scholarly journals FAKTOR – FAKTOR PENGHAMBAT PELAYANAN DI TEMPAT PENDAFTARAN PASIEN BPJS RAWAT JALAN DI RUMAH SAKIT SARI MUTIARA, LUBUK PAKAM TAHUN 2019

2019 ◽  
Vol 4 (2) ◽  
pp. 668-674
Author(s):  
Puput Melati Hutauruk ◽  
Meha Marito Br. Gurning
Keyword(s):  

Pelayanan rawat jalan (ambulatory services) adalah salah satu bentuk dari pelayanan kedokteran. Secara sederhana yang dimaksud dengan pelayanan rawat jalan adalah pelayanan kedokteran yang disediakan untuk pasien tidak untuk rawat inap (hospitalization). Penelitian ini bertujuan untuk mengetahui faktor – faktor penghambat pelayanan di tempat  pendaftaran pasien BPJS rawat jalan di RSU Sari Mutiara Lubuk Pakam. Jenis penelitian ini menggunakan metode deskriptif dilaksan dengan sampel sebanyak 64 orang pasien BPJS rawat jalan. Dari hasil penelitian dari 64 orang pasien BPJS rawat jalan yang diteliti menunjukkan bahwa sebanyak 38 orang (59,4 %) telah mengetahui berkas pendaftaran pasien BPJS rawat jalan. Berdasarkan waktu penyediaan dokumen rekam medis didapatkan bahwa rata – rata waktu yang dibutuhkan untuk pendaftaran adalah 7 menit..Penyediaan dokumen rekam medis > 10 menit sebanyak 11 orang (17,2 %). Berdasarkan hasil penelitian tersebut, diharapkan agar selalu dilakukan keterbukaan atas informasi berkas persyaratan pendaftaran dan pelayanan kesehatan terhadap peserta BPJS Kesehatan. Bentuk penyimpanan dokumen rekam medis sebaiknya menggunakan dua sistem yaitu sentralisasi dan desentralisasi juga tracer agar keberadaan dokumen rekam medis dapat diketahui yaitu dipinjam atau sudah dikembalikan tetapi tidak sesuai dengan urutan nomor rekam medisnya.

Author(s):  
Alex Buoite Stella ◽  
Giovanni Furlanis ◽  
Nicolò Arjuna Frezza ◽  
Romina Valentinotti ◽  
Milos Ajcevic ◽  
...  

AbstractThe autonomic nervous system (ANS) can be affected by COVID-19, and dysautonomia may be a possible complication in post-COVID individuals. Orthostatic hypotension (OH) and postural tachycardia syndrome (POTS) have been suggested to be common after SARS-CoV-2 infection, but other components of ANS function may be also impaired. The Composite Autonomic Symptom Scale 31 (COMPASS-31) questionnaire is a simple and validated tool to assess dysautonomic symptoms. The aim of the present study was to administer the COMPASS-31 questionnaire to a sample of post-COVID patients with and without neurological complaints. Participants were recruited among the post-COVID ambulatory services for follow-up evaluation between 4 weeks and 9 months from COVID-19 symptoms onset. Participants were asked to complete the COMPASS-31 questionnaire referring to the period after COVID-19 disease. Heart rate and blood pressure were manually taken during an active stand test for OH and POTS diagnosis. One-hundred and eighty participants were included in the analysis (70.6% females, 51 ± 13 years), and OH was found in 13.8% of the subjects. Median COMPASS-31 score was 17.6 (6.9–31.4), with the most affected domains being orthostatic intolerance, sudomotor, gastrointestinal and pupillomotor dysfunction. A higher COMPASS-31 score was found in those with neurological symptoms (p < 0.01), due to more severe orthostatic intolerance symptoms (p < 0.01), although gastrointestinal (p < 0.01), urinary (p < 0.01), and pupillomotor (p < 0.01) domains were more represented in the non-neurological symptoms group. This study confirms the importance of monitoring ANS symptoms as a possible complication of COVID-19 disease that may persist in the post-acute period.


PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 813-819
Author(s):  
Paul W. Newacheck ◽  
Neal Halfon

Using data from the 1981 Child Health Supplement to the National Health Interview Survey, we examined differences in access to ambulatory services for children of different family incomes. The results indicate that much progress has been made in equalizing access since the War on Poverty was initiated in the mid-1960s. Poor children with superior health status now generally see physicians at the same rates as children in similar health but from higher income families. However, children with substantial health problems from low-income families continue to lag behind their higher income counterparts in similar health. Medicaid was shown to substantially improve access to ambulatory services for economically disadvantaged children in poor health, but less than half of these children are covered by Medicaid. Recent changes in federal and state policies concerning Medicaid are discussed as well as policy options for addressing the needs of children afflicted by both poverty and ill health.


PEDIATRICS ◽  
2000 ◽  
Vol 106 (Supplement_3) ◽  
pp. 937-941
Author(s):  
Kenneth D. Mandl ◽  
Charles J. Homer ◽  
Oren Harary ◽  
Jonathan A. Finkelstein

Objective. To determine the impact of reduced postpartum length of stay (LOS) on primary care services use. Methods. Design: Retrospective quasiexperimental study, comparing 3 periods before and 1 period after introducing an intervention and adjusting for time trends.Setting: A managed care plan.Intervention: A reduced obstetrical LOS program (ROLOS), offering enhanced education and services.Participants: mother-infant dyads, delivered during 4 time periods: February through May 1992, 1993, and 1994, before ROLOS, and 1995, while ROLOS was in effect.Independent Measures: Pre-ROLOS or the post-ROLOS year.Outcome Measures: Telephone calls, visits, and urgent care events during the first 3 weeks postpartum summed as total utilization events. Results. Before ROLOS, LOS decreased gradually (from 51.6 to 44.3 hours) and after, sharply to 36.5 hours. Although primary care use did not increase before ROLOS, utilization for dyads increased during ROLOS. Before ROLOS, there were between 2.37 and 2.72 utilization events per dyad; after, there were 4.60. Well-child visits increased slightly to .98 visits per dyad, but urgent visits did not. Conclusion. This program resulted in shortened stays and more primary care use. There was no increase in infant urgent primary care utilization. Early discharge programs that incorporate and reimburse for enhanced ambulatory services may be safe for infants; these findings should not be extrapolated to mandatory reduced LOS initiatives without enhancement of care.


2013 ◽  
Vol 23 (12) ◽  
pp. 1481-1492 ◽  
Author(s):  
Thomas Kopetsch ◽  
Hendrik Schmitz

Author(s):  
Albert Crawford ◽  
Suzanne Langner ◽  
Nancy Marnell ◽  
Mary Morrison ◽  
Carol Scattergood ◽  
...  

2019 ◽  
Vol 28 (10) ◽  
pp. 817-825
Author(s):  
Nusrat Homaira ◽  
Louise K Wiles ◽  
Claire Gardner ◽  
Charlotte J Molloy ◽  
Gaston Arnolda ◽  
...  

BackgroundBronchiolitis is the most common cause of respiratory hospitalisation in children aged <2 years. Clinical practice guidelines (CPGs) suggest only supportive management of bronchiolitis. However, the availability of CPGs do not guarantee that they are used appropriately and marked variation in the clinical management exists. We conducted an assessment of guideline adherence in the management of bronchiolitis in children at a subnationally representative level including inpatient and ambulatory services in Australia.MethodsWe searched for national and international CPGs relating to management of bronchiolitis in children and identified 16 recommendations which were formatted into 40 medical record audit indicator questions. A retrospective medical record review assessing compliance with the CPGs was conducted across three types of healthcare setting: hospital inpatient admissions, emergency department (ED) presentations and general practice (GP) consultations in three Australian states for children aged <2 years receiving care in 2012 and 2013.ResultsPurpose-trained surveyors conducted 13 979 eligible indicator assessments across 796 visits for bronchiolitis at 119 sites. Guideline adherence for management of bronchiolitis was 77.3% (95% CI 72.6 to 81.5) for children attending EDs, 81.6% (95% CI 78.0 to 84.9) for inpatients and 52.3% (95% CI 44.8 to 59.7) for children attending GP consultations. While adherence to some individual indicators was high, overall adherence to documentation of 10 indicators relating to history taking and examination was poorest and estimated at 2.7% (95% CI 1.5 to 4.4).ConclusionsThe study is the first to assess guideline-adherence in both hospital (ED and inpatient) and GP settings. Our study demonstrated that while the quality of care for bronchiolitis was generally adherent to CPG indicators, specific aspects of management were deficient, especially documentation of history taking.


PEDIATRICS ◽  
2001 ◽  
Vol 108 (1) ◽  
pp. 103-110 ◽  
Author(s):  
E. A. Alessandrini ◽  
K. N. Shaw ◽  
W. B. Bilker ◽  
K. A. Perry ◽  
M. D. Baker ◽  
...  

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