scholarly journals Kinerja Rumah Sakit Swasta dengan Pembayaran INA-CBGs di Era Jaminan Kesehatan Nasional: Casemix, Casemix Index, Hospital Base Rate

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Dr. Atik Nurwahyuni, SKM, MKes ◽  
Ery Setiawan Setiawan
Keyword(s):  
Cross Sectional Study ◽  
Base Rate ◽  
Fee For Service ◽  
Cross Sectional ◽  
Private Hospitals ◽  
Cost Weight ◽  
Class B ◽  
Class C ◽  
Almost All ◽  
The Cost

Abstrak Pembayaran ke rumah sakit yang sebelumnya fee for service, pada era JKN diselenggarakan melalui pola DRG atau INA-CBGs. Rumah sakit swasta harus memonitor kinerjanya menggunakan indikator yang lazim digunakan dalam sistem pembayaran DRG yaitu casemix, casemix index dan Hospital base rate. Kajian ini bertujuan untuk menganalisis kinerja rumah sakit swasta meliputi casemix, casemix index dan hospital base rate. Studi cross sectional ini dilakukan dengan sampel 7 RS yang dipilih secara purposif mewakili RS swasta kelas B, C, dan D yang tersebar di 6 provinsi. Casemix dan CMI RS sangat dipengaruhi oleh kapasitas RS sehingga RS kelas B memiliki casemix dan CMI lebih tinggi dari RS kelas C dan D. Terdapat fenomena CMI di RS kelas C lebih kecil dari kelas D yang kemungkinan disebabkan oleh akurasi koding. Kelengkapan dan ketepatan pengkodean diagnosis dan prosedur sangat berdampak pada besaran casemix dan CMI RS. Hampir semua RS memiliki HBR di atas HBR Nasional kecuali RSC3. Dapat dipastikan RSC3 mendapatkan profit dari implementasi INA-CBGs. Rumah sakit sebaiknya memonitor casemix, CMI dan HBR secara berkala. Kementerian Kesehatan diharapkan mempublikasikan cost weight dan HBR Nasional INA-CBGs serta besaran rata-rata casemix dan CMI menurut kelas RS agar dapat digunakan sebagai benchmark oleh RS. Abstract Private hospitals must monitor their performance using indicators commonly used in DRG payment systems: casemix, casemix index and hospital base rate. This study aims to analyze the performance of private hospitals including casemix, casemix index and hospital base rate. This cross sectional study was conducted with a sample of 7 hospitals selected purposively representing private hospital type B, C, and D in 6 provinces. Casemix and CMI RS are strongly influenced by the hospital capacity, which the hospitals class B have higher casemix and CMI than class C and D hospitals. There is a phenomenon, CMI in class C hospitals smaller than class D which is probably caused by coding accuracy. The completeness and accuracy of diagnosis and procedures coding predominating affect the casemix and CMI. Almost all hospitals have HBR which are higher than National HBR except RSC3. It definitely will trigger profit from the implementation of INA-CBGs. Hospitals should monitor casemix, CMI and HBR regularly. The Ministry of Health is expected to publish the Cost Weight and National HBR as well as the average of casemix and CMI according to class of hospital, for a benchmark by hospitals.

scholarly journals Contraceptive User’s Profile

2016 ◽  
Author(s):  
Eka R Gunardi
Keyword(s):  
Obstet Gynecol ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Contraceptive Methods ◽  
Cross Sectional ◽  
Study Population ◽  
The Mean ◽  
The Difference ◽  
Almost All ◽  
The Cost

Objective: To obtain informations regarding the profile of contraceptive users in Raden Saleh Clinic, Jakarta. Method: A cross-sectional study was conducted in June 2012, at Raden Saleh Clinic, Jakarta. The study population was the patient who came to Raden Saleh Clinic from 2008 until 2011. Results: The mean age of the contraception users was 34.06 and the mean of their husband’s age was 38.91 years old. Most of the patients were graduated from senior high school (43.2%) and university (37.9%). More than half of the patients (55.2%) were not working and more than a half of their husband (53.2%) were private employee. Almost all (92.6%) of the patient were married. Most of the patient (38.8%) came with no prior contraception. After consultation, all patients had chosen their preferred contraceptive methods, namely IUD (61.4%), injectable contraception (20.9%), pill (13.7%), sterilization (3.4%), and implant (0.6%). Conclusion: Family planning reduces maternal mortality and the best method is different for each patient because of the difference in their own condition and the consideration of the cost and benefit. [Indones J Obstet Gynecol 2013; 1-4:179-82] Keywords: contraception, contraceptive users profile

scholarly journals The collateral impact of COVID19 among surgeons and residents: Second cross-sectional survey about the Colombian perspective

2021 ◽  
Vol 36 (2) ◽  
pp. 312-323
Author(s):  
Carlos Eduardo Díaz-Castrillón ◽  
Natalia Cortés ◽  
Juan Felipe Díaz-Castrillón ◽  
Manuela Pineda ◽  
Sara Sierra Tobón
Keyword(s):  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Private Hospitals ◽  
Electronic Survey ◽  
General Surgeons ◽  
Almost All ◽  
The Impact

Introduction. The COVID-19 pandemic has led health services to adapt, surgical training has had to restructure, and personal life has had to thrive hardships. We aimed to describe the evolution of surgeons' and residents' perceptions about the impact COVID-19 has had on Colombia's surgical practice. Methods. Descriptive cross-sectional study using a structured electronic survey among general surgery residents, and graduated surgeons who have a clinical practice in Colombia. Results. 355 participants were included, with a median age of 37 years (IQR 30, 51), and 32.1% female. There were 28.7% residents, 43.3% general surgeons, and 27.8% subespecialist in surgery. Overall, 48.7% of respondents were from Bogotá, and 38.8% worked at academic private hospitals. Although almost all participants reported having used telemedicine platforms during the pandemic, 58% of the respondents did not view telemedicine as sufficient for follow-up consults. More than 80% of surgeons surveyed reported that their monthly incomes had been reduced. Discussion. The second survey showed a better-perceived adherence to safety protocols at their institutions than at the beginning of the pandemic. However, the toll on economic and academic domains are substantial among the surgical community. As the pandemic's effects are expected to last longer in our region, telemedicine services acceptance and healthcare providers' job stability need to be improved in Colombia.

scholarly journals Penelitian Perbedaan Tarif Riil dan INA-CBG’s Penyakit Talasemia di Ruang Perawatan Anak RSUP Sanglah Bali Tahun 2017

2018 ◽  
pp. 95-101
Author(s):  
Anak Agung Made Wijaya Kusuma ◽  
Ketut Ariawati
Keyword(s):  
Iron Chelation ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Thalassemia Patient ◽  
Cross Sectional ◽  
Pediatric Ward ◽  
Real Cost ◽  
Almost All ◽  
The Cost ◽  
Case Based

Abstrak Biaya pengobatan suportif seperti transfusi darah dan kelasi besi seumur hidup pada seorang pasien talasemia sangat besar. Hampir seluruh pasien talasemia di RSUP Sanglah Bali merupakan peserta Badan Penyelenggara Jaminan Sosial (BPJS) yang menggunakan sistem pola pembayaran Indonesia Case Based Groups (INA-CBG’s). Penelitian dilakukan untuk mengetahui perbedaan tarif biaya riil dan INA-CBG’s penyakit talasemia di ruang perawatan anak RSUP Sanglah Bali. Penelitian potong lintang menggunakan desain deskriptif, dilakukan pada bulan Januari sampai dengan Desember 2017. Data dalam penelitian ini terdiri dari data karakteristik dan perbedaan antara tarif riil rumah sakit dengan tarif INA-CBGs penyakit talasemia di ruang perawatan anak RSUP Sanglah. Terdapat 313 kasus rawat inap dari 29 pasien talasemia yang diikutsertakan dalam penelitian. Rumah Sakit Umum Pusat Sanglah mendapat nilai positif Rp 534.784.590 (21,8%) dari selisih total tarif paket INA CBG’s dengan total tarif riil rumah sakit pada tahun 2017. Terdapat perbedaan positif antara tarif riil rumah sakit dengan tarif sesuai INA CBG’s pada perawatan anak dengan talasemia di RSUP Sanglah, yang memberi keuntungan bagi pihak rumah sakit. Kata kunci: talasemia, asuransi, JKN, INA-CBG’s Abstract The cost of supportive treatment such as blood transfusion and lifelong iron chelation in thalassemia patient is very expensive. Almost all thalassemia patients at Sanglah Bali Hospital are participants of Badan Penyelenggara Jaminan Sosial (BPJS) who use Indonesia Case Based Groups (INA-CBG’s) payment system. The study was conducted to determine the discrepancy hospital and INA-CBG’s fare of Thalassemia disease at pediatric ward Sanglah Bali Hospital. Cross sectional study using descriptive design, conducted in January until December 2017. The data in this study consisted of data on the characteristics and differences between the hospitals real cost with INA-CBG’s fare in the child with Thalassemia disease at Sanglah Hospital. There were 313 inpatient cases of 29 thalassemia patients enrolled in the study. Sanglah Hospital received a positive value of Rp 534,784,590 (21.8%) from discrepancy of the INA CBG’s fare with the total real cost of hospitals in 2017. There is a positive discrepancy between hospital and INA-CBG’s fare of Thalassemia disease at pediatric ward which gives benefits to the hospital. Keywords: thalassemia, insurance, JKN, INA-CBG’s

scholarly journals Need Assessment for an Adolescent Clinic in a Periurban Hospital

1970 ◽  
Vol 29 (3) ◽  
pp. 133-137
Author(s):  
S Tasnim
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Cross Sectional Study ◽  
Health Providers ◽  
Cross Sectional ◽  
Special Services ◽  
Contraceptive Services ◽  
Adolescent Clinic ◽  
Almost All ◽  
The Cost

Background: Adolescents are a heterogeneous group with special reproductive health needs based on their age, sex, marital status and socioeconomic status. Existing health care system is not capable to respond to adolescents’ demands. Objective: To explore the idea regarding specific centre for adolescents and to identify the components of information and health services rendered through the centre. Method: A cross sectional study was conducted with 70 participants in a half day workshop in the Institute of child and mother health (ICMH) on 9th August’ 2006. The respondents filled up a set questionnaire containing both open and closed questions focusing different issues regarding functioning of an adolescent clinic. The responses were analysed using SPSS program Result: Almost all respondents expressed the need for a separate clinic for adolescents, that should serve both boys and girls (84.3%), health providers at the centre should be doctors from both Paediatrics and Gynae & Obstetrics department (42.9%) and nurses (42.1%) and the working schedule should be similar to existing out patient hours. It was suggested that the clinic should provide counseling on sexuality issues, contraceptive services and special services as required in addition to general health care. About 75% opined that the cost of the services should be same as those of existing out patient services while 52.9% thought that the services should be free. Conclusion: The need for an adolescent clinic was commonly felt and it is recommended to establish adolescent friendly services at ICMH. Key words: Adolescent; Reproductive health; Adolescent friendly service DOI: http://dx.doi.org/10.3329/jbcps.v29i3.9433 JBCPS 2011; 29(3): 133-137

scholarly journals Cross-sectional study of prevalence and risk factors, and a cost-effectiveness evaluation of screening and preventive treatment strategies for latent tuberculosis among migrants in Singapore

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e050629
Author(s):  
Vanessa W Lim ◽  
Hwee Lin Wee ◽  
Phoebe Lee ◽  
Yijun Lin ◽  
Yi Roe Tan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cost Effectiveness ◽  
Length Of Stay ◽  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ltbi Prevalence ◽  
The Cost

ObjectivesWHO recommends that low burden countries consider systematic screening and treatment of latent tuberculosis infection (LTBI) in migrants from high incidence countries. We aimed to determine LTBI prevalence and risk factors and evaluate cost-effectiveness of screening and treating LTBI in migrants to Singapore from a government payer perspective.DesignCross-sectional study and cost-effectiveness analysis.SettingMigrants in Singapore.Participants3618 migrants who were between 20 and 50 years old, have not worked in Singapore previously and stayed in Singapore for less than a year were recruited.Primary and secondary outcome measuresCosts, quality-adjusted life-years (QALYs), threshold length of stay, incremental cost-effectiveness ratios (ICERs), cost per active TB case averted.ResultsOf 3584 migrants surveyed, 20.4% had positive interferon-gamma release assay (IGRA) results, with the highest positivity in Filipinos (33.2%). Higher LTBI prevalence was significantly associated with age, marital status and past TB exposure. The cost-effectiveness model projected an ICER of S$57 116 per QALY and S$12 422 per active TB case averted for screening and treating LTBI with 3 months once weekly isoniazid and rifapentine combination regimen treatment compared with no screening over a 50-year time horizon. ICER was most sensitive to the cohort’s length of stay in Singapore, yearly disease progression rates from LTBI to active TB, followed by the cost of IGRA testing.ConclusionsFor LTBI screening and treatment of migrants to be cost-effective, migrants from high burden countries would have to stay in Singapore for ~50 years. Risk-stratified approaches based on projected length of stay and country of origin and/or age group can be considered.

Demonstration of the relationship between MSD and online learning during the COVID-19 pandemic

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kochu Therisa Karingada ◽  
Michael Sony
Keyword(s):  
Online Learning ◽  
Undergraduate Students ◽  
Online Survey ◽  
Cross Sectional Study ◽  
The Body ◽  
Body Parts ◽  
Cross Sectional ◽  
Content Type ◽  
The Right ◽  
Almost All

PurposeThe COVID-19 pandemic lockdown has caught many educational institutions by surprise and warranted an abrupt migration from offline to online learning. This has resulted in an education change, without any time for due consideration, as regards its impact on musculoskeletal disorders (MSD) on students. The purpose of this study is to investigate MSD related to online learning during the COVID-19 pandemic lockdown.Design/methodology/approachA cross-sectional study was conducted on undergraduate students in India. In total, 261 students participated in this online survey.FindingsThe study finds that around 80% of students have reported some symptom in the head, neck and eyes since they started online learning. In total, 58% have reported MSD symptom in the right shoulder and 56% in the right hand fingers. Besides, more than 40 % of students experienced some MSD symptoms, in almost all the body parts studied, due to online learning. Correlation analysis is conducted between time spent on online learning per day and MSD symptoms.Originality/valueThis is the first study conducted on MSD and online learning during COVID-19 pandemic.

Inter-Basal and Septal Connections of Papillary Muscles - An Anatomical Rationale for Rhythmic Opening of AV Valves - A Multicentric Medical College Based Cross Sectional Study

2021 ◽  
Vol 8 (31) ◽  
pp. 2865-2869
Author(s):  
Praveen Mulki Shenoy ◽  
Amith Ramos ◽  
Narasimha Pai ◽  
Bharath Shetty ◽  
Aravind Pallipady Rao
Keyword(s):  
Left Ventricle ◽  
Papillary Muscle ◽  
Interventricular Septum ◽  
Cross Sectional Study ◽  
Papillary Muscles ◽  
Cross Sectional ◽  
Medical College ◽  
Moderator Band ◽  
Almost All ◽  
And Function

BACKGROUND The papillary muscle basal connections have significant clinical implications. Variety of studies done on its morphology and function by various specialists in different departments. A close look on these revealed the interconnections of papillary muscles to one another and to the interventricular septum of both ventricles is related to uncoordinated contractions of papillary muscles, leading to hyper or hypokinesia or prolapse or even its rupture. METHODS Our study done in 25 formalin soaked hearts revealed after the deep and meticulous dissection, reflecting the walls of ventricles laterally the numerous interconnections of papillary muscles at its bases and IVS. Ventricles are opened by inverted ‘L’ shaped incision and its reflected more laterally till all the papillary muscles is visible in one frame after incising the moderator band. The connections were noted, measured, photographed, tabulated, compared with similar studies and analysed with experts with respective fields. RESULTS Almost all the specimens did have the interconnections. Further the post mortem findings of the cardiac related deaths with involvement of papillary muscles suggest damage to such ‘bridges’. The moderator band extensions to the base of right APM, and its extension to the posterior groups is noted in all the specimens. The bridge from the IVS to bases of both the groups of papillary muscles is noted in left ventricle. In90% of specimens the one PPM is found to be loosely connected, more so in left ventricle. CONCLUSIONS We are of a conclusion that such basal interconnections and to the interventricular septum are responsible for rhythmic contractions of papillary muscles of both ventricles. Since the AV valves have to open simultaneously, interconnections becomes mandatory as the impulse has to reach it before it reaches the trabeculae carniae. One of the Posterior papillary muscles is loosely connected to other papillary muscles, may be the reason for its rupture, more so in left ventricle. KEYWORDS Papillary Muscle, Interbasal Connection, Moderator Band, Valvular Prolapse, AV Valves

scholarly journals Awareness and perception of budding doctors: A focal scenario on eye donation

1970 ◽  
Vol 13 (4) ◽  
pp. 141-150
Author(s):  
Mausumi Basu ◽  
Palash Das ◽  
Biman Roy ◽  
Jayanta Kumar Baruah
Keyword(s):  
Medical Students ◽  
Corneal Transplantation ◽  
Cross Sectional Study ◽  
Undergraduate Medical Students ◽  
Cross Sectional ◽  
Proper Training ◽  
Sight Restoration ◽  
Almost All ◽  
Perceived Reasons ◽  
Eye Donation

Background: Diseases affecting the cornea constitute a major cause of blindness. Corneal transplantation offers the potential for sight restoration. Due to non-availability of healthy cornea, many people continue to live in a dark world.Objectives: To assess the awareness and perception of undergraduate medical students towards eye donation.Methods: A cross-sectional study was conducted among undergraduate medical students of Kolkata on August 2010 using a pre-designed, pre-tested, semi-structured, self-administered questionnaire. The data were analyzed using Epi-info software package version 6.04.Results: Almost all (98.9%) participants knew that eyes can be donated and 70.8% were aware at the time of eye collection. However, only 43.7% respondents knew whom to approach for pledging their eyes for donation; 80.7% were either willing (76.0%) or had already pledged (4.7%) to donate their eyes. Television was the major source (78.1%) of information on eye donation. Nobility was the main motivation (87.7%) and 75.5% felt the need for helping the blind. Of these medical students, 19.3% were unaware and did not pledge eye donation due to objection by family members and dislike of the idea of separating their eyes.Conclusion: The present study revealed that medical students were well aware of eye donation with a favorable attitude towards it and most of them were inclined to pledge for eye donation. The perceived reasons for not donating eyes need to be considered while creating awareness about eye donation in the community. Students can be actively involved as volunteers in eye donation campaigns and after proper training in counselling techniques, they can act as counsellors for eye donation activities.

scholarly journals Analisis zat gizi dan biaya sisa makanan pada pasien dengan makanan biasa

2005 ◽  
Vol 1 (3) ◽  
pp. 108
Author(s):  
Mihir Djamaluddin ◽  
Endy Paryanto Prawirohartono ◽  
Ira Paramastri
Keyword(s):  
Length Of Stay ◽  
Food Waste ◽  
Economic Value ◽  
Food Service ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Regular Diet ◽  
The Difference ◽  
The Cost

Background: The quality of food service in a hospital can be assessed from the inpatients’ nutritional status. Food waste is an indicator of food service among inpatients. Besides its therapeutic value, food has a significant economic value. The wasting cost in term of food waste affects the total availability of food costs.Objective: This study analyzes the nutrient quantity and the cost of food waste among inpatients with regular diet at Dr. Sardjito Hospital, Yogyakarta.Method: This was a cross sectional study. The subjects were inpatients aged 17 to 60 years old who got regular diet with length of stay was at least three days, and were willing to take part in this study (n=100). The amount of food waste was measured using the Comstock visual estimation. The cost of food waste was calculated as the proportion of food waste from cost per serving. The quantity of nutrients in food waste was calculated using the Food Processor 2 software. The data were analyzed using Chi-square test.Results: There was a difference of food waste according to gender. Rice waste was found more frequent among female (p<0,005). There was a difference of food waste according to ward class. There were more waste of meat and vegetables among inpatients in class II and the difference was significant (p<0,05). There were more waste of meat and vegetables among patients with length stay of 7 – 14 days and > 15 days (p<0,05). The vegetables and rice waste were more frequent among surgery and cancer inpatients (p<0,05). In average the nutritional value of food waste was 19,85% - 9,33% of a patient’s RDA, while the wasting cost per day was Rp 1265,08 or 10,79% of all food cost per day. The annual wasting cost of food waste was Rp 45.543.120 or 4,4% of the available budget of Rp 1.038.605.333,00.Conclusion: There were differences of food waste according to gender, ward class, length of stay, and kind of disease, especially rice, meat, and vegetables.

scholarly journals Acceptance of the COVID-19 vaccine in Generation Z: A cross-sectional study in Southeast Sulawesi, Indonesia

2021 ◽  
Vol 7 (4) ◽  
pp. 139-144
Author(s):  
Chevin Ramadhan Hadiwijaya ◽  
Muhammad Imam Zan Zabiyla Analuddin ◽  
Ayikacantya Sudayasa ◽  
Muhammad Hoki Akbar ◽  
Lilyana Aritonia Ahmad ◽  
...  
Keyword(s):  
Analytical Study ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Effective Strategies ◽  
Generation Z ◽  
The Media ◽  
Cross Sectional Design ◽  
Almost All ◽  
The City

Background: Adequate health systems and effective strategies are needed to increase trust and acceptance in vaccines. Generation Z is more concerned with environmental issues related to the pandemic situation.Objective: This study aimed to assess the acceptance of the COVID-19 vaccine in Generation Z.Methods: This was an observational analytical study with a cross-sectional design on generation Z in Southeast Sulawesi, Indonesia, from May to July 2021. The samples were taken by cluster sampling using faculty classification. Data was collected using a questionnaire with a google form, included the characteristics, knowledge regarding COVID-19 and vaccine, and the media information.Results: There were 396 participants. Most of them were 20 years (52.6%), female (74.8%), and Muslim (93.7%). About 61.6% live outside the city and had insurance (77.3%). Half of the participants knew the COVID-19 symptoms (51.26%), some participants were hesitant (11.8%) and did not even know (0.76%). Almost all participants were aware of the COVID-19 vaccination program (99.2%), benefits (95.2%), side effects (84.1%), and knew the contents of the COVID-19 vaccine (62.1%). Most of them were willing to take the COVID-19 vaccine (77.8%). However, 17.93% were hesitant, and 4.29% were unwilling to participate. Most participants were not trusting vaccines (43.9%), did not feel the need (29.3%), and felt access was not easy (26.8%). Most of them used social media to get information about COVID-19 (89.1%).Conclusion: Generation Z has a good acceptance of the COVID-19 vaccine, even though there are still doubts and rejects. Accurately and sustainable information is needed.

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