scholarly journals Evaluation of the Accuracy of Implementation of Obstetric Referral Cases to the Emergency in the JKN Era

2019 ◽  
pp. 159-165
Author(s):  
Omo Abdul Madjid ◽  
Arietta R.D. Pusponegoro ◽  
Immanuel S Margatan
Keyword(s):  
Emergency Department ◽  
Monitoring And Evaluation ◽  
Cross Sectional Study ◽  
Referral System ◽  
Local Health ◽  
Cross Sectional ◽  
Primary Health ◽  
Obstetric Emergencies ◽  
Obstetric Referral

Abstract Objective: To investigate the circumstances of the obstetric referral case at the emergency department of the Dr.Cipto Mangunkusumo Hospital as well as the accuracy of the referral implementation. Method: We used cross-sectional study. Medical records of obstetric patients at Emergency department in RSCM in January 2013-July 2014 were obtained, then information about patients and their characteristic were collected. The accuracy of referral cases is based on emergency obstetric criteria by BPJS rules. Results: Primary Health Care became the leading referrer. Inappropriate diagnostic referral cases amounted to 21.2%when JKN first began to be implemented in 2014. Cases with improper diagnoses were more referred when JKN was implemented which amounted to 16.8% and non-emergency referral cases of 6.9% in 2014. Conclusion: Referral implementation has not been efficient and effective, the number of obstetric referral cases to emergency department of RSCM that can actually be handled in the secondary advanced health services after the application of JKN is still high. Monitoring and evaluation is needed by the Local Health Office to improve the quality of the referral system that applied in the newly JKN era.   Keywords:accuracy of referrals,BPJS, JKN, obstetric emergencies, referral system.   Abstrak Tujuan: Mengetahui gambaran kasus rujukan obstetri di IGD RSCM dan ketepatan pelaksanaan rujukan.  Metode: Deskriptif desain studi potong lintang. Data diambil dari rekam medis pasien obstetri di IGD RSCMpada bulan Januari 2013 hingga Desember 2014, kemudian informasi mengenai data dan karakteristik pasien dikumpulkan. Ketepatan pelaksanaan rujukan kasus gaat daraurat obstetri berdasarkan Krietria gawatdarurat bagian kebidanan menurut ketentuan BPJS Kesehatan. Hasil: Perujuk terbanyak adalah Puskesmas (FKTP). Kasus rujukan dengan ketidaksesuaian diagnosa lebih banyakjumlahnya pada saat JKN mulai diterapkan pada tahun 2014 sebesar 21.2%. Kasus dengan diagnosa yang tidak tepat rujuk lebih banyak pada saat JKN di laksanakan yaitu sebesar 16.8% dan kasus rujukan yang bukan gawatdarurat sebesar 6.9% pada tahun 2014. Kesimpulan: Pelaksanaan rujukan belum efisien dan efektif, jumlah rujukan obstetri ke IGD RSCM yangsebenarnya dapat ditangani di fasilitas kesehatan tingkat lanjutan sekunder setelah penerapan JKN masih tinggi. Dibutuhkan monitoring dan evaluasi oleh Dinas Kesehatan setempat untuk meningkatkan kualitas sistem rujukan yang berlaku di era JKN yang baru diterapkan. Kata kunci :  BPJS, gawat darurat obstetri, JKN, ketepatan rujukan, sistem rujukan.

scholarly journals Assessment of primary health care received by the elderly and health related quality of life: a cross-sectional study

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Vivian C Honorato dos Santos de Carvalho ◽  
Sinara L Rossato ◽  
Flávio D Fuchs ◽  
Erno Harzheim ◽  
Sandra C Fuchs
Keyword(s):  
Quality Of Life ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Health Related Quality ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Health ◽  
Related Quality ◽  
Health Related

scholarly journals What factors are associated with health‐related quality of life among patients with chronic musculoskeletal pain? A cross‐sectional study in primary health care

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kirsti Krohn Garnaes ◽  
Siv Mørkved ◽  
Øyvind Salvesen ◽  
Torgrim Tønne ◽  
Lars Furan ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Health Related Quality ◽  
Sectional Study ◽  
Hrqol Score ◽  
Cross Sectional ◽  
Primary Health ◽  
Related Quality ◽  
Health Related ◽  
Pain Characteristics

Abstract Background Chronic musculoskeletal pain (CMP) affects daily life function and is the most prevalent disorder in primary health care. The primary objective was to examine demographic factors and pain characteristics associated with reduced health-related quality of life (HRQoL) among patients in primary care reporting CMP. Our secondary objective was to compare HRQoL in patients with and without CMP. Method This cross-sectional study was conducted in Trondheim, Norway. Twenty randomly selected GPs, and their listed patients aged 21–58 were invited to participate. Self-reported CMP data was collected using online questionnaires. HRQoL was measured by the 15D questionnaire, total score of 0.9 was used as cut-off for clinical reduced HRQoL. Results A total of 969 patients (650 females) were recruited from six GPs’ patient lists, mean age 45.6 (SD 10.1). CMP was reported by 517 (53%). Factors significantly associated with reduced HRQoL were gender (OR 2.0, 95% CI 1.2, 3.4), disability pension (OR 26.6, 95% CI 3.1, 228.0), mood (OR 1.3, 95% CI 1.1, 1.6), relations with other people (OR 0.8, 95% CI 0.6, 0.9), sleep (OR 1.2, 95% CI 1.0, 1.3) and enjoyment (OR 1.2, 95% CI 1.0). CMP patients had significantly lower total HRQoL score compared to patients without CMP (Between group difference 0.08, 95% CI 0.07–0.09). Half of the CMP patients reported a HRQoL score < 0.9 compared to 14% in the no CMP group. Conclusions Being female, receiving disability pension, and several psychosocial factors were found highly associated with reduced HRQoL in CMP patients, whereas pain characteristics were not. Patients with CMP reported statistically and clinically significant lower HRQoL than patients without CMP. Due to low response rate the conclusions must be handled with caution. Trial registration Clinicaltrials.gov (NCT02020772)

scholarly journals COVID-19 Pandemic Impact on Emergency Department Visits and Quality of Service: A Comparative Cross-Sectional Study in a Tertiary Centre

2021 ◽  
pp. 471-483
Author(s):  
Maram Mohammed Jaboua ◽  
Warif Jameel Abdulhaq ◽  
Nada Saeed Almuntashiri ◽  
Sarah Saud Almohammdi ◽  
Asayel Qeblan Aldajani ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cross Sectional Study ◽  
Emergency Department Visits ◽  
Critical Conditions ◽  
Sectional Study ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Number Of Patients ◽  
Ed Visits

Background: The COVID-19 pandemic has contributed to a devastating impact on emergency departments worldwide, resulting in a global crisis with various health consequences. We aimed to evaluate this impact on an emergency department (ED) visit of critical conditions such as Acute Coronary Syndrome (ACS), Cerebrovascular accident (CVA), Sepsis and Febrile neutropenia (FN), and to assess the quality of the ED after new adaptive measures were applied. Methods: This is a comparative cross-sectional study to assess the number of patients who presented to the ED of King Abdullah Medical city with the specified diagnosis. We collected data via the E-medical records. We compared the data over three periods pre-lockdown, lockdown and post lockdown in years 2019-2021. For quality measurement, Adaa (Ministry of Health's program) was used to calculate the percentage of patients who stayed 4 hours or less in the ED. Results: The total number of ED visits in the specified periods of study was 8387. The total numbers of patients for 2019, 2020, and 2020 respectively were 2011 (, ACS 70.4%, CVA 16.3%, sepsis and FN 13.3%.), 2733 (ACS 73.1%, CVA 9.9%, sepsis and FN 17.0%), and 3643 (ACS 64.0%, CVA 19.4%, sepsis and FN 16.7). The average percentage of patients who stayed 4 hours or less in the ED was 60% and 57.5% for 2020 and 2021, respectively. Conclusion: Although we expected reductions in ED visits during COVID-19 periods, we found that visits were rising through the years 2019-2021.

Nonwillingness to Return to the Emergency Department and Nonattendance of Follow-Up Care Arrangements Following an Initial Suicide-Related Presentation

Crisis ◽  
2021 ◽  
Author(s):  
Hannah Y. Rosebrock ◽  
Philip J. Batterham ◽  
Nicola A. Chen ◽  
Lauren McGillivray ◽  
Demee Rheinberger ◽  
...  
Keyword(s):  
Emergency Department ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Self Report ◽  
Local Health ◽  
Cross Sectional ◽  
South Wales ◽  
Patients Experience ◽  
Suicidal Crisis

Abstract. Background: For people experiencing a suicidal crisis the emergency department (ED) is often the only option to find help. Aims: The aims of this study were (a) to identify predictors of patients' nonwillingness to return to the ED for help with a future suicidal crisis, and (b) whether nonwillingness to return was associated with follow-up appointment nonattendance. Method: This study utilized baseline data from the RESTORE online survey, and included 911 participants who had presented to an ED for suicidal crisis in the past 18 months, across participating local health districts in the Australian Capital Territory and New South Wales. Results: Patients who reported a more negative ED experience and longer triage wait times were less willing to return. Those who were less willing to return were also less likely to attend their follow-up appointment. Limitations: Due to the cross-sectional study design, causal inferences are not possible. Additionally, the self-report measures used are susceptible to recall bias. Conclusion: Patients' experience of service at EDs is a key indicator to drive improvement of patient outcomes for individuals experiencing a suicidal crisis.

scholarly journals Quality of Diabetes Care in Primary Health Centres in North Al-Batinah of Oman

2014 ◽  
Vol 8 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Mohammed Al-Shafaee ◽  
Yousuf Al-Farsi ◽  
Yousuf Al-Kaabi ◽  
Yajnavalka Banerjee ◽  
Najat Al-Zadjali ◽  
...  
Keyword(s):  
Diabetes Care ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Poor Quality ◽  
Cross Sectional ◽  
Primary Health ◽  
Quality Of Diabetes Care ◽  
The Mean

Objective: To assess the quality of diabetic care provided in primary health care settings in Oman. Methods: This was a cross-sectional study of randomly selected 500 patients with diabetes mellitus (DM) attending 6 primary care diabetic clinics in the north Al-Batinah region of Oman from January to December 2010. Nine standards on the quality of diabetes care were audited. Results: The mean age of the sample was 51±13 years, ranging from 15 to 87 years; the majority (61%) were females. The mean duration of DM was 4±3 years, ranging from 1 to 18 years. Seventy-seven percent of the patients attended diabetic clinics at least 4 times per year. Of the 9 assessed diabetic standards, HbA1c was documented in 33% of the patients, body mass index in 12%, low-density lipoprotein cholesterol (LDL-C) in 40%, urinary albumin:creatinine ratio in 28%, creatinine in 63% and blood pressure (BP) in 96%. Optimal control among the documented indicators was noted in 32, 21, 25, 85, 95 and 19%, respectively. Twenty percent of the patients had their ECGs done while only 39% of the patients had foot examination. No patient had attained control in all of HbA1c., BP and LDL-C. Conclusion: There is a gap between the recommended DM care guidelines and current practice with consequent poor quality of care in these patients.

Practice and Opinion of Doctors in Primary Health Care Centers Toward Referral System: Samples from Nine Governorates in Iraq

2021 ◽  
Vol 17 (2) ◽  
pp. 100-106
Author(s):  
Sahar Abdul Hassan Al-Shatari ◽  
Lamyaa Ali Hasan ◽  
Ziyad Tarik Maki Shwaish ◽  
Ali A.K. Abutiheen ◽  
Taghlub Hemmed Ryhan ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Cross Sectional Study ◽  
Referral System ◽  
Cross Sectional ◽  
Primary Health ◽  
Inadequate Knowledge ◽  
Analytic Elements ◽  
Primary Health Care Centers ◽  
Health Care Centers

Background: Most primary Health Care Centers (PHCCs) in Iraq have a referral system records; however, this mechanism does not function well because of the lack of other requirements for an efficient referral system. Objective: To assess the practice & opinion of doctors in PHCs toward the referral system, and to determine the doctors in PHC's commitment to referral system instructions and guidelines. Subjects and methods: A cross-sectional study with analytic elements was conducted in nine health directorates in Iraq, from the 1st October 2018 – 30th June 2019.One PHC was selected randomly form each sector in every governorate, A questionnaire was used to collect the required information. SPSS version 24 analysis was used for the statistical analysis. Results:  sixty-three doctors were working in PHCs had participated in the current study, the mean age (40.03 ±10.24), 58.7%were female, 46% were general practitioner, 30.2% of the participated doctors had 300 and less patient/month; 31.7% of doctors had ≤10 Patients referred/month, emergencies was the main cause for referral (46.03%), and 37(58.37%) of doctors announced that the referred-form not retrained to the PHC, and ever retrained-forms had no feedback 29(46%), 28(44%)of the participated doctors agreed that the current referral-system was effective and seven of them strongly agreed, 59(93.7%) believe in the importance of hospital-feedback, with a significant relationship between their attitude about the effective-current-referral system & Refer cases Percentage, while no significant-relation with their Patients examined/month. Loaded crowded and hospital doctors shortage as possible causes and suggest to referral-system activation especially the hospital -part". Conclusions: there was inadequate knowledge of referral-policies and lack of coordination or/and clear feedback-expectations and PHCs-hospitals collaboration and lack of referral-system integrated within an electronic-health-record.

scholarly journals Patients’ utilisation and perception of the quality of printed health education materials in primary health care: a cross-sectional study

BJGP Open ◽  
2019 ◽  
Vol 3 (4) ◽  
pp. bjgpopen19X101672
Author(s):  
Alhan Haji
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Education ◽  
Healthy Lifestyle ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Health

BackgroundPrinted health education (HE) materials are commonly provided in primary health care (PHC). However, little is known about their use by PHC visitors.AimThis study explored patients’ opinions and use of printed HE materials in order to determine an ideal output format for HE.Design & settingThis was a cross-sectional study, which was conducted in three PHC centres at King Abdulaziz Medical City in Riyadh, Saudi Arabia.MethodData were collected through a self-administered questionnaire.ResultsFifty-five point two per cent of participants obtained printed HE materials from PHC waiting areas. The majority read one or more materials and found it helpful and memorable. Seventy-seven point two per cent applied the written message, 24.0% of participants regularly read HE materials, and more than half spent time reading them in the PHC centre’s waiting area. Around half (51.1%) put the material back in its place after reading it. The preferred format was card with text and graphs. The preferred content was healthy lifestyle advice.ConclusionPatients do use printed HE materials in a positive way. More efforts are needed to improve the quality of the materials. Different healthcare providers should contribute more in HE.

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