Information Department Research Articles

The application of health information technology for the elderly care in the emergency department: a conceptual model

IntroductionIn the emergency departments (EDs), usually the longest waiting time for treatment and discharge belongs to the elderly patients. Moreover, the number of the ED admissions for the elderly increases every year. It seems that the use of health information technology in geriatric emergency departments can help to reduce the burden of the healthcare services for this group of patients. This research aimed to develop a conceptual model for using health information technology in the geriatric emergency department.MethodsThis study was conducted in 2021. The initial conceptual model was designed based on the findings derived from the previous research phases (literature review and interview with the experts). Then, the model was examined by an expert panel (n = 7). Finally, using the Delphi technique (two rounds), the components of the conceptual model were reviewed and finalized. To collect data, a questionnaire was used, and data were analyzed using descriptive statistics.ResultsThe common information technologies appropriate for the elderly care in the emergency departments included emergency department information system, clinical decision support system, electronic health records, telemedicine, personal health records, electronic questionnaires for screening, and other technologies such as picture archiving and communication systems (PACS), electronic vital sign monitoring systems, etc. The participants approved all of the proposed systems and their applications in the geriatric emergency departments.ConclusionThe proposed model can help to design and implement the most useful information systems in the geriatric emergency departments. As the application of technology accelerates care processes, investing in this field would help to support the care plans for the elderly and improve quality of care services. Further research is recommended to investigate the efficiency and effectiveness of using these technologies in the EDs.

Sex Disparity in Stroke Mortality among Adults: A Time Series Analysis in the Greater Vitoria Region, Brazil (2000-2021).

The disparity between the sexes in stroke mortality has been demonstrated in people from different locations. The objective of this study was to analyze the disparity between sexes in stroke mortality in adults in the metropolitan area of Greater Vitoria between 2000 and 2021. Ecological time series design was conducted with a database of the Brazilian Health System Informatics Department. The annual percentage change and average annual percentage change were calculated through joinpoint regression. Pairwise comparisons using parallelism and coincidence tests were applied to compare temporal trends between men and women. Men had higher mortality rates in most years between 2000 and 2021. In contrast, women had higher proportional mortality values in all years evaluated from 2000 to 2021. The paired comparison revealed a disparity between the sexes in the proportional mortality time series (parallelism test: p = 0.003; coincidence test: p < 0.001). However, the time series of the mortality rates showed no disparity between the sexes (parallelism test: p = 0.114; coincidence test: p = 0.093). From 2000 to 2021, there was a disparity in proportional mortality from stroke between the sexes of the population in the metropolitan area of Greater Vitoria, Brazil. However, the time series of mortality rates between the sexes did not reveal any disparity in the study period.

Epidemiological profile and spatial analysis of probable cases of dengue registered from 2010 to 2021 in the state of Maranhão

Dengue is a disease of viral etiology transmitted by mosquitoes, with a high incidence in tropical countries. Dengue has great epidemiological importance in the Americas and in Brazil. The goal of this study was to analyze the spatial distribution and to describe the epidemiological profile of probable cases of dengue in the State of Maranhão from 2010 to 2021. Statistical analysis through non-parametric tests and spatial analysis were performed using the Moran’s Global Index and Local Indicators of Spatial Association (LISA) and Space-time Scan statistic. Data were collected from the Department of Informatics of the Unified Health System in Brazil (DATASUS) between 2010 and 2021. The highest number of probable cases occurred in 2016 (23,938) and they were concentrated in the first half of each year. The female gender had the highest proportion of cases (54.9%). The cases predominated in the group of people aged between 20 and 39 years old (35.5%). People with incomplete elementary school degree were the most affected (43.0%). The brown race had more registered cases (80.7%). The municipality that had the highest incidence was Barra do Corda (7,418.5 per 100.000 inhabitants in 2016). In the local spatial analysis, 55.8% of the clusters of municipalities High- High occurred in the South region from the State of Maranhão. The municipality of Barra do Corda presented the highest relative risk (55.91) in the Space-time Scan statistic. People of the brown race, with incomplete schooling and young adults were the most affected by the dengue disease. The South region of the State showed greater epidemiological importance because it has representative clusters High-High. KEY WORDS: Dengue; incidence; spatial analysis; State of Maranhao.

Teachers and Students Perceptions on Hybrid Learning in Informatics Department: Challenges and Benefits

Hybrid learning has been adopted by colleges and universities after the COVID-19 pandemic era. This study aims to investigate the challenges and benefitsof hybrid learning in Informatics engineering department. Teachers and students’ perceptions were gathered by semi-structured interview to gain deeper information. Five teachers and five students were selected from Informatics department. The data gathered from semi-structured interview showed that both teacher and students experienced some challenges and benefits, which are technological challenges, engagement strategies, support and training, and flexibility and autonomy. This study result could be a beneficial insight for further research regarding hybrid learning.

Increased Risk of Preterm Delivery Subtypes and Hypertensive Disorders of Pregnancy in First Deliveries of Patients With Systemic Vasculitis.

The goal of this study was to investigate the risk of preterm birth subtypes and hypertensive disorders of pregnancy in patients with systemic vasculitis using large, statewide databases. Births to nulliparous patients with prevalent systemic vasculitides (Takayasu arteritis [TAK], Behçet disease [BD], antineutrophil cytoplasmic antibody-associated vasculitis [AAV], and Kawasaki disease [KD]) were identified using International Classification of Diseases, Ninth Revision codes in linked administrative data and birth records from the California Department of Health Care Access and Information and California Vital Statistics from 1991 to 2012. Hypertensive disorders of pregnancy and preterm delivery (PTD) subtypes were identified. Multivariable-adjusted Poisson models estimated risk ratios (RRs) of these outcomes compared with the general birthing population without history of rheumatic disease. A total of 96 births to nulliparous patients with systemic vasculitis were identified (TAK, 14; AAV, 31; BD, 26; KD, 15) and compared with 4,191,900 births of the nulliparous general population. Adjusted RRs for all PTD types were elevated in patients with vasculitis (RR 3.21, 95% confidence interval [CI] 2.15-4.79), as were the RRs of all PTD subtypes including preterm premature rupture of membranes (RR 4.30, 95% CI 2.05-9.01) and spontaneous PTD (RR 4.99, 95% CI 3.01-8.28). Of the spontaneous PTDs among patients with vasculitis, 16.7% were early PTDs (20-31 weeks), with the remaining 83.3% occurring between 32 to 36 weeks. Patients with vasculitis also had an elevated risk of hypertensive disorders of pregnancy (RR 2.96, 95% CI 1.72-5.10). Among first-time births, we found that patients with systemic vasculitis have an elevated risk of PTD subtypes as well as hypertensive disorders of pregnancy.

إدارة برنامج اللغة العربية لمجتمع تحت شجارة في جامعة الأستاذ سيف الدين زهري الإسلامية الحكومية بورووكرتو

The purpose of this study is to describe the management of the Arabic language development program for the Tahta Syajarah community at UIN Prof. K.H. Saifuddin Zuhri Purwokerto based on the concept of George Robert Terry. The method uses descriptive qualitative with data sources from the management of the Tahta Syajarah community with interview and observation techniques. Data analysis techniques using Miles and Huberman. The results of the study show that the development of Arabic in the Tahta Syajarah community has applied the concept; 1) planning, planning programs in the form of learning Nahwu and Shorof, Khitobah, Taqdimul Qishah, Ghina, Syi'ir, Qiroatul Akhbar, Munadzarah Ilmiyah, and Qiroatul Pole, 2) organizing, forming management in the form of BPH (daily management team), Department of Communication and Information, and divisions, 3) actuating, implementing programs that have been planned and organized, 4) controlling and evaluating, internal supervision and formative evaluation and summative evaluation.

Early detection of pediatric health risks using maternal and child health data

Machine learning (ML)-driven diagnosis systems are particularly relevant in pediatrics given the well-documented impact of early-life health conditions on later-life outcomes. Yet, early identification of diseases and their subsequent impact on length of hospital stay for this age group has so far remained uncharacterized, likely because access to relevant health data is severely limited. Thanks to a confidential data use agreement with the California Department of Health Care Access and Information, we introduce Ped-BERT: a state-of-the-art deep learning model that accurately predicts the likelihood of 100+ conditions and the length of stay in a pediatric patient’s next medical visit. We link mother-specific pre- and postnatal period health information to pediatric patient hospital discharge and emergency room visits. Our data set comprises 513.9K mother–baby pairs and contains medical diagnosis codes, length of stay, as well as temporal and spatial pediatric patient characteristics, such as age and residency zip code at the time of visit. Following the popular bidirectional encoder representations from the transformers (BERT) approach, we pre-train Ped-BERT via the masked language modeling objective to learn embedding features for the diagnosis codes contained in our data. We then continue to fine-tune our model to accurately predict primary diagnosis outcomes and length of stay for a pediatric patient’s next visit, given the history of previous visits and, optionally, the mother’s pre- and postnatal health information. We find that Ped-BERT generally outperforms contemporary and state-of-the-art classifiers when trained with minimum features. We also find that incorporating mother health attributes leads to significant improvements in model performance overall and across all patient subgroups in our data. Our most successful Ped-BERT model configuration achieves an area under the receiver operator curve (ROC AUC) of 0.927 and an average precision score (APS) of 0.408 for the diagnosis prediction task, and a ROC AUC of 0.855 and APS of 0.815 for the length of hospital stay task. Further, we examine Ped-BERT’s fairness by determining whether prediction errors are evenly distributed across various subgroups of mother–baby demographics and health characteristics, or if certain subgroups exhibit a higher susceptibility to prediction errors.

Extraction of Knowledge Models from Textbooks

Isaac Alpizar-Chacon is an assistant professor in the Software Technology for Learning and Teaching group at the Department of Information and Computing Sciences, Utrecht University. In addition to his primary role, he is also an associate professor at the Instituto Tecnológico de Costa Rica. His research interests focus on the impact of GenAI tools in computing education, the integration of these tools into the classroom, the teaching and learning of computational thinking skills, and knowledge extraction. Dr. Alpizar-Chacon holds a MSc degree in Computer Science from Saarland University (Saarbrücken, Germany) and a PhD degree in Information and Computing Sciences from Utrecht University (Utrecht, Netherlands). Homepage: https://isaacalpizar.info/

Self-marketing and its role in building the personal brand of graduates of the Library and Information Department on LinkedIn: an exploratory study

Self-marketing and its role in building the personal brand of graduates of the Library and Information Department on LinkedIn: an exploratory study

Theoretical and Practical Elements of the Educational Component “Management of Information, Library and Archival Studies” in Forming Future Managers’ Professional Competences

The aim of the article is to study theoretical and practical elements of the educational component “Management of Information, Library and Archival Studies” in grounding general and special competences of applicants for the Master’s degree in speciality 029 “Information, Library and Archival Studies.” Research methods: the article uses both general scientific and special research methods. The method of analysis and synthesis contributes to studying the theoretical foundation of the theme; systemic, structural and functional ones allow to determine the structure of the educational component and the peculiarities of its teaching. The prognostic method makes it possible to outline the ways of improving organisational foundations of the theoretical and practical training of the Master’s degree students. The scientific novelty consists in substantiating the interrelationship of the theoretical and practical elements of the educational component “Management of Information, Library and Archival Studies” in forming general and special competences of the Mmaster’s degree sudents as future managers of the sphere. Main conclusions. The theoretical and practical elements of the educational component presented in this article contribute to the formation of general and special competencies of future sphere managers, particularly, the ability to motivate people and move towards a common goal, promote the formation of an effective sphere management system; organise the work and manage information and analytical structural departments at enterprises, organisations and institutions. The programme results of mastering the educational component include the ability to form strategies for system organisation, modernisation, to increase the efficiency of management in the sphere, to use applied socio-communicative technologies in order to organise effective communication at the professional, scientific and social levels. Thus, the educational component is necessary in grounding the competencies of future professional managers. Nowadays, the work is underway to improve the content and technology of teaching the educational component, which will contribute to higher quality training of students for the Master’s degree in speciality 029 “Information, Library and Archival Studies.”

The Influence of Emergency Department Information System (EDIS) in the Quality of Health Data: The Case of Muhimbili National Hospital

The study investigated the extent to which the EDIS is adopted among health care workers at the Muhimbili National Hospital – Emergence Medicine Department (MNH – ED), EDIS data quality among health care workers at MNH – ED and the influence of using EDIS to health data quality improvement at MNH. The study used mixed research approach where both quantitative and qualitative techniques were utilized. Data collected by using questionnaire and Interview. Total of 220 out of 238 respondents completed the survey and 6 employees from the Emergency Department (ED) were interviewed. Respondents of this study obtained from ED at MNH. It is further reported that accuracy of data has significant positive impact on Effective use of EDIS (β = 0.282, P = 0.024). Results indicated that, completeness of data have significant positive impact on Effective use of EDIS (β = 0.426, P = 0.046). Moreover, the results indicated that, consistency of data have significant positive impact on Effective use of EDIS (β = 0.249, P = 0.034). Results indicated that, timeliness of data have significant positive impact on Effective use of EDIS (β = 0.518, P = 0.000). Moreover, effective use of EDIS has a positive effect on improved data quality outcomes. This implies that use of EDIS indicators including ease of use had (β= 0.123, p-value=0.014), Suitability for the task had (β=0.360, p=0.003) and user satisfaction had (β=0.32, p= 0.004 which have significant positive impact on outcome of data quality.

Geoelectric Investigation for Groundwater in Imo State University Campus and Environs using Direct Current Electrical Resistivity Method

Eighteen, vertical electrical soundings (VES), were carried out in Imo State University and Environs to delineate the potential site for groundwater. Data were acquired using ABEM SAS 300 resistivity meter. Schlumberger array and maximum electrode spread of 700m were adopted. Data were interpreted with IP2WIN software. Contour maps were done using Sulfer 20 software. Geoelectric cross-sections constructed along three profile lines delineated subsurface stratification. Sediments consist of sequence of sandstone/gravel, silty sand/sand and clay with geology representing the Benin Formation. Groundwater was delineated within the zone interpreted to be sand with quartz making up more than 95% of all grains. Resistivity of aquifer varies across study area and ranges from 159Ωm, observed around Library and Information Department (VES 11) to 100000Ωm recorded at IMSU Plaza (VES 10). Depth to water table also varied across study area with higher values of 150m and 130m observed at College of Health Science (VES 3) and Behind Old ETF (VES 4). A relatively shallow aquifer is delineated behind Senate Building and Okwu-Uratta with water table at depths of 23.5m and 26.5m. The transmissivity values are moderately high except at some locations. The variation in longitudinal conductance and transverse resistance values show that part of the study area such as Aso Rock, Female Hostel, Law Faculty and IMSU Plaza are underlain by relatively resistive (low longitudinal conductance) aquifer material. Distribution of hydraulic conductivity and electrical conductivity values indicates that in some of the VES points, the values are fairly constant. This could be seen as areas with similar geologic settings and water quality. Storativity of study area ranges from 0.00003 at VES 1 and 12 to 0.00028 at VES 4. Study area shows a good prospect for groundwater development, except at Library and Information Department, where the zone delineated is an aquitard.

A Nationwide Study on Emergency Department Utilization among Pediatric Patients in Korea: A Special Focus on Pediatric Emergency Medical Centers

Objective: Despite Korea’s low birth rate, pediatric emergency medical centers (PEMCs) are grappling with overcrowding. This study evaluates the use of PEMCs in Korea amid a declining birth rate and increased overcrowding.Methods: Data from 176 emergency medical centers (EMCs, 2018–2021) was analyzed using the National Emergency Department Information System, focusing on demographics, Korean Triage and Acuity Scale (KTAS) scores, and pediatric patient outcomes. The most common complaints and diagnoses were identified by the EMC level. This study also examined the characteristics of patients visiting PEMCs.Results: There was a 48% drop in pediatric visits to EMCs during the coronavirus disease 2019 (COVID-19) pandemic. The majority of patients were boys aged 1–4, primarily visiting in the evenings and weekends. The breakdown of cases included 66% disease-related and 34% injury-related. Notably, 8.5% of these visits were via ambulance, 36% were high-acuity according to KTAS, 88% resulted in discharge, and 11% in hospitalization. The median stay was 85 minutes, with 83% utilizing local emergency services. Fever, abdominal pain, and vomiting were the most common complaints, comprising 40% of all visits.Conclusion: Despite a decrease in birth rates, PEMC usage in Korea saw an initial rise followed by a significant decrease during the COVID-19 pandemic. Children aged 1–4 were the most frequent users. The majority of cases were medical rather than trauma-related, and resulted in patient discharge. Strategic redirection of non-urgent cases may help alleviate overcrowding in emergency departments.

Cases of Human Visceral Leishmaniasis in the Municipality of Coité do Noia - AL, from 2013 to 2019, Brazil.

Canine Leishmaniasis visceral is a common disease in countries of the Americas. In Brazil, its occurrence has been increasing in municipalities in the Brazilian Northeast due to the increase in the number of animals within the country, which may increase the number of animals infected by the protozoan Leishmania. The objective was to report the temporal trend and describe the distribution of incidence rates of Leishmaniose visceral in the municipality of Coité do Noia, state of Alagoas, from 2013 to 2019. An epidemiological survey was carried out in the State of Alagoas and in the municipality of Coité de Nóia - AL, from 2013 to 2019. The data used were obtained from the website of the Department of Informatics of the Sistema Único de Saúde (DATASUS), selecting the Leishmaniose Visceral item, the information was compiled from the number of cases notified in the region of Alagoas in Brazil. From 2013 to 2019, 15 cases of Leishmaniose Visceral were confirmed, with 2 deaths. There was a predominance of cases in women with 12 cases, and 4 for men. The study showed a higher occurrence for the municipality of Coite do Noia between 2018 and 2019 with prevalence for women.

Congenital syphilis, syphilis in pregnancy and prenatal care in Brazil: An ecological study.

The aim of this research was to evaluate the incidence of congenital syphilis and the ratio between congenital syphilis and syphilis in pregnant women in Brazil according to socioeconomic indicators (inadequate water supply and sanitation; illiteracy at 15 years of age or older; household income per capita; proportion of poor people; Gini index; human development index; and average health expenditure per inhabitant by the health system) and prenatal quality-of-care indicators. We conducted an ecological study using a sample composed of 257 municipalities, each with ≥ 100,000 inhabitants. Data was collected from four public databases: the Brazilian Institute of Geography and Statistics, comprising socioeconomical data from the 2010 census; and the data of 2019 available in the databases of the Department of Informatics of the Brazilian Health System, Information and Management of Primary Care, and the Electronic Citizen Information System. Descriptive analysis of dependent and independent variables and bivariate analysis by Negative Binomial regression were carried out. The mean incidence of congenital syphilis was 38% higher in municipalities with a Human Development Index up to 0.785 (ratio of means [RM] = 1.38; p = 0.049) and 57% higher among populations where less than 50% of primary healthcare services provided a rapid test for syphilis (RM = 1.57; p < 0.001). The ratio between congenital syphilis and syphilis in pregnant women was 29% higher in municipalities with a low household income per capita (RM = 1.29; p < 0.001) and 28% higher in locations where less than 50% of the primary healthcare services provided a rapid test for syphilis (RM = 1.28; p < 0.001). There was no statistical significance of the quality of prenatal care compared to the outcomes. This result underscores the challenges in detecting syphilis infections among pregnant women during prenatal care, consequently increasing the risk of vertical transmission of the disease to the fetus. Traits of inequality in the occurrence of congenital syphilis also draw attention to strategies to reduce health inequities and improve prenatal care.

K-Means Algorithm for Clustering Students Based on Areas of Expertise (A Case Study)

Every student of the Software Engineering Technology study program, the Computer and Informatics Department of the Politeknik Negeri Medan in the lecture process is required to take all the courses in the curriculum. From the courses in the curriculum, there are several subject groups that shape student expertise, such as Software Engineering, System Analyst, Database Administrator, and IT Entrepreneur. It is hoped that this expertise will later be used as a reference by students in carrying out their thesis at the end of lectures. The purpose of this study is to group students based on their respective expertise based on data processing of student course scores related to each skill. The data used is data on student scores for batches of 2020 and 2021 with a range of courses from semester 1 to semester 3. The data is tested by implementing the K-Means algorithm. The results of the tests that have been carried out show the grouping of students based on their expertise, with 7 times the number of iterations. Then, data testing was carried out with the RapidMiner application to get the results of the distribution of cluster members obtained, including 12 students occupying Software Engineer skills, 21 students with System Analyst skills, 5 students with Database Administrator skills, and 31 students with IT Entrepreneur skills, along with the distribution chart. Thus, the K-Means algorithm is quite good at grouping students based on their expertise

Epidemiological analysis of hospitalization of the elderly in Brazil between 2019 and 2023

Brazil has seen an increase in the elderly population as a result of falling mortality rates. Associated with the ageing process, there is an increased risk of developing comorbidities, which is why the health system has found it difficult to keep up with the rapid demographic transition and support this more fragile section of the population. The aim of this study was to describe the epidemiological aspects of hospitalization of the elderly in Brazil. This is a retrospective epidemiological study, with a quantitative approach, which used data from the Hospital Information System and the Unified Health System, made available by the Department of Informatics of the Unified Health System, for the period 2019 to 2023. The variables analyzed were: type of care, gender, race, reason for hospitalization, cause of death and region with the highest incidence. 16,779,162 elderly people were admitted to hospital units: 78% (n= 16,069,729) were admitted as emergencies. Of these individuals, 51% (n= 8,595,199) were male and 41% (n= 6,892,500) were white. Initially, 21% (n= 3,485,803) were hospitalized for diseases related to the circulatory system, but the main cause of death was pneumonia, which accounted for 7% (n= 1,195,048) of these patients, and was most prevalent in the southeast region with 508,696 deaths. Hospitalizations of the elderly in Brazil are on the rise, and epidemiological characteristics, a reduction in the number of public investments and social factors are determining factors in this variation. The main related diseases are those affecting the cardiovascular and respiratory systems, accounting for almost half of the deaths in this age group. The increase in the number of hospitalizations demonstrates the need to formulate public policies to improve the quality of life of the elderly population.

Insurance Disparities in Quality of Care Among Patients With Head and Neck Cancer

Significant insurance status disparities have been demonstrated in head and neck cancer (HNC) outcomes. The effects of insurance status on HNC outcomes may be explained by differential access to high-quality care. To evaluate the association of insurance status with the quality of the treating hospital and receipt of guideline-compliant care among patients with HNC. This retrospective cohort study of data from the California Cancer Registry dataset linked with discharge records and hospital characteristics from the California Department of Health Care Access and Information included adult patients with HNC diagnosed between January 1, 2010, and December 31, 2019. Data were analyzed from May 10, 2023, to March 25, 2024. Insurance status: commercial, Medicare, Medicaid, uninsured, other, or unknown. Quality of the treating hospital (tertiles), receipt of National Comprehensive Cancer Network guideline-compliant care, and overall survival. A total of 23 933 patients (mean [SD] age, 64.8 [12.3] years; 75.3% male) met the inclusion criteria. Treatment in top-tertile hospitals (hazard ratio, 0.87; 95% CI, 0.79-0.95) was associated with improved overall survival compared with treatment in bottom-tertile hospitals. Medicare (odds ratio [OR], 0.78; 95% CI, 0.73-0.84), Medicaid (OR, 0.60; 95% CI, 0.54-0.66), and uninsured (OR, 0.38; 95% CI, 0.29-0.49) status were associated with lower likelihood of treatment in high-quality hospitals compared with commercial insurance. Among patients with advanced disease, Medicaid (OR, 0.72; 95% CI, 0.62-0.83) and uninsured (OR, 0.64; 95% CI, 0.44-0.93) patients were less likely to receive dual-modality therapy. Among patients with surgically resected advanced disease, Medicaid coverage (OR, 0.73; 95% CI, 0.58-0.93) was associated with lower likelihood of receiving adjuvant radiotherapy. This study found significant insurance disparities in quality of care among patients with HNC. These findings highlight the need for continued health insurance reform in the US to improve the quality of insurance coverage, in addition to expanding access to health insurance.

Efficiency of hospitals in COVID-19 era: a case study of an affected country

BackgroundThe COVID-19 pandemic has affected all aspects of human life and society and has damaged the global economy. Health systems and hospitals were not exempted from this situation. The performance of hospitals during the COVID-19 pandemic was affected by policies related to the pandemic and other factors. This study aimed to investigate hospital performance indicators such as admissions and revenue.MethodsThe medical records of patients with selected orthopedic and general surgical diseases were studied in two government hospitals in the capital city of Urmia in the second quarter of 2019, with the same period in 2020. Data were extracted based on the number of medical records, including length of stay, hospitalization type, sex, age, insurance, number of deaths, and readmissions from the medical records department. Payment amounts were collected from the revenue department and Hospital Information System. Two performance indicators, two result indicators, and two control indicators were used. Mean disease-specific revenue, total revenue, length of stay, and bed occupancy rate were calculated for both periods. Data were analyzed using SPSS (version 16) and the Mann-Whitney statistical test.Results2140 cases were studied in the two disease groups. An increase was observed in the number of hospitalizations and average length of stay during the pandemic. The mean disease-specific revenue in the quarter of 2020 was higher than in 2019. However, total revenue decreased, and the difference in the mean of total revenue was significant for the two years (P = 0.00) in teaching center. The number of readmissions remained unchanged throughout in the pandemic. The number of deaths due to general surgery diseases in 2020 compared to the same period in 2019 was associated with a relative increase.ConclusionsThe COVID-19 pandemic increased the slope of health care costs. The analysis of the studied variables as performance, result, and control indicators showed that hospitalization rate, bed occupancy rate, and total revenue followed a similar and decreasing pattern in the selected hospitals during the COVID-19 pandemic. Hospitals should adopt appropriate strategies so that, in conditions identical to the COVID-19 pandemic, their performance is accompanied by proper management of resources, efficiency, and minimal reduction in revenue.

PENYELENGGARAAN SISTEM PEMERINTAHAN BERBASIS ELEKTRONIK DI LINGKUNGAN PEMERINTAH KOTA BATAM

Batam City is the only city in the Riau Islands Province with a good SPBE index out of the 5 regencies and cities in the province. However, in implementing the SPBE policy, problems were encountered, one of which was related to the lack of coordination between SPBE organizers. This creates a discrepancy between the predicate achieved and what is implemented. Bearing in mind that the SPBE maturity level of the Batam City government is the highest in the Riau Islands Province. This research uses a qualitative research method with a descriptive approach. Data collection techniques were carried out by interviews, observation and documentation with the informant selection technique, namely purposive sampling. Meanwhile, the data validity technique uses source triangulation. This research uses the theory of policy implementation proposed by Ripley and Franklin which consists of 2 variables, namely Compliance and What's Happening and Why (What happened and why?) The results of this research indicate that the implementation of the SPBE policy in Batam City has not been implemented optimally. This is caused by (1) minimal understanding of the policy by implementors, unplanned coordination activities between implementers, and no socialization of policy guidelines. (2) factors beyond control that influence the implementation process, namely the agency's lack of awareness of the existence of policy guidelines. (3) inadequate infrastructure factors, and very rapid technological development factors. Thus, the Batam City Communication and Information Department as the main actor needs to fix these problems so that the implementation of the SPBE policy can run effectively