Hubungan Mutu Pelayanan Keperawatan dan Perilaku Caring Perawat dengan Kepuasan Pasien Badan Penyelenggara Jaminan Sosial Kesehatan dan Umum di Rawat Inap Kelas III RSUD Sunan Kalijaga Kabupaten Demak

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi Rumah Sakit 2017 ABSTRAK Siwi Bagus Ajiningrat Hubungan Mutu Pelayanan Keperawatan dan Perilaku Caring Perawat dengan Kepuasan Pasien Badan Penyelenggara Jaminan Sosial Kesehatan dan Umum di Rawat Inap Kelas III RSUD Sunan Kalijaga Kabupaten Demak xvi + 128 halaman + 30 tabel + 8 lampiran Banyak faktor yang diduga mempengaruhi perbedaan tingkat kepuasan pasien BPJS dan pasien umum di rawat inap kelas III di RSUD Sunan Kalijaga Kabupaten Demak, diantaranya mutu pelayanan keperawatan dan perilaku caring perawat. Kenyataan bahwa mutu pelayanan keperawatan di rumah sakit seperti itu akibat dari perilaku caring perawat sehingga berdampak kepada ketidakpuasan pasien. Jenis penelitian adalah kuantitatif, pendekatan cross sectional. Responden 120 orang, pasien BPJS kesehatan 100 orang, pasien umum 20 orang. Analisis data dengan analisis independent t test. Hasil penelitian, pasien BPJS kesehatan umur 59-65 tahun 22,0%, perempuan 52,%, pendidikan SMP 38,0%, sebagai petani 34,0%, menikah 80,0%, mutu pelayanan keperawatan kategori cukup 62,0% dan baik 38,0%, perilaku caring perawat kategori cukup 17,0% dan baik 83,0%, kepuasan kategori cukup 11,0% dan baik 89,0% Pasien umum umur 45-51 tahun 45,0%, laki-laki 55,%, pendidikan SMA 60,0%, bekerja swasta 80,0%, menikah 100,0%. mutu pelayanan keperawatan kategori cukup 5,0%, baik 95,0%. perilaku caring perawat umum kategori baik 100,0%, kepuasan kategori baik 100,0%. Tidak ada perbedaan mutu pelayanan keperawatan pada pasien BPJS kesehatan dan umum (α=0,094). Tidak ada perbedaan perilaku caring perawat pada pasien BPJS kesehatan dan umum (α=0,129). Ada perbedaan kepuasan pada pasien BPJS kesehatan dan umum (t hitung =2,635, α=0,012). Tidak ada hubungan mutu pelayanan Keperawatan terhadap kepuasan pada pasien BPJS kesehatan dan umum (α=0,173). Ada hubungan perilaku caring perawat terhadap kepuasan pada pasien BPJS kesehatan dan umum (α = 0,049) Agar RSUD lebih mendorong meningkatkan mutu pelayanan keperawatan dan perilaku caring perawat dengan cara selalu memberikan pembinaan teknis, pendidikan pelatihan dan mengoptimalkan tugas dan peran dalam bidang keperawatan. Kata kunci : Mutu Pelayanan Keperawatan, Perilaku Caring Perawat, Kepuasan Pasien Kepustakaan : 60 (1990-2010)Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Hospital Administration 2017 ABSTRACT Siwi Bagus Ajiningrat The Relationship of the Quality of Nursing Service and Nurse’s Caring Behaviours with Patients’ Satisfaction of Health Social Insurance Agency and General at Inpatient Installation of Class III at the Public Hospital of Sunan Kalijaga in Demak Regency xvi + 128 pages + 30 tables + 8 appendices Some factors suspected influencing the differences of patients’ satisfaction levels of Health Social Insurance Agency (HSIA) and General at inpatient installation of Class III at the Sunan Kalijaga Public Hospital in Demak Regency were a quality of nursing services and nurse’s caring behaviours. In fact, low quality of nursing services was due to nurse’s caring behaviours in which it led to patients’ dissatisfaction. This was a quantitative study using cross-sectional approach. Number of respondents were 120 persons which consisted of 100 HSIA patients and 20 general patients. Data were analysed using an Independent t test. The results of this research showed that among HSIA patients, a proportion of age 59-65 years old was 22.0%, a proportion of female was 52.0%, as many as 38.0% graduated from Junior High School, 34.0% of the respondents worked as a farmworker, 80.0% of the participants had got married, as many as 62.0% of the respondents had fairly good quality of nursing services and the rest was good (38.0%), as many as 17.0% of the respondents had fairly good nurse’s caring behaviours and the rest was good 83.0%), and as many as 11.0% were fairly satisfied and the rest was satisfied 89.0%. In contrast, among general patients, a proportion of age 45-51 years old was 45.0%, a proportion of male was 55.0%, as many as 60.0% graduated from Senior High School, 80.0% of the respondents worked as in private sectors, 100.0% of the participants had got married, as many as 5.0% of the respondents had fairly good quality of nursing services and the rest was good (95.0%), all of the respondents (100.0%) had good nurse’s caring behaviours, and all of the respondents (100.0%) were satisfied. There was no difference in the quality of nursing services between HSIA and general patients (p=0.094). There was no difference in the nurse’s caring behaviours between HSIA and general patients (p=0.129). There was any difference in satisfaction between HSIA and general patients (t=2.635; p=0.012). There was no significant relationship between the quality of nursing services and satisfaction of HSIA and general patients (p=0.173). There was no significant relationship between the nurse’s caring behaviours and satisfaction of HSIA and general patients (p=0.049). The public hospital needs to improve the quality of nursing services and the nurse’s caring behaviours by providing a technical guidance, education, training, and optimising tasks and roles in nursing. Keywords : Quality Of Nursing Services, Nurse’s Caring Behaviours, Patients’ Satisfaction Bibliography: 60 (1990-2010

Application of the option pricing model to estimate expected stock returns : a thesis presented in partial fulfilment of the requirements for the degree of Master of Business Studies in Finance at Massey University

This thesis refines and tests an option-based methodology for estimating the expected rate of return on firms' equity, being an approach proposed by Hsia (1991). Hsia's approach is based on an option-theoretic model of the firm, as proposed by Merton (1974) and others. Tests of the Hsia approach are thus joint tests of the Merton model and of the Hsia approach. The Merton model is successfully fitted in its basic form by solving for firm asset volatility and, consistent with prior studies, the implied volatility for firms' assets is found, on average, to be higher than that expected from examining historical equity volatility. The Hsia-based expected excess returns on equity are then estimated and tested in regressions against realised excess stock returns. The Hsia-based expected excess returns are found to be only weakly, positively associated with realised excess returns, and not of statistical significance. When the sample is split in half on the basis of various option-like characteristics (such as higher gearing), the Hsia approach is found to work better for the more option-like sub-sample. This research thus provides some tentative support for the Hsia approach, but does not provide a clear conclusion about its ability to explain the variation in realised excess stock returns. It also provides some ideas and possible directions for further research into applying the Hsia approach

Research priorities for data collection and management within global acute and emergency care systems.

Barriers to global emergency care development include a critical lack of data in several areas, including limited documentation of the acute disease burden, lack of agreement on essential components of acute care systems, and a lack of consensus on key analytic elements, such as diagnostic classification schemes and regionally appropriate metrics for impact evaluation. These data gaps obscure the profound health effects of lack of emergency care access in low- and middle-income countries (LMICs). As part of the Academic Emergency Medicine consensus conference "Global Health and Emergency Care: A Research Agenda," a breakout group sought to develop a priority research agenda for data collection and management within global emergency care systems

Empirical analysis of the Hsia option-pricing based model cost of capital

The cost of capital is a fundamental concept in strategic decisions such as capital investments, capital structure, new issues, mergers and acquisitions, spin-offs and other corporate restructurings. This paper explores empirically the option-based model developed by Hsia (1991) for estimating the cost of equity and the cost of capital of the firm. The composition of the sample in this exploratory study is all 17 non-financial companies listed in the Euronext Lisbon that are included in the market index PSI20. The Hsia model is used for estimating the cost of equity and the cost of capital of the firm for these 17 companies and is compared to the estimates obtained from the Capital Asset Pricing Model (CAPM) and the traditional weighted average cost of capital (WACC). The difference between the means of the cost of equity estimated by Hsia model and CAPM is not statistically significant at 1% level and their correlation of 46.2% is statistically significant at 1% level. However, the differences at the individual level are quite large. One of the limitations found in this study was the inconsistency on the computation of the cost of debt. The problem arise from the fact that the cost of debt do not follow the pattern expected in the theory, but we also find that the Hsia model is unable to deal with potential inconsistencies of the financial market.N/

Changes in Emergency Department Care Intensity from 2007-16: Analysis of the National Hospital Ambulatory Medical Care Survey

Introduction: Emergency departments (ED) in the United States (US) have increasingly taken the central role for the expedited diagnosis and treatment of acute episodic illnesses and exacerbations of chronic diseases, allowing outpatient management to be possible for many conditions that traditionally required hospitalization and inpatient care. The goal of this analysis was to examine the changes in ED care intensity in this context through the changes in ED patient population and ED care provided.Methods: We analyzed the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2007-2016. Incorporating survey design and weight, we calculated the changes in ED patient characteristics and ED care provided between 2007 and 2016. We also calculated changes in the proportion of visits with low-severity illnesses that may be safely managed at alternative settings. Lastly, we compared ED care received and final ED dispositions by calculating adjusted relative risk (aRR) comparing ED visits in 2007 to 2016, using survey weighted multivariable logistic regression.Results: NHAMCS included 35,490 visits in 2007 and 19,467 visits in 2016, representing 117 million and 146 million ED visits, respectively. Between 2007 and 2016, there was an increase in the proportion of ED patients aged 45-64 (21.0% to 23.6%) and 65-74 (5.9% to 7.5%), while visits with low-severity illnesses decreased from 37.3% to 30.4%. There was a substantial increase in the proportion of Medicaid patients (22.2% to 34.0%) with corresponding decline in the privately insured (36.2% to 28.3%) and the uninsured (15.4% to 8.6%) patients. After adjusting for patient and visit characteristics, there was an increase in the utilization of advanced imaging (aRR 1.29; 95% confidence interval [CI], 1.17-1.41), blood tests (aRR 1.16; 95% CI, 1.10-1.22), urinalysis (aRR 1.22; 95% CI, 1.13-1.31), and visits where the patient received four or more medications (aRR 2.17; 95% CI, 1.88-2.46). Lastly, adjusted hospitalization rates declined (aRR 0.74; 95% CI, 0.64-0.84) while adjusted discharge rates increased (aRR 1.06; 95%CI 1.03-1.08). Conclusion: From 2007 to 2016, ED care intensity appears to have increased modestly, including aging of patient population, increased illness severity, and increased resources utilization. The role of increased care intensity in the decline of ED hospitalization rate requires further study

A Novel Survey Tool to Quantify the Degree and Duration of STEMI Regionalization Across California.

IntroductionCalifornia has been a global leader in regionalization efforts for time-critical medical conditions. A total of 33 local emergency medical service agencies (LEMSAs) exist, providing an organized EMS framework across the state for almost 40 years. We sought to develop a survey tool to quantify the degree and duration of ST-elevation myocardial infarction (STEMI) regionalization over the last decade in California.MethodsThe project started with the development of an 8-question survey tool via a multi-disciplinary expert consensus process. Next, the survey tool was distributed at the annual meeting of administrators and medical directors of California LEMSAs to get responses valid through December, 2014. The first scoring approach was the Total Regionalization Score (TRS) and used answers from all 8 questions. The second approach was called the Core Score, and it focused on only 4 survey questions by assuming that the designation of STEMI Receiving Centers must have occurred at the beginning of any LEMSA's regionalization effort. Scores were ranked and grouped into tertiles.ResultsAll 33 LEMSAs in California participated in this survey. The TRS ranged from 15 to 162. The Core Score range was much narrower, from 2 to 30. In comparing TRS and Core Score rankings, the top-tertiles were quite similar. More rank variation occurred between mid- and low-tertiles.ConclusionThis study evaluated the degree and duration of STEMI network regionalization from 2004 to 2014 in California, and ranked 33 LEMSAs into tertiles based upon their TRS and their Core Score. Successful application of the 8-item survey and ranking strategies across California suggests that this approach can be used to assess regionalization in other states or countries around the world

ANALISIS KERENTANAN JARINGAN DENGAN MENGGUNAKAN SKOR CVSS DAN METODA NETWORK RISK METRIC

Banyaknya pihak-pihak yang tak bertanggung jawab melakukan pengrusakan data, pencurian data, manipulasi data, dan sebagainya dengan memanfaatkan ‘celah’ dari suatu jaringan marak terjadi. Padahal, rentannya suatu jaringan adalah seperti membiarkan pintu yang terbuka bagi pihak-pihak yang tak bertanggung jawab untuk dapat menembus suatu jaringan. Oleh karena itu, tugas akhir ini membahas langkah-langkah awal bagaimana untuk menganalisis kerentanan pada suatu jaringan. Pada penelititan ini, dilakukan analisis pemindaian terhadap kerentanan jaringan terhadap lima tempat. Adapun analisis yang dilakukan adalah mengukur risk jaringan dengan Network Risk Metric. Network Risk Metric adalah salah satu metoda vulnerability assessment yang diusulkan oleh Hemanidhi, Sanonchimmanee serta Sanguansat pada tahun 2014. Metoda Lai-Hsia juga digunakan untuk perbandingan. Metoda Lai-Hsia diusulkan oleh Lai dan Hsia pada tahun 2007. Hasil analisis menunjukkan bahwa tempat yang memiliki IP host lebih banyak memicu lebih banyak rentannnya suatu jaringan. Dalam kasus ini, bila diurutkan dari yang terbesar, pengukuran pada tempat pertama, yaitu dengan total estimated risk 5,32%, disusul dengan tempat ketiga dengan 4,03%, kemudian tempat keempat dengan 3,09%, tempat kedua dengan 1,77% dan tempat kelima dengan 1,45%. Pada perhitungan dengan metoda Lai-Hsia didapatkan bahwa tempat pertama memiliki Risk Lai-Hsia sebesar 54,72%, kemudian tempat ketiga dengan 46,46%, tempat keempat dengan 42,61%, tempat kedua dengan 34,85%, dan tempat kelima dengan 29,25% Kata Kunci : keamanan jaringan, metrik keamanan, CVSS, pemindai kerentanan nessus, metrik resiko jaringan, metoda lai-hsi