Effect of Patient Centered Care Application on Inpatient Outcomes in Rskdia Pertiwi and Rsia Ananda (Woman and Child Hospitals)

BACKGROUND: Patient-centered care (PCC) is a new paradigm in healthcare that places patients as the center of care to improve health outcomes and increase patient and family satisfaction. AIM: The study aimed to evaluating the effect of PCC application on inpatient outcomes, notably patient satisfaction, and clinical outcomes in RSKDIA Pertiwi and RSIA Ananda. METHODS: The study was quantitative analytic with cross-sectional design. A sample of 92 patients were determined proportionally, and selected with the inclusion criteria. Data were collected using measuring tools consisting of PCC questionnaires, patient satisfaction questionnaires, and patient medical record to evaluate the clinical outcomes of patient. Bivariate analysis was carried out to compare the PCC application between the two hospitals, and multivariate analysis to correlate the effect of PCC application to patient satisfaction, and clinical outcomes of inpatient in each hospital. RESULTS: There was effect of PCC application on patient satisfaction in RSKDIA Pertiwi (p = 0.017) and RSIA Ananda (p = 0.000), but there was no effect show to the clinical outcomes in RSKDIA Pertiwi (p = 0.718) and RSIA Ananda (p = 0.440), also there was no differences in the application of PCC (p = 0.492) between both hospitals. CONCLUSION: It can be concluded that the application of PCC attributed to patient satisfaction, but did not affect the clinical outcomes of inpatients at RSKDIA Pertiwi and RSIA Ananda; also there were no differences of PCC application between both hospitals. The hospitals management should improve the application of PCC, particularly in coordination of care

Human influenza A H5N1 in Indonesia: health care service-associated delays in treatment initiation.

BACKGROUND: Indonesia has had more recorded human cases of influenza A H5N1 than any other country, with one of the world's highest case fatality rates. Understanding barriers to treatment may help ensure life-saving influenza-specific treatment is provided early enough to meaningfully improve clinical outcomes. METHODS: Data for this observational study of humans infected with influenza A H5N1 were obtained primarily from Ministry of Health, Provincial and District Health Office clinical records. Data included time from symptom onset to presentation for medical care, source of medical care provided, influenza virology, time to initiation of influenza-specific treatment with antiviral drugs, and survival. RESULTS: Data on 124 human cases of virologically confirmed avian influenza were collected between September 2005 and December 2010, representing 73% of all reported Indonesia cases. The median time from health service presentation to antiviral drug initiation was 7.0 days. Time to viral testing was highly correlated with starting antiviral treatment (p < 0.0001). We found substantial variability in the time to viral testing (p = 0.04) by type of medical care provider. Antivirals were started promptly after diagnosis (median 0 days). CONCLUSIONS: Delays in the delivery of appropriate care to human cases of avian influenza H5N1 in Indonesia appear related to delays in diagnosis rather than presentation to health care settings. Either cases are not suspected of being H5N1 cases until nearly one week after presenting for medical care, or viral testing and/or antiviral treatment is not available where patients are presenting for care. Health system delays have increased since 2007