Hospital Jakarta Research Articles

Optimalisasi Penegakan Diagnosis Keperawatan Sesuai Standar Asuhan Keperawatan di Rumah Sakit X

This study aims to analyze the enforcement of nursing diagnoses according to the Nursing Care Standards of X Hospital Jakarta. The research method uses a case study approach with interviews, document review and observation, and performs problem analysis using fishbone analysis. The results showed that the enforcement of nursing diagnoses in accordance with the Standards of Nursing Care was not optimal, so that it had an impact on the quality of care and its documentation. Nursing diagnoses that are in accordance with Nursing Care Standards are 48.6%. Lack of supervision from managers, assessments using personal assumptions and the standard of writing diagnoses in the local Hospital Information System (SIRS) has not been facilitated. Through strengthening the directing function with SAK media innovation, there was an increase in writing nursing diagnoses according to SAK to 62.3%. In conclusion, optimizing the enforcement of nursing diagnoses in accordance with Nursing Care Standards can be implemented with SAK media innovations (Softfiles on the Google Form Platform and flipcharts) which are given to implementing nurses at X Hospital.
 
 Keywords: Diagnosis, Nursing Documentation, Quality, Nursing Care Standards

Syndromic testing for increasing diagnostic accuracy in gastrointestinal infection.

Diarrhea is a global problem that commonly occurs in cases of gastrointestinal infection. The prevalence of diarrhea in Indonesia was 6.8% according to Riskesdas 2018 data. The conventional diagnosis in cases of gastrointestinal infection is limited in sensitivity and time. This may be overcome by gastrointestinal syndromic testing that can detect a number of pathogens simultaneously in one assay. The aim of this study was to determine the role of the gastrointestinal syndromic testing panel in patients with gastrointestinal infection. This retrospective study of stool specimens performed syndromic testing and microbiological cultures at a private hospital in Central Jakarta. Of the 119 specimens with negative culture test results, syndromic gastrointestinal testing found pathogens in 46 specimens (38.7%), of which 32 specimens contained a single pathogen and 14 specimens had > 1 pathogen. The most frequently found pathogens were enteropathogenic E. coli, enteroaggregative E. coli, and C. difficile A/B toxins. Syndromic testing can increase the etiologic diagnosis of gastrointestinal infections in a shorter time period than the conventional methods.

Emerging progressive atypical acute kidney injury in young children linked to ethylene glycol and diethylene glycol intoxication.

There had been a sudden surge of unusually severe and rapidly progressing acute kidney injury (AKI) incidence in Indonesia since August 2022 which did not correspond to the rise of COVID-19 incidence. We suspected this was related to ethylene glycol (EG) and diethylene glycol (DEG) intoxication. This study is aimed at describing the clinical and laboratory characteristics of AKI related to D(EG) intoxication in order to spread awareness of the possibility of intoxication in cases of rapidly progressing AKI with unknown etiology. We conducted a cross-sectional study by collecting secondary data from the pediatric AKI registry at a national referral hospital in Jakarta, Indonesia. Data on children admitted from January to November 2022 with diagnosis of stage 3 AKI based on KDIGO criteria were included. Data regarding demographics, symptoms prior to anuria, laboratory results, infection panel including COVID-19 status, treatment administered, and mortality were analyzed. Sixteen patients tested positive for EG and DEG, all with history of consuming syrup-based medications. High anion gap metabolic acidosis was observed in majority of patients with mean pH 7.33 ± 0.07 and mean anion gap 15.6 ± 7.8mEq/L. No patient had high osmolal gap (mean osmolal gap 3.46 ± 4.68). One deceased patient, who had kidney biopsy performed, showed severe damage and calcium oxalate crystals in the kidney tissue. Mortality was recorded in six patients (37.5%). Careful history taking of patient's clinical course, including consumption of syrup-based medications and laboratory findings, might aid clinicians to establish a working diagnosis of D(EG) intoxication without needing to wait for blood toxicology test. Early diagnosis and therapy are crucial to prevent substantial mortality.

Prosedur Pemeriksaan MRI Brain Pada Kasus Stroke Hemoragik

Magnetic Resonance Imaging (MRI) is a medical imaging technique that combines magnetic fields and radio waves to create images and analysis of body tissue, blood circulation and metabolic function of the body. Some indications for MRI brain include detecting and identifying cases such as multiple sclerosis, infarction, hemorrhage, infection, trauma, and tumor or metastatic disease. Hemorrhagic stroke is bleeding that occurs when the blood vessels leading to the brain leak. Hemorrhagic stroke occurs when blood comes out of a blood vessel due to tearing of the blood vessel wall. Blood vessel walls can be weakened by the process of atherosclerosis and can also be due to congenital defects. The research method used was qualitative research. With a case study type of research. Data collection was carried out from July 2023 to August 2023 using a 3 Tesla MRI aircraft. The patient samples used in this study were three patients with complaints in the head. Data collection was carried out through observation, interviews and documentation. The MRI brain examination procedure in hemorrhagic stroke cases at one of the hospitals in Jakarta uses the Plain localizer axial, sagittal and coronal sequence, T1_fl2_axial, T2_tse_darkfluid_axial, T2_tse_axial, ep2d_diff_4scan_trace, asl_3d_axial, tof_cs_carotids, flow_pc3d_MRV, tof_brain_MRA, T2_swi_axial. In this case, there is a different sequence used, namely T2_swi_axial. Sequence susceptibility weighted imaging (SWI) is an innovative radiological imaging method that is often used in diagnosing neuroradiological disorders.

Association Between the Emergency Department Length of Stay and in-Hospital Mortality: A Retrospective Cohort Study.

The number of emergency department (ED) visits and prolonged ED length of stay (LOS) are increasing worldwide. Prolonged ED LOS may be associated with a higher risk of in-hospital mortality. Here, we analysed the association between of ED LOS and the risk of in-hospital mortality in a hospital in Jakarta, Indonesia. This was a single-centre retrospective cohort study performed in a referral academic hospital in Jakarta, Indonesia. Data on ED visits in 2019 were obtained from the electronic medical records. ED patient was used as the unit of the analysis. The dependent variable was all-cause in-hospital mortality during one's visit. The main independent variable was ED LOS with respect to approval (<8 h) and prolonged (≥8 h). Potential confounders were sex, age, triage categories, trauma-related case, malignancy-related case, labour-related case, and referral patients from other healthcare facilities. Multivariate logistic regression analysis was performed to evaluate the association of ED LOS and in-hospital mortality after adjusting for other confounders. There were 18,553 participants included in the analysis. The in-hospital mortality was 13.5% among all participants, and 63.5% participants had an ED LOS ≥8 h. Multivariate analysis showed that a prolonged ED LOS was associated with an increased risk of in-hospital mortality (adjusted relative risk, 2.69; 95% confidence interval, 2.40-3.03; P<0.001). Prolonged ED LOS was associated with risk an increased of in-hospital mortality after adjusting for several confounders. In future, hospital service plans should aim to reduce ED LOS and increase patient flow from the ED to in-patient wards.

Role of Ureaplasma urealyticum and Ureaplasma parvum as Risk Factors for Cervical Dysplasia with Human Papillomavirus

Human papillomavirus (HPV) can be transmitted sexually and causes cervical malignancies in women. Among the risk factors, sexually transmitted infections (STIs) caused by bacteria have raised concerns because they are asymptomatic and persistent and can increase the risk of HPV infection. This study assessed the correlation among Ureaplasma urealyticum, Ureaplasma parvum, Chlamydia trachomatis, and Mycoplasma hominis infections towards abnormal cervical cells positive for HPV. Seventy outpatients at the Colposcopy Outpatient Clinic, Dr. Cipto Mangunkusumo Hospital in Jakarta, Indonesia, were enrolled in this cross-sectional study. Viruses and bacteria were detected using polymerase chain reaction and compared with liquid-based cytology results for cervical cytology. Of the 70 patients, 24 (34.28%) showed abnormal cervical cytology. Among those with abnormal cervical cytology, C.trachomatis was reported in 1 patient (4.2%), M.hominis in 6 patients (25%), U.urealyticum in 13 patients (54.2%), and U.parvum in 10 patients (41.7%). Statistical analysis demonstrated an association between U.urealyticum and U.parvum infections and HPV infection (U.urealyticum p = 0.012; U.parvum p = 0.022). U.urealyticum and U.parvum were more prevalent than C.trachomatis and M.hominis in HPV-positive women, suggesting their role in HPV infection.

Correlation between Steatosis Degree and Hypertension Degree in Non-Alcoholic Fatty Liver Disease Patients in Indonesia

Non-alcoholic fatty liver disease (NAFLD) has been recognized closely linked to cardiovascular diseases including hypertension. The connection between these conditions can be attributed to lipotoxicity, that induces systemic inflammation by activating the sympathetic nervous system (SNS) and triggers the release of angiotensin II within the renin-angiotensin-aldosterone system (RAAS). This study examined the correlation between degree of steatosis and degree of hypertension in NAFLD patients at Hajj Hospital Jakarta in 2019-2022. A cross-sectional approach was used to analyse the medical record data obtained through consecutive sampling. B-mode abdominal ultrasound examination assessed the degree of steatosis in NAFLD. Blood pressure grading was based on the 2020 International Society of Hypertension (ISH) Global Hypertension Practice Guidelines. The data were processed using Somers’d test to define the correlation between steatosis and hypertension.Of 53 NAFLD subjects, 56.6% were female, and mild steatosis was dominant (54.7%). The proportion of hypertension among NAFLD patients was 39.7%, with a higher prevalence of 61.9% among those aged 50 years or older. Majority of patients were grade I hypertension, whereas all subjects with grade II hypertension exhibited severe steatosis. There was correlation between the degree of hypertension and steatosis patients with NAFLD, with a p-value of 0.029 and a weak correlation coefficient (r= 0.251). This study found a correlation between steatosis and degree of hypertension. It was suggested females aged 50 years or older with grade II hypertension should be screened for fatty liver.

The Impact of High D-Dimer on The Clinical Outcome of Covid-19 patients at A Private Hospital in Jakarta

D-Dimer is a fibrin degradation product as the resultof thrombus degradation by fibrinolysis. Elevated D-dimer in the blood is a presumptive marker of thrombosis. D-dimer levels above 1g/mL are risk factors for poorprognosis in patients with COVID-19. To evaluate the impact of high D-Dimer on the clinical outcome of Covid-19 patients at Private Hospital in Jakarta. A retrospective cohort study with convenience sampling was applied in this study. There were 980 patients but only 320 patients were eligible for inclusion criteria. This study only included confirmed COVID-19 patients who were hospitalized from March to June 2021, and the study was conducted from March to June 2022. The gender of the majority patients as the sample was male, 165 (52%) and 155(48%) female patients with moderate severity. Correlation between D-dimer and clinical outcome of COVID-19 patients using Fisher's exact method showed a higher survival rate of 287(89.7%) patients compared to 33(10.3%) patients who died with a p-value &lt;0.05. The survival analysis for COVID-19 patients using the Kaplan Meier method showed that patients receiving D-dimer &lt;500ng/mL had a median survival rate of about 90% after approximately 21 days of treatments, whereas patients whowere receiving &gt;500 ng/mL had a 50% survival rate after 30 days of treatment. Patients receiving D-dimer &lt;500ng/mL had a survival rate of about 90% after undergoing treatment for approximately 21 days, while patients who had D-dimer&gt;500 ng/mL had a survival rate of about 50% after 30 days of treatment. Anticoagulants were given to almost all patients, roughly 10 percent died during hospitalization with hypercoagulation complications.

Risk Factors of Worsening of Systemic Lupus Erythematosus in Patients at Two Tertiary Hospitals in Jakarta

Systemic Lupus Erythematosus (SLE) is a prototypical multiorgan autoimmune disease with a fluctuating and chronic disease course. As an emerging disease in this century, SLE will burden stakeholders and the country. This study was conducted to determine the prognostic factors for SLE worsening, especially in ambulatory patients. This ambispective study used logistic regression to view the risk factors for worsening SLE in patients. Anemia, age, body mass index, education level, employment status, marital status, hydroxychloroquine, and immunosuppressants were the independent variables in this study. This study concludes that anemia is statistically significant and, therefore, a risk factor for worsening SLE in patients (RR = 5.31; p-value&lt;0.005), while age, body mass index, education level, employment status, marital status, hydroxychloroquine, and immunosuppressants are not statistically significant.

The Validity of Informed Refusal With Elements of Forced Discharge of COVID-19 Patients From Hospitals, as Reviewed in Accordance With Law No. 29 of 2004 on Medical Practices, in Conjunction With Law No. 4 of 1984 on the Prevention of Infectious Diseases

Health is a vital aspect of human life. Covid-19 has had a significant impact on the Indonesian population, particularly on their health. During this period, the healthcare profession has come under intense scrutiny due to its direct involvement in healthcare. In the management of the Covid-19 pandemic, challenges have arisen, notably the high number of patients or their families requesting forced discharge before recovery. The research problem and objectives revolve around the validity of informed refusal with elements of forced discharge at the request of Covid-19 patients from hospitals and the legal consequences for both patients and doctors. The research methodology employed is empirical juridical, with primary data collected through questionnaires at a private hospital in West Jakarta, complemented by references from various sources, including books, journals, and legal regulations. Data analysis was conducted using a qualitative normative approach. The research findings indicate that cases of forced discharge following a Covid-19 diagnosis persist despite the existence of regulations such as the Health Law and the Law on the Prevention of Infectious Diseases. In conclusion, informed refusal does not constitute an agreement but rather a unilateral statement by the patient to the hospital and/or doctor. Consequently, full responsibility lies with the patient, as there are currently no regulatory provisions or prohibitions allowing patients to voluntarily leave the hospital, even if the patient's condition has not been assessed as fully recovered by the hospital or doctor.

Workload and Stress Level in Non-COVID-19 Zoning Nurses at National Central Public Hospital Jakarta

The COVID-19 pandemic has increased the workload for nurses directly handling COVID-19 patients and those working in non-COVID-19 zones. As the number of COVID-19 cases rises, nurses face psychological problems, including stress. This study aimed to determine the relationship between workload and stress levels in a non-COVID-19 zoning ward using a cross-sectional approach and Spearman’s correlation test conducted on 94 nurses at one hospital in Jakarta, Indonesia, selected through simple random sampling. The workload questionnaire with 15 items and the DASS 42 questionnaire were used to measure stress levels. The results indicated that most nurses (73.4%) experienced a heavy workload. Regarding stress levels, most nurses (66%) reported severe stress, while a small number experienced mild (2.1%) and moderate stress (2.1%). The Spearman’s test revealed a significant relationship between workload and stress levels in the non-COVID-19 zoning ward (p-value = 0.001). Based on these findings, hospitals are urged to effectively manage nurses’ workload during the COVID-19 pandemic and implement specific interventions for nurses experiencing occupational stress.

Optimizing Revenue through Inventory Planning, Budget Revision, and Buprenorphine Inventory Turnover Analysis at Jakarta Drug Dependence Hospital Jakarta

This research has the main objective of examining the impact of inventory planning, budget revision, and inventory turnover of buprenorphine drugs on revenue at the Drug Dependence Hospital (RSKO) Jakarta. The research process was conducted in the environment of RSKO Jakarta, focusing on drug addiction. The data used are secondary data obtained from the Finance Department, Planning Department, and Pharmacy Installation of RSKO Jakarta from 2017 to 2021. Data analysis was performed using the path analysis method with the support of SmartPLS software version 3.0. The research results show some significant findings. First, it was found that the inventory planning of buprenorphine drugs has a positive and significant impact on revenue at RSKO Jakarta. Second, budget revisions do not have a significant impact on revenue at RSKO Jakarta. Third, the inventory turnover of buprenorphine drugs has a positive and significant impact on revenue at RSKO Jakarta.

Prevalence and Sensitivity Pattern of Acinetobacter baumannii in the Intensive Care Unit of Private Hospital in Jakarta

Background Acinetobacter baumannii is one of the bacteria that cause nosocomial infections, especially in the intensive care unit. These bacteria can cause infections, including bacteremia, pneumonia, urinary tract infections, surgical site infections, and meningitis. Most of these bacteria are multi-resistant to various antibiotics, impacting cure rates and length of stay. This study aimed to determine these bacteria's prevalence and antibiotic susceptibility patterns in the intensive care unit. Methods This research is descriptive research with a retrospective approach. The data was taken from the antibiotic susceptibility report in the intensive care unit of a private hospital in Jakarta in the period January 2020 – December 2021. The antibiotic susceptibility report was processed using the WHONET 2018 software. Results From 681 specimens examined in the intensive care unit, the prevalence of Acinetobacter baumannii was 28.7%, 80% of which came from respiratory specimens. In the sensitivity test results, only the antibiotic Colistin has the best sensitivity to this bacteria, which is 100% sensitive, while other antibiotics have poor sensitivity. Conclusions Acinetobacter baumannii is the bacteria that causes infection in the intensive care unit, with almost all of them being multi-drug resistant bacteria.

Antecedents of Online Patient Experience of the Hospital Telemedicine Application and Its Consequences

Hospitals had to adjust by offering telemedicine services in response to the COVID-19 outbreak. In contrast to telemedicine, which is developed independently, telemedicine used to have adequate resources. Unfortunately, few studies have been conducted to capture online patient experience from hospital telemedicine services. Therefore, this study attempts to analyze factors that can affect Online Patient Experience (OPX) and assess the impact on Continue Usage Intention (CUI) and Intention to Recommend (ITR). The independent variables that become the antecedents of OPX are Professional Knowledge (PKL), Physician Rank (PRK), Physician Image (PIM), Response Speed (RSP), Service Commitment (SCM), Service Attitude (SAT), and Communication Efforts (CEF). This study is a quantitative survey with cross-sectional data obtained by questionnaire instrument. Respondents were taken purposively using judgment sampling to get those who had received telemedicine services managed by a large group of hospitals in Jakarta. Based on the result, 172 respondents were eligible. The result indicated that all the antecedents studied had a positive and significant relation (p-value &lt; 0,05) with OPX. The results also found that RSP (β = 0.317), SCM (β = 0.216), and PIM (β = 0,186) are the three constructs that play the dominant role. Thus, it is important to create a positive online patient experience so that patients can continue to use teleconsultation services and recommend them to others.

The Effect Of Compensation And Organizational Climate On Job Attitude Mediated By Nurse Motivation At Murni Teguh Sudirman Hospital, Jakarta

Factors related to the quality of a hospital's service are the Job Attitude of health workers with a good nurse's Job Attitude, it can also create good health services for patients, where one of the dimensions of Job Attitude is job satisfaction. Employees who do not get job satisfaction will not achieve psychological satisfaction and eventually negative behavior arises. Conversely, employees who get job satisfaction will work well, enthusiastically, actively, thereby encouraging work passion and being able to perform better. Job Attitude/work attitude can be reflected in 4 indicators, namely leaving/exit, aspirations/voice, loyalty/loyalty, and neglect/neglect. Based on a report from the Human Resources (HR) unit for 2022, in the last 1 year there were 15 out of 66 nurses (± 23%) at Murni Teguh Sudirman Hospital Jakarta who resigned which according to Hasibuan (2012) the turnover should not be more than 10% . Even with the easing of the Covid-19 pandemic, the nurse turnover rate is getting higher. Researchers conducted a search, namely that more and more nurses felt that the compensation provided by the hospital was not in accordance with the workload given, the organizational climate was less supportive in professional development so that it had an impact on decreased work motivation.The purpose of this study was to analyze the effect of compensation and organizational climate on job attitudes mediated by the motivation of nurses at Murni Teguh Sudirman Hospital, Jakarta. This study uses a survey method, which is research that takes samples from a population using a questionnaire as the principal data collection tool to examine the observed symptoms or phenomena. This study uses a causality design based on the cross-sectional time dimension, namely measurements of the independent and dependent variables are carried out at the same time. The unit of analysis is the individual, the data analysis method uses Regression. The number of samples obtained and fulfilling the inclusion criteria was 55 samples. Based on the research results, it was found that compensation, organizational climate and motivation simultaneously had an influence on job attitude, but motivation could not be an intervening variable. The implications of this research in theory will prove the influence of research variables and managerially can improve the compensation system in hospitals.

Deviation of Communication Ethics in Hospitals During the Covid 19 Pandemic Period March 2020 to January 2021 (Case Study at Menteng Mitra Afia Hospital)

This study aims to analyze the Deviation of Communication Ethics seen from Medical Action Management Response and Communication Contravention. In this study, data was collected through an interview method with 10 health workers at Menteng Mitra Afia Hospital and 1 external resource person. The problem in this research is "Ethical Deviation and crisis communication at Menteng Mitra Afia Hospital in Central Jakarta in handling the crisis due to the Covid-19 outbreak which requires speed of action but is highly dependent on the government so that it can become a guide in the future". In this study, data were collected through an interview method with 10 health workers at Menteng Mitra Afia Hospital and 1 external resource person using the Research Paradigm to find out various medical actions in crisis situations, forms or types of ethical deviations, examine management responses and formulate policy models. Then analyze the data obtained in the form of Inductive Analysis, this analysis uses qualitative research methods, induction and case studies. Where one research begins with specific observations and measurements. By starting to detect patterns and regularities,formulate some tentative hypotheses that we can explore and finally develop some conclusions or general theories and concepts. The results of this study are that there are problems with the availability of facilities and infrastructure that have the potential to affect deviations in communication ethics, communication problems originating from human resources, doctors and health workers, and problems with deviations from the service system that have the potential to affect communication ethics

The Influence Of Service Quality And Hospital Image For Patient Satisfaction And Loyalty Dental And Oral Hospital In Jakarta

This study aims to analyze the effect of service quality and hospital image on patient satisfaction and loyalty of Dental and Oral Hospital in Jakarta. The research method used is a quantitative method with primary data from 200 patients who have or are receiving treatment at RSGM Jakarta. Non-probability sampling technique in the form of purposive sampling was used to take samples in this study using a Google Form questionnaire. Analysis of each research variable was carried out with SPSS version 25 and analysis of the influence between variables was carried out using Structural Equation Modeling (SEM). The results of the study stated that there were several hypotheses that had a positive effect including; (H1) The hospital's image of patient satisfaction; (H2) Quality of service for patient satisfaction; (H4) The hospital's image of patient loyalty; (H5) Quality of service for patient loyalty; (H6) The hospital's image of patient loyalty through patient satisfaction; (H7) Quality of service to patient loyalty through patient satisfaction. The conclusion in this study is that patient satisfaction does not have a positive effect on patient loyalty. This research is used as evaluation material for the management of the Dental and Oral Hospital to make various innovations to improve the quality of service and the image of the hospital in order to shape patient satisfaction to gain patient loyalty.

The Effect of Call Center Service Quality On Outpatient Satisfaction Level At St. Carolus Hospital Jakarta

This study aims to analyze The Effect of Call Center Service Quality on Outoutpatient Satisfaction Levels at St. Carolus Hospital Jakarta. The variables studied are Service Quality (Reliability (X1) and Assurance (X2)) and Outoutpatient Satisfaction (Y). The type of research used is the type of research, and the type of data is primary. The technique of collecting research data is through the questionnaire method. Furthermore, the sampling technique used is purposive sampling with 75 respondents. Data analysis in this study used SPSS version 25. The analysis used in this research is a validity test, reliability test, multicollinearity test, heteroscedasticity test, normality test, multiple linear analysis, correlation coefficient analysis test t test, F test, and coefficient of determination (R2). The results of testing and analysis of this study show that the Assurance variable has a significant influence with a sig value of 0.000 &lt;0.05, a t-count value of 4.336 &gt; t-table, and a beta (β) value of 0.308, so it can be concluded that the Assurance variable (X2) has a significant influence significant to the dependent variable (Y), namely outpatient satisfaction.

The Relationship between Exclusive Breastfeeding and Non-Exclusive Breastfeeding on the Incidence of Acute Respiratory Infection in Children aged 0-24 Months at YARSI Hospital Jakarta and its review according to an Islamic perspective

Acute respiratory infections are the most important cause of morbidity in children. Based on the results of the 2018 Riskesdas, the highest category of the population experiencing ISPA was in the age range of 1-4 years (25.8%). The prevalence of ISPA according to the population age group 0 to 11 months was (9.4%). One of the factors that influence the incidence of ARI is the history of breastfeeding. Data obtained from the DKI Jakarta Province Health Profile shows that the coverage of exclusive breastfeeding in 2016 was 48.1% and decreased to 46.60% in 2017 with Central Jakarta City as the region with the lowest percentage of exclusive breastfeeding. The community needs to know the important role of exclusive breastfeeding both from a health perspective and from an Islamic point of view. This research is an analytic observational study using a cross-sectional design conducted on children aged 0-24 months at YARSI Hospital, Jakarta. After conducting a review based on the history of breastfeeding, the results of the Chi Square Test p 0.031 indicated that there was a relationship between exclusive breastfeeding and non-exclusive breastfeeding on the incidence of ARI in children aged 0-24 months at YARSI Hospital, Jakarta. Most mothers give exclusive breastfeeding which is in accordance with Islamic recommendations.

Comparison of Hospitals in Jakarta as Decision-Making Unit for Technical Efficiency and Cost Values: Application of DEA and SFA

The implementation of national health insurance in Indonesia in 2014 as an effort to provide universal health care was known asthe BPJS program. It was named after the responsible agency: Badan Penyelenggara Jaminan Sosial (Health Social Security Administrator). In its early years of implementation, it was indicated that it was not financially optimal because it made a significant financial loss. Therefore, this research was conducted to examine the efficiency level of several hospitals in Jakarta from a technical and cost perspective. The 2018 data was obtained from the Ministry of Health and BPJS. The survey covered 36 hospitals from various regions in Jakarta and was analyzed using Data Envelopment Analysis and Stochastic Frontier Analysis. DEA Solver LV 8 and Frontier 4.1 were the primary tools in this study. There were two significant results of this study. First, most hospitals in Jakarta were efficient in terms of technical efficiency score of DEA (0.73) and SFA (0.52), whereas cost efficiency was mediocre with a score of DEA (0.56) and SFA (0.50). Second, three indices (regional technical efficiency score, regional cost efficiency score, and ownership cost efficiency score) showed similar patterns for DEA and SFA efficiency scores except for the ownership technical efficiency index. It is recommended that the government should immediately improve the centralized national database for hospitals and decide strategic policy to arrange for cooperation between hospitals primarily by sharing their data on hospitals’ load and staff availability.