Dampak Kebijakan Jaminan Kesehatan Nasional terhadap Efisiensi Rumah Sakit: Studi Kasus di Provinsi Sulawesi Selatan

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

The Impact of Accreditation on the Quality of Hospital Service

Background: It is hypothesized that hospital accreditation improves the quality of health services. This is because every accredited hospital must implement the standard issues by an independent accreditation organization. However, there is a lack of evi­den­ce in Indonesia to support this hypothesis. This study aimed to investigate the impact of accreditation on the quality of hospital service. Subjects and Method: This was a systematic review conducted by searching articles related to hospital accreditation and the quality of health service. The articles were col­lec­ted from PubMed database. The keywords were “hospital accreditation” AND “qua­lity” AND “impact”. The activation filter used in the PubMed were free and full text. The articles were reviewed based on PRISMA flow diagram. Results: Eight articles reported that the hospital accreditation improved the quality of health service. These articles provide some valid evidence in the four stages of accre­ditation cycle, namely the initiation phase, pre-survey phase, after accreditation phase, and stagnation phase. The quality of hospital health services had increased significantly from initiation phase to the after accreditation phase. Conclusion: Hospital accreditation increases the quality of hospital health service. This is because hospitals must work in accordance with standard issued by independent hospital accreditation to maintain hospital quality. Keywords: hospital accreditation, impact, qualit

The Cost and Quality of Laboratory Automation: A Systematic Review

Background: An increased number of visit to health facilities increases the number of laboratory examination. Laboratories are required to achieve better efficiency, accu­ra­cy, standardization, quality, and patient safety. A strategy to meet this demand is la­bo­­ra­tory automation. However, some laboratories are hesitant to implement labora­to­ry au­tomation because of high cost and quality. This stu­dy aimed to systematically review the cost and quality of laboratory auto­ma­tion. Subjects and Method: A systematic review was conducted by searching articles from 2009 to 2019 using PubMed, Science Direct, and Scopus databases. The keywords were “la­boratory auto­mation”, “clinical”, “cost”, and “quality”. The inclusion criteria were: (1) Articles published in English language; (2) Research or review articles; (3) Published from January 2009 to July 2019. The articles were reviewed based on PRIS­MA flow diagram. Results: Seven articles reported a decrease in cost due to laboratory automation. The decrease in cost was mainly due to a decrease in the number of employees needed for cer­tain jobs. The quality aspect was mainly assessed using Turnaround Time (TAT). In rou­tine test laboratory, quality through TAT showed an increase, whereas in cito-examination the re­sults can still be validated according to the specified time. The first six months after the im­­plementation of laboratory automation was a vulnerable time due to several fac­tors, including untrained staff. Continuous improvement and close monitoring were needed at this time. Conclusion: When implemented properly, laboratory automation can reduce cost and increase the quality. Keywords: laboratory automation, clinical laboratory, cost, quality, turnaround tim

The Relationship between Inpatient Corridor Layout and the Risk of Infection Transmission in Hospital: A Systematic Review

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, environmen

Evaluation of Nurses Need Planning: A Systematic Review

Background: The recruitment system is important to address the supply of nursing per­sonnel and ensure continuity of health service delivery. However, the number of health workers alone is not enough to strengthen the health system. The health system must be in accordance with health care need to accelerate health outcome. This study ai­med to review systematically the evaluation of nurses need planning. Subjects and Method: A systematic review was conducted by searching published ar­ticles from 2015 to 2019 from databases including Wiley Online library, ProQuest, and ScienceDirect. The keywords for this review included “evaluation”, “health work­force”, “nursing”, and “planning”. The inclusion criteria were English and full text. Af­ter review process, 8 articles were retained in this review. Results: There were several factors that affected nurse recruitment planning, in­clu­ding nurse orientation towards culture and rule, education, scheduling, source of allo­ca­tion, and workforce composition. Conclusion: There are several factors that affect nurse recruitment planning, in­clu­ding nurse orientation towards culture and rule, education, scheduling, source of allo­ca­tion and workforce composition. Keywords: evaluation, health workforce, nurses, plannin