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Journal : Proceedings of the International Conference on Applied Science and Health

REDUCED LENGTH OF STAY IN CHILDREN WITH DIARRHEA FOLLOWING IMPLEMENTATION OF CLINICAL PATHWAY I Nyoman Gede Bayu Wiratama Suwedia; Atik Nurwahyuni
Proceedings of the International Conference on Applied Science and Health No. 4 (2019)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: Diarrhea or Acute Gastroenteritis (AGE) is a dissease that common found in toddlers at emergecy room. The complication of diarrhea such as dehydration may go undetected by parents will affect the treatment and length of stay in the hospital. Decreasing the length of stay in the hospital can be done by implementing clinical pathways. This study aims to examine the effect of implementing clinical pathways on length of stay in children with diarrhea. Methods: This study was a systematic review that used PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Data obtained from Electronic databases Proquest and Scopus that published between 2009-2019 and used English. By using keywords such as clinical pathway, gastroenteritis, and length of stay to find the relevant articles. Results: The search found 610 studies, of which 6 studies were included in the systematic review. These studies conducted majority in USA and 1 study in Australia. Analysis of the studies found out that implemented clinical pathway can decrease length of stay 0.4 days (95% CI 0.04 to 0.7, p <0.01). The decreased of length of stay can increased 2.5% (CI 0.25% to 4.38%) used of medical beds then the bed can be more effective and used by other patients. Conclusion: Implementing clinical pathway in the treatment process of diarrhea towards children not only reduce the length of stay in hospital but also useful in providing patient diagnosed and reduce the bed use per day and year.
ANTIMICROBIAL STEWARDSHIP STRATEGY TO REDUCE LENGTH OF STAY AND COST OF ANTIBIOTIC CONSUMPTION: A SYSTEMATIC REVIEW Anak Agung Istri Agung Sri Stuti Damayan; Ida Bagus Nyoman Maharjana; Atik Nurwahyuni
Proceedings of the International Conference on Applied Science and Health No. 4 (2019)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: Reducing the cost of care and length of stay for patient in hospital are important to monitor the benefits of implementing an antimicrobial management program. An antimicrobial management program is a strategy to decrease Antimicrobial Resistance (AMR) that affect to the treatment of the patient. One of the antimicrobial management programs is Antimicrobial Stewardship Programs (ASP). This study aims to determine the appropriate strategies in the application of Antimicrobial Stewardship Programs (ASP) that can reduce the length of stay and cost of antibiotic consumption for patient in hospital.Methods: This study was a systematic review that used PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Data obtained from Electronic databases ProQuest and Medline (PubMed) that published five years times span. By using keywords such as antimicrobial stewardship, antimicrobial resistance, length of stay, length of the hospital and patient cost to find the relevant journal. Results:  The search found 3,541 studies, of which 26 studies were included in the systematic review. After excluded the article review, there were 9 studies that used quasi-experimental, observational cohort studies and Randomized Control Trial (RCT). These studies conducted majority in Europe and USA, only 1 study that conducted in Asia. Analysis of the studies found out that 6 of 9 studies mentioned if ASP can reduce the length of stay of the patient in hospital. Only 3 of 9 studies that examined the effect of ASP in cost of care and these 3 studies mentioned ASP can reduce the cost of care. Conclusion: This study showed that implementing ASP can reduced the length of stay and antibiotics consumption among patient in hospital by manage the antimicrobial use, conduct audits and feedback in an appropriate step, and intravenous to oral switch program.
THE VARIATION OF CAESARIAN SECTION COSTS IN INDONESIAN HOSPITALS: A NARRATIVE REVIEW Tetriyadi Tetriyadi; Atik Nurwahyuni
Proceedings of the International Conference on Applied Science and Health No. 4 (2019)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: In providing services, hospital, as one of the health care providers, must be able to regulate the number of costs obtained in accordance with the proportion/variation. The costs incurred by hospitals in providing complete personal health services consist of various cost components, including service fees, pharmacy costs, accommodation costs, action costs, investigation fees, and administrative costs. The cost calculation is one of the strategic steps that must be taken in marketing because it will be used for pricing. Caesarean Section (CS) surgery is one of the largest services and costs a lot in the hospital; careful planning is needed. This study aims to look at the variation in the cost components of CS services in Indonesia based on hospital level, hospital ownership. Methods: This study is a quantitative research Narrative Review by analyzing twenty hospitals in six provinces representing Indonesia from the thesis found in lib.ui database. The analysis in this study is the amount of proportion/variation in the cost components with the type of hospital and hospital ownership. Meanwhile, the criteria for selected hospitals are government-owned and private hospitals with types A, B, C and D. To be able to compare these data and avoid inflation differences, it is necessary to do data collection or valuation presentation (VP). The chosen cases were the usual CS without emergency and complication Results: There was a wide variation in CS service cost components, namely medical services (25% - 90%), accommodation (2% -39%), investigations (1% -36%) and drugs and BHP (2% -50%) both in government and private hospitals. Government-owned type B hospitals and government and private type C costs for medical services are greater than 44%. Conclusion: There are variations in the cost components of CS services at hospital types B and C. There is a need for government efforts to make regulations regarding the magnitude of the ideal cost component as a reference for all hospitals in Indonesia.
THE ACCURACY OF DIAGNOSIS, PROCEDURES AND CODING COMPLETENESS AND THEIR CORRELATION WITH INA-CBG CLAIMS Yuliani Yuliani; Atik Nurwahyuni
Proceedings of the International Conference on Applied Science and Health No. 4 (2019)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: Since 1 January 2014, the INA-CBG system has been applied as a method of payment for outpatient and inpatient services. Indonesian-Case Based Groups (INA-CBG) tariff is the amount of payment claimed by the Health Social Security Administering Agency (BPJS) to the hospitals for a package of services based on the classification of diagnoses and procedures of diseases. The inequality in the number of claims received by the hospital compared to the resources used will be unbeneficial to the hospital. The purpose of this study is to identify the correlation of incompleteness and inaccuracy of diagnosis, procedures, and coding to the number of INA-CBG claims at hospitals in Indonesia. Method: The research method is the literature review. The authors found five articles cited by Google Scholar published in journals and two theses taken from the Library of Universitas Indonesia that include ”factors that influence INA-CBGs claim amounts at hospitals” or related concepts in the title or abstract. Articles and theses published from 2014 to 2018 were search using the following terms in the title or abstract: “accuracy, completeness, diagnosis, coding, INA-CBG claims.”.Result: The authors found seven articles that met our criteria: Two studies used qualitative approach, three studies were quantitative studies, two studies used a mix method. From these studies, there were five practical considerations that were considered as the factors that influenced the number of INA-CBGs claims at hospitals in Indonesia: completeness of filling a medical resume, accuracy of coding, accuracy in filling medical resumes, the accuracy of information systems, and completeness of claim administration document.Conclusion: The study has indicated the factors that influence the amount of INA-CBG claims in hospitals in Indonesia, mainly, the factor of completeness of medical resumes and the factor of accuracy in coding by the coders. The completeness of a medical filling resume which is highly dependent on physician compliance and accuracy coding. All the human resources who have a role in coding and claims, need to improve their capability on it, through a workshop, or any other education funded by the hospital. Coder certification must be done. Hospital has to develop hospital management information system for acceleration in coding and claim.
EFFECTIVENESS OF CAESAREAN SECTION CLINICAL PATHWAY TOWARDS HOSPITAL LENGTH OF STAY: A SYSTEMATIC REVIEW Maria Wahyu Daruki; Atik Nurwahyuni; Adang Bachtiar
Proceedings of the International Conference on Applied Science and Health No. 4 (2019)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: Improving quality and efficiency in hospital services can be done by using Clinical Pathway (CP). CP can decrease the hospital length of stay and cost. In indonsia, the increasing number of Caesarean Section (SC) affects to the Length of Stay (LOS) in hospital. This study aims to examine the effectiveness of clinical pathway in caesaren section to length of stay in the hospital. Methods: This study was a systematic review used PRISMA guidelines. Data obtained from Electronic journal databases Pubmed and ProQuest that published between 2014 until 2019 and used English language. By using keywords such as clinical pathway, childbirth labor, and length of stay to find the relevant journal. Results: The search found out 4,937, studies from 2 journal databases. The articles that not suitable with the criteria inclusion must be exclude. Totally, 6 studies were analyzed in this study. 1 study explained the affect of increasing length of stay in the National Health Insurance, 2 studies mentioned that CP was not affected to the length of stay in hospital and 3 studies mentioned that CP was reduced the length of stay in hospital. Conclusion: Clinical pathway in Caesarean section can reduced the length of stay in hospital. The hospital should implement the clinical pathway in caesarean section to increase the quality of hospital service and reduce the cost.