Hospitals In Indonesia Research Articles

Healthcare Quality Received by Insured Patients in Two Indonesian Regional Public Hospitals.

Background: Hospitals are required to improve the quality of health services provided to patients. Purpose: Evaluating and comparing the healthcare quality received by insured patients hospitalized in two Indonesian regional public hospitals. Methods: Secondary data analysis used the 2019 and 2020 Indonesian National Health Insurance e-claim databases of Hospital A and Hospital B. Descriptive and crosstabs analyses were used to determine INA-CBGs diagnoses that were categorized as high volume, high risk, and high cost. Results: The admissions that caused financial loss at the Hospital A were 21.1% in 2019 and 19.8% in 2020, while 30.3% in 2019 and 27.5% at the Hospital B. More than 60% of these admissions were placed in the 3rd class of inpatient wards of the two hospitals. Of these admissions, < 5% at the Hospital A and >5% at the Hospital B were readmitted within 30 days, although more than 90% were previously discharged based on physicians' approval. Conclusions: Inadequate healthcare quality received by insured patients. Hence, an integrated clinical pathways based professional nursing practice model is highly recommended to increase patient outcomes and decrease 30 days hospital readmission rates.

Analysis of water, sanitation, and hygiene facilities using the WASH-FIT approach and its relation to patient satisfaction and maternal mortality at hospitals in Indonesia.

The provision of Water, Sanitation, and Hygiene (WASH) is critical to reducing infection and enhancing the quality of health care services. The study aims to assess WASH facilities in Indonesian hospitals using the Water, Sanitation, and Hygiene Facility Improvement Tool (WASH-FIT) approach and examine their association with customer satisfaction and maternal mortality owing to infection. We utilized the national scale Health Facilities Research dataset in Indonesian hospitals in 2019. WASH status is determined using WASH-FIT indicators, i.e., water, sanitation, waste management, hand hygiene, environmental cleaning, and management services, and then divided into three levels: poor, adequate, and good categories. The majority of hospitals in Indonesia had a good category, i.e., the range of hospitals with a good category was 79-97% nationally, in 6 aspects: water, sanitation, hand hygiene, environmental cleaning, and management services, except for waste management services (13%). Good WASH service facilities are more frequently found in government hospitals than in private and specialized hospitals, while lower-level hospitals tend to have poor levels of all WASH-FIT indicators. There are significant relationships between adequate sanitation services (β = 0.724), adequate and good categories of hand hygiene services (β = 0.712 and 0.866, respectively), environmental cleaning (β = -0.501 and -0.503, respectively), and management (β = -0.645 and 0.446, respectively), with the proportion of maternal mortality owing to infection. Furthermore, there was no relationship between WASH-FIT indicators and patient satisfaction, except for good hand hygiene services (β = 0.453). Despite good conditions in almost all WASH-FIT indicators, the improvement of waste management is urgently needed to improve the WASH services in hospitals in Indonesia, as also found in other developing countries.

Practical Aspects of Providing Intradialytic Parenteral Nutrition for Hemodialysis Patients in Indonesia

This paper conducts a comprehensive literature review on the administration of intradialytic parenteral nutrition (IDPN) for patients undergoing hemodialysis (HD) in Indonesia. The objective is to assess the current status and challenges associated with IDPN in the country and propose potential strategies for enhancement. The review, encompassing articles published between 2013 and 2023 from databases such as PubMed, Scopus, and Google Scholar, exposes significant risks and the prevalence of malnutrition, particularly protein-energy wasting (PEW), among patients undergoing HD. This patient cohort often necessitates nutritional therapy, and IDPN emerges as a viable option for both prevention and definitive treatment. However, detailed data on malnutrition among HD patients in Indonesia are limited. Challenges include a shortage of nutrition experts in kidney care, low patient adherence to dietary advice, and the inability of Indonesian hospitals to provide IDPN to malnourished hemodialysis patients. The non-uniform cost coverage by the National Health Insurance further complicates matters, despite consumable costs for HD being uniform across all hospitals. The payment system by BPJS does not accommodate the provision of parenteral IDPN with varying prices, as listed in the e-catalog by the national public procurement agency. To offer IDPN to patients, hospitals must achieve cost-efficiency within their HD units, or they risk financial losses. Currently, IDPN is exclusively administered to HD patients with acute conditions in an inpatient setting. A recommendation for policymakers is to explore the adoption of distinct tariffs for HD patients undergoing outpatient care, particularly those managing complex conditions such as PEW. This approach can contribute to improved nutritional support for hemodialysis patients in Indonesia.&#x0D;

Determinants of Digital Adoption Capability for Service Performance in Indonesian Hospitals: A Conceptual Model

Determinants of Digital Adoption Capability for Service Performance in Indonesian Hospitals: A Conceptual Model

Value-Based Employer Branding to Attract and Retain Millennial Doctors at Hospitals in Indonesia

Purpose: In the face of competition, hospitals must attract and retain the best talent, such as millennial doctors. This study seeks to assess the dimensions of employer branding that influence recruiting and retaining millennial doctors. Theoretical Framework: This study is grounded in the theoretical concepts of employer branding and generational work values. It specifically examines the influence of employer branding on job choice and retention among millennials, integrating theories from marketing, human resource management, and generational studies. Design/Methodology/Approach: The research adopts a quantitative methodology, surveying 265 millennial-generation doctors across several hospitals in Bandung, Indonesia. Data were collected through structured questionnaires focusing on various dimensions of value-based employer branding. Statistical analysis was used to evaluate the data and draw conclusions. Findings: The research found that Indonesian hospitals are generally perceived as having good value-based employer branding. Key dimensions that emerged as most critical for attracting and retaining millennial doctors include social, development, and application values. These findings suggest a distinct set of priorities and preferences among millennial medical professionals. Research, Practical &amp; Social Implications: The study's results have implications for hospital management and policymakers. It highlights the importance of aligning employer branding strategies with the values and expectations of millennial doctors. Practically, it guides hospital leadership in policy formulation and establishing work practices that resonate with this demographic, potentially improving recruitment and retention rates. Originality/Value: This research contributes to the existing literature on employer branding and generational work values, specifically within the healthcare sector in Indonesia. Its novel focus on millennial doctors in Bandung hospitals provides fresh insights, enhancing an understanding of how digital media and value-based branding can be leveraged in human resource strategies.

Conventional vs. hangback technique in bilateral lateral rectus recession for basic intermittent exotropia: a retrospective study in Indonesian tertiary eye hospitals

Conventional vs. hangback technique in bilateral lateral rectus recession for basic intermittent exotropia: a retrospective study in Indonesian tertiary eye hospitals

Analisis Faktor Keberhasilan Pengobatan Penderita TB-Paru Di RSU Imelda Pekerja Indonesia Tahun 2023

To achieve recovery, TB sufferers must have self-confidence about how serious the condition and symptoms of the disease are and the impact on daily life. So that TB sufferers are able to carry out treatment for a long period of time and TB sufferers have the confidence to recover from the disease. The aim to be achieved in this research is to analyze the success factors for treatment of pulmonary TB sufferers at the Imelda Workers Indonesian RSU in 2023.&#x0D; This type of research uses a descriptive analytical survey with a cross sectional design. The population in this study were all category I pulmonary tuberculosis patients who visited the Imelda Workers Indonesian Hospital from January to September 2023, a total of 118 people were sampled using the accidental sampling method while the sample was 91 people. Data analysis was carried out using univariate, bivariate and multivariate analysis.&#x0D; Based on the results of the chi-square test, it is known that patient success influences knowledge, family support, supervision of taking medication and support from health workers with a value of p = 0.001, meaning that there is an influence of knowledge, family support, supervision of taking medication and support from health workers on the success of TB treatment. Lungs. From the results of the multivariate analysis, it is known that the most influential variable in this study is the medication monitoring variable with an OR value of 15.104.&#x0D; The conclusion in this study is that medication-taking supervisors are the dominant factor influencing the success of pulmonary TB treatment at the Indonesian Imelda Workers RSU. The advice given is in the form of instructions for using a daily insulated medicine box, using a smart calendar during treatment which is brought to you every time you come for treatment and in the current digital era, using the mHealth application is also very helpful in providing TB information notifications and reminders to take medication regularly for sufferers and PMOs.

COVID-19 infection prevention and control for hospital workers in Indonesia.

The outbreak of SARS-CoV-2 in 2019 led to a global pandemic, posing unprecedented challenges to healthcare systems, particularly in hospitals. This study explores the intricacies of strategies employed for preventing and controlling COVID-19 in Indonesian hospitals, with a particular focus on the protocols, challenges, and solutions faced by healthcare professionals. Using a cross-sectional analysis, we examined 27 hospitals and uncovered disparities in their preparedness levels. During our investigation, we observed the robust implementation of infection prevention measures, which encompassed stringent protocols, adequate ventilation, and proper use of personal protective equipment. However, shortcomings were identified in areas such as surveillance, mental health support, and patient management. This study underscores the importance of addressing these gaps, suggesting tailored interventions, and continuous training for healthcare staff. Effective leadership, positive team dynamics, and adherence to comprehensive policies emerge as pivotal factors. Hospitals should strengthen weak areas, ensure the ethical execution of emergency protocols, and integrate technology for tracking and improving standard operating procedures. By enhancing the knowledge and skills of healthcare workers and maintaining strong management practices, hospitals can optimize their efforts in COVID-19 prevention and control, thereby safeguarding the wellbeing of professionals, patients, and communities.

A holistic approach to geriatric telemedicine: developing and implementing the Shinta workflow and communication model for senior health services in Indonesian hospitals

A holistic approach to geriatric telemedicine: developing and implementing the Shinta workflow and communication model for senior health services in Indonesian hospitals

Navigating Uncertainty: How Dynamic Capabilities Drive Competitive Advantage in Indonesian Hospitals

Navigating Uncertainty: How Dynamic Capabilities Drive Competitive Advantage in Indonesian Hospitals

Role of electromedical personnel in ensuring the availability of electromedical device in hospitals

Objective: To examine the validity and reliability of a questionnaire used to assess the role of electromedical personnel in ensuring the availability of electromedical equipment for healthcare services in Indonesian hospitals, both during normal times and the COVID-19 pandemic. Methodology: This study involved the participation of 70 electromedical personnel from government hospitals in Surabaya and Yogyakarta, which are central and referral hospitals for COVID-19 patients. The questionnaire consisted of 16 questions that represented various skills required by electromedical personnel, including maintenance, repair, testing, monitoring, calibration, inspection, safety, fitness for use testing, assembly, installation planning, and review of electromedical devices. To evaluate the validity and reliability of the questionnaire, statistical measures such as Pearson product-moment correlation and Cronbach's alpha coefficient were utilized. The Smart PLS 3.0 program was employed to conduct these tests. Results: The reliability test demonstrated that all valid questions in the questionnaire were reliable, as indicated by a Cronbach's alpha coefficient of 0.936. Among the authorities assessed, the highest coefficient values for the role of conducting inspection of device performance (0.813) and the role of conducting safety inspections (0.821). Conclusion: The questionnaire is a valid and reliable research instrument for measuring the role of electromedical personnel in ensuring the availability of electromedical equipment in hospitals.

Top Management Characteristics, Performance Measurement Systems Design and Strategic Change of Reformed Public Hospitals in Indonesia

This study examined the impact of top management characteristics on strategic change in public hospitals in Indonesia, focusing on the mediating role of performance measurement system (PMS) design. Questionnaires were distributed to 157 top managers from Indonesian regional public hospitals undergoing reform. The findings indicate that younger, short-tenured top managers with business administration backgrounds are likelier to lead the strategic change, specifically the shift from a defender to a prospector strategy. Additionally, PMS design partially mediates the relationship between top managers' age, educational background, and strategic change. However, no significant mediation effect of PMS design was observed in the relationship between top managers' tenure and strategic change. These results suggest that healthcare organizations should consider their top managers' characteristics when planning and implementing strategic change. The role of PMS design in facilitating strategic change should also be carefully evaluated, especially when considering younger and less-tenured top managers as change leaders.

Detection of Enteropathogens in Human Immunodeficiency Virus and Non-Human Immunodeficiency Virus-Infected Children with Acute Diarrhea in an Indonesian Tertiary Hospital Using Multiplex Real-Time Polymerase Chain Reaction.

Diarrhea is one of the leading causes of mortality in children living in developing countries. The etiology of acute diarrhea in each healthcare center varies depending on place, time, and population. This study aimed to identify pathogen patterns in human immunodeficiency virus (HIV)-infected and non-HIV children suffering from acute diarrhea, using multiplex real time reverse transcriptase polymerase chain reaction (RT-PCR), in an Indonesian tertiary hospital. This cross-sectional study was conducted at Dr. Cipto Mangunkusumo National Hospital from March 2019 to April 2020. The study showed that multiplex RT-PCR results were positive in 58.9% of the specimens, with more positive results in HIV-infected children than in non-HIV-infected children (70% vs. 54.7%). Altogether 72 enteropathogens were detected from all specimens. Enteropathogens in non-HIV children with acute diarrhea consisted of bacteria (70.6%) and viruses (29.4%) with a predominance of enteroaggregative Escherichia coli (25.4%), followed by Campylobacter spp. (11.8%), enteropathogenic E. coli (9.8%), Norovirus GII (7.8%), and Clostridium difficile (7.8%). Enteropathogens in HIV-infected children consisted of viruses (57.1%), bacteria (28.6%), and parasites (14.3%) comprising Norovirus GII (24%), Cryptosporidium spp. (14.3%), Campylobacter spp. (14.3%), Norovirus GI (14.3%), and Astrovirus (14.3%). Cryptosporidium spp. was the only parasite found in this study and was found only in HIV-infected children. In non-HIV children with acute diarrhea, most pathogens were invasive bacteria, while in HIV-infected children, more viral and parasite infections occurred, primarily caused by opportunistic pathogens. The pattern of enteropathogens can help clinicians determine further examinations and appropriate empirical antimicrobial therapy for the patient.

Digital capabilities of health workers to use electronic medical records: Digital maturity self-assessment in Indonesian hospitals

Digital skills influence the successful implementation of information systems and electronic medical records (EMR) in health care facilities. The Ministry of Health measures digital maturity levels to identify gaps in improving digital transformation, including the digital skill of health workers in hospitals in 2022. The digital maturity in all hospitals in Indonesia was measured quantitatively based on the 7 components of Hospital Information Systems Maturity Model (HISMM). The low response rate was anticipated with a number of efforts such as outreach, capacity building and a circular letter from the Ministry of Health. Internal and external consistency was conducted to ensure the quality of the self-assessment. Specifically, the level of digital skills was analysed by calculating the average score of one components of digital maturity, namely Human Resources, Skills and Use of Hospital Information Systems. There are 11 parameters for assessing the level of digital literacy, perceived usefulness and encouragement to use RME in hospitals. All parameters were assessed using a 5-point scale and were analysed quantitatively. The response rate was 31.9% (973 out of 3,052 hospitals) where overall average of digital maturity level was 2.6. Hospital type A, higher accreditation status and located in Jawa-Bali has relatively high maturity level compare to others. The digital skills of health workers in hospitals are relatively high, with the majority already using the hospital information system. This was align with the perception of the ease of use and usefulness of using a hospital information system. Even though there have been several digital health champions in the hospital, health workers have not been fully involved in the process of developing information systems in hospitals and not many hospitals have utilized HIS to assess the performance of health workers. It is clearly that health workers in hospitals are capable and quite aware of the use of digital technology. However, their role needs to be increased to support the development of appropriate digital technology.

Outpatient Length of Stay (OLOS) Analysis at Edelweis Hospital using Machine Learning Algorithm

Patient satisfaction may be impacted by the length of stay (LOS) that a patient perceives during an outpatient clinic visit. With the increasing competition in the healthcare industry and patients’ demands for higher-quality care, hospitals are focusing more on enhancing their quality from a clinical and management perspective. The Indonesia Ministry of Health has established minimum standards (SPM) for healthcare services that all Indonesian hospitals are required to meet, particularly the hospital waiting time indicator, which must be no longer than 60 minutes. Furthermore, there is a term in healthcare called outpatient length of stay (OLOS) that is not yet specified in SPM. OLOS is defined as the amount of time a patient spends in a hospital from the moment he or she arrives at the administration until he or she leaves. Edelweis Hospital is one of a private hospital located in Bandung that has established a 2-hour maximum LOS standard for its outpatient services. Providing accurate information about LOS may increase patient satisfaction by reducing uncertainty. However, effective methods to predict the length of stay for outpatients (OLOS) in Pediatric Clinics are seldom known. This study’s goal is to design a prediction model for OLOS based on patient characteristics and several other clinical attributes. By identifying the attributes that affected OLOS, the model will help hospital make relevant decisions. We used machine learning algorithms such as random forest, decision tree, k-nearest neighbor (kNN), adaboost, and gradient boosting to design prediction models for OLOS. From the validation set, random forest has the highest accuracy rate with a value of 99.3%, followed by decision tree and gradient boosting were 99.2% each. Furthermore, machine learning models were used to determine the importance of attributes. These models could eventually be used alongside with real-time IT system data to provide accurate real-time estimates of OLOS at the Pediatric Clinic.

Experiences of discharge planning practices among Indonesian nurses: A qualitative study.

Discharge planning is vital to preventing hospital readmission, and nurses play a key role. The COVID-19 pandemic has posed challenges to hospital services that may persist or recur. Therefore, exploring nurses' experiences with discharge planning practices before and during this pandemic is crucial. This study aimed to describe the experiences of discharge planning practices among nurses at an Indonesian tertiary hospital before and during the COVID-19 pandemic. A qualitative descriptive study design was used. Telephone interviews were conducted to collect data among ten nurses from March 2019 and continued between December 2020 and August 2021. Content analysis was done for data analysis. Two main themes emerged: 1) Challenges in discharge planning practices and 2) Perceived discharge planning as a professional responsibility. Implementing the inpatient ward fusion policy as part of the hospital's pandemic response presented greater challenges to nurses in coordinating care and performing discharge planning. Fear of COVID-19 infection, social distancing measures, and using personal protective equipment also affected how nurses delivered discharge education during the pandemic. However, the nurses sensed a greater responsibility to ensure the maintenance of essential components of discharge planning procedures to guarantee the patient's capability to perform self-care at home. Nurses viewed discharge planning practices as their responsibility and continued them during the pandemic despite facing various challenges. In addition to recognizing the significance of nurses' roles in discharge planning practices and overall patient care, it is crucial to anticipate and address the diverse working patterns and styles among healthcare professionals in unified wards, ensuring effective coordination.

The Effect of Anthropometric Shoes on Lactic Acid Reduction in Nurses: A Mixed-Methods Study from Indonesia.

The mobilization characteristics of nurses' work, such as standing, walking, and transferring patients for a long time, can increase the risk of musculoskeletal disorders. Repetitive activities nurses perform can cause foot problems such as discomfort and insecurity, characterized by increased lactic acid levels. Anthropometric shoes are specifically designed to reduce complaints on nurses' feet. This study aimed to determine the effect of individual anthropometric shoes on lactic acid levels in nurses at the hospital. This study used a mixed-method study design. This study involved 71 nurses in the quantitative study and 15 nurses in the qualitative study. Nurses in Emergency Room, Central Surgical Installation, Inpatient Room, Intensive Care Unit, and Outpatient Installation were randomly selected using a stratified random sampling technique. The instruments used were the Accutrend Lactacyd tool, demographic questionnaire and interview questionnaire. Bivariate data analysis was using Statistical Package for Social Sciences (SPSS) and qualitative data analysis using thematic analysis. This mixed-method study shows that anthropometric shoes can reduce nurses' lactic acid levels. In the quantitative study; there was a significant difference in lactic acid levels of nurses before and after using anthropometric shoes with the average results of measuring lactic acid levels, namely pre-test (22.48 mg/dL) and post-test (16.27 mg/dL), with a p-value (0.000). The qualitative study data revealed positive results related to increased nurse knowledge, positive views on the effect of shoes on nurse performance, and the impact of using anthropometric shoes in providing comfort and safety, such as decreased muscle fatigue and pain. The findings of this study highlight the effect of individualized anthropometric shoes on lactic acid levels in nurses in Indonesian hospitals. It is essential to conduct further research and evaluate the results in a broader setting to ensure that anthropometric shoes can directly affect lactic acid levels.

Cross-culture adaptation and validation of Indonesian version of the postpartum depression literacy scale

Mental health illiteracy has been found to be a risk factor in a large number of disorders. The purpose of this study was adapting cross-culturally the Postpartum depression literacy scale (PoDLiS) questionnaire in Indonesian pregnant and postnatal women. There were three stages involved in this study: translation, cultural adaptation, and validation of an instrument. A cross-sectional study was carried out on a convenient sample of pregnant and postpartum women who visited the prenatal and pediatric clinics of an Indonesian general hospital. Construct validity and reliability testing was conducted using factors analysis, confirmatory factors analysis, and convergent and discriminant validityThe scale’s reliability was determined using internal consistency. Within their own factor, the bulk of the elements had a high factorial weight (&amp;gt;.50). The model with seven factors shows excellent fit indices after confirmatory factor analysis (CFI=0.94; TLI=0.98; RMSEA=0.056 [95% CI 0.011-0.095]). Because seven components have average variance extracted (AVE &amp;gt;50), there is convergent validity. Because the AVE coefficients for the seven components are greater than the correlation coefficients for each dimension, each dimension possesses discriminant validity. The PoDLiS structure is suitable for pregnant and postpartum women from various cultures, particularly Indonesia.

Green hospital practices on patient’s satisfaction in Indonesian hospital: medical specialist department case investigation

PurposeThis study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department factors from patients’ perspectives as service consumers.Design/methodology/approachThis research is a type of nonintervention empirical research that uses an open survey to explore the views and experiences of users of specialist medical department services. The targeted population is hospital patients included in the top five national PERSI (Indonesian Hospital Association) Award 2022 Green Hospital Category, with a total number of respondents of 572 people. This study uses the partial least square-structural equation modeling analysis method with the SmartPLS application.FindingsPatient flow problems generally affect the quality of eco-friendly health services, except for the waiting time problem, which affects service quality. It should be understood as a top priority for patients to receive services from medical specialists without risking time as a core service aspect from the patient’s perspective. In addition, all variables in eco-friendly hospital services affect patient satisfaction, except in the case of visits to specialist medical departments, which do not affect medical support services and hospital practices that are responsive to the delivery of care services resulting from medical support services that are inseparable in integrated services as well as health care following medical ethics.Originality/valueThis study has a novelty in understanding the implications of green practice in determining patient satisfaction in medical specialist department as the epicenter of hospital services and the main object of assessment for the quality of hospital services.

Characteristics of pressure injuries among geriatric patients at an Indonesian tertiary hospital: a cross-sectional study

BACKGROUND Pressure injury develops due to sustained pressure at the bony prominence of the skin and tissues. Geriatric patients often have multiple comorbidities, predisposing them to pressure injury. Data on the characteristics of the geriatric with pressure injuries are still limited. This study aimed to report the characteristics of geriatric patients with pressure injuries admitted at a tertiary hospital in Indonesia.&#x0D; METHODS This cross-sectional study used medical records of geriatric patients admitted with all stages of pressure injuries consulted to the Department of Dermatology and Venereology at a tertiary hospital in Indonesia between January 2017 and April 2021. Pressure injuries were classified based on the 2019 National Pressure Injury Advisory Panel guideline.&#x0D; RESULTS 39 patients presented with varied pressure injury characteristics. The sacral region was the most reported site (36%), with stage 2 pressure injury being the most commonly found stage in the patients (74%). Interestingly, 22% of the patients had pressure injuries found on the atypical sites due to prolonged surgery or the pressure of medical devices. More than half of the patients used conventional dressings (51.3%). Immobility was found in 35.9% of the patients due to being bedridden.&#x0D; CONCLUSIONS No characteristics were found as a significant risk factor for pressure injury formation during or outside the admission period. However, a history of surgery might be related to pressure injury formation during admission.