General Polyclinic Research Articles

Factors Associated with Delays in Services for General Policy Outpatient Patients at The Registration Lock of The Nuhon Health Center, Banggai District Year 2023

Delays in patient services are generally often found in health facilities, both hospitals and community health centers. One of the community health centers in Banggai Regency which still often experiences problems with delays in patient service is the Nuhon Community Health Center. This health center, which is located in the Nuhon District area, serves outpatients in several polyclinics, one of which is the general polyclinic. One of the hopes of patients when visiting health facilities is that they don't have to wait long to get service, but there are still many statements from patients who complain about delays in service at the registration counter. This study aims to determine the factors associated with delays in general poly outpatient services at the Public Health Center Registration CounterNuhon, Nuhon District, Banggai Regency in 2023. This research is an analytical survey research with a type approachcross-sectional, by taking samples by accidental sampling with a total sample of 130 people. The statistical test used is Chi square to see the relationship between service delays and the performance of registration counter staff and facilities. The results of this study indicate that there is a relationship between the performance of the registration counter staff, facilities and delays in providing services to general poly outpatients at the Nohon Health Center Registration Counter, Nuhon District, Banggai Regency and the value of health workers isp =0.000 while the means have a relationship with a value of p = 0.000. Therefore, it is necessary to improve the performance of health workers and provide supporting facilities in the health service process.

Pengaruh Mutu Pelayanan Terhadap Kepuasan Pasien Poliklinik Umum Di RSU Bethesda Gunung Sitoli

Quality is one of the important elements in every health service. Therefore, in providing health services for the community, health service providers must always maintain the quality of services provided. The purpose to be achieved in this study is to analyze the factors that affect the quality of health services on patient satisfaction of the General Polyclinic at Bethesda Gunungsitoli General Hospital. This type of research uses a descriptive analytical survey with a cross sectional design. The population in this study was all patients who came for outpatient treatment at the General Polyclinic at Bethesda General Hospital Gunungsitoli approximately 2235 visits to take smpel using the Accidental sampling method.While the sample amounted to 100 people. Data analysis was carried out by univariate, bivariate and multivariate analysis. Based on the results of the chi-square test, it is known that the incidence of hypotension affects Tangible, Responsiveness, Reliability, Assurance and Empahaty p = 0.000, meaning that there is Tangible, Responsiveness, Reliability, Assurance and Empahaty to patient satisfaction. From the results of multivariate analysis, it is known that the most influential variable in this study is the Responsiveness variable with an OR value of 15,104. The conclusion in this study is that responsiveness is the dominant factor affecting patient satisfaction at the General Polyclinic at Bethesda General Hospital Gunungsitoli. To be able to improve the quality of services that must be improved, especially security and comfort guarantees for patients such as: completing patient administration, responding quickly to patient complaints, providing drugs quickly and precisely, providing information and quick response in handling patients to be improved to create a patient satisfaction that becomes patient satisfaction at the General Polyclinic at Bethesda General Hospital Gunungsitoli.
 

Tingkat Kepuasan Pasien Rawat Jalan Terhadap Mutu Pelayanan Kesehatan Di Unit Poli Umum Puskesmas Bolou Kecamatan Sabu Timur Tahun 2023

Patient satisfaction embodies patient loyalty to health services that can provide maximum service quality. Calculating the level of patient satisfaction is an indicator of the quality of health services. The total number of outpatients visiting the Bolou Community Health Center in 2020 was 6,477, in 2021 there were 3,571, in 2022 there were 1,834 and in 2023 there were 3,970. This shows that over the last four years patients visiting the Bolou Community Health Center have decreased. The decline that occurred in the level of outpatient satisfaction in the General Poly Unit was 42% in 2021, 35% in 2022, and 27% in 2023. To find out the description of outpatient satisfaction in the General Poly Unit which includes the dimensions of tangible, reliability, responsiveness, assurance and empathy, this research was conducted. The type of research used is quantitative research with a descriptive design where this research is carried out with the aim of describing an objective condition. The population in this study was all outpatients at the General Polyclinic in 2023, totaling 3,970 patients. The sample in this research was an accidental sampling technique, namely 94 samples. The questionnaire measuring tool is the instrument in this research. Univariate analysis is the analysis used in research. research results, the description of the tangible aspect with the most indicator achievements expressed satisfaction (70.2%), the description of the reliability aspect with the most indicator achievements expressed satisfaction (58.5%), the description of the responsiveness aspect with the most indicator achievements expressed dissatisfaction (52.1%) , the description of the assurance aspect with the most indicator achievements expressed satisfaction (61.7%), the description of the empathy aspect with the most indicator achievements expressed satisfaction (53.2%).

Implementation of Jackson Queueing Network in General Polyclinic and Dental Polyclinic Patient Services at Jelekong Health Center

The buildup in the service system is generally caused because service facilities cannot meet service needs, so service users need time to use the facilities. Health Center is one of the facilities that provide services in the health sector. However, the number of doctors needed in health centers in Indonesia has yet to be met, and the number of patients who are never empty every day causes a buildup in the service system. The application of the service network system using the open Jackson queueing network can model the optimal service system and analyze its performance. The observation method was used to observe patients' arrival and departure times at the Jelekong Health Center, especially in the registration section, general polyclinic, dental polyclinic, and pharmacy, for three days. There was an increase in patient waiting time before being served and time in the system at the general polyclinic after implementation, so one additional service facility was added. Meanwhile, the dental polyclinic experienced decreased patient waiting time before being served and time in the system, so there was no need to add service facilities.

Risk factors for decreased hand grip strength in type 2 diabetes mellitus patients at the Tabanan Public Health Center II

Introduction: The condition of decreased muscle mass and function in people with type 2 diabetes mellitus (DMT2) will lead to a significant effect on the decline in quality of life. A commonly found manifestation of sarcopenia is the presence of a decrease in the strength of the hand grip. Other research showed a significant inverse relationship between the strength of the hand grip and DMT2. But to date, there are still few studies that assess the factors that cause a decrease in the strength of the hand grip in DMT2 patients. This study aims to evaluate risk factors that are related to the strength of the decrease in the strength of the hand grip in patients with DMT2. Methods: Cross-sectional analytical research. The data was taken through interviews, physical examinations and data collection of laboratory examination results at the general polyclinic of the Tabanan Public Health Center II. The bivariate test used chi-square and the multivariate analysis with logistic regression was used in assessing the magnitude of influence between variables that have a meaningful relationship with HGS and looking for the magnitude of the adjusted odd ratio (AOR) value. Results: The study discovered a strong correlation between age (p=0.002), body mass index (p=0.002), and fasting blood sugar levels (p=0.001) and hand grip strength. In the multivariate analysis, it was found that the relationship of age more than 50 years to the decrease in hand grip strength was greater than high fasting blood sugar levels, while no significant relationship was found on excess nutritional status in this multivariate analysis (p=0.44). Conclusion: Age, body mass index, and fasting blood sugar levels are the risk factors for decreased hand grip strength in type 2 diabetes mellitus patients.

Lean Healthcare Improvement Model Using Simulation-Based Lean Six-Sigma and TRIZ

As a part of primary care clinic, the Indonesian-community health center is responsible for efforts to encourage independence and create a community for healthy living. The service facility commonly used is the general polyclinic. A number of problems occur are non-value added activities that lead to a longer waiting time. Therefore, the aim of this study is to improve the service performance at Indonesian-community health center. This research used six sigma DMAIC model in evaluating the current service system using value stream mapping (VSM), determining critical waste using the Borda count method, identifying the root causes of critical waste, designing the alternative service system improvements using theory of inventive problem solving (TRIZ), building alternative simulation models using Flexsim software, and evaluate the improvement plan. The result shows that the average time of general polyclinic services in current system is 107 minutes with waiting as critical waste (23%). There are two health-service improvement scenarios developed using theory of inventive problem-solving method (TRIZ), i.e. scenario 1 and scenario 2. Both scenarios are evaluated by considering some criterias, i.e. idle time, waiting time, number of patients served, lead-time and process cycle efficiency. The best scenario is scenario 2 with 48.2% reduction in lead time and process cycle efficiency increased by 48%.

National Health Insurance Participants Satisfaction in General Polyclinic Services at First Level Healthcare Facilities

The need of health services, especially at first level healthcare facilities (FKTP) for the community to accessbasic health services has increased in Indonesia. This condition related to the regulation for the entire citizenin Indonesia to become a National Health Insurance (JKN) participant. Some problems related to the servicesstill occur, such as queues length and non-optimal examination process. This research aimed to analyzepatients’ satisfaction in general polyclinic services differences in FKTP. This was an observational researchwith a cross-sectional study using primary data from both types of FKTP (Puskesmas and Non-Puskesmas)as the healthcare provider in two cities of East Java. The number of research respondents was 219 in 20FKTP. The sampling method used was proportional random sampling technique. Patients’ satisfactionscores obtained from the two types of FKTP were analyzed using independent sample T Test. The resultsobtained was the satisfaction score in Puskesmas and Non-Puskesmas exceeded 95%. Patients’ satisfaction inPuskesmas was significantly higher than Non-Puskesmas (p = 0.01). Out of the six dimensions, dimensionsof service ability and aesthetics in exception, the other four dimensions had significant differences. Theresults provide recommendation that FKTP should improve their services from various dimensions.

Queue analysis of public healthcare system to reduce waiting time using flexsim 6.0

Public healthcare is a health service facility from the government at a low cost. The problem is the long queue, which makes long patients’ waiting times. The patients are waiting for a maximum of more than 3 hours in the general polyclinic. Besides, the registration counter is almost busy all the time. The utilization is about 96.96%. Therefore, the objective of this research is to reduce the patients’ waiting time using the simulation method. Flexsim 6.0 software is employed to develop the public healthcare system and also develop some alternatives to improve the problem. The simulation model has been verified and validated. The result shows the waiting time is decreased by more than 80% by adding the resource in the registration counter. For managerial insight, this research could help the public healthcare system in satisfying the patients.

Pioneering work in the teaching of pediatrics in Brazil: Carlos Artur Moncorvo de Figueiredo and the General Polyclinic of Rio de Janeiro, 1882-1901

The scientific activities of Carlos Artur Moncorvo de Figueiredo at the General Polyclinic of Rio de Janeiro (Policlínica Geral do Rio de Janeiro), which he himself founded, are analyzed. His professional and political actions were fundamental for the introduction of pediatrics both in the establishment of a technical space for healing and in the formation of a specific discipline for the teaching of pediatrics at the faculties of medicine in the Empire, then based in the Court and in Salvador. Rather than arising in response to the social issue surrounding the fight against infant mortality, as is often implied in the historiography, pediatrics seems to have emerged from a movement for the implementation of experimental medicine.

Petri Net Model and Max-Plus Algebra on Queue in Clinic UNS Medical Center

Patients come to the clinic UNS (Universitas Sebelas Maret) Medical Center to get a medical treatment. The clinic provides two health services include dental polyclinics and general polyclinics. Majority of patients do not know exactly how long the process of service from patient registration to getting medicine. Moving queues to each service is an event and people who queue up at each service are state. It is clear that the sum of all possible states is finite. This problem includes a Discrete Event System (DES). One of the uses of petri net is to model a DES. In this research, service flow was built in the clinic using Petri Net and service scheduling was modeled using Max-Plus Algebra. Furthermore, a coverability tree was built to determine the liveness and deadlock of the patient service queue and analyze the petri net flow. The selection of service start time can be chosen randomly to simulate the scheduling and length of service time.

ANALYSIS OF DEVELOPMENT OF DIAGNOSTIC ALGORITS IN THE HEALTHCARE UNION OF THE REPUBLIC OF UZBEKISTAN

Uzbekistan is a central Asian country that became independent in 1991 with the break-up of the Soviet Union. Since then, it has embarked on several major health reforms covering health care provision, governance and financing, with the aim of improving efficiency while ensuring equitable access. Primary care in rural areas has been changed to a two-tiered system, while specialized polyclinics in urban areas are being transformed into general polyclinics covering all groups of the urban population. Secondary care is financed on the basis of past expenditure and inputs (and increasingly “self-financing” through user fees), while financing of primary care is increasingly based on capitation. There are also efforts to improve allocative efficiency, with a slowly increasing share of resources devoted to the reformed primary health care system. Health care provision has largely remained in public ownership but nearly half of total health care expenditure comes from private sources, mostly in the form of out-of-pocket expenditure. There is a basic benefits package, which includes primary care, emergency care and care for certain disease and population categories. Yet secondary care and outpatient pharmaceuticals are not included in the benefits package for most of the population, and the reliance on private health expenditure results in inequities and catastrophic expenditure for households. While the share of public expenditure is slowly increasing, financial protection thus remains an area of concern.

Utilization of the smoking cessation clinic at Public Health Centre 1 North Denpasar: A qualitative study

Background and objectives: The incidence of morbidity and mortality due to tobacco use is very high. There are several strategies to help smokers quit, one of which is counseling to stop smoking in a clinic setting. The purpose of this study was to explore in depth the utilization of smoking cessation clinics at a PublicHealth Centre (PHC).Method: A qualitative study through in-depth interviews was conducted with 14 informants who had been provided with a counseling at a smoking cessation clinic, consisting of two informants who had quit smoking and 12 informants who were still smoking. Triangulation of data was carried out by conducting in-depth interviews with the head ofPHCand one counselor on duty at the smoking cessation clinic. The information collected includes the utilization of the clinic, strategy of PHCin recruiting patients, knowledge of clinics about smoking cessation and the benefits of attending counseling. Data collection was carried out at the home of each informant during March-April 2018. The results of the interviews were analyzed thematically after a verbatim transcription being conducted. The data presented in a narrative to provide an in-depth description of the utilization of smoking cessation clinics in a PHC.Results: The results of interviews with PHC staff showed that in order to increase the utilization of the smoking cessation clinic, the services are integrated into the general polyclinic. Interviews with informants who have not stopped smoking indicate that to improve the utilization of the clinic, promotion and service variations are needed andnot only focus on counseling. Interviews with informants who have stopped smoking show that counseling at the clinic can increase their willingness to stop smoking.Conclusion: To improve the utilization of smoking cessation clinics, in addition to integrating services into the general polyclinic, promotion and variations in services are also required.

OPTIMALISASI WAKTU TUNGGU RAWAT JALAN DENGAN METODE LEAN HEALTHCARE DI KLINIK PRATAMA

The length of outpatients’ service waiting time reflects how health care facilities manage the service components adjusted to the patient's situation and expectations. Pratama Clinic dr. M. Suherman is a clinic that provides first-rate outpatients services where there are problems found on waiting times that are not yet standardized as stated in Kepmenkes No. 129, 2008 about the minimum service standard that it should be in 60 minutes. Thus, this research intends to make the outpatients waiting time in this clinic be more efficient by sticking to the standard of outpatients care. It implements lean healthcare as the research method with root withdrawal using fishbone and 5M management elements. It is a qualitative research and the data are collected by employing interview, observation, and brainstorming techniques. This research reveals the following results; the outpatients’ service waiting time in Pratama Clinic dr. M. Suherman averaged 108 minutes with a ratio of percentage between Value Added and Non Value Added is 20.83%: 79.16%, therefore, it means that the service process to the outpatients is not yet efficient. The unit that sends the most waste comes from general polyclinic. It is caused by several factors such as the speed of the number of outpatients registering in general polyclinic runs over the speed of the polyclinic service and the time of the outpatients' examination at each doctor range too long.

Conocimientos y actitudes sobre la acupuntura en médicos de hospitales y servicios públicos del Ecuador

ObjectiveTo identify the knowledge and attitudes about acupuncture in physicians linked to public hospitals in central Ecuador. MethodA quantitative, cross-sectional, descriptive, multicentre study was conducted with a total population of 289 physicians. The study was performed in several hospitals, although the older population belongs to the General Polyclinic Hospital of Riobamba. ParticipantsRural, general and specialist physicians. Pre- and post-graduate students were excluded. ResultsThe theoretical foundations of acupuncture are unknown by 72% of physicians, although 53% of them are aware of acupuncture therapy, and 59% have a good attitude to undergo acupuncture treatment. The referring of patients to acupuncture services is only 33%. Acceptance for teaching these fundamentals is shared by 54% of physicians. ConclusionsThere is a basic level of knowledge by physicians about the meaning of acupuncture, but not about its theoretical foundations. In addition they show a positive attitude to accepting acupuncture therapies and the inclusion of these studies in the medical curricula. A negative attitude persists for referral of patients to acupuncture therapies.

Pengaruh Kualitas Jasa Dan Nilai Pelanggan Terhadap Minat Kunjungan Ulang Melalui Kepuasan Pasien Di Poli Umum Di RSISA Semarang

Patient’s satisfaction is one of the indicators in assessing a service quality at a hospital. Fluctuations in number of total visit of patients and declining trend of old patient visit number at a general polyclinic at Sultan Agung Islam Hospital (SAIH) in Semarang during the period of 2010-2013 indicated that there were any problems at the polyclinic. The aim of this study was to comprehensively analyse a service quality and customer value that influenced towards willingness to revisit through patient’s satisfaction at outpatient/general polyclinic at SAIH in Semarang.This was an explanatory study using cross-sectional approach and an analytic method. Population was all patients at outpatient unit/general polyclinic at SAIH in Semarang who had visited the polyclinic at least two times. As many as 125 respondents were selected as samples using a method of purposive sampling. Data were collected using a structured questionnaire and measured using Likert scales of 1-5 and analysed using SEM performed by software of Smart PLS 2.0. The results of this research showed that the service quality and the customer value positively significantly influenced patient’s satisfaction. In addition, the patient’s satisfaction positively significantly influenced willingness to revisit. The patient’s satisfaction could be explained by the service quality and the customer value equal to 45.3%. Meanwhile, willingness to revisit could be explained by the service quality, the customer value, and the patient’s satisfaction equal to 45.0%. Overall, the service quality and the customer value at the general polyclinic of SAIH in Semarang are good. Notwithstanding, there still needs improvement in timeliness of service, availability of accurate service information, consistent and polite officers, greetings, and smiling to patients in order to improve patient’s satisfaction and to increase willingness to revisit at the general polyclinic of SAIH in Semarang.

Pengaruh Mutu Pelayanan Dokter Terhadap Loyalitas Pasien di RS PKU Muhammadiyah Bantul

Doctors is one of the main resources that provide services directly to patients. Doctor’s quality service at the hospital will build the patient’s attitudes and trust related to the reuse of hospital services. Loyal patients will have linkages with hospital and enable the ralization of long term relationship. Purpose knowing the influence of technical skills, interpersonal relationship, availability of information and the involvement of patient to the patient loyalty at general polyclinic in RS PKU Muhammadiyah Bantul. This research is an analytic inferential with cross sectional approaches. Populations of this research are olden patient in general polyclinic at RS PKU Muhammadiyah Bantul. Sampling technique is purposive sampling with number of samples are 87 persons. Collecting data using kuesioner. Data analysis with multiple regretion analysis. T here is influence doctor quality service to the patient loyalty. Dimentions who influence to the patient loyalty are technical ski ll , interpersonal relationship, availability of information, and patent involvement. A ll dimensions of doctor quality service include technical skills, interpersonal relationship, and availability of information and the involvement influence of patient to the patient loyalty. Technical skills, interpersonal relationship, availability of information, and patent involvement have an influence to the patient loyalty in general polyclinic in RS PKU Muhammadiyah Bantul .

Passive smoking increases pain perception in children undergoing venous catheterization

To establish whether there is any association between passive smoking and pain perception in children, in the absence of existing studies into possible links. This single-centre study focused on 100 children - 50 who had been exposed to passive smoking and 50 who had not - who were admitted to general polyclinics from September 2012 to December 2012 and needed venous catheterization. Patients with chronic diseases, neurologic and psychiatric illnesses, communication problems and analgesic use in the last 24h were excluded. The passive smoking group had a mean age of 7.3years (56% male) and the nonpassive smoking group had a mean age of 7.7years (44% male). The main study parameter was the Wong-Baker faces pain rating scale (WBFPS) score during catheterization. There was a statistically significant difference between the pain perceptions of the 100 children studied and smoke exposure. The WBFPS scores of the 50 children who were passive smokers were significantly higher than the scores of the 50 who were not passive smokers (p=0.00). Passive smoking increases pain perception in children during invasive medical procedures.

Saúde bucal do idoso atendido na Policlínica Geral do Rio de Janeiro: uma análise radiográfica

The aim of this study was to establish an oral health status of elderly patients with consultations at the General Polyclinic of Rio de Janeiro. Forty-eight radiographs exams, randomly selected, were evaluated by a single examiner using lightbox. Data were stored and analyzed. The results showed 44% (Na versao em Portugues consta 46%) of edentulousness and 56% of patients with teeth. In the last case, 37% had periodontal disease; 24% had unitary prostodontic; 20% had restorations; 15% had endodontic treatment and 2% still had radicular roots. The results of this study were similar to the literature, which emphasizes the need for dental treatment in the elderly population

Psychiatric services in Soviet general outpatient clinics

The author believes that the first level of psychiatric care in the U.S.S.R.--the general polyclinics (outpatient clinics) and the medical-sanitary units--have not been adequately studied. He describes this level of care, which is considered useful and progressive in that the clinics are supposed to make psychiatric care available to the population, lighten the load placed on psychiatric facilities, and improve follow-up therapy. However, he also points out the shortcomings in this first level of psychiatric care in the U.S.S.R., including the bureaucratic nature of the system and the uneven quality of service the clinics render to various social groups in urban and rural areas.