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Introduction: The COVID-19 pandemic has created various challenges and problems for healthcare facilities around the world. This problem also occurs in Indonesia, a country with a high rate of transmission and death of COVID-19. Hospitals, both as health facilities and businesses, must determine the necessary strategies to ensure their business continuity during the Pandemic. Therefore, the factors that affect the continuity of the hospital's business must be determined before making a strategy. The purpose of this study was to identify and analyze the factors affecting the continuity of a hospital's business during a pandemic. Method: A scoping review was done using PRISMA-ScR guidelines and population, concept, context (PCC) framework. Studies from Pubmed, Google Scholar, and Portal Garuda were collected and analyzed. Results: Among 326 articles found, five studies were included and analyzed. Each study examined the impact of COVID-19 on various aspects of the hospital, both as a business and as a healthcare facility. Moreover, some studies also proposed solutions to minimize the impact of disruptions due to COVID-19. Changes and innovations in facing biological, financial, and resource management problems are essential for hospitals in Indonesia to maintain business continuity during the COVID-19 Pandemic. Conclusions: COVID-19 Pandemic brought significant challenges for hospitals around the world. Factors affecting hospital business continuation in Indonesia appear in biological, financial, and resource management problems.

The healthcare system is a presuming indicator of the development of a country. The corporality of a welcome healthcare system will provide welfare and health for every citizen. However, the reality is that not all countries have the same rights and access to health services. Therefore, to obtain equal basic needs, right, and access to health services for every citizen, various countries are trying to implement universal/national health insurance. The implementation of universal health insurance is still a challenge for Indonesians. It is also related to the healthcare system that is still low compared to several other developing countries and Indonesia's neighboring countries. Therefore, the purpose of this paper is to find a comparison between the healthcare system and the implementation of universal health insurance among neighboring countries in Indonesia. The analysis of this study was conducted by the literature review method. Each country has unique and different characteristics, so the healthcare system and universal health insurance that apply in each country have advantages and disadvantages. Therefore, every homeland strives for its healthcare system and instead seeks to build a strong, more stable, and stable health system so that every citizen can enjoy a quality and quality healthcare system

Introduction: The use of social media as a marketing tool has only grown in the last decade, so social media research has mostly focused on defining what it is through explaining the new terminology and concepts that form its foundation and exploring the impact of health care integration of social media on the behavior of health care users. Methods: This literature focuses on being able to describe what social media marketing is and to find out what factors influence the behavior of health service users relative to social networks by using the literature study or literature review method Objective: Approaches to communicating with health care users have changed a lot with the advent of social media. Therefore, health care workers must learn how to use social media in a manner that is consistent with their work plan. Result and discussion: Is that the technology readiness of health service users is important to be remembered by health services when marketing on social networks in the context of product marketing. Conclusion: Health service providers as health services must be able to market comprehensive services through social media properly as a means of expanding networks in order to provide the best service.

The Covid-19 pandemic has greatly impacted physical therapy services. In the context of the physical distancing strategy, physical therapy services at health care centers are very limited. Telemedicine or telerehabilitation offers a solution that is expected to be realized by physical therapy services so that it can be accessed by patients with impaired function and movement from home and can reduce the risk of the getting Covid-19 virus infection during this pandemic. This study aims to systematically review the effectiveness of physical therapy services through telemedicine or telerehabilitation during Covid-19 pandemic. The method used is a systematic review done by searching for articles from Science Direct, Scopus, and Proquest with the keywords "Effective AND Physical Therapy AND Telemedicine OR Telerehabilitation AND Coronavirus". The inclusion criteria are articles published from April 2020 to April 2021, full-text articles, and in English. Research subjects are physical therapy patients who use telemedicine or telerehabilitation. The exclusion criteria were articles that had topics outside of physical therapy services through telemedicine or telerehabilitation during the Covid-19 pandemic. The literature search yielded 30 potential articles and 8 of them met the eligibility criteria. All selected studies show that physical therapy services through telemedicine or telerehabilitation have a good result on the recovery process of movement and body function of patients with cardiorespiratory, musculoskeletal, and neuromuscular disorders during the Covid-19 pandemic. This method of remote health care delivery allows patients to carry out an exercise program at home and reduces their risk of getting Covid-19 virus infection.

Dampak dari pandemi COVID-19 sangat berpengaruh bagi dokter gigi dalam pelaksanaan pelayanan kesehatan gigi dan mulut selama masa pandemi COVID-19. Perlunya pedoman pelayanan kedokteran gigi selama pandemi virus COVID-19 dan terdapat sejumlah hal yang perlu diperhatikan oleh dokter gigi dalam menjalankan tugasnya. Oleh karena itu, untuk menindaklanjuti kasus COVID-19 saat ini diperlukan dokter gigi dalam memenuhi pedoman tersebut dalam evaluasi protokol kesehatan dalam praktik dokter gigi. Penelitian menggunakan metode PRISMA (Preferred reporting Items for Systematic Reviews and Meta-analyses). Systematic review ini menggunakan database yakni PubMed, Springerlink dan Science Direct berdasarkan kriteria inklusi dan kriteria eksklusi yang ditetapkan. Dari hasil review, pasien dilakukan triase kondisi praktik melalui teledentistry untuk menilai perlu tidaknya tindakan perawatan gigi dan mulut secara langsung. Pasien yang terlanjur mendatangi unit perawatan gigi dilakukan screening, ditinjau kontak pasien dan lakukan strategi untuk menghindari prosedur yang menghasilkan aerosol, serta prosedur desinfeksi untuk praktek dokter gigi sebelum, selama, dan setelah setiap kunjungan pasien. Serangkaian rekomendasi dan standar diterapkan dalam konteks pandemi COVID-19. Ruangan diatur, menerapkan protokol kesehatan, penggunaan alat pelindung diri lengkap, meminimalisir tindakan aerosol generating procedure, prosedur desinfeksi, melakukan vaksin dan penerapan protokol kesehatan pada pasien dalam rangka menekan paparan COVID-19.

Pendahuluan: Pandemi COVID-19 memberikan dampak bagi semua sektor termasuk sektor kesehatan. Ibu hamil merupakan kelompok rentan terpapar virus ini. Data WHO menunjukkan terdapat 290 juta kasus terkonfirmasi positif, dan dari data CDC didapatkan 155 ribu kasus pada ibu hamil di United States. Tujuan: Penelitian ini dilakukan untuk mengetahui bagaimana strategi implementasi clinical pathway pada pelayanan obstetri di masa pandemi ini. Metode: Penelitian dilakukan secara systematic review berdasarkan alur diagram PRISMA. Didapatkan 7 artikel yang dibahas dalam penelitian ini. Hasil: Implementasi clinical pathway pada masa pandemi ini meliputi diagnosis COVID-19 pada ibu hamil, alat pelindung diri (APD) saat persalinan, manajemen sistem clinical pathway, serta pendukung dan penghambat dalam implementasi clinical pathway. Kesimpulan: Implementasi clinical pathway pada pelayanan obstetri di rumah sakit pada masa pandemi merupakan suatu tantangan dan langkah penting yang tetap harus dapat diterapkan oleh rumah sakit agar mutu pelayanan dan keselamatan pasien tetap terjamin.

Pendahuluan: Pandemi COVID-19 yang terjadi berdampak pada perkembangan teknologi informasi dan komunikasi yang semakit pesat. Peranan internet dan media online dapat menjadi strategi baru rumah sakit untuk melakukan pemasaran secara digital. Hal ini membuat interaksi dengan konsumen rumah sakit menjadi lebih mudah dan cepat, dengan biaya yang relatif lebih murah. Tujuan: Kajian literatur ini adalah untuk mengetahui bagaimana strategi implementasi digital marketing di rumah sakit. Metode: Penulisan ini dilakukan secara literature review dari database ProQuest, SpringerLink, dan Science Direct. Artikel diskrining sesuai dengan kriteria inklusi dan eksklusi. Sebanyak 6 artikel disaring dari 6.220 artikel dan kemudian dilakukan kajian literatur. Hasil: Rumah sakit perlu mengetahui dampak perubahan perilaku konsumen akibat COVID-19, melakukan integrasi teknologi digital dalam pelayanan kesehatan berdasarkan Healthcare 4.0, dan prinsip penerapan digital marketing berupa contactless services dan Integrated Marketing Communication. Penerapan digital marketing di rumah sakit dapat diterapkan melalui media massa, sosial media, platform digital/ online, serta aplikasi. Kesimpulan: Diperlukan langkah-langkah strategi implementasi digital marketing di rumah sakit yang tetap mengutamakan konsep 4P dan konsep 4C.

Background: Employing a knowledge broker (KB) is one way to transform ideas into action, especially in relation to the development of a specialized hospital. This study aimed to explore the concept of knowledge brokering intervention in the development of a specialize hospital in Indonesia. Methods: A descriptive qualitative method was applied in this study to collect detailed, rich data from a small number of participants. A snowball sampling approach was chosen to recruit 17 participants from various backgrounds who have worked with KB of a specialized hospital. The data analysis was performed using a content analysis method to identify the themes and categories. Results: Five themes and 14 categories were constructed for developing the knowledge brokering intervention in the development of a specialized hospital in Indonesia. The themes included characteristics of KB, the role of KB, demand brokering, various perceptions of specialized hospitals, and challenges in developing the specialized hospital. Conclusion: The findings suggest that the framework of the knowledge brokering intervention consisted of individual and interpersonal capabilities. Characteristics of KBs should be introduced that are trained in all development settings to boost the achievement of the goals in the health sector. The researchers suggest that the concept of KB should be considered for realizing national projects, as this will escalate the health development of the country. This study contributes to the identification and connection of indicators on health knowledge brokering in translating science into practice at specialized hospital in Indonesia.

Pandemi covid-19 membuat rumah sakit harus cermat dalam melakukan pengelolaan pendapatan khususnya untuk pembiayaan kegiatan belanja operasional. Salah satu kebutuhan belanja vital di rumah sakit adalah logistik kefarmasian oleh Instalasi Farmasi Rumah Sakit (IFRS) untuk melakukan pengelolaan ketersediaan sediaan farmasi, alat kesehatan, dan bahan medis habis pakai yang aman, bermutu, bermanfaat, dan terjangkau. Ada 4 tahap dalam analisis pengelolaan obat meliputi seleksi, perencanaan dan pengadaan, distribusi, dan penggunaan yang memerlukan dukungan dari organisasi, ketersediaan pendanaan, pengelolaan informasi dan pengembangan sumber daya manusia di dalamnya. Jenis penelitian yang dilakukan adalah penelitian non-eksperimental dengan metode deskriptif menggunakan pendekatan kualitatif. Dilakukan pada bulan Oktober-Desember tahun 2020. Lokasi penelitian yaitu unit farmasi rawat jalan, depo rawat inap, gudang farmasi, bagian keuangan, dan bagian pengadaan. Data primer didapat dari hasil observasi dan wawancara. Data sekunder didapat dari hasil telusur dokumen. Analisis data dilakukan dengan mengukur pencapaian indikator pengelolaan obat RSUA terhadap indikator standar menurut Kemenkes (2008), Pudjaningsih (1996), dan WHO (1993). Hasil : SDM di IFRS berjumlah 25 orang, terdiri dari 10 orang Apoteker, 11 orang D3 Teknis Kefarmasian, dan 4 orang lulusan SMF. Dari hasil analisis, didapatkan dari 21 indikator yang diukur, terdapat 12 indikator sudah sesuai dengan standar serta 9 indikator belum sesuai dengan standar.

Purpose One of the most frequent causes of cardiac mortality is ST elevation myocardial infarction (STEMI). Delay in the management of STEMI patients is a cause of high mortality and morbidity. This study aims to determine the effect of the implementation of the CODE STEMI program on major adverse cardiac events (MACE) and mortality of STEMI patients at Dr. Cipto Mangunkusumo General Hospital. Patients and Methods This was a retrospective cohort study that enrolled 207 STEMI patients who underwent primary percutaneous coronary intervention (PPCI) in 2015-2018. The patients were divided into two groups. The first group was treated prior to establishing the CODE STEMI program. The other group was treated according to the program, which was implemented in January 2017. Data were collected from medical records, and we retrospectively analyzed all in-hours, MACE, and mortality of STEMI patients from both groups as primary outcomes. Data analysis was done using the Mann-Whitney and chi-square test. Results There were 72 and 135 patients in the pre-CODE STEMI and CODE STEMI groups, respectively. D2BT was significantly reduced by 130 min (288±306 vs 158±81, P< 0.001) since the implementation of CODE STEMI program. There were trends to lower in-hospital mortality rates (8.3% vs 4.4%, RR = 0.53) and MACE at 30 days (48.61% vs 37.78%, RR = 0.77). Conclusion Implementation of the CODE STEMI program can reduce door-to-balloon time and decrease the MACE and mortality rate in STEMI patients in general hospitals.

Objective The purpose of the study was to assess the level of efficiency and productivity of the BLUD Hospital in South Sulawesi Province during the period of implementation of the National Health Insurance policy in Indonesia. Methods This research used Data Envelopment Analysis method to assess the level of hospital efficiency and productivity. The population and sample were 25 BLUD hospitals in South Sulawesi Province. The data analyzed are hospital performance data for the period 2014–2017. Result The results found that the average level of efficiency was 1.023. There are 14 hospitals (56%) inefficient and 11 hospitals (44%) efficient. The average hospital productivity growth rate is 4%. Conclusion The role of technology, competitive human resources, good management systems, and strong leadership are needed for hospitals to improve their efficiency and productivity level.

Praktik swamedikasi dianggap dapat menjadi solusi cepat dalam pengobatan ketika seseorang tidak dapat mengakses pelayanan kesehatan formal tetapi pada sisi yang lain perilaku ini dapat menambah beban ekonomi serta kerugian kesehatan jika tidak terawasi dengan baik. Sementara itu, merokok dipandang sebagai perilaku negatif yang juga dapat menimbulkan beban ganda, baik dari segi peningkatan, pengeluaran, juga mengakibatkan efek buruk bagi kesehatan. Penelitian ini bertujuan memberikan gambaran perilaku swamedikasi di antara para perokok di Indonesia serta determinan yang memengaruhinya. Studi ini merupakan studi kuantitatif dengan menggunakan data sekunder Survei Sosial Ekonomi Nasional (SUSENAS) tahun 2017. Unit observasi adalah individu, kriteria sampel adalah perokok dengan probabilitas melakukan swame-dikasi karena gangguan kesehatan. Jumlah sampel yang dianalisis adalah sebanyak 53.317 orang. Analisis deskriptif digunakan untuk melihat prevalensi Swamedikasi diantara perokok. Regresi logistik digunakan untuk melihat faktor determinan yang memengaruhi keputusan seorang perokok untuk melakukan swamedikasi. Hasil analisis lanjutan menun-jukkan bahwa sebagian besar perokok melakukan swamedikasi (75,99%). Tingkat Pendidikan (p=0,005) dan kepemilikan asuransi kesehatan (p=0,000) berpengaruh secara signifikan terhadap perilaku Swamedikasi. Melalui penelitian ini diharapkan dapat menjadi bahan pembelajaran dan advokasi tentang perilaku dalam mencari pengobatan pada perokok.

Objective The purpose of this study was to assess changes in productivity scores of BLUD hospital since the implementation of the National Health Insurance policy in Indonesia from 2014 to 2017. Methods The population and sample of the study were all Government General Hospitals with the status of Regional Public Service Agencies in the Province of South Sulawesi with a unit of research analysis being the annual performance of 25 BLUD hospitals in the 2014–2017 period. To analyze the productivity growth rate of the BLUD hospital in South Sulawesi, the Malmquist Total Factor Productivity Index approach was used. Results During the 2014–2017 period the average productivity level of hospitals grew by 4%, but the annual analysis showed that the productivity of hospitals continued to decline from year to year, from the 2014–2015 period grew by 7.4%, the 2015–2016 period fell to 4.1% and in the 2016–2017 period only grew by 0.5%. Conclusion The results of the study show that since the implementation of the National Health Insurance policy, the level of hospital productivity has continued to decline.

Background: The government makes various policies to improve the health of pregnant women, which in turn has an impact on reducing maternal mortality and infant mortality. Antenatal care (ANC) is the most important strategy to improve the health of pregnant women. Distric/city governments must ensure the availability of antenatal services for their communities in primary health facilities (PHF). Midwives are the primary provider of antenatal care at PHF. This study describes the time required for midwives to provide standardized antenatal care.Methods: This study was a time study method, which analyzes the average time of ANC Services by midwives in PHF. The study observed fifty-eight midwives who gave ANC services to five hundred fifty-two pregnant women in six districts in West Java. The data collection was carried out in January-February 2019.Results: In this study, it was found that the time to ANC varied widely; for ANC-I, the average is 30.34 minutes (Min 25 minutes- Max 50 minutes; lower mean 56,7%), ANC-II 23.12 minutes (Min 17 minutes - Max 36 minutes; Lower mean 63,5%), and ANC-T 26.9 minutes (Min 23 minutes - Max 35 minutes; lower mean 53,2%). The order of service time is as follows: ANC-I, ANC-T and ANC-II.Conclusions: The time used for ANC is still significantly less than that recommended by the WHO for pregnant women's visits (40 minutes per visit). The reason will undoubtedly affect the quality of ANC services. It is hoped that District/City Administrative and Health Authorities will pay more attention to the duration time of ANC visits by developing a standard time of visit per patient or increasing the number of midwives in carrying out ANC services at that location.

To improve the quality of health services at Primary Health Care (FKTP) in implementing the National Health Insurance Program in Indonesia, the government has issued a performance-based capitation payment (KBK) policy at the FKTP. This study aims to evaluate the performance-based capitation payment policy in Merial Health clinic from the aspects of effectiveness, efficiency, facilities and infrastructure, availability of human resources, adequacy, and legal compliance. This study performed in-depth interviews and document reviews. The results showed that the effectiveness of the policy has been optimal but is still constrained by the socialization of the KBK policy and visits to health numbers for BPJS Health participants. The efficiency of the KBK policy has been running optimally in increasing the capitation income of the Merial Health clinic. The adequacy of the policy is as expected because it improves the quality of health services. The availability of human resources is in accordance with the BPJS Health provider standards. Facilities and infrastructure are in accordance with cooperation rules as a BPJS Health provider. Legal compliance has been running optimally because it has met the applicable requirements. The study concludes that the implementation of the performance-based capitation policy at the Merial Health clinic has been running optimally.

Assessment of management commitments is required for investment in Occupational health and safety program. This systemic literature review evaluates 15 cases of Occupational health and safety (OHS) interventions to assess whether the implementation of OHS is beneficial. Search engines used in literature review are Medline, Embase, Web of Science, Cochrane Library, Pubmed. Studies related to benefit cost analysis included in the search include also looking at company productivity. The focus of this analysis includes samples, design, theoretical framework, implementation OHS, validity and results.Results show,in 15 cases, cross-sectional research design looked at pre-after comparisons in the absence of control groups. The positive return on investment from the implementation of OHS is shown in 13 studies. Two other studies concluded that their chosen implementation of OHSwas not cost-effective. The main benefit is to reduce sick leave. In 3 cases the perceived benefit is an increase in productivity and quality. The conclusions in this study required a guideline for the evaluation of the implementation of OHS.

Not only the Central Government, local governments also have a role to shape, adapt and provide a holistic response to the COVID-19 pandemic. One of the most important actions taken by local governments during the COVID-19 pandemic is to make immediate, timely, and targeted decisions for the right institutions in order to give an effective response. Regarding financing, the main point is to focus on increasing support and accelerating fiscal transfer funds to local governments in an effort handle COVID- 19. This paper wants to observe the empirical practice of local governments in various countries in responding to the COVID-19 pandemic, especially in terms of financing various programs and activities related to the COVID-19 response. Literature was obtained from several databases, namely PubMed, ScienceDirect, Cochrane Library and Google Scholar. Of the 783 articles obtained at the start of the search, in the end only 11 articles met the inclusion and exclusion criteria of this study. The impact of the COVID-19 pandemic is aparrent in all parts of the world, including in countries’ local governments, that forced them to carry out various efforts of mitigating the severity of the pandemic. Although the detailes of local governments budgeting were not found in most of the articles studied in this literature review, it is sufficient to provide a fairly significant picture of the function of local government in tackling the spread of COVID-19.

Back-Referral Program (PRB) is one way to improve the quality of the health services for BPJS participants in conducting quality control and cost control. The unavailability of pharmacies and drugs for PRB causes the PRB program not to run optimally, thus increasing the catastrophic disease sufferers and absorbing big claims in JKN. This study is qualitative research with a descriptive approach using the method of in-depth interviews and document review. The research informants' criteria were: the elements of the leadership and policy management officers in the DKI Jakarta Provincial Health Office, Central Jakarta Health Office, Central Jakarta BPJS Health Center, Central Jakarta District Health Center, and Central Jakarta PRB Pharmacy. The results showed that the implementation performance was not optimal, which was influenced by policy standards and objectives, resources, communication between organizations, the implementers' attitude, the implementing organization's characteristics, and the economic, social, and politics. Coordination, commitment, and evaluation of activities from the Ministry of Health, BPJS Health, Government Service Goods Procurement Policy Institute, and DKI Jakarta Provincial Health Office are needed in terms of the availability of this PRB drug.

Background One of the highest causes of cardiac mortality is ST Elevation Myocardial Infarction (STEMI). Delay in the management of STEMI patients resulted high mortality, morbidity, and economic burden. CODE STEMI is a protocol to reduce door to balloon time and improve patient’s quality care and clinical outcome. This study aims to determine the effect of the implementation of CODE STEMI on clinical outcome and cost efficiency of a quality care of STEMI patients at Dr. Cipto Mangunkusumo General Hospital.Method This is a retrospective cohort study that reviewed 207 medical records of STEMI patients who underwent primary percutaneous coronary intervention (PPCI) in 2015–2018. The patients were divided into two groups. The first group was treated prior to establishing the CODE STEMI program. The other group was treated according to the program, which was implemented in January 2017. The primary outcome was to measure in-hospital mortality and morbidity and total hospital cost between both groups. Secondary end-points included length of stay (LOS) and Cost Efficient Analysis. Data analysis was done using Mann Whitney and Chi square test.Results There were 72 and 135 patients in Pre-CODE STEMI and CODE STEMI groups respectively. In CODE STEMI group, median D2BT was significantly reduced by 130 min (P vs 4.4%) and MACE at 30 days (48.61% vs 37.78%).Conclusion Implementation of CODE STEMI can improve clinical outcome, reduce length of stay and cost efficiency of STEMI patients in general hospitals.

Completing the basic immunization and implementing Universal Child Immunization (UCI) are the objectives for the Immunization Program according to the Ministry of Health of Republic Indonesia Strategic Planning. In 2017, Kapuas district achieved 66,6% of the Completed Basic Immunization target and 32,2% of the Universal Child Immunization (UCI) target. There is still a 26,4% gap and a 62,8% gap, respectively, from the 95% target of Strategic Plan Ministry of Health 2015-2019. This study aims to discuss the performance of policy implementation of Completed Basic Immunization (CBI) and Universal Child Immunization (UCI) in 2018 at Kapuas Regency, using qualitative research with case study design at 6 Puskesmas in Kapuas Regency. The total informants in this research are 34 informants. The study showed that the performance of policy implementation regarding indicator achievement of CBI and UCI of Kapuas Regency in 2018 have not been optimal. So, policy improvement is needed to increase CBI and UCI achievement of Kapuas Regency next year.Abstrak. Indikator yang diukur untuk menilai kinerja pelaksanaan imunisasi di Indonesia berdasarkan Renstra Kemenkes RI adalah pencapaian imunisasi dasar lengkap (IDL) sedangkan indikator programnya adalah pencapaian universal child immunization (UCI). Pencapaian indikator IDL Kabupaten Kapuas pada tahun 2017 sebesar 66,6% di mana selisih ada selisih 26,4% dari target Renstra Kemenkes RI 2015-2019 sebesar 95%. Pencapaian indikator UCI desa/kelurahan Kabupaten Kapuas Tahun 2017 sebesar 32,2% dan ada selisih 62,8% dari target UCI berdasarkan RPJMN sebesar 95%. Tesis ini bertujuan untuk membahas kinerja implementasi kebijakan terkait pencapaian indikator imunisasi dasar lengkap (IDL) dan Universal Child Immunization (UCI) tahun 2018 di Kabupaten Kapuas. Penelitian ini adalah penelitian kualitatif dengan desain rapid assessment procedure (RAP) yang dilaksanakan di 6 puskesmas yang berada di kabupaten Kapuas. Jumlah informan dalam penelitian ini ada 34 informan. Pengumpulan data primer dilakukan dengan wawancara mendalam dan observasi melalui telaah dokumen dan kemudian dilakukan analisis data kualitatif. Hasil dari penelitian menunjukkan bahwa kinerja implementasi kebijakan terkait pencapaian indikator imunisasi dasar lengkap (IDL) dan Universal Child Immunization (UCI) di 6 puskesmas yang ada di kabupaten Kapuas tahun 2018 kurang optimal sehingga diperlukan upaya perbaikan untuk meningkatkan pencapaian IDL dan UCI di tahun berikutnya.

Pendahuluan: Pengelolaan limbah medis merupakan salah satu hal yang penting dalam penanganan pandemi Corona Virus Disease 2019 (Covid-19). RS Sentra Medika Cikarang merupakan salah satu rumah sakit rujukan Covid-19 yang menghasilkan limbah medis. Perlu adanya evaluasi pengelolaan limbah medis sebelum dan saat pandemi Covid-19. Metode: Desain penelitian ini adalah studi kasus. Penelitian ini dilaksanakan pada bulan Agustus tahun 2020. Informan kunci dalam penilitian ini adalah sanitarian dan perawat. Hasil dan Pembahasan: Pengelolaan limbah medis saat pendemi tidak berbeda jauh dengan sebelum pandemi. Jumlah pasien yang berkunjung ke pelayanan kesehatan menurun akibat pandemi. Limbah yang dihasilkan dari pelayanan Covid-19 meliputi bekas makanan atau minuman pasien serta APD seperti hazmat, masker, sarung tangan. Berat limbah tersebut jauh lebih ringan. Kesimpulan. Limbah medis di Rumah Sakit Sentra Medika sudah dilakukan pengelolaan sesuai dengan regulasi yang telah ditetapkan pemerintah.

Pendahuluan: Target program penanggulangan TB nasional yaitu eliminasi pada tahun 2035 dan Indonesia bebas TB tahun 2050. Rumah sakit harus menetapkan Tim DOTS yang bertanggung jawab terhadap pelaksanaan program Penanggulangan TB dan wajib melakukan pencatatan dan pelaporan terhadap setiap kejadian penyakit. Pelaporan kasus TB menggunakan Sistem Informasi Tuberkulosis Terpadu (SITT) yang menjadi Sistem Informasi Tuberkulosis (SITB) sejak tahun 2020. RS Syarif Hidayatullah termasuk 1 dari 3 rumah sakit yang belum melengkapi pelaporan dalam SITB. Metode: Penelitian ini merupakan penelitian kualitatif dengan desain studi kasus. Teknik pengambilan data dengan telaah dokumen, observasi dan wawancara mendalam pada informan kunci. Hasil dan Pembahasan. Pencatatan dan pelaporan tidak berjalan maksimal karena 1) kurangnya SDM perawat sebagai ujung tombak pencacatan manual, 2) belum adanya pendaan untuk program TB DOTS termasuk untuk pencatatan dan pelaporan, 3) belum terintegrasinya SIMRS ke semua unit pelayanan, 4) jeraring internal tidak berjalan baik. Kesimpulan: Peningkatan komitmen manajemen dalam implementasi program TB DOTS.

The implementation of National Health Insurance in 2014 is expected to increase access in health services while reducing the economic burden due to illness. This study aims to see how the behavior of people in choosing treatment when experiencing health problems, whether they tend to select self-medication or outpatient treatment. Quantitative analysis was carried out on variables previously formed based on the KOR Data questionnaire found in SUSENAS 2017. The results of the study showed that more respondents chose to do self-medication than those who accessed formal services with outpatient care. Multivariate tests show all variables except secondary education significantly influence individual decisions to self-medication.

Background: The physical design of the hospital is an important component of infec­tion control measures to minimize the risk of transmission of infectious diseases. Most hospitals in developing countries are not scientifically designed including wards and corridors. This study aimed to review systematically the relationship of inpatient cor­ridor layout in hospital with risk of infection transmission. Subjects and Method: A systematic review was conducted by searching published articles from 2010 to 2019, from databases including Scopus, ProQuest, and EBSCO. The keywords were “hospital OR inpatient AND corridor OR hallway OR passageway AND infection or healthcare-associated infection”. The inclusion criteria of this study were articles published in the last 10 years, full text, system, and open access. After review process, 9 articles were included in this review. Results: Two studies examined the effects of corridor shape on hospitals and mapped the distribution of infections. One article was related to aerosol dilution in the inpatient cor­ridor, another related to energy efficiency as an effect of hospital corridor de­sign. Three studies were concerned with infection transmission through the air, another in­ves­­tigated the use of natural ventilation in buildings. One article looked at the la­test air sys­tem development. Conclusion: Looped double corridor has a higher risk of spread of infection compared to hybrid and double-loaded corridor. Movement in the looped double corridor is short, so the spread of infection can occur quickly. In addition to the shape of the corridor, the spread of infection in the inpatient room is also influenced by the particular air system used. In double-loaded corridors it is not recommended to apply natural ventilation. Keywords: corridor, hospital, infection, environment

Tantangan utama unit laboratorium klinik di rumah sakit saat ini adalah melakukan efisiensi biaya terutama biaya sumber daya manusia. Di sisi lain pasien dan dokter menginginkan hasil pemeriksaan laboratorium yang lebih cepat dan akurat. Penelitian ini bertujuan untuk mengetahui jumlah kebutuhan ahli teknologi laboratorium medik berdasarkan beban kerja di Unit Laboratorium Klinik Rumah Sakit Santa Maria Pekanbaru. Metode penelitian yang digunakan adalah operational research dengan analisis kuantitatif dan kualitatif. Analisis beban kerja dilakukan terhadap seluruh tenaga ahli teknologi laboratorium medik yang berjumlah 15 orang dengan metode kombinasi work sampling dan daily log . Perhitungan kebutuhan tenaga dilakukan dengan 3 metode yaitu Metode Ilyas, Metode WISN, dan Metode Full Time Equivalent . Hasil penelitian adalah dibutuhkan 18 orang tenaga ahli teknologi laboratorium medik menurut Metode Ilyas, 21 orang menurut Metode WISN, dan 17 orang menurut Metode Full Time Equivalent . Disarankan kepada Rumah Sakit Santa Maria Pekanbaru agar menambah 3 orang tenaga ahli teknologi laboratorium medik. ABSTRACT The main challenge of the clinical laboratory unit in hospitals nowdays is making expenditures efficiency, especially human resources expenditures. On the other hand, patients and doctors normally request faster and more accurate laboratory checking results. The purpose of this study is to get proper number of medical laboratory technology experts needed based on workload in Santa Maria Pekanbaru Hospital Clinical Laboratory Unit. Research method applied is operational research with quantitative and qualitative analysis. Workload analysis was done toward the whole medical laboratory technology experts, which were 15 person, with the combination method of work sampling and daily log. The calculation of expert need was done with 3 methods: Ilyas, WISN, and the Full Time Equivalent Method. The study result is there are 18 medical laboratory technology experts needed according to Ilyas Method, 21 experts according to WISN Method, and 17 experts according to Full Time Equivalent Method. It is suggested to Santa Maria Pekanbaru Hospital to add 3 more medical laboratory technology experts.

Health development in the period 2015-2019 is Indonesia Sehat program with the goal to improve the health and nutritional status of the community through health and community empowerment efforts which are supported with financial protection and health care equity. Social Health Security Agency (BPJS) as JKN organizers estimate in 2015 is a deficit of more than 6 trillion rupiahs. In 2016, the deficit is estimated to be 11 trillion rupiahs. This study used a cross-sectional study design. The population in this study were outpatients at the sub-district Kramat Jati and Pasar Rebo primary health care with the total number of 800 people and studied sample of 100 people. Patient satisfaction in this study has mean score of 43,06. Education variable; job and services are not significantly affects patient satisfaction JKN Non PBI at East Jakarta district primary heallth care. In conclusion, dimension of punctuality; convenience in obtaining services and ease in obtaining services most influence on patient satisfaction JKN Non PBI in East Jakarta district primary health care with the p value = 0,000 < 0,05. In addition, politeness and friendliness within the service still have big influence on patient satisfaction bicause it is important factors on patient satisfaction. Therefore, the author gives some recommendations to appropriate and thorough improvement added with upgrading to the punctuality of service, conducting a survey of patient satisfaction by BPJS and primary health care, disseminating the research results regarding the effect of service quality on patient satisfaction level, further and in-depth research needs to be done related to the effect on service quality dimension to JKN patient satisfaction level in all primary health care included in East Jakarta district, especially at primary health care which has never been conducted with survey and research on JKN patient satisfaction level.

The upfront payment policy in the hospital caused controversy and rejection from the society. To anticipate this, some hospitals apply no upfront payment policy. However the policy causes an increase in bad debts. Seeing this dilemma, the authors will conduct research to analyze the different of hospital financial performance before and after no upfront payment policy. The research method used is comparative descriptive with analyzed by paired sample t-test. The result was no upfront payment policy has a positive impact on hospital financial performance. The results of this study were expected to be an input for hospital management and government to revise and refine on the upfront payment policy.

Memasuki Era Jaminan Kesehatan Nasional (JKN), pengelolaan rumah sakit yang efisien dengan tetap memperhatikan kendali mutu dan biaya menjadi kunci agar mampu bertahan dan berkembang. Tujuan penelitian adalah untuk mengetahui dampak penerapan kebijakan JKN terhadap tingkat efisiensi rumah sakit di Provinsi Sulawesi Selatan. Efisiensi RS dinilai dengan metode Data Envelopment Analisis (DEA). Sampel adalah seluruh rumah sakit umum yang telah berstatus badan layanan umum daerah di Provinsi Sulawesi Selatan. Jumlah sampel penelitian sebanyak 25 rumah sakit. Data yang dianalisis adalah data tahun 2014 hingga 2017. Hasil penelitian menunjukkan rata-rata RS BLUD di Provinsi Sulawesi Selatan hanya efisien pada tahun 2016 sedangkan pada tahun 2014, 2015 dan 2017 rata-rata RS tidak efisien. Perubahan sistem pelayanan kesehatan pada era JKN telah membawa dampak negatif terhadap tingkat efisiensi RS. Hal ini disebabkan seringnya terjadi keterlambatan pencairan pembayaran klaim BPJS Kesehatan dan rendahnya tarif INA-CBGs. Oleh karena itu pemerintah perlu mengeluarkan kebijakan untuk mengatasi permasalahan tersebut.

Objective: This exploratory study aimed to evaluate and compare the treatment costs of taxane-based versus cisplatin-based chemotherapy.Methods: This study used data from the medical and financial records of ovarian cancer patients who were admitted to Dharmais NationalCancer Hospital (RSKD) between 2008 and 2012 and subsequently underwent surgery and were treated with chemotherapy. Data were analyzedusing descriptive analysis, and a Kaplan–Meier graph was plotted to compare the survival of the patients in the taxane-based and cisplatin-basedchemotherapy groups.Results: Of 41 patients, treatment costs were available for nine patients who had undergone taxane-based chemotherapy and for 31 patients who hadundergone cisplatin-based chemotherapy. In general, surgical procedures accounted for the highest proportion of the treatment costs, followed bychemotherapy. Taxane-based chemotherapy (six cycles) was 4 times more expensive than cisplatin-based therapy. The pre- and post-chemotherapycosts of care among those treated with the taxane-based regimen were 3-4 times more expensive than those of the patients who received cisplatinbasedtreatment. The disease-free recurrence duration of the patients treated with taxane was longer (median=18 months) than that of the patientstreated with cisplatin (median=5 months).Conclusions: Taxane-based therapy increased the disease-free recurrence duration of the patients, with disease-free recurrence 3 times longer thanthat of the patients treated with the cisplatin-based regimen. However, the treatment costs of the taxane-based regimen were 4 times higher thanthose of the cisplatin-based treatment.

Abstract. The rapid change from presidential regulation no.19 year 2016 on health insurance into presidential regulation no.28 year 2016 on health insurance get a big attention. This research was purposed to analyze about health insurance policy which changed very quickly. It changed from presidential regulation no.19 year 2016 into presidential regulation no.28 year 2016 on health insurance. The researcher used qualitative methods. The analysis from the input processing and output showed that the change of presidential regulation is a responsive form from president when he looked public rejection response for the increase of fee. The president extended it through the department of health affairs. In terms of inputs, the resources of this policy change are still very limited, while at the stage of the process there is still a lack of cross-sector coordination with related institutions and difficulties in getting the materials needed in the discussion. Presidential Regulation No.28 of 2016 on Health Insurance that became the output in this change is considered to be able to accommodate the demand of the people but the changes are not in accordance with the actuary calculations. This change of presidential regulation not yet affected to appropriate the fee adequacy on BPJS Implementation. The department of health affairs as a leader of health sector was recommended to increase the cross-sectoral coordination which can manifest the better product of health policy and to complete the policy instrument that yet to be determined. It also used to be concern from the department of health affairs, DJSN and BPJS which explained the increase of fee must be offset by a quality improvement rather than the implementation of national health insurance. Keywords: change, policy, presidential