scholarly journals Disparity in the Hospitals Utilization among Regions in Indonesia

2021 ◽  
Vol 9 (E) ◽  
pp. 1461-1466
Author(s):  
Trias Mahmudiono ◽  
Agung Dwi Laksono
Keyword(s):  
Health Care ◽  
Multinomial Logistic Regression ◽  
Individual Characteristics ◽  
Health Care Facilities ◽  
Hospital Utilization ◽  
Continuous Variables ◽  
Chi Square ◽  
Care Facilities ◽  
Chi Square Test ◽  
The Difference

Abstract: The utilization of hospital services is a benchmark for the success of a health care referral system. Indonesia as the largest archipelago in the world encounters challenging conditions along with lack of infrastructure posed economic and health disparity among its regions. Disparities as a result of this development also have an impact on the accessibility of health care facilities. Regions with good economic movements tend to have good accessibility to health care facilities. For this reason, reducing disparity to achieve universal health services is the goal of health planners and policy makers. Chi Square test was used to test dichotomy variables and t-tests was performed for analysing the difference among continuous variables. These tests were employed to assess the hypothesis that there was significant regional difference in the access of health care in Indonesia. Estimation using multinomial logistic regression test was used to study the disparity between regions in hospital utilization. The results of this study showed that disparities between regions in Indonesia exist in term of hospital utilization. The disparities in hospital utilization among regions in Indonesia were associated with: marital status, socioeconomic status, education level, occupation and insurance ownership. However, the difference in odds ratio for mortality between regions decreased compared to the previous period. Conclusion. Disparities in the hospital utilization among region in Indonesia was associated with complex factors from individual characteristics through geographic barriers.

Disparity in the Hospitals Utilization among Regions in Indonesia

2020 ◽  
Author(s):  
Agung Dwi Laksono ◽  
Beben Benyamin ◽  
Trias Mahmudiono
Keyword(s):  
Health Care ◽  
Data Collection ◽  
Multinomial Logistic Regression ◽  
Continuous Variables ◽  
Chi Square ◽  
Chi Square Test ◽  
The Difference ◽  
Outpatient Utilization ◽  
Significant Regional Difference ◽  
Ethical Clearance

Abstract Background. The utilization of hospital services is a benchmark for the success of a health care referral system. Indonesia as the largest archipelago in the world encounters challenging conditions along with lack of infrastructure posed economic and health disparity among its regions. Disparities as a result of this development also have an impact on the accessibility of health care facilities.Methods. Chi Square test was used to test dichotomy variables and t-tests were performed for analyzing the difference among continuous variables. These tests were employed to assess the hypothesis that there was significant regional difference in the access of health care in Indonesia. Estimation using multinomial logistic regression test was used to study the disparity between regions in hospital utilization.Results. The results of this study indicate that there were disparities between regions in Indonesia. In the inpatient category all regions have better utilization than the Papua region, except the Sumatra region. The highest disparity occurs between the Nusa Tenggara region and the Papua region. Possibility of utilizing hospital vs. inpatient facilities not using the hospital 1,439 times in adults in the Nusa Tenggara region compared to the Papua region (OR = 1,439; 95% CI = 1,271 - 1,629). In the category of outpatient utilization as well as hospitalization in hospitals, the Papua region has better hospital utilization compared to other regions. The greatest disparity with the Sumatra region (OR = 0.484; 95% CI = 0.392 - 0.597).Conclusion. In conclusion, there were disparities between regions in Indonesia even though the odds ratio for mortality between regions decreased compared to the previous period.Ethical Clearance. The 2013 RISKESDAS survey had ethical clearance that was approved by the national ethical committee in the NIHRD (ethic number: 01.1206.207). Informed consent was used during data collection, which considered aspects of data collection procedure, voluntary, and confidentiality.

scholarly journals Access to chronic medicines: patients’ preferences for a last kilometre medicine delivery service in Cape Town, South Africa

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Siraaj Adams ◽  
Mwila Mulubwa ◽  
Mea van Huyssteen ◽  
Angeni Bheekie
Keyword(s):  
South Africa ◽  
Health Care ◽  
Health Facility ◽  
Employment Status ◽  
Health Care Facilities ◽  
Chronic Patients ◽  
Chi Square ◽  
Delivery Service ◽  
Care Facilities ◽  
Chi Square Test

Abstract Background Chronic patients are required to access their chronic medicines on a regular basis, often only to refill their repeat prescriptions. Adherence to chronic medicines is challenging and has stimulated health care providers to devise differentiated service delivery models of care to decentralise chronic medicine distribution to decrease the frequency of medicine collection at health care facilities. One such option includes a last kilometre medicine delivery service. This study investigated chronic patients’ preferences for a last kilometre medicine delivery service model. Methods An exploratory non-randomised quantitative study was conducted over 4 weeks at four public sector primary health care facilities in Cape Town, South Africa. Data was collected on a structured questionnaire from chronic patients queuing to receive medication at each facility’s pharmacy waiting area. Patient demographics were noted to align with preferences for chronic medicine service delivery characteristics including; mobile ordering, fee for service and location for delivery. Chi-square test and frequencies were employed to analyse data using SPSS version 23. Results A total of 116 patients participated in this study. Most were interested in a medicine delivery service (80.2%) and were willing to use a mobile application to order their medicines (84.5%). Almost all patients (96.8%) preferred that their medicines be delivered to their home. More than three quarters of participants were willing to pay for the service (77.6%). Chi-square test showed that gender, age group, employment status, distance to the health facility and /or average waiting time at the clinic significantly influenced the preference for certain characteristics of the medicine delivery service (p < 0.05). Conclusion Most participants were interested in a last kilometre medicine delivery service, especially those older than 45 years, waiting for more than 6 h at the facility, and staying within one kilometre radius of the clinic. More studies are needed to establish the influence of patients’ employment status and the distance to health facility on interest in the medicine delivery service.

scholarly journals TINGKAT KECEMASAN IBU HAMIL TERHADAP KUNJUNGAN ANTENATAL CARE DI MASA PANDEMI COVID-19

2021 ◽  
Vol 13 (01) ◽  
pp. 96
Author(s):  
Nining Sulistyowati ◽  
Yeti Trisnawati
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Personality Inventory ◽  
Health Care Facilities ◽  
Chi Square ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Pregnancy Anxiety ◽  
Care Facilities

ABSTRAKLatar belakang: Pandemi Covid-19 menyebabkan banyak pembatasan hampir ke semua layanan rutin termasuk pelayanan kesehatan maternal dan neonatal. Ibu hamil menjadi enggan ke puskesmas atau fasiltas pelayanan kesehatan karena takut tertular, adanya anjuran menunda pemeriksaan kehamilan dan kelas ibu hamil Kurangnya kunjungan ANC ini bisa menyebabkan bahaya bagi ibu maupun janin seperti terjadinya perdarahan saat masa kehamilan karena tidak terdeteksinya tanda bahaya. Tujuan penelitian: Untuk menganalisis kecemasan ibu hamil terhadap kunjungan antenatal care di masa pandemic covid-19. Metode: Penelitian analitik dengan rancangan cross sectional. Penelitian dilakukan di Praktik Mandiri Bidan di Kota Tanjungpinang dari bulan Januari – Februari 2021. Populasi seluruh ibu hamil TM III yang terdata di Praktik Mandiri Bidan di Kota Tanjungpinang dengan sampel sebanyak 32 responden. Teknik purposive sampling dengan kriteria antara lain ibu hamil dengan usia kehamilan trimester III, mampu mengungkapkan perasaan dan kecemasannya, mempunyai handphone dan nomor whatsapp, memiliki Buku KIA serta skor L-MMPI (Lie-Score Minnesota Multiphase Personality Inventory) <10. Hasil penelitian: Hasil uji statistik chi square diperoleh nilai p 0,016 (p<0,05) disimpulkan ada hubungan antara tingkat kecemasan ibu hamil dengan kunjungan antenatal care ke fasilitas pelayanan kesehatan di masa pandemi Covid-19. Simpulan: Hasil penelitian menunjukkan bahwa kunjungan ANC ibu hamil ke fasilitas pelayanan kesehatan pada masa pandemi covid-19 sebagian besar melakukan kunjungan ANC teratur 22 ibu hamil (68,8%), ibu hamil tidak mengalami kecemasan 9 (28,1%). Ibu hamil yang mengalami kecemasan dan tidak teratur melakukan kunjungan ANC sebanyak 12 ibu hamil (37,5%). Ibu hamil yang tidak mengalami cemas seluruhnya melakukan kunjungan ANC secara teratur yaitu 9 responden.Kata kunci: umur, Pendidikan, pekerjaan, kehamilan, kecemasan, frekuensi antenatal carePREGNANT MOTHER'S ANXIETY LEVELS ON ANTENATAL CARE VISITS DURING THE COVID-19 PANDEMICABSTRACTBackground: The Covid-19 pandemic has caused many restrictions on almost all routine services, including maternal and neonatal health services. Pregnant women are reluctant to go to the puskesmas or health service facilities for fear of contracting it, there are recommendations to postpone pregnancy checks and classes for pregnant women. This lack of ANC visits can cause danger to the mother and fetus, such as bleeding during pregnancy because no danger signs are detected. The purpose of the study: To analyze the anxiety of pregnant women regarding antenatal care visits during the covid-19 pandemic. Methods: Analytical research with cross sectional design. The study was conducted at the Independent Midwife Practice in Tanjungpinang City from January - February 2021. The population of all TM III pregnant women recorded at the Midwife Independent Practice in Tanjungpinang City with a sample of 32 respondents. Purposive sampling technique with criteria including pregnant women with the third trimester of pregnancy, being able to express their feelings and anxieties, having a cellphone and whatsapp number, having a KIA Book and an L-MMPI (Lie-Score Minnesota Multiphase Personality Inventory) score <10. Research results: The results of the chi square statistical test obtained a p value of 0.016 (p <0.05) it was concluded that there was a relationship between the level of anxiety of pregnant women and antenatal care visits to health care facilities during the Covid-19 pandemic. Conclusion: The results showed that ANC visits of pregnant women to health care facilities during the covid-19 pandemic mostly carried out regular ANC visits 22 pregnant women (68.8%), pregnant women did not experience anxiety 9 (28.1%). Pregnant women who experience anxiety and do not regularly visit ANC as many as 12 pregnant women (37.5%). Pregnant women who do not experience anxiety all make regular ANC visits, namely 9 respondents.Keywords: age, education, occupation, pregnancy, anxiety, antenatal care frequency.

scholarly journals A cross sectional study of the morbidity pattern among stone quarry workers and their associated risk factors

2021 ◽  
Vol 8 (9) ◽  
pp. 4451
Author(s):  
Vijayakumar M. ◽  
Jeshtin M.
Keyword(s):  
Health Care ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Care Seeking ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Chi Square Test ◽  
Associated Risk Factors

Background: Construction sector is a thriving industry which comprises most of the unorganized workers and providing widespread opportunities for employment of most of the poorest and marginalized sections of society in India. The workers are more susceptible to various occupational hazards due to working conditions in dusty environment. This study is proposed to identify the morbidity pattern, availability and usage of safety measures, health care seeking behaviour and health care facilities at the quarry site.Methods: A cross sectional study was conducted among the stone quarry workers of Maduranthakam area in Kancheepuram district from February 2018 to May 2018. The sample size was calculated as 94 and five quarries were selected randomly. The study tool was interview based semi structured questionnaire and clinical examination. Appropriate descriptive and inferential statistics like Chi square test, Fischer’s exact test was done to determine significant association (p<0.05).Results: The common morbidities among the participants were abdominal conditions (54%), injuries (34%) and musculoskeletal disorders (27%). One in five individuals had respiratory problems and those with breathing difficulty had decreased peak expiratory flow rate. Usage of personal protective equipments is low and about 63.8% of them were using government health care facilities.Conclusions: Increasing demand for stone and aggregates has led to extensive stone quarrying operations. Awareness and enforcement of personal protective equipment, vaccination against diseases like tetanus, periodic health check- ups should be enforced for people working in quarries.

Universal screening for Lynch syndrome (LS) in colorectal cancer (CRC) and survival.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 415-415 ◽  
Author(s):  
Sigurdis Haraldsdottir ◽  
Christina Sing-Ying Wu ◽  
Heather Hampel ◽  
Wendy Frankel ◽  
Xueliang Jeff Pan ◽  
...  
Keyword(s):  
Universal Screening ◽  
Gene Sequencing ◽  
Rank Test ◽  
Continuous Variables ◽  
State University ◽  
Chi Square ◽  
Chi Square Test ◽  
The Difference ◽  
The Ohio State University ◽  
Or Gene

415 Background: It has been argued that universal screening for LS should be performed on all patients (pts) diagnosed with CRC because screening LS pts and their relatives can detect early cancers and improve outcomes. This approach is being adopted by many comprehensive cancer centers around the country. The Ohio State University (OSU) began screening for deficient mismatch repair (dMMR) proteins by immunohistochemistry (IHC) on all CRC cases in 2006. This retrospective study aims to assess whether universal screening with IHC followed by conclusive testing (BRAF mutation in setting of MLH1 deficiency, and/or gene sequencing) affects pts survival. Methods: All CRC pts diagnosed at OSU from 3/2006-6/2012 with dMMR testing per IHC were included, and their charts were reviewed. Chi-square test was used to for categorical parameters, t-test was used for continuous variables, and the log-rank test for overall survival (OS) to compare the difference between pts with full conclusive testing vs those without full testing. Patients who expired within 4 weeks of diagnosis were excluded (n=10) from the OS analysis. Results: One hundred and twenty-two tumors (15.7% of 777 tumors tested) had dMMR by IHC during the study period. Fifty-one pts went on to have conclusive testing done; thirteen patients (25.5%) were diagnosed with LS, 29 patients (56.9%) had MLH1-hypermethylated tumors, and 9 patients (17.6%) were not found to have MMR mutations on gene sequencing. In an OS analysis, patients undergoing conclusive testing had significantly longer survival as compared to those with abnormal IHC without further testing (median OS not reached vs. 38 months, p=0.04). The difference was similar and remained marginally significant (p= 0.04-0.09) after correcting for age, stage and testing date using different models. Conclusions: Patients who had conclusive testing after initial abnormal universal screening with IHC had significantly longer OS compared to pts who had abnormal IHC without follow-up testing. It is possible that ascertainment bias and pts compliance influenced survival so larger prospective studies that document stage and treatment are needed to determine if increased surveillance in the setting of a LS diagnosis leads to better OS.

scholarly journals Determinan Pemilihan Tempat Persalinan di Puskesmas Tapin Utara

2020 ◽  
Vol 10 (1) ◽  
pp. 200-211
Author(s):  
Lisda Handayani ◽  
Elvine Ivana Kabuhung ◽  
Yunita Afriani
Keyword(s):  
Public Health ◽  
Health Care ◽  
Targeted Delivery ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Chi Square ◽  
Cross Sectional ◽  
Cost Factor ◽  
Care Facilities ◽  
The Cost

Latar Belakang : Salah satu indikator persalinan bersih dan aman adalah pertolongan ditolong tenaga kesehatan di fasilitas kesehatan (faskes). Standar Pelayanan Minimal (SPM) bidang kesehatan tahun 2016 menyatakan target persalinan sesuai standar adalah 100%, sedangkan data Puskesmas tapin Utara menyebutkan persalinan di faskes sebesar 56,8% dan non faskes Sebanyak 43,2%. Dari data yang didapat disimpulkan bahwa persalinan di wilayah puskesmas Tapin Utara belum mencapai target SPM bidang kesehatan. Tujuan : Menganalisis determinan pemilihan tempat persalinan oleh ibu bersalin diwilayah puskesmas Tapin Utara.Metode : Penelitian Kuantitatif dengan pendekatan cross sectional. Pengambilan sampel  dengan tekhnik total sampling sebanyak 62 ibu bersalin selama januari 2017. Analisis bivariat digunakan Uji chi square dan analisis multivariat regresi lostik bergandaHasil : Gambaran pemilihan tempat persalinan oleh ibu bersalin diwilayah puskesmas tapin utara adalah ibu bersalin di faskes (43,5%) dan non faskes (56,5%). Determinan pemilihan tempat persalinan adalah budaya (p=0,000), Pemeriksaan Kehamilan (p=0,001), pengetahuan(p=0,000), dan Biaya persalinan (p=0,001), sedang yang bukan merupakan determinan pemilihan tempat persalinan adalah pendapatan (p=0,154), akses ibu ke faskes (p=0,207) dan dukungan keluarga (p=0,439). Determinan paling dominan adalah biaya persalinan (p=0,008, OR=11,712).Simpulan : Determinan pemilihan tempat persalinan di wilayah puskesmas tapin utara adalah budaya, pemeriksaan kehamilan, pengetahuan dan biaya sedangkan yang bukan determinan adalah pendapatan, akses ke faskes dan dukungan keluarga. Determinan paling dominan adalah biaya persalinan.Kata kunci : Tempat Persalinan, Budaya, Pemeriksaan Kehamilan, Pengetahuan, Pendapatan, Biaya Persalinan, Akses ibu ke Faskes dan dukungan keluarga.                                                  Abstract:Background : Maternal mortality rate still high because delivery is not at health facilities. Information of north tapin central public health said there had been 470 delivery and while non health facilities about 43,2 % .For which figures obtained concludea that delivery in district tapin not reached target public health years 2016 who was targeted delivery service at health facilities appropriate standard 100 % service. Objective : analysis determinant factors relating to the selection of the place of birth in the puskesmas Tapin utara.Methods : Quantitative research by approach cross sectional . Sampling used total sampling about 62 delivered in january 2017 .The stastik used is chi square and regression lostik simple.Result : there are 43,5 % mother who has deivery  at health care  facilities, while the non health care  facilities are 56.5 %. Correlation factors of  cultural deals namely p = 0,000 value , the anc p = 0,001 value , p value knowledge = 0,000 , delivery fees p = 0,001 value , p income = 0,154 value , mother access to health care facilities p = 0,315 value , and support the family p = 0,411 value .Value the ordi highest of the results of the test stastik safinat logistic regression simple namely the cost factor of 11,712 childbirth.Conclusion : The result of 7 factor in some 4 factors that there are dealing with the selection namely the delivery: cultural factors , a pregnancy , knowledge , and the delivery fee .The cost factor a factor most dominant dealing with the selection the delivery Keywords : The delivery , culture , pregnancy, knowledge , income , the delivery fee , access health care, support by family

scholarly journals Effect of different stages on match outcomes during high level judo competitions

2020 ◽  
Vol 15 (1) ◽  
pp. 14
Author(s):  
Bayram Ceylan ◽  
Furkan Öztürk ◽  
Sükrü Serdar Balci
Keyword(s):  
Efficiency Index ◽  
Descriptive Statistics ◽  
The Other ◽  
Continuous Variables ◽  
Chi Square ◽  
Men And Women ◽  
Chi Square Test ◽  
Judo Athletes ◽  
The Difference ◽  
High Level

<p>This study aimed to demonstrate the effect of successive stages of high-level judo competitions on match outcome and the factors effecting it. A total of 4550 official matches in both men and women were included in the analysis. Frequencies and percentages were used for descriptive statistics. Mean and standard deviations with 95% confidence intervals were also presented. The difference in the variables investigated for each stage of judo competitions was analysed with the Chi-square test. Continuous variables were analysed with the Kruskal-Wallis test. The way competitors won a match differed in elimination, final stages, and medal matches (<em>p</em>=.02). When the difficulty of the matches increased, the percentage of the matches ended with <em>ippon </em>decreased and the percentage of the matches resulted with <em>waza-ari</em> increased. The percentage of the matches without any <em>shido</em> decreased from the elimination to the finals while there was a significant increase in the percentage of the matches with s<em>hido </em>(<em>p</em>=.01). The match duration was found to increase from eliminations to the finals (<em>p</em>=.00). The efficiency index of the winner athletes during the first stage was higher than the other stages (<em>p</em>&lt;.05). In conclusion, high-level judo athletes won a match with different scores at different stages during high-level judo competitions. Moreover, athletes were awarded with penalties more during the finals compared to eliminations, and match duration incrementally increased from the eliminations to the finals.</p>

scholarly journals SORE THROAT

2018 ◽  
Vol 25 (09) ◽  
pp. 1421-1425
Author(s):  
Liaqat Ali ◽  
Sabir Khan ◽  
Haroon Israr ◽  
Aamir Furqan
Keyword(s):  
Sore Throat ◽  
Sampling Technique ◽  
P Value ◽  
Continuous Variables ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test ◽  
Spss Software ◽  
The Difference ◽  
Trial Setting

Objectives: To compare the effect of ketamine nebulization and ketamine gargleon post operative sore throat. Study Design: Randomized control trial. Setting: Department ofAnaesthesia Ibn e Sina Hospital. Multan and National, Lahore. Period: May 2016 to May 2017.Methodology: After provision form ethical committee and informed consent to be included instudy. Patients of age 20-60 years, ASA status I and II, elective surgeries under GA and both sexwere included in the study through consecutive sampling technique. SPSS software was used toanalyze all variables included in the study continuous variables were measured and presentedas mean and standard deviation, categorical measurement were measured in numbers andpercents. Chi square test was applied to check the difference among both groups. P value ≤0.05 was considered as significant. Results: Overall, 100% (n=160) patients were included, inthis study; divided into two equal groups, 50% (n=80) in each, gargled ketamine group (GKgroup) and nebulization group (NK group) respectively. The incidence of postoperative sorethroat at 0, 2, 4, and 24 hours, in GK group, was (n=8) 40%, (n=4) 20%, (n=3) 15% and (n=3)15%respectively. While, at corresponding time point in group NK it was (n=1) 5%, (n=7) 35%,(n=4) 20% and (n=2) 10%respectively. Conclusion: The observations of our study revealedthat ketamine nebulization and ketamine gargles having no significant difference in reductionof POST incidence.

The Associated Factors Due Satisfaction of BPJS Services in Hospital Hikmah of Makassar

2021 ◽  
Vol 4 (2) ◽  
pp. 232-238
Author(s):  
Andi Nailah Amirullah ◽  
Yuliani ◽  
Nurhidayat
Keyword(s):  
Health Services ◽  
Health Workers ◽  
Sampling Technique ◽  
Health Care Facilities ◽  
Chi Square ◽  
Cross Sectional ◽  
Care Facilities ◽  
Chi Square Test ◽  
Quality Of Health Services

Health care facilities are expected to provide satisfactory services in hospitals. Have not being able to provide the maximum service expected by service users is the problem often faced by hospitals. Where the main assessment of the quality of health services is patient satisfaction. Based on a preliminary study at the RS Hikmah Makassar, it was found that more people were dissatisfied with health services. The purpose of this study was to find out the factors related to BPJS service satisfaction in BPJS Health participants at Hospital Hikmah of Makassar. The research design used Cross-Sectional. The population is 426 people. The sample in this study were some participants who used BPJS cards in Hospital Hikmah Of Makassar as many as 81 people, taking samples by purposive sampling technique. This research was conducted in May - June 2019. Data was collected with Questioner and analysed with the Chi-Square test. The results showed that there was a relationship between BPJS administration services, doctors and nurses services, supporting examination services and drug services with the satisfaction of BPJS services for BPJS Health participants in Hospital Hikmah of Makassar. The study suggested to health workers provide patients with a more friendly attitude and attention to patients recipients of health services.

Professional Negligence and the Occupational Therapist

1983 ◽  
Vol 50 (2) ◽  
pp. 45-48
Author(s):  
Hilary Jarvis
Keyword(s):  
Health Care ◽  
Health Care Professional ◽  
Occupational Therapists ◽  
Health Care Facilities ◽  
Occupational Therapist ◽  
Gradual Shift ◽  
Legal Implications ◽  
Care Facilities ◽  
The Difference

This paper will attempt to clarify the meaning of negligence. The difference between the negligent acts of a layman and a professional are defined and compared, as well as professional and non-professional occupations. The method of determining the standard by which occupational therapists are measured is discussed as well as the points the Courts consider when the standard is breached and harm to the patient results. Consideration is given to the gradual shift of responsibility from the physician to the health care professional, the ensuing legal implications, and the division of responsibility for negligence. The position of occupational therapists employed by health care facilities, in relation to the liability of the employer and the practitioner are outlined. The points discussed are illustrated by cases from the British, Canadian and American Courts.

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