Determinants of Approval Claims at Hospital Among COVID-19 Patients

The COVID-19 pandemic is an issue that is being faced by Indonesia and even most countries in the world. The impact due to the COVID-19 pandemic is disruption of hospital with cash flow. It was caused by the delay in hospital payment of claims which are not approved by Badan Penyelenggara Jaminan Sosial (BPJS Kesehatan). Siloam Sentosa Hospital Bekasi provides services for COVID-19 patients. However, out 81 claims of COVID-19 patients in August-October 2020, there were 65 claims (80.25%) not approved by BPJS Kesehatan. The purpose of this study was to analyze the factors that affect the approval claims among patients with COVID-19 at Siloam Sentosa Hospital Bekasi. This type of research was descriptive analysis with a quantitative approach. The research population was 108 claims and the sample used the total population. A Logistic regression test was used to analyze the data. The results of the study explained the completeness of claims, the quality of the medical resume, the completeness of filling out the epidemiological investigation form, and the quality of clinical coding that affected the approval claims. The study showed 21.5% of other factors that are not examined can affect the approval claims. Socialization of policies related to payment of claims to hospitals as well as monitor and evaluate from both hospitals and BPJS Kesehatan need to be improved to prevent claims that are not approved

Tinjauan Kelancaran Klaim Pasien Covid-19

Peningkatan kasus Covid-19 yang terjadi di Indonesia mempengaruhi sistem pembiayaan dalam pelayanan kesehatan. Salah satu kebijakan yang dihasilkan dampak dari peningkatan kasus Covid-19 adalah Kementerian Kesehatan menerbitkan petunjuk teknis penggantian klaim biaya pelayanan kesehatan bagi rumah sakit yang menyelenggarakan pelayanan Covid-19. Dalam pelaksanaan aturan tersebut, terdapat kendala sehingga klaim yang diajukan tertunda pembayaranya atau tidak lancar. Tujuan dari penelitian ini adalah menganalisis kelancaran klaim Covid-19 ditinjau dari komponen input, proses, dan luaran. Metode penelitian ini adalah potong lintang dengan pendekatan kuantitatif deskriptif. Penelitian dilakukan di RS Siloam Sentosa Bekasi dengan telaah dokumen klaim Covid-19. Populasi pada penelitian ini adalah seluruh klaim Covid-19 pada Januari-Februari 2021. Sampel diambil menggunakan sampel jenuh dengan jumlah 108 dokumen. Aplikasi yang digunakan untuk proses klaim yaitu INA-CBG. Dalam pelaksanaan pengajuan klaim, rumah sakit mengadopsi kebijakan petunjuk teknis penggantian klaim yang diterbitkan oleh Kementerian Kesehatan dan telah menerapkannya. Hasil telaah menunjukan 63% klaim lancar. Penyebab klaim tidak lancar yaitu kelengkapan dokumen klaim, ketidak konsistenan pengisian rekam medis, dan hasil pengodean yang dilakukan

Reporting Helicopter Emergency Medical Services in Major Incidents: A Delphi Study

Peer reviewe

Reduced Inflammatory Threshold Indicates Skin Barrier Defect in Transglutaminase 3 Knockout Mice

Recently a transglutaminase 3 knockout (TGM3/KO) mouse was generated that showed impaired hair development, but no gross defects in the epidermal barrier, although increased fragility of isolated corneocytes was demonstrated. Here we investigated the functionality of skin barrier in vivo by percutaneous sensitization to fluorescein-isothiocyanate (FITC) in TGM3/KO (n=64) and C57BL/6 WT mice (n=36). Cutaneous inflammation was evaluated by mouse ear swelling test (MEST), histology, serum IgE levels, and by flow-cytometry from draining lymph nodes. Inflammation induced significant MEST difference (P<0.0001) was detected between KO and WT mice and was supported also by histopathology. A significant increase of CD4+ CD25+ activated T-cells (P<0.01) and elevated serum IgE levels (P<0.05) in KO mice indicated more the development of FITC sensibilization than an irritative reaction. P. acnes induced intracutaneous inflammation showed no difference (P=0.2254) between the reactivity of WT and KO immune system. As in vivo tracer, FITC penetration from skin surface followed by two-photon microscopy demonstrated a more invasive percutaneous penetration in KO mice. The clinically uninvolved skin in TGM3/KO mice showed impaired barrier function and higher susceptibility to FITC sensitization indicating that TGM3 has a significant contribution to the functionally intact cutaneous barrier.Journal of Investigative Dermatology accepted article preview online, 24 July 2013. doi:10.1038/jid.2013.307

Dynamical Mean Field Theory for Self-Generated Quantum Glasses

We present a many body approach for non-equilibrium behavior and self-generated glassiness in strongly correlated quantum systems. It combines the dynamical mean field theory of equilibrium systems with the replica theory for classical glasses without quenched disorder. We apply this approach to study a quantized version of the Brazovskii model and find a self-generated quantum glass that remains in a quantum mechanically mixed state as T -> 0. This quantum glass is formed by a large number of competing states spread over an energy region which is determined within our theory.Comment: 10 pages, 4 figure

Inactivation of lmpA, Encoding a LIMPII-related Endosomal Protein, Suppresses the Internalization and Endosomal Trafficking Defects in Profilin-null Mutants

Profilin is a key phosphoinositide and actin-binding protein connecting and coordinating changes in signal transduction pathways with alterations in the actin cytoskeleton. Using biochemical assays and microscopic approaches, we demonstrate that profilin-null cells are defective in macropinocytosis, fluid phase efflux, and secretion of lysosomal enzymes but are unexpectedly more efficient in phagocytosis than wild-type cells. Disruption of the lmpA gene encoding a protein (DdLIMP) belonging to the CD36/LIMPII family suppressed, to different degrees, most of the profilin-minus defects, including the increase in F-actin, but did not rescue the secretion defect. Immunofluorescence microscopy indicated that DdLIMP, which is also capable of binding phosphoinositides, was associated with macropinosomes but was not detected in the plasma membrane. Also, inactivation of the lmpA gene in wild-type strains resulted in defects in macropinocytosis and fluid phase efflux but not in phagocytosis. These results suggest an important role for profilin in regulating the internalization of fluid and particles and the movement of material along the endosomal pathway; they also demonstrate a functional interaction between profilin and DdLIMP that may connect phosphoinositide-based signaling through the actin cytoskeleton with endolysosomal membrane trafficking events

Best practice advice on pre-hospital emergency anaesthesia & advanced airway management

Abstract Background Effective and timely airway management is a priority for sick and injured patients. The benefit and conduct of pre-hospital emergency anaesthesia (PHEA) and advanced airway management remains controversial but there are a proportion of critically ill and injured patients who require urgent advanced airway management prior to hospital arrival. This document provides current best practice advice for the provision of PHEA and advanced airway management. Method This best practice advice was developed from EHAC Medical Working Group enforced by pre-hospital critical care experts. The group used a nominal group technique to establish the current best practice for the provision of PHEA and advanced airway management. The group met on three separate occasions to discuss and develop the guideline. All members of the working party were able to access and edit the guideline online. Results This EHAC best practice advice covers all areas of PHEA and advanced airway management and provides up to date evidence of current best practice. Conclusion PHEA and advanced airway management are complex interventions that should be delivered by appropriately trained personnel using a well-rehearsed approach and standardised equipment. Where advanced airway interventions cannot be delivered, careful attention should be given to applying basic airway interventions and ensuring their effectiveness at all times