Hospital Jakarta Research Articles

Validity and Reliability of the Peds QLᵀᴹ 4.0 Generic Core Scale in Indonesian Version in Children with Chronic Kidney Disease Undergoing Hemodialysis in the Dialysis Unit of Cipto Mangunkusumo Hospital

Background: The Peds QLᵀᴹ 4.0 Generic Core Scales is a modular instrument for measuring health-related quality of life (HR-QoL) in children and adolescents aged 2 to 18 years. The Peds QLᵀᴹ 4.0 GCS consists of 23 items applicable to healthy school and community populations and populations of children with acute and chronic health conditions. The Pediatric Quality of Life Inventory (Peds QLᵀᴹ 4.0 Generic Core Scales) is a modular instrument designed to measure health-related quality of life (HR-QoL) in children and adolescents aged between two and thirteen years. It measures health-related quality of life (HR-QoL) in children and adolescents with progressive chronic kidney disease (CKD), regardless of the underlying etiology, due to the need for regular follow-up visits, strict medication regimens, and dietary intake. Purpose: This study aimed to evaluate the validity and reliability of the Peds QLᵀᴹ 4.0 GCS Indonesian version in children with CKD undergoing hemodialysis (HD) in the Dialysis Unit of Cipto Mangunkusumo Hospital. Methods: This type of research is analytical and observational in nature. The Peds QLᵀᴹ 4.0 GCS were administered to 30 children and 30 parents recruited from a pediatric dialysis unit. This study was conducted at a pediatric dialysis unit at Cipto Mangunkusumo Hospital Jakarta, Indonesia, in Mei-Juni 2024. Validity was tested using Pearson product moment, and reliability was tested using Cronbach's alpha. Results: A total of 30 children and 30 parents undergoing hemodialysis agreed to participate. The average age of the patients was 8–18 years old. Cronbach’s alpha coefficient for the total Peds QLᵀᴹ 4.0 GCS (α child self-report 0.918; α parent proxy report 0.928). Conclusion: The Indonesian versions of The Peds QLᵀᴹ 4.0 GCS were valid and reliable instruments to measure the HR-QoL of children with CKD on hemodialysis. The Peds QLᵀᴹ 4.0 GCS can be applied to provide relevant evidence that helps the function of quality of life among Indonesian patients on hemodialysis in evaluating health programs.

Pengaruh Komitmen Organisasi Terhadap Kinerja Manajerial dengan Anggaran Sebagai Variabel Moderating

Performance measurement is a process of assessing the progress of work against the goals and objectives predetermined, performance measurement used to assess the achievements manajaer and units of the organization he leads. the concept of managing public sector organizations based on three main elements, namely: economy, efficiency, and effectiveness. This study will analyze the influence of the independent variable on the dependent variable, namely the Participation Effect budget and organizational commitment to managerial performance in Islamic hospital Jakarta Cempaka Putih. Results showed partial (according t test) effect on theorganizational commitmen with budgetary participation as moderating variable of managerial performance. Then according to the results of t test, the partial effect on the organization's commitment managerial performance in performing their tasks and responsibilities. In carrying out the duties and responsibilities as a manager, it takes a strong commitment to the organization. Test results F illustrates that the simultaneous participation of the budget and organizational commitment jointly influence on managerial performance. R Square Test results showed R2 values ​​shown in the table amounted to 0.690 means that the variable budgetary participation and organizational commitment, able to explain 69.0% of these variations on managerial performance variable (Y). Keyword: organizational commitment, managerial performance, participation budget,

Patient-centered endometriosis care implementation at tertiary and secondary care hospitals in Indonesia

BackgroundEndometriosis has a high recurrence rate within five years (40–50 %). High recurrence remarkably reduces Health-Related Quality of Life (HRQOL). Patient-centered endometriosis care (PCEC) is a range of care that respects the patient's preferences and needs while being guided by the patient's values and may provide better treatment for patients. Our study is the first to evaluate the implementation of PCEC in Indonesia. Materials and methodsWe evaluated PCEC at Dr. Cipto Mangunkusumo Hospital in Jakarta (Center-1), Raden Mattaher Hospital in Jambi, and dr. Zainoel Abidin Hospital in Aceh (Center-2) from October 2021 to May 2022. Center-1 represented tertiary care, and center-2 represented secondary care. This study used the ENDOCARE Questionnaire (ECQ) instrument, which produced mean important score (MIS), percentage of negative performance (PNP), and patient-centeredness score (PCS) as outcomes. Higher PCS reflects greater patient-centered care of the center. ResultsA total of 73 patients were recruited and divided into two groups of centers. Patients from Center-1 had significantly higher patient-centeredness scores vs. patients in centers without the training and guideline: dimension "Respect for patients' values, preferences, and needs" (Center-1 7.33, 6–10, Center-2 6, 6–6; p < 0.001), dimension "Coordination and integration of care" (Center-1 6, 4.44–8.67, Center-2 5.5, 4–6; p = 0.006), dimension "Information, communication, and education" (Center-1 7.14, 6–8.29, Center-2 5.14, 5.14–6; p < 0.001), dimension "Physical comfort" (Center-1 6, 6–8, Center-2 6, 6–6; p = 0.033), dimension "Endometriosis clinical staff" (Center-1 6, 6–9, Center-2 6, 6–6, p = 0.049). Subjects with higher education and experienced endometriosis recurrences statistically had higher patient-centeredness scores. ConclusionOur findings suggest that endometriosis training and having endometriosis clinical guidelines could improve patients' experience in receiving PCEC. Information for patients should be made simple so they can understand the purpose of the treatment.

The Effect of Compensation, and Work/Family Conflict Through Job Satisfaction on Employee Retention

This study aims to analyze the effect of compensation and work/family conflict that is allegedly mediated by job satisfaction on employee retention. The data used in this study is data obtained from a questionnaire survey distributed in several type-A hospitals in DKI Jakarta. The smartPLS software is used to analyze the data. The research uses surveys obtained from structured questionnaires. The research was carried out cross-sectionally and data were taken from the staff of type A hospitals in Jakarta. The limitations of this study/implications of this study are that this study contributes to the theory by specifically analyzing the relationship between compensation and work/family conflict in a complex health service environment, one of the limitations of this study is the adoption of cross-sectional design; Future studies can be improved by using a variety of power gathering sources. The practical implication of this study is that this study highlights the magnitude of the influence of compensation and work/family conflict that is allegedly mediated by job satisfaction on employee retention. It can be concluded that compensation has a positive effect on job satisfaction, and work-family (W/F) conflict hurts job satisfaction, both of which have been proven to be true. In addition, W/F conflict has also been proven to have a negative influence on employee retention.

The Influence of HRM, Employee Engagement, and Organizational Commitment on Employee Turnover Intention

High turnover rates are a significant challenge in the healthcare sector, where employee retention is critical to maintaining service quality and organizational performance. The purpose of this research is to determine and analyze the effect of HRM, employee engagement and organizational commitment on employee turnover intention at Tebet Hospital Jakarta, Atmajaya Hospital Jakarta, and UKI Hospital. The research method used was qualitative, which involved in-depth interviews with key respondents from the three hospitals. Primary data was collected using a structured questionnaire and analyzed using SEM-PLS (Structural Equation Modeling-Partial Least Squares). The findings show that HRM has a positive but not statistically significant influence on employee engagement, while significantly reducing turnover intention. Organizational commitment is positively and significantly related to employee engagement and decreased turnover intention. In addition, turnover intention positively affects employee performance. This research has implications highlighting the need for hospitals to develop more effective HRM strategies that encourage employee engagement and strengthen organizational commitment, ultimately reducing turnover rates.

PENGARUH EKUITAS MEREK TERHADAP PENGGUNAAN MONITOR PASIEN MEREK PHILIPS DI JAKARTA

This research aims to find out how responses, consumer loyalty and brand equity influence consumer loyalty of Philips monitor patients. Questionnaire respondent data was obtained from end users, namely nurses who work in intensive care rooms in 5 vertical hospitals in Jakarta. The questionnaire was distributed directly to 185 respondents. Hypothesis for 3 hypotheses using SEM PLS analysis with SmartPLS 3. Testing consists of Outer Model, namely Convergent Validity Test, Discriminant Validity Test, Average Variance Extracted (AVE) Test, Composite Reliability Test, Cronbach Alpha Test, Inner Model and Bootstrapping. Test results show that H1: Brand awareness has a positive and significant effect on consumer loyalty. H2: Brand association has a positive and significant effect on consumer loyalty. H3: Perceived quality has a positive and significant effect on consumer loyalty. It is hoped that this research can provide input to companies as a strategy to increase consumer loyalty and can provide good benefits for further research.

P99-2 Clinical characteristics of osteosarcoma in tertiary referral cancer center hospital in Jakarta, Indonesia

P99-2 Clinical characteristics of osteosarcoma in tertiary referral cancer center hospital in Jakarta, Indonesia

Correlation of Asymmetric Dimethylarginine With Podocytopathy Markers in Diabetic Kidney Disease Patients.

Diabetic kidney disease (DKD) is the leading cause of end-stage kidney disease, and podocytopathy is an early manifestation of DKD characterized by the urinary excretion of podocyte-specific proteins, such as nephrin and podocin. Asymmetric dimethylarginine (ADMA)-a biomarker of endothelial dysfunction-is associated with progressive kidney dysfunction. However, the mechanism of endothelial dysfunction in DKD progression is unclear. The aim of this study was to investigate the correlations of ADMA levels with nephrin, podocin, and the podocin:nephrin ratio (PNR) in DKD patients. A cross-sectional study of 41 DKD outpatients was performed in two hospitals in Jakarta from April-June 2023. The collected data included the subjects' characteristics, histories of disease and medication, and relevant laboratory data. Serum ADMA was measured using liquid chromatography, while urinary podocin and nephrin were measured using the enzyme-linked immunosorbent assay (ELISA) method. A correlation analysis was performed to evaluate the correlation of ADMA with nephrin, podocin, and PNR. Regression analysis was performed to determine confounding factors. The mean value of ADMA was 70.2 (SD 17.2) ng/mL, the median for nephrin was 65 (20-283 ng/mL), and the median of podocin was 0.505 (0.433-0.622) ng/mL. ADMA correlated significantly with nephrin (r = 0.353, p = 0.024) and PNR (r = -0.360, p = 0.021), but no correlation was found between ADMA and podocin (r = 0.133, p = 0.409). The multivariate analysis showed that body mass index was a confounding factor. This study revealed weak positive correlations between ADMA and urinary nephrin and between ADMA and PNR. No correlation was found between ADMA and urinary podocin.

Characteristics of Chemotherapy Treatments for Breast Cancer Patients at Bhayangkara Tk.1 Pudsdokkes Polri Hospital, Jakarta

Background: Breast cancer is a malignant breast tumor that develops in the ductal or lobular epithelium and usually attacks women. Chemotherapy is a cornerstone of breast cancer treatment, particularly for patients with advanced disease or those who are not candidates for surgery or radiation therapy. This research aims to observe the use of chemotherapy drugs for breast cancer patients in terms of chemotherapy regimens and cycles at Bhayangkara Tk.1 Pudsdokkes Polri Hospital. Methods: This study employs descriptive quantitative approaches. Data were gathered retrospectively from medical records of breast cancer patients receiving chemotherapy at Bhayangkara Tk.1 Pudsdokkes Polri Hospital Jakarta from July to December 2021. Results: From 110 patients, 86 (78.18%) patients used the CAF regimen, 18 (16.36%) patients used the AC regimen, and 3 (2.73%) patients used the TAC regimen, while the regimen that did not comply with the guidelines was 2 (1.82%) patients using the combination of paclitaxel and epirubicin, 1 patient utilizing the combination of paclitaxel and doxorubicin. Forty-six (41.82%) patients with the CAF regimen had completed six cycles of chemotherapy with intervals of 3 weeks or 21 days, while only 5 patients (3.63%) completed four cycles of the AC regimen at 3-week or 21-day intervals. At the time of data collection, 11 patients, and 1 patient utilizing the AC regimen. This was because 59 patients had not yet finished the chemotherapy cycle, specifically in the advanced stage. Conclusions: The CAF regimen was the most commonly used chemotherapy regimen, followed by the AC and TAC regimens. This finding aligns with current clinical guidelines for breast cancer treatment. A significant number of patients had not yet completed their chemotherapy cycles, particularly those with advanced-stage breast cancer. This highlights the challenges associated with treating advanced disease and the need for more effective and less toxic treatment options.

Simple Geographic Distribution of Patients with Stroke According to their Medical Care Financing System in a Private University Hospital

Aims: To reveal the geographical distribution of stroke patients in a private university hospital in Jakarta, Indonesia according to their address and further divide them into three sub group of using universal health coverage (UHC) vs other type of insurance ((OTI) vs private non insurance patient (private) Study Design: simple retrospective cross-sectional study. Place and Duration of Study: Sample: Medical record from patients of the Department of Neurology, Rumah Sakit Universitas Kristen Indonesia, Jakarta Indonesia; a private university hospital located in Jakarta Indonesia, between January 2021 and December 2023. Methodology: We analyzed medical record of 162 patients (90 men, 72 women; age range 15-87 years (mean age 61.12 SE± .82) with history of stroke and at the present routinely underwent routine medical control (outpatient) or with current diagnosis of stroke (inpatient in our hospital). We further divided them based on their medical care financing system (UHC vs OTI vs private) and using the help from GPS service made available by Google Maps™ we simply try to make a geographical distribution of those patients based on their address/residence location Results: Geographical distribution of patients using UHC were closer to the hospital compared to the other 2 non UHC medical care financing users. Conclusion: Our analysis regarding stroke patients in our hospital (2021-2023), we found that 55.6% male patients, 42% were in the range of age between 55-64 years old, most of the patient (94.4%) using BPJS as their medical care financing system, with 27.7% came from sub district Makkasar which is near from our hospital. Further analysis using the help of Google maps™ we can show that the UHC or BPJS health referral system has facilitated patients receiving health services at the health facility closest to their residence.

Adequate serum 25-hydroxy-vitamin D levels are correlated with low anti-PF4 levels in mild COVID-19 Patients: An observational study.

The worldwide spread of coronavirus disease 2019 (COVID-19) has resulted in an unparalleled health emergency of global proportions. Around 31% of individuals with COVID-19 experience thrombosis associated with hypercoagulation. COVID-19 patients have shown an increase in platelet activation, but the mechanism has not been fully understood yet. One theory suggests that this could be related to the heparin-induced thrombocytopenia phenomenon, where platelet activation involves anti-PF4 antibodies that are associated with thrombosis. Vitamin D has been established to exert an influence on immunological responses and inflammation. The aim of this study is to analyze the correlation between serum 25-hydroxy-cholecalciferol [25(OH)D] levels and anti-PF4 antibodies among COVID-19 patients. A cross-sectional study was conducted among 160 COVID-19 patients at Cipto Mangunkusumo General Hospital and Wisma Atlit Hospital Jakarta from October 2021 to January 2022. The mean serum 25(OH)D level was 15.1 ng/mL. A significant negative correlation was found between serum 25(OH)D and anti-PF4 levels in mild COVID-19 patients (P = .035; R = -0.236). Remarkably, P-selectin levels were significantly higher in the moderate COVID-19 group compared to the severe group (P = .031). Serum 25(OH)D level had a significant negative correlation with anti-PF4 level in mild COVID-19 patients. Thus, it is highly recommended to ensure that serum 25(OH)D levels are maintained above 30 ng/mL. Remarkably, the P-selectin level was significantly higher in the moderate COVID-19 group compared to the severe group.

Completeness of Medical Records Documents with Diagnosis of Bronchial Asthma in Outpatients at Pondok Kopi Islamic Hospital Jakarta

Completeness of medical record documents is the assessment or review of documents, and contents of medical records related to documentation, services and/or assessing the completeness of medical records. Medical records are written or recorded information or notes regarding identity, which contain 1). Notes, which include a description of the patient's identity, patient examination, diagnosis results, treatment, actions and other services carried out by doctors, dentists or other health workers according to their competence; 2). Documents, which are complete records, include x-ray photos, laboratory results and other information by scientific competence. Types of medical records consist of conventional medical records; and electronics. Medical Records can be stored alphabetically and numerically. The record management process is carried out by Medical Records officers at the Hospital at RSIJ Pondok Kopi Jakarta starting from the stage of preparing the Medical Record document (Assembling), the Indexing process (list of illnesses, actions, doctors and deaths), Quantitative analysis of medical records (Analysing) and finally storage of medical records according to the applicable alignment system (Filling). The factors that influence incomplete medical records are: 1). HR; 2). Tools/Machines; 3). Method/Method; 3). Material; and 4) Finance/Money.

The Role of Ultrasound in the Diagnosis and Management of Pediatric Abdominal Emergencies in Jakarta, Indonesia

Introduction: Pediatric abdominal emergencies demand swift and accurate diagnosis for optimal management. In resource-constrained settings, point-of-care ultrasound (POCUS) has emerged as a valuable tool. This study aimed to evaluate the utility of ultrasound in diagnosing and managing pediatric abdominal emergencies in Jakarta, Indonesia. Methods: A retrospective review of pediatric patients (age ≤ 18 years) presenting with acute abdominal pain to a tertiary care hospital in Jakarta from 2018 to 2023 was conducted. Data collected included demographics, clinical presentation, ultrasound findings, final diagnosis, and management decisions. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ultrasound for various abdominal emergencies were calculated. Results: A total of 543 patients met the inclusion criteria. The most common diagnoses were appendicitis (n=187, 34.4%), intussusception (n=82, 15.1%), and gastroenteritis (n=75, 13.8%). Ultrasound demonstrated high sensitivity and specificity for diagnosing appendicitis (92% and 88%, respectively), intussusception (95% and 90%), and free fluid in the abdomen (98% and 94%). POCUS influenced management decisions in 68% of cases, including expediting surgery or avoiding unnecessary interventions. Conclusion: Ultrasound is a valuable tool for the diagnosis and management of pediatric abdominal emergencies in Jakarta. Its high sensitivity and specificity, coupled with its point-of-care availability, make it particularly useful in resource-limited settings.

The effectiveness of hyperoxygenation in preventing oxygen desaturation in intubated infants treated with endotracheal suctioning

Endotracheal suctioning is an effective nursing intervention for intubated infants undergoing invasive mechanical ventilation. However, this intervention has the potential to cause side effects, such as hypoxemia, which typically requires hyperoxygenation. Despite the widespread use of hyperoxygenation in clinical practice, there are limited reports on its effectiveness in infants. This study aims to determine the effect of hyperoxygenation on oxygen saturation of intubated infants.The study procedures were carried out using a quasi-experimental method with a cross-over approach. In addition, the sample population comprised 22 intubated infants who were treated at the perinatology unit of Dr. Cipto Mangunkusumo Hospital in Jakarta from March to April 2018. The participants were then divided into 2 groups based on their condition, and oxygen saturation level was assessed. The intervention comprised endotracheal suctioning with and without hyperoxygenation, with a 3-hour washing period. Data collection was performed at different measurement intervals, namely before, during, and after suctioning, followed by statistical analysis.The paired-sample t-tests and Wilcoxon test showed that there was a significant difference in oxygen saturation at certain measurement intervals (p=0.006; p=0.010; p=0.001; p=0.001; p=0.001). In addition, Friedman test also showed the presence of a significant difference in the reduction of oxygen saturation between the control and intervention groups (p=0.001).In conclusion, hyperoxygenation had the potential to prevent the reduction of oxygen saturation during endotracheal suctioning in intubated infants. However, individual assessment of the need for suctioning and hyperoxygenation was necessary for a safe and effective procedure.

H1N1pdm09 infection in children: A case report of reemerging disease in COVID-19 pandemic

An outbreak of H1N1 infection was first declared by the World Health Organization in 2009 and confirmed in the post-pandemic phase in 2010. Amid the COVID-19 pandemic, we found a confirmed case of H1N1pdm09 in Bunda Women and Children Hospital Jakarta. A 13-year-old boy was referred to our hospital after four days of hospitalization due to worsening tachypnea following a productive cough and fever. The patient had severe dyspnea with inspiratory effort and oxygen desaturation to 80%, therefore admitted to our pediatric intensive care unit. On physical examination, the patient had increased work of breathing, looked irritable, had a respiratory rate of about 40x/minute with non-rebreathing mask support, and crackles were heard in both lungs. Chest x-ray showed right bronchopneumonia. There was a history of a generalized seizure for less than 1 minute, which stopped spontaneously in previous hospital care. The patient was diagnosed with mucopolysaccharidosis at age six years old and has never received enzyme replacement therapy. Laboratory results revealed thrombocytopenia, leukopenia, neutrophilia, monocytosis, high c-reactive protein and procalcitonin, and elevated liver enzymes. The investigation of etiology was performed using the respiratory panel test and showed a positive real-time polymerase chain reaction for H1N1pdm09 and Influenza A. The patient was given oxygen therapy with a high-flow nasal cannula with an oxygen fraction of 40% and a flow of 20 liters per minute, fluid maintenance while fasting, antibiotics, inhaled beta-2 agonists, and a neuraminidase inhibitor (oseltamivir). The patient's clinical and laboratory markers improved on the third day of treatment, and he was discharged two days later.

Care of children with congenital rubella syndrome (CRS) in Indonesia.

Congenital rubella syndrome (CRS) is associated with severe birth defects, that lead to disability in later life. Hence, early detection and intervention are needed to prevent permanent disability and mortality in children with CRS. We evaluated the time to diagnosis or correction intervention related to survival rate using survival analysis. A retrospective cohort study was conducted to evaluate the follow-up of CRS-confirmed cases from 2011-2018 at a national referral hospital in Jakarta, Indonesia. Parents of eligible children who registered in the national CRS registry as laboratory-confirmed CRS cases were contacted through phone calls or home visits and interviewed about the current situation of their child's health. We also obtained clinical data from the medical records. Fifty children, age 4 to 14 years, identified with laboratory-confirmed CRS were included in this study. Half (54%) of these children were female. All were born from mothers with no previous rubella vaccination history. Ophthalmic abnormalities such as congenital cataracts (88%) were the most common birth defect. Multiple congenital abnormalities including congenital heart disease, ocular abnormalities, and auditory defects were identified in 52% of the children. Based on Kaplan-Meier analysis, 50% of children were diagnosed at four months. Ophthalmic corrections such as cataract surgery were performed earlier than heart or auditory correction, with 50% of children undergoing eye correction one month after the diagnosis. There is a vital need to implement CRS surveillance in Indonesia to know the burden of CRS and reinforce the preventive actions, including vaccination against rubella.

Correlation Between Tuberculosis Type and Comorbidities with Nutritional Recovery Rates Post-Tuberculosis Treatment in Pediatric Patients

Background: Tuberculosis remains a significant cause of mortality in children. Nutritional status is one of the major risk factors for tuberculosis severity. This study investigated the factors influencing nutritional status in tuberculosis patients. Methods: This is a retrospective, cross-sectional study conducted in the tertiary national-referral hospital in Jakarta, Indonesia. Data were obtained from electronic health records from 2012-2018. This study included patients aged 0-18 years-old who were diagnosed and treated with anti-tuberculosis drugs. Patients who did not complete the therapy for minimum 2 months were excluded. Results: A total of 207 patients were included in this study. The type of tuberculosis was associated with the nutritional status of children after 2 months of treatment (p value = 0.014; 95% CI = 0.422 - 0.914). Children with extrapulmonary TB showed better improvement in nutritional status compared to those with pulmonary TB. Comorbidities were also associated with nutritional status (p-value = 0.020; CI95% = 1.063 - 2.382). Patient without comorbidities experience better nutritional status improvement than those with comorbidities. Conclusion: The nutritional status of tuberculosis patients improved after the 2-months of treatment. The type of tuberculosis and the presence of comorbidities influence the outcomes of nutritional status during anti-tuberculosis treatment.

Analysis Of Financial Performance Of Muhammadiyah Aisyiyah Hospital In Jakarta Before And After The Covid-19 Pandemic

This study aims to analyze differences in the financial performance of the Muhammadiyah-Aisyiyah Hospital (RSMA) in Jakarta before and after the COVID-19 pandemic. Data was obtained from financial reports (2017Q1-2022Q4) which were analyzed using the ANOVA difference test. Based on the analysis and discussion, it was found that there was a significant difference in financial performance in the financial ratios of TATO and PBT, while the difference in DAR was not significant before and after the COVID-19 pandemic in the RSIJ Group. Apart from that, it was found that financial performance was better after the COVID-19 pandemic.This research provides practical insights for hospital managers and stakeholders in designing more effective policies for financial management during and after the pandemic. The increase in the Debt to Assets Ratio in several hospitals shows the need for better debt management strategies, while the decrease in the Total Assets Turnover Ratio emphasizes the importance of increasing the efficiency of assets use. The increase in Profit Before Tax in several hospitals indicates opportunities to increase profitability through appropriate management despite existing challenges. To improve the financial performance of Muhammadiyah private hospitals in DKI Jakarta, it is recommended to improve asset management to make it more effective, diversify income sources to reduce financial risks, improve revenue and operational expense management strategies, and invest in advanced health technology.

Validity test of the Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria compared with the American Society for Parenteral and Enteral Nutrition (ASPEN) criteria in inpatients at Dr. Cipto Mangunkusumo hospital

Background: Malnutrition experienced by numerous inpatients is linked to various complications. The Global Leadership Initiative on Malnutrition (GLIM), which established the latest malnutrition criteria, recommends a two-step methodology for diagnosing malnutrition in adult inpatients. This study aims to evaluate the validity of the GLIM criteria for the diagnosis of malnutrition in hospitalized patients at Cipto Mangunkusomo Hospital Jakarta by comparing them with the ASPEN criteria. Methods: This cross-sectional study was conducted at Cipto Mangunkusomo Hospital, Jakarta. Secondary data was taken from 100 inpatients from October 2021 to February 2022 selected by consecutive sampling technique. The diagnosis of malnutrition in the patients applied the ASPEN and GLIM criteria. Furthermore, data were analyzed using Cohen's Kappa and chi-square tests. Results: Of 100 inpatients, 63% were diagnosed with malnutrition according to the GLIM diagnostic criteria. Meanwhile, 48% of them were found to be malnourished according to the ASPEN criteria. The GLIM criteria have a specificity of 69.2%, a sensitivity of 97.9%, a PPV of 74.6%, and an NPV of 97.3%. Conclusion: The GLIM diagnostic criteria are valid as an instrument for diagnosing malnutrition but require further research to assess the severity of malnutrition.

Drug Related Problems (DRPs) penggunaan obat antidiabetik pada pasien rawat inap diabetes mellitus tipe 2

rates continue to rise annually. Indonesia ranks fifth globally in the number of diabetes cases. Drug-related problems (DRPs) are common in clinical practice and can occur at all stages of the treatment process. Objective: This study aims to identify DRPs in hospitalized patients with Type 2 Diabetes Mellitus. Methods: This descriptive study employed a cross-sectional approach. Data were collected retrospectively from medical records of 61 hospitalized patients with Type 2 Diabetes Mellitus at a hospital in Jakarta. Results: The analysis of DRPs in hospitalized patients with Type 2 Diabetes Mellitus revealed that 5 cases (14%) involved inappropriate drug selection, 6 cases (17%) involved suboptimal dosing, 10 cases (29%) involved adverse drug reactions (ADRs), and 14 cases (40%) involved drug interactions. Conclusion: Polypharmacy requires careful attention as it has the potential to cause drug interactions and adverse drug reactions.