scholarly journals Cost of Treatment Demam Berdarah Dengue (DBD) di Rawat Inap Berdasarkan Clinical Pathway di RS X Jakarta

2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Vera Marietha Meinar Rejeki ◽  
Atik Nurwahyuni
Keyword(s):  
Health Care Providers ◽  
Clinical Pathway ◽  
Clinical Pathways ◽  
Unit Cost ◽  
Care Providers ◽  
Cost Of Treatment ◽  
Cross Sectional ◽  
Dengue Disease ◽  
Real Cost ◽  
The Cost

Abstrak Rumah Sakit sebagai pemberi layanan kesehatan saat ini dituntut untuk melakukan kendali mutu dan biaya, namun tetap berkualitas. Clinical pathway yang menjadi dasar pengendalian mutu dan biaya sudah ada tetapi belum diaudit penggunaan­nya oleh tim rumah sakit. Penelitian ini bertujuan untuk mengetahui unit cost layanan dan cost of treatment DBD di RS X Ja­karta. Penelitian kuantitatif melalui pengambilan data cross sectional dengan jumlah sampel penelitian sebanyak 190 pasien DBD. Hasil penelitian didapatkan adanya kesenjangan antara cost of treatment perawatan pasien DBD berdasarkan clinical pathway (Rp. 2.184.588) dan cost of treatment berdasarkan kondisi riil (Rp. 2.382.512) dengan selisih terbesar di rawat inap dan obat-obatan. Cost of treatment tanpa perhitungan gaji dan investasi untuk pasien DBD dapat berkurang menjadi 29% dari cost of treatment semula. Cost of Treatment tanpa perhitungan gaji maka cost of treatment dapat turun menjadi 42%. Diperlukan sistem pemantauan kepatuhan terhadap clinical pathway, pembentukan tim casemix rumah sakit untuk peman­tauan dan evaluasi implementasi JKN di rumah sakit .Abstract Hospitals as health care providers are now required to perform cost and quality control without neglecting the quality of services. Clinical pathways which underlying quality and cost control in the hospital are available but has not been audited. This study aims to determine the unit cost of services in RS X Jakarta, the utilization of hospital services for dengue disease and cost of treatment of DHF in RS X Jakarta. A cross-sectional study was performed in this study. A quantitative approach was done through data collection from hospital information system, medical record and financial data. The result showed that there was a gap between the cost of treat­ment of DHF patients which based on the clinical pathway (2,184,588 IDR) and the cost of treatment based on the real condition (2,382,512 IDR). The biggest difference between cost of treatment and real cost was in the hospitalization cost and medicine cost. Cost of treatment without salary and investation calculation for DHF patients can be reduced significantly by 29%. Cost of treatment without salary calculation for DHF patients can be reduced significantly by 42%. There is a need for monitoring system and the estab­lishment of hospital case mix team in order to optimize the hospital clinical pathway in the JKN era. 

scholarly journals Knowledge, Perceptions and Effects of Ebola Virus Disease Outbreak on the Pig Value Chain in the Agro-pastoralist District of Luwero, Central Uganda

2021 ◽  
Author(s):  
Samuel Majalija ◽  
Doreen Birungi ◽  
Gabriel Tumwine ◽  
Charles Drago Kato ◽  
Tonny Ssekamatte ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Value Chain ◽  
Ebola Virus ◽  
Virus Disease ◽  
Unit Cost ◽  
Cross Sectional Study ◽  
Traditional Healers ◽  
Care Providers ◽  
Cross Sectional ◽  
Farming Communities

Abstract Background: Ebola outbreaks have continued to affect the health, wellbeing and livelihoods of communities. In particular, Ebola response interventions affect food value chains, food and income security of pig farming communities. There is paucity of information on the effect of Ebola outbreak on the pig value chain as well there is a gap on the knowledge and perceptions of those engaged in the pig value chain on Ebola. Therefore, this study aimed at assessing the knowledge, perceptions on the occurrence of Ebola and its effects on the pig value chain in the agro-pastoral district of Luweero, Central Uganda.Methods: A cross sectional study was conducted in two parishes of Ssambwe and Ngalonkulu, Luwero district. A total of 229 respondents were included in the study. Structured questionnaires, key informant interviews and focus group discussions were conducted to collect data. Quantitative data was analysed using SPSS version 22 while qualitative data was analysed using thematic content analysis.Results: Of the 229 respondents, 95.6% could recall the occurrence of the last Ebola outbreak in their locality. The proportion of respondents that associated touching pigs or eating pork with acquisition of Ebola virus was 24.5%. Ebola was perceived as a spiritual manifestation of witchcraft activities. Traditional healers were among the first line of health care providers to Ebola patients in the outbreak. There was no significant association between the perceived human practices such as bush meat consumption, contact with wild animals and acquiring of Ebola virus. The number of pigs sold during the outbreak was significantly reduced (p= 0.001) and this normalized 2 months after the area was declared Ebola free. There was a significant reduction (p= 0.03) in consumption of pork, as well as the unit cost per kilogram of pork during the Ebola outbreak due to fear of acquiring the disease from pork. Conclusion: The study showed that the pig value chain was negatively affected by Ebola outbreak. Therefore, there is need to sensitize the stakeholders on Ebola in order to minimize the negative economic impacts associated with EVD outbreaks.

scholarly journals Use of rabies immune globulin in seven urban emergency rooms in Pakistan

2014 ◽  
Vol 8 (1) ◽  
pp. 61-65 ◽  
Author(s):  
Naseem Salahuddin ◽  
Khadija Mubashar ◽  
Naila Baig-Ansari
Keyword(s):  
Emergency Room ◽  
Immune Globulin ◽  
Health Care Providers ◽  
Cross Sectional Study ◽  
Human Rabies ◽  
Care Providers ◽  
Emergency Rooms ◽  
Cross Sectional ◽  
Life Saving ◽  
The Cost

Abstract Background: Human rabies is a fatal infectious disease that is entirely preventable if correct and timely postexposure prophylaxis is given. Unfortunately, rabies immune globulin (RIG) administration, a life-saving biological, is often avoided by Emergency Room health care providers (HCPs). Objective: To understand the practices of HCPs for administration of RIG in severe dog-bite exposures, which are common causes of emergency room visits in Pakistan. Methods: A cross-sectional study was conducted among 103 HCPs working in seven hospitals in three cities of Pakistan. Results: Of 103 HCPs who responded to the questionnaires, 97.1% had administered rabies vaccine and 31.1% had administered ERIG in the past three years of their practice; three quarters said they would prefer to use HRIG if available; 35% said they would not inject wounds at all, 24.3% would only vaccinate a patient with severe dog bites, but not administer RIG. More than 55% were concerned about the cost of human and equine RIG. Conclusion: Although there is awareness about use of RIG, this life saving biological is grossly underused because of poor availability in Emergency Rooms (ERs) even though stocked by local dealers. Animal bite centers must make RIG available for severe exposures.

scholarly journals Analisa Biaya Pengobatan Demam Tifoid Berdasarkan Clinical Pathway Di Rumah Sakit Harapan Bunda

2019 ◽  
Vol 13 (2) ◽  
Author(s):  
Pieter Hazmen ◽  
Shirly Kumala ◽  
Prih Sarnianto
Keyword(s):  
Length Of Stay ◽  
Typhoid Fever ◽  
Clinical Pathway ◽  
Clinical Pathways ◽  
High Volume ◽  
Antibiotic Use ◽  
Observational Research ◽  
Cost Of Treatment ◽  
Significant Difference ◽  
The Cost

Clinical pathways are used in quality and cost control with indicators of length of stay. Cases of typhoid fever at Harapan Bunda Hospital include the criteria for the first rank of High Volume in 2018 and Problem Prone in the cost of treatment. The purpose of the study is to analyze the cost of treatment based on the implementation of clinical pathways in antibiotic therapy. Observational research with comparative studies of the use of injection antibiotics based on clinical pathway implementation. Retrospective data collection with dependent outcome therapy variables (cost and length of stay) while the independent variable regimen of antibiotic use. The population of typhoid fever patients according to the criteria for the implementation of clinical pathway ICD code (A0.10) 571 patients. Samples using total sampling that fulfills the criteria of direct inclusion are made into samples divided by the antibiotic regimen of the payment system, the group with the least amount excluded. There were 4 observation groups: generic ceftriaxone (n = 52) branded ceftriaxone (n = 51), generic cefotaxime (n = 53) and branded cefotaxime (n = 57) totaling 213 patients. Satatistic test results of length of stay (p> 0.05) explained that they did not have a significant difference, the average value (5.1596). Medical expenses for generic cefotaxime (Rp 4,072,002,6792), generic cherryax (Rp 4,479,480,4808), branded cefotaxime (Rp 6,945,258,3333) and branded ceftriaxone (Rp 7,296,933,5686). Conclusions based on JKN (AMiB) antibiotic payment systems are cheaper than general and the cheapest cefotaxime cheapest generic antibiotics.

WHICH DRUGS ARE BULLYING US FINANCIALLY? PRESCRIPTION COST ANALYSIS IN EX-SERVICEMAN POLYCLINIC DISPENSARY IN INDIA

2021 ◽  
pp. 60-64
Author(s):  
Bharat Singh ◽  
Saroj Kumar Patnaik ◽  
Chandrasekhara T ◽  
Bhaskar J Kalita ◽  
Kushagra Patel
Keyword(s):  
Cost Analysis ◽  
Health Care Providers ◽  
Unit Cost ◽  
Healthcare Facility ◽  
Essential Medicines ◽  
Care Providers ◽  
Educational Approach ◽  
Prescription Cost ◽  
The Cost ◽  
Cost Awareness

Aims: To carry out prescription cost analysis in Ex-Serviceman Contributory Health Scheme (ECHS) Polyclinic dispensary in India Study Design: Retrospective Prescription Cost Analysis Place And Duration Of Study: ECHS Polyclinic Dispensary from 01 December 2019 to 31 December 2019 on all working days Methodology: A total of 8295 prescriptions were received at ECHS dispensary in the month of December 2019 at an average of 346 prescriptions per day and a maximum of 445 per day and minimum of 242 per day. On each working day data were collected for previous day and segregated in pre-dened format as per National List of Essential Medicines (NLEM) 2015. The cost toward each group of drugs were calculated on prescribed quantity of medicines and added to calculate unit prescription cost at ECHS Dispensary. Results: It is observed that the highest number of prescriptions 4599 (55.44%) were from General OPD. The total cost of prescribed medicines worked out to be INR 25,55,103.81 for the month of December 2019. Most of the cost was ascribed to amount of INR 13,03,489.31 (51.02%) by section 21 (Hormones, other endocrine medicines and contraceptives). The estimated unit cost of prescription was INR 308.03. Conclusion: Implementing change in prescribing behaviors remains a major challenge for administrators and an inclusive approach with integrated with non-coercive educational approach should be utilized to change the behavior in prescriptions writing. Inculcating the culture of cost awareness amongst the health care providers pays good dividends in the long run. As far as cost containment in the healthcare facility is concerned, the rst step forward can be cost awareness toward what and how much clinician are prescribing.

scholarly journals Cost Recovery Rate Tarif Rumah Sakit dan Tarif INA-CBG’s Berdasarkan Clinical Pathway pada Penyakit Arteri Koroner di RS Pemerintah A di Palembang Tahun 2015

2017 ◽  
Vol 1 (4) ◽  
Author(s):  
Mardiah Mardiah ◽  
Ronnie Rivany
Keyword(s):  
Clinical Pathway ◽  
Recovery Rate ◽  
Clinical Pathways ◽  
Coronary Intervention ◽  
Cost Recovery ◽  
Cost Of Treatment ◽  
Severity Level ◽  
Level I ◽  
Artery Disease ◽  
The Cost

AbstrakAdanya selisih negatif pada kasus Coronary Artery Disease (CAD) pada tindakan Percutaneous Coronary Intervention (PCI), mengindikasikan pembiayaan kesehatan masih terdapat kesenjangan antara tarif rumah sakit dengan tarif INA-CBG’s. Penelitian ini bertujuan untuk melihat perbedaan cost recovery rate (CRR) tarif INA-CBG’s dan tarif rumah sakit kasus CAD dengan PCI di RS A Palembang. Hasil penelitian menunjukkan berdasarkan cost of treatment berbasis clinical pathways pada severity level I CRR RS berada diatas CRR tarif INA-CBG’s, sedangkan pada severity level II CRR RS lebih rendah dari CRR tarif INA-CBG’s. Pada severity level III CRR tarif INA-CBG’s dengan utilisasi stent 1 dan 2 lebih tinggi dari CRR RS. Tarif INACBGs tidak memperhitungkan jumlah stent dalam setiap tindakan PCI. Perlu evaluasi metode penghitungan tarif INA-CBGs dari hospital base rate ke metode perhitungan cost of treatment berdasarkan clinical pathway, sehingga biaya operasional RS dapat dipenuhi dan tetap mampu berikan pelayanan yang bermutu. AbstractThe difference of cost negative in the case of Coronary Artery Disease (CAD) with Percutaneous Coronary Intervention (PCI), indicate health financing gap between of hospital rates and INA-CBG’s rates. This study aimed to see the difference between the cost recovery rate (CRR) of hospital rates and INA-CBG’s rates for CAD with PCI at A Hospital. The results showed that the cost of treatment based on clinical pathways at the severity level I had a higher CRR Hospital rates compared to INA-CBG’s CRR, whereas at the severity level II, Hospital CRR rate was lower than INA-CBG’s CRR for the utility of less than 2 stents. At severity level III, CRR INA-CBGs’ rates with utilization of 1 and 2 stents performed higher rates than the hospitals CRR. This was related to INA-CBG’s rate that did not take the magnitude of the stentulitizationinto account. It is necessary to improve INA-CBG’s tarif development method from hospital base rate to clinical pathway-based cost of treatment in order to meet hospital operational cost and ensure the best quality of service.

scholarly journals “What is the actual goal of the pathway?”: Examining emergency department clinicians’ perspectives on the implementation of a pediatric concussion pathway using the Theoretical Domains Framework

2019 ◽  
Author(s):  
Anh Ly ◽  
Roger Zemek ◽  
Bruce Wright ◽  
Jennifer Zwicker ◽  
Kathryn Schneider ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Clinical Pathway ◽  
Clinical Pathways ◽  
Theoretical Domains Framework ◽  
Local Context ◽  
Evidence Based ◽  
Care Providers ◽  
Structured Interviews ◽  
Pediatric Concussion

Abstract Background Multiple evidence-based clinical practice guidelines (CPGs) exist to guide the management of concussion in children, but few have been translated into clinical pathways (CP), which operationalize guidelines into accessible and actionable algorithms that can be more readily implemented by health care providers. This study aimed to identify the clinical behaviours, attitudinal factors, and environmental contexts that potentially influence the implementation of a clinical pathway for pediatric concussion. Methods Semi-structured interviews were conducted with 42 emergency department clinicians (17 physicians, 25 nurses) at five urban emergency departments in Alberta, Canada. A Theoretical Domains Framework (TDF)-informed interview guide contained open-ended questions intended to gather feedback on the proposed pathway developed for the study, as well as factors that could potentially influence its implementation. Results The original 14 domains of the TDF were collapsed into 6 clusters based on significant overlap between domains in the clinical behaviours, thematic areas, and other issues raised by clinicians: 1) knowledge, skills, and practice; 2) professional roles and identity; 3) attitudes, beliefs, and motivations; 4) goals and priorities; 5) local context and resources; and 6) engagement and collaboration. The 6 clusters identified in the interviews each reflect 2-4 predominant topics that can be condensed into six overarching themes regarding clinicians’ views on the implementation of a concussion CP: 1) standardization in the midst of evolving research; 2) clarifying and communicating goals; 3) knowledge dissemination and alignment of information; 4) a team-oriented approach; 5) site engagement; and 6) streamlining clinical processes. Conclusion Application of a comprehensive, evidence-based, and theory-driven framework in conjunction with an inductive thematic analysis approach enabled six themes to emerge as to how to best implement a concussion clinical pathway. These overarching themes must be addressed to successfully implement a CP for pediatric concussion.

COVID-19: knowledge, awareness and perceived stress among Jordanian healthcare providers (Preprint)

2020 ◽  
Author(s):  
Emad Aborajooh ◽  
Mohammed Qussay Al-Sabbagh ◽  
Baraa Mafrachi ◽  
Muhammad Yassin ◽  
Rami Dwairi ◽  
...  
Keyword(s):  
Social Media ◽  
Psychological Stress ◽  
Health Care Providers ◽  
Best Practice ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Ordinal Logistic Regression Analysis ◽  
Source Of Information

UNSTRUCTURED We aimed to measure levels of knowledge, awareness, and stress about COVID-19 among health care providers (HCP) in Jordan. This was a cross-sectional study on 397 HCPs that utilized an internet-based questionnaire to evaluate knowledge about COVID-19, availability of personal protective equipment (PEE), future perception, and psychological distress. Ordinal logistic regression analysis was used to evaluate factors associated with knowledge and psychological stress. Overall, 24.4% and 21.2% of the participants showed excellent knowledge and poor knowledge, respectively. Social media (61.7%) was the most commonly used source of information. Being female (β= 0.521, 95% CI 0.049 to 0.992), physician (β=1.421, 95% CI 0.849 to 1.992), or using literature to gain knowledge (β= 1.161, 95% CI 0.657 to 1.664) were positive predictors of higher knowledge. While having higher stress (β= -0.854, 95% CI -1.488 to -0.221) and using social media (β= -0.434, 95% CI -0.865 to -0.003) or conventional media (β= -0.884, 95% CI -1.358 to -0.409) for information were negative predictors of knowledge levels. HCPs are advised to use the literature as a source of information about the virus, its transmission, and the best practice. PPEs should be secured for HCPs to the psychological stress associated with treating COVID-19 patients.

Portuguese Patient Dignity Question: A cross-sectional study of palliative patients cared for in primary care

2020 ◽  
Vol 18 (6) ◽  
pp. 658-661
Author(s):  
Mafalda Lemos Caldas ◽  
Miguel Julião ◽  
Ana João Santos ◽  
Harvey Max Chochinov
Keyword(s):  
Primary Care ◽  
Health Care Providers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Sectional Study ◽  
Clinical Tool ◽  
Cross Sectional ◽  
Old Patients ◽  
Promising Tool ◽  
Palliative Patients

AbstractIntroductionThe Patient Dignity Question (PDQ) is a clinical tool developed with the aim of reinforcing the sense of personhood and dignity, enabling health care providers (HCPs) to see patients as people and not solely based on their illness.ObjectiveTo study the acceptability and feasibility of the Portuguese version of the PDQ (PDQ-PT) in a sample of palliative care patients cared for in primary care (PC).MethodA cross-sectional study using 20 palliative patients cared for in a PC unit. A post-PDQ satisfaction questionnaire was developed.ResultsTwenty participants were included, 75% were male; average age was 70 years old. Patients found the summary accurate, precise, and complete; all said that they would recommend the PDQ to others and want a copy of the summary placed on their family physician's medical chart. They felt the summary heightened their sense of dignity, considered it important that HCPs have access to the summary and indicated that this information could affect the way HCPs see and care for them. The PDQ-PT's took 7 min on average to answer, and 10 min to complete the summary.Significance of resultsThe PDQ-PT is well accepted and feasible to use with palliative patients in the context of PC and seems to be a promising tool to be implemented. Future trials are now warranted.

scholarly journals Prevalence, risk factors and sources of anxiety among Emergency Department healthcare workers in Pakistan during COVID-19 pandemic: A single center survey

2021 ◽  
Vol 2 ◽  
Author(s):  
N. Haroon ◽  
S. S. Owais ◽  
A. S. Khan ◽  
J. Amin
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Health Care Providers ◽  
Healthcare Workers ◽  
Work Performance ◽  
Nonparametric Tests ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Frontline Workers

Summary COVID-19 has challenged the mental health of healthcare workers confronting it world-wide. Our study identifies the prevalence and risk of anxiety among emergency healthcare workers confronting COVID-19 in Pakistan. We conducted a cross-sectional survey in an Emergency Department using the Generalized Anxiety Scale (GAD-7), and questions about sources of anxiety. Of 107 participants, 61.7% were frontline workers. The prevalence of anxiety was 50.5%. Nonparametric tests determined that nurses, younger and inexperienced staff, developed significant anxiety. Multivariate ordinal regression determined independent risk factors for developing anxiety were younger age (OR 2.11, 95% CI 0.89–4.99) and frontline placement (OR 1.34, 95% CI 0.33–1.66). Significant sources of stress were fear of infecting family (P = 0.003), lack of social support when the health care providers were themselves unwell (P = 0.02) and feelings of inadequate work performance (P = 0.05). Our study finds that HCWs’ anxiety is considerable. Appropriate measures for its alleviation and prevention are required.

Breastfeeding Experiences of Baccalaureate Nursing Students: A Qualitative Study

2020 ◽  
pp. 089033442097998
Author(s):  
Cheryl Langford ◽  
Marcella Gowan ◽  
Monica Haj
Keyword(s):  
Nursing Students ◽  
Health Care Providers ◽  
Baccalaureate Nursing ◽  
Community Support ◽  
Baccalaureate Nursing Students ◽  
Care Providers ◽  
Structured Interviews ◽  
Breastfeeding Support ◽  
Cross Sectional

Background Students returning to school who are breastfeeding face unique challenges. There is limited literature on breastfeeding university students. Several researchers have studied breastfeeding employees in the workplace. Institutions of higher education closely mimic the employment environment. Breastfeeding college students who express their milk while at school share similar challenges to employed mothers. A baccalaureate nursing program is rigorous and little is known about the challenges facing breastfeeding student nurses returning to classes. Research aim To explore the breastfeeding experience of baccalaureate nursing students. Methods Our study was a cross-sectional descriptive qualitative design. Purposive sampling was used to enroll participants ( N = 12). In depth, semi-structured interviews were conducted. Qualitative thematic analysis was used to analyze the data both manually and using Dedoose QDA software. Results An overarching theme of pervasive conflict between the role of the breastfeeding mother and the role of the student nurse surfaced. Three interrelated organizing themes also emerged; challenging, vulnerability, and resilience. Time constraints, self-care versus role demands, and structural accommodations contributed to the challenges. Only one participant indicated a knowledge of her breastfeeding rights. All of the participants expressed gratitude for faculty and community support, regardless of conflicts. Conclusion Breastfeeding participants were both vulnerable and resilient. Faculty may improve experiences through providing specific areas of support. A breastfeeding support policy outlining student rights and faculty responsibilities is needed to educate, guide, and enforce protections. Health care providers may enhance breastfeeding students’ experiences through anticipatory guidance, education, and continued support.

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