde; Doenças do Sistema Endócrino; Indicadores Básicos de Saúde.Abstract Objective: to describe hospitalizations, deaths and public hospital costs for Diabetes Mellitus in Northeastern Brazil between 2013 and 2017. Method: this is a quantitative, descriptive and ecological study with secondary data collection from the Hospital Information System. Data was collected regarding hospitalizations, deaths, hospital costs, average hospitalization value and average length of stay. Data was analyzed using simple descriptive statistics, presenting them using tables prepared using Excel software. Results: 136,504 hospitalizations and 7,424 deaths from diabetes mellitus were recorded in the Brazilian Northeast. Also noteworthy were the public hospital costs over R$ 65 million, with an average hospitalization value of R$ 545.08 and an average length of stay of 5.4 days. Conclusion: it can be concluded that hospitalizations, deaths and public hospital costs for Diabetes Mellitus showed a slight reduction and, even so, they significantly implied the public budget, in addition to the personal and family repercussions imposed by the disease. Descriptors: Public Health; Epidemiology; Endocrinology; Health Care Costs;ResumenObjetivo: describir las hospitalizaciones, muertes y costos hospitalarios por diabetes mellitus en el noreste de Brasil, entre 2013 y 2017. Método: se trata de un estudio cuantitativo, descriptivo y ecológico, con la recopilación de datos secundarios del Sistema de Informaciones Hospitalarias. Se recopilaron los datos de hospitalizaciones, muertes, costos hospitalarios, valor promedio y tiempo de permanencia de la hospitalización. Los datos se analizaron mediante estadísticas descriptivas simples y se presentaron a través de tablas elaboradas en el software Excel. Resultados: se registraron 136,504 hospitalizaciones y 7,424 muertes por diabetes mellitus en el noreste de Brasil. Además, se destacaron los costos hospitalarios públicos superiores a R $ 65 millones, con un valor promedio de hospitalización de R$ 545.08 y una permanencia con promedio de 5,4 días. Conclusión: se concluye que las hospitalizaciones, las muertes y los costos hospitalarios debidos a la diabetes mellitus presentaron una ligera reducción, y aun así, estaban significativamente implicados en el presupuesto público, además de las repercusiones personales y familiares impuestas por la enfermedad. Descriptores: Salud Pública; Epidemiología; Endocrinología; Costos de la Atención en Salud; Enfermedades del Sistema Endocrino; Indicadores de Salud.

scholarly journals Efektifitas Implementasi Clinical Pathway Terhadap Average Length Of Stay dan Outcomes Pasien DF-DHF Anak di RSUD Kota Yogyakarta

2018 ◽  
Vol 2 (2) ◽  
pp. 175
Author(s):  
Neri Faradina Nur Fadilah ◽  
Savitri Citra Budi
Keyword(s):  
Length Of Stay ◽  
Clinical Pathway ◽  
Average Length ◽  
P Value ◽  
Cross Sectional ◽  
Average Length Of Stay

Latar belakang: Clinical pathway digunakan sebagai kendali mutu dan biaya dalam pelayanan kesehatan. Mutu pelayanan salah satunya dapat dilihat dari average length of stay dan outcomes. Implementasi clinical pathway yang sudah diterapkan perlu diukur efektifitasnya dalam menurunkan rata-rata lama dirawat dan menghasilkan outcomes yang lebih baik. Kasus DF dan DHF masuk dalam daftar 10 besar penyakit rawat inap di RSUD Kota Yogyakarta.Tujuan: Mengukur perbedaan average length of stay dan outcomes pasien DF-DHF anak antara sebelum dan setelah implementasi clinical pathway di RSUD Kota Yogyakarta.Metode: Jenis penelitian ini adalah penelitian kuantitatif dengan metode survey analitik dan rancangan cross sectional. Pengumpulan data dilakukan dengan studi dokumentasi pada 146 berkas rekam medis dan formulir clinical pathway.Hasil: Persentase outcomes tertinggi pada pasien DF yaitu pada kategori membaik 71,4% sebelum CP dan 80,9% setelah CP. Persentase outcomes tertinggi pada pasien DHF yaitu pada kategori membaik 83,9% sebelum CP dan 90,3% setelah CP. Average length of stay setelah CP lebih kecil dibandingkan sebelum CP pada pasien DF-DHF anak, dengan p-value DF anak = 0,016 < α = 0,05 dan p-value DHF anak = 0,021 < α = 0,05. Tidak ada perbedaan outcomes pasien DF-DHF anak antara sebelum dan setelah implementasi clinical pathway, dengan p_value DF anak = 0,775 > α = 0,05 dan p-value DHF anak = 1 > α = 0,05.Kesimpulan: Implementasi clinical pathway dapat menurunkan average length of stay, namun belum mampu membuktikan adanya perbedaan pada outcomes pasien.

scholarly journals Analysis of Cesarean Section Clinical Pathway Compliance at a Private Hospital in Yogyakarta

2019 ◽  
Vol 9 (1) ◽  
pp. 38
Author(s):  
Beta Haninditya ◽  
Tri Murti Andayani ◽  
Nanang Munif Yasin
Keyword(s):  
Length Of Stay ◽  
Cesarean Section ◽  
Pain Intensity ◽  
Clinical Pathway ◽  
Private Hospital ◽  
Clinical Pathways ◽  
P Value ◽  
Type C ◽  
The Relationship ◽  
Real Costs

This study aims to analyze the relationship between the compliance with the implementation of clinical pathways to therapeutic outcomes (ILO events, length of stay, pain intensity) and the total real cost of cesarean section patients. The study was conducted at a type C private hospital in Yogyakarta. This study is a non-experimental analytical study (observational analytic) with a cross sectional design using a retrospective data collection method and analyzed using Chi square test and non parametric regression test. Descriptive analysis for compliance with the implementation of clinical pathways was carried out by assessing the compliance of each care point contained in the clinical pathway section of the cesarean consisting of 12 points of care and will be grouped into two categories namely low compliance category with the average compliance value for clinical pathway <85% and good compliance with the average compliance value for clinical pathway ≥85%. Descriptions of adherence to the implementation of clinical pathway cesarean section each patient showed that as many as 686 patients (98%) had a good average compliance score and 14 patients (2%) had a low average compliance score. Outcome description 700 patients with cesarean section were found 1 patient experienced ILO, LOS according to clinical pathway (≤3 days) as many as 620 patients and 700 patients with pain scale ≤3. The results of the analysis of the relationship between the compliance and the implementation of the clinical pathway to the outcome of therapy (ILO events, length of stay, and pain intensity) showed the existence of a compliance relationship to the implementation of the clinical pathway with a value of p<0.05. The analysis of the relationship between the compliance to the implementation of the clinical pathway and the total real costs shows the relationship between the compliance   with   the   implementation   of  the  caesarean  section  clinical  pathway  at  a  type  C  private hospitals in Yogyakarta with the total real costs with p value of 0,000 and r value of 0.014.

scholarly journals Factors that influence the length of hospitalization for acute heart failure patients in RSUP Dr. M Djamil

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
M. Syaoqi ◽  
Andri Andri ◽  
Citra Kiki Krevani ◽  
Muhammad Syukri
Keyword(s):  
Heart Failure ◽  
Length Of Stay ◽  
Acute Heart Failure ◽  
Medical Records ◽  
Average Length ◽  
Descriptive Analysis ◽  
Heart Failure Patients ◽  
Average Length Of Stay ◽  
Baseline Characteristics ◽  
Length Of Hospitalization

More than 500,000 new patients were diagnosed with heart failure each year in all developing countries. Previous studies had shown that longer hospitalizations for patients with acute heart failure are associated with worse outcome. We analyzed factors that influence length of stay in our centre. We used a retrospective and descriptive analysis of acute heart failure patients at RSUP DR. M. Djamil from January to March 2018. We collected patient data from medical records including baseline characteristics, laboratory and echocardiographic results. We used statistical analysis to find the average length of stay (LOS) and possible causes of longer hospitalization. Among 30 patients had been collected, mean LOS was 6.23 days. Mean for age, BMI, and LVEF were 59.87 years, 23.55 kg/m2, and 36.93%, respectively. Patients those had LOS > 6 days may had relationship with initial degree edema pretibial (p=0.025) and systolic BP below 120 mmHg (p=0.018), but no significant with rales (p=0.543) and pulmonary infection (p=0.709). Length of stay associated with the degree of pretibial pitting edema and systolic blood pressure at admission.

Hospital Costs of Nosocomial Infections: A Prospective Three-Month Study In a Community Hospital

1980 ◽  
Vol 1 (3) ◽  
pp. 150-152 ◽  
Author(s):  
William E. Scheckler
Keyword(s):  
Length Of Stay ◽  
Nosocomial Infections ◽  
Community Hospital ◽  
Average Length ◽  
Hospital Costs ◽  
Hospital Charges ◽  
Average Hospital ◽  
Average Length Of Stay ◽  
Therapeutic Services ◽  
Tract Infections

AbstractA prospective three-month study of the hospital costs associated with nosocomial infections was done in a 390-bed, 30-bassinet community-teaching hospital early in 1978. All hospital charges for diagnostic and therapeutic services required by nosocomial infections, and added length of stay due to the infections, were recorded. During the study period 123 infections occurred in 104 patients (a 2.7% incidence, considering the 4,485 patients discharged during this time). The average length of stay was prolonged 3.0 days for all nosocomial infections; this accounted for about half of the $636 average hospital charges for each nosocomial infection. The 65 nosocomial urinary tract infections prolonged the length of stay an average of 0.6 days and the total hospital charges were $146 for each infection, leading us to believe that the proportion of nosocomial infections at any given site may greatly alter the “average” cost of nosocomial infections. Our data from a community hospital show a shorter prolongation of length of stay and lower hospital costs when compared with the few other studies in the literature.

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