Regional Public Hospital Research Articles

The Impact of Malnutrition on the Increasing Risk of Bronchopneumonia Among Under Five-Year children

Background: Bronchopneumoniabecomes, one of the infectious diseases, is causing mortality in under five-year children. One of the risk factors of pneumonia in under five-year children is nutritional status. One of the types of pneumonia is the inflammation occurred on the tip of the bronchioles. Aim: This research aimed to observe the relation of nutritional status and bronchopneumonia among under five-year children. Method: This research had been approved by the Research Ethics Committee in Universitas ‘Aisyiyah Yogyakarta. This control case research was conducted in the Public Regional Hospital of Panembahan Senopati, Bantul Yogyakarta. The study used 86 respondents (under five-year children) aged 12 to 60 months suffering from bronchopneumonia and 86 respondents (under five-year children) with pneumonia with the same ages as the previous one. The respondents were found using the random sampling technique listed in this research. The data were collected from the secondary data from the medical record. Results: The chi-square statistical test result showed that the under five-year children with the malnutrition had three times higher risk of suffering bronchopneumonia than those with good nutritional status (p-value: 0.001 and 95% CI: 1611-5.578). Keywords: Nutritional Status, Bronchopneumonia, Under Five-Year Children

ANALISIS WASTE MENGGUNAKAN METODE VALUE STREAM ANALYSIS TOOLS PADA PROYEK PEMBANGUNAN INSTALASI GAWAT DARURAT RSUD PIDIE JAYA

Construction project is a long process activity where the researcher finds obstacles which cannot be separated from the used resources. Everything in the projects which may add the needed costs called by the term waste. In the project implementation of Regional Public Hospital (IGD) construction project in Pidie Jaya, there was a significant delay in the project schedule which could be caused by several things which may lead the project into waste construction. This is the main reason why does the Value stream analysis tools (VALSAT) method was used during the research in order to identify the cause of occuring waste. This goal of this research is to identify the waste which potentially occure during the Regional Public Hospital (IGD) project in Pidie Jaya. Besides, this research is also determine the grade and tool waste by using the VALSAT. Based on the literature review, there are 8 wate categories which could be reviewed based on materials, labor and tools used during the project. The identified waste data are obtained by the interview conducted to 4 respondents and questionaire with 15 respondents and handed out to contratctors. Based on the result and data processing which using descriptive analysis, it can be concluded that the most influential waste on the project was waste waiting and waste overprocessing which obtain a value of 5 and cause the excessive effects on the project. Furthermore, the result of the grade analysis and tool waste determination by using the VALSAT method produced a process Acivity Mapping to analyze the occuring waste that occurs with a total score of 135.

Antibiotic Consumption and Resistance Pattern of 3 Coagulase-Negative Staphylococci Species: An Ecological Study

A group of coagulase-negative staphylococci (CoNS) was historically classified as a nonpathogenic bacteria. Over the last few decades, nosocomial infections caused by CoNS as opportunistic pathogens have increased and become one of the major nosocomial pathogens. The aim of this study was to identify the relationship between the use of an antibiotic agent for CoNS in Bali’s regional public hospital and the development of antibiotic resistance during 3 years period. This study was a retrospective ecological study of antibiotic resistance and antibiotic consumption secondary data collected prospectively. It was conducted over a three years period of inpatient data. Susceptibility of CoNS to antibiotics was obtained from the hospital antibiogram of all isolates from 2017 to 2019. Sensitivity results in antibiogram were based on the standards provided by the Clinical and Laboratory Standards Institute (CLSI) with the disk diffusion method. Antibiotic consumption in DDDs/100 bed-days. The relationships between DDDs/100 bed-days of each antibiotic and rates of antibiotic resistance of each resistant strain of CoNS were tested using Spearman correlation and logistic regression. There was no significant correlation between antibiotic consumption (DDD) and the percentage of antibiotic resistance among the three CoNS species (p>0.05). However, this study found there was an inverse relationship between DDD and antibiotic resistance in Staphylococcus hominis species (OR = 0.063; CI [0.004-0.915]; p=0.043). We conclude that no significant correlation between antibiotic consumption and antibiotic resistance of the 3 CoNS species. There needs to be further research to identify antibiotic consumption, antibiotic resistance and other factors affecting antibiotic resistance.

Medical service quality, patient satisfaction and intent to revisit: Case study of publichub hospitals in the Republic of Korea.

This study aimed to construct and test structural equation modeling of the causal relationship between quality of healthcare, patient satisfaction, and intent to revisit perceived by patients using regional hub public hospitals. In this study, data of 2,951 outpatients and 3,135 inpatients were collected using the "2018 Regional Hub Public Hospital Operational Evaluation." A structural equation model was used to understand the relationship between patient satisfaction and intent to revisit, and bootstrap analysis was performed. In the direct effect, outpatients were presented in the order of the physician's practice service, the hospital's environment, and patient satisfaction. Inpatients were in the order of the physician's practice service and, medical staff's kindness and consideration,; patient satisfaction was shown in this order. In the indirect effect, the outpatients were presented in the order of physician's practice service, medical staff's kindness and consideration, and hospital's physical environment. Inpatients were introduced in the order of medical staff's kindness and consideration, nurse's practice service, physician's practice service, and patient satisfaction. Regional hub public hospitals need high-quality medical services and efforts from all departments to treat patients with sincerity to improve patient satisfaction and increase intent to revisit.

Caring Professional Attitude Of nursing In Palliative Nursing Care

Background: Caring is an important part of nursing care. Caring is a behavior that interacts emotion with the patient's response.
 Purpose: This research aims to determine the caring behavior of nurses in providing palliative nursing care
 Methods: The research employed qualitative method (FGD), using hermeneutic phenomenology approach (n=7, chemotherapy nurses) and interview guide instruments. The data analysis used was Interpretative Phenomenology Analysis and has obtained ethics worthy of KEP UNISA Yogyakarta: 1342/KEP-UNISA/IX/2020 and KEP Yogyakarta Regional Public Hospital: 41/KEP/RSUD/X/2020.
 Results: Based on the results of the study, there are 2 major themes of professional caring attitudes of nurses in providing palliative care, that are the emotional closeness of nurses to patients and their families and an attitude full of empathy with a sense of humor.
 Conclusion: Nurses always provide nursing care in a professional caring manner to patients and their families by prioritizing comfort, emotional closeness and humor.

The Risk Factors of Coronary Heart Disease and its Relationship with Endothelial Nitric Oxide Synthase

BACKGROUND: Coronary heart disease (CHD) is the leading cause of death and start with injury to the endothelium of a coronary artery. The common feature of endothelial dysfunction is a decrease of nitric oxide (NO) bioavailability that regulated by endothelial NO synthase (eNOS) activity. AIM: The aim of our study was to study the relationship between risk factors of CHD patients with the level of eNOS. METHODS: Thirty-seven outpatients in cardiology department of the regional public hospital diagnosed as CHD were included in our study. Thirty healthy individuals were included as the control group. Risk factors of CHD were identified according to anamnesis and laboratory finding. eNOS was measured by ELISA methods. RESULTS: Endothelial NOS levels were significantly higher in the CHD when compared to the controls (p < 0.05). The most dominant risk factor for CHD is overweight, and followed by dyslipidemia, smoking, hypertension, history of CHD, and diabetes mellitus. eNOS in CHD patients who had one risk factor was 37.598 ± 0.1541 ng/ml, two risk factors 42.154 ± 22.329 ng/ml, three risk factors 25.329 ± 6.083 ng/ml, four risk factors 22.483 ± 4.022 ng/ml, and five risk factors 15.994 ± 4.774 ng/ml. There were significant differences in the average eNOS levels based on the number of risk factors (p < 0.05), and a tendency that more risk factors in CHD patients, the lower the average level of eNOS. CONCLUSION: In our study, eNOS levels showed highly significant relation with CHD and related to the number of risk factors those the CHD patients had.

Australian nurses' suggestions for the management of violence in the workplace: 'The people who make the policy are not the people on the floor'.

To ascertain nurses' perceptions about, and suggestions for, management solutions to workplace violence perpetrated by patients. Violence towards nurses from patients in the workplace is high in Australia. There is a need for good management responses, and experienced nurses can provide logistical suggestions about effective strategies. This study uses an exploratory qualitative design. Focus group interviews were undertaken with 23 nurses working in a regional public hospital in Queensland, Australia. The COREQ research reporting checklist was followed, and the qualitative data were transcribed and thematically analysed manually and byNVivo. Policy implementation, training, staff movement, seclusion, debriefing and a full reporting cycle were identified as central themes. Workplace violence management happens before, during and after a violent event. Weak processes undermine management; staff training on de-escalation is needed. Affected staff need freedom to move from the ward. Better medical orders should be in place before an event. A full debriefing and feedback cycle are required, along with easier reporting processes. Nursing management can reduce violence by ensuring better institutional support, consistent follow-up and complete feedback procedures. Legal support, follow-up mechanisms and staff training in de-escalation are key points.

The Effect of Work Satisfaction and Leadership on Patient Safety Culture in Nurses at Lagaligo Regional Public Hospital I East Luwu Regency

Realization of the application of patient safety and efforts to fulfill employee job satisfaction through employee development have not met the targets set in the strategic goals for the achievement of hospital quality indicators. This study aims to analyze the effect of job satisfaction based on the dimensions of job characteristics, rewards, work environment, relationship with management and leadership based on directive, supportive, participatory, achievement-oriented dimensions of patient safety culture in nurses at Lagaligo I Hospital, East Luwu Regency. This type of research is a quantitative study using an analytic observational study with a cross sectional study design. The sample used was 119 respondents to nurses at Lagaligo I Hospital, East Luwu Regency. The results showed that there was an influence of job characteristics, rewards, work environment, relationship with management on the variable job satisfaction of nurses on patient safety culture, there was an influence of directive, supportive, participatory, achievement-oriented dimensions on leadership variables on patient safety culture, and job satisfaction of nurses. jointly influence the culture of patient safety in Regional General Hospital (RSUD) I Lagaligo, East Luwu Regency. Therefore, it is hoped that the hospital will pay more attention to a safe and comfortable work environment and for leadership it is expected to set standards for developing competency through trainings, solving any existing problems quickly and responsively.

Analysis of Factors Associated With Variability and Acidosis of the Umbilical Artery pH at Birth.

Background: Perinatal asphyxia is a significant contributing factor for neonatal morbidity and mortality. The aim of this study was to investigate the clinical factors associated with umbilical artery pH variability and fetal acidosis at birth.Methods: This is a single center cross-sectional study in a public regional hospital in southeastern Spain from January to December 2019. The reference population was 1.655 newborns, final sample of 312 experimental units with validated values of umbilical cord blood pH.Results: Factors such as gestational age at term (: 7.26 ± 0.08--at−term: 7.31 ± 0.05, p: 0.00), primiparity (: 7.24 ± 0.078-: 7.27 ± 0.08, p: 0.01), induced labor (: 7.24 ± 0.07-: 7.26 ± 0.081, p: 0.02), vaginal delivery (:7.25 ± 0.08-:7.27 ± 0.07, p: 0.01), and prolonged dilation duration (: 7.22 ± 0.07-: 7.27 ± 0.08, p: 0.00), expulsion duration (: 7.23 ± 0.07-: 7.26 ± 0.08, p: 0.01), and total labor duration (: 7.23 ± 0.07-: 7.27 ± 0.08, p: 0.00) are associated with a decrease in umbilical artery pH at birth. However, only three factors are associated with acidosis pH (<7.20) of the umbilical artery at birth: the induction of labor [OR: 1.74 (95% CI: 0.98–3.10); p: 0.04], vaginal delivery [OR: 2.09 (95% CI: 0.95–4.61); p: 0.04], and total duration of labor [OR: 2.06 (95% CI: 1.18–3.57); p: 0.01].Conclusions: Although several factors may affect the variability of umbilical artery pH at birth by decreasing their mean values (gestational age, primiparity, induced labor, vaginal delivery and prolonged: dilation duration, expulsion duration and total labor duration), only induction of labor, vaginal delivery and total duration of labor are associated with an acidosis (<7.20) of same.

An integrated multicomponent care model for men affected by prostate cancer: A feasibility study of TrueNTH Australia.

ObjectiveTo evaluate the feasibility of implementing an integrated multicomponent survivorship care model for men affected by prostate cancer.MethodsUsing a single arm prospective cohort study design, men with prostate cancer were recruited from two regional public hospitals in Australia for a 6‐months program that provided information and decision support, exercise and nutrition management, specialised clinical support, and practical support through localised and central care coordination. Carers of the men were also invited to the program. Data were collected from multiple sources to evaluate: (1) recruitment capability and participant characteristics; (2) appropriateness and feasibility of delivering the specific intervention components using an electronic care management tool; and (3) suitability of data collection procedures and proposed outcome measures.ResultsOf the 105 eligible men, 51 (consent rate 49%) participated in the program. Of the 31 carers nominated by the men, 13 consented (consent rate 42%). All carers and 50 (98%) men completed the program. Most (92%) men were newly diagnosed with localised prostate cancer. All men attended initial screening and assessment for supportive care needs; a total of 838 episodes of contact/consultation were made by the intervention team either in person (9%) or remotely (91%). The intervention was implemented as proposed with no adverse events. The proposed outcome measures and evaluation procedures were found to be appropriate.ConclusionsOur results support the feasibility of implementing this integrated multicomponent care model for men affected by prostate cancer.

Analysis of the Level of Patient Satisfaction on Out-Patient Installation Based on Hospital Minimum Service Standard in Dr. Pirngadi Regional Public Hospital Medan City

Minimum service standard is intended to provide guidelines for the regions in implementing the planning implementation and control as well as supervision and accountability for the implementation of hospital minimum service standards. Hospital minimum service standard includes types of service indicators and standards for achieving hospital service performance, one of which is out-patient services. According to The Decree of the Minister of Health of the Republic of Indonesia No. 560/Menkes/SK/IV/2003, that out-patient services are patient services for observation, diagnosis, treatment, medical rehabilitation and other health services without being hospitalize. The research is conducted on 100 out-patient respondents at the Dr. Pirngadi Regional Public Hospital in Medan City. This research used quantitative descriptive method, the analysis carried out using statistical tests of the data collected, using the help of the SPSS programme. The result of the research found that patients are satisfied with the hospital's minimum service standard with the dimensions of service quality summarized by the hospital service standard indicators based on government regulations. Keywords: Service Standard, Patient Satisfaction.

Mean Platelet Ratio, Neutrophil to Lymphocyte Ratio, and the Risk of Febrile Seizures in Children Aged 6–59 Months

BACKGROUND: The occurrence of febrile seizure is affected by numerous factors, but some studies indicated that inflammatory cytokines might contribute to the development of febrile seizure. In resource limited settings, complete blood count (CBC) might serve as potential indices for inflammatory response. AIM: The aim of the present study was to determine the role of mean platelet ratio and neutrophil to lymphocyte ratio (NLR) on the risk of febrile seizures in children aged 6–24 months and 25–59 months at S.K. Lerik Regional Public Hospital in Kupang City, East Nusa Tenggara, Indonesia. METHODS: A case-control study was carried out in 104 patients (52 in the case group and 52 in the control group) aged 6–59 months. The CBC tests were taken on the first visit in the emergency room at S.K. Lerik Regional Public Hospital. RESULTS: Our study found that the odds for experiencing febrile seizure in younger children aged 6–24 months were 3.281 (95% confidence interval 1.470, 7.324) times as large as the odds for older children aged 25–59 months. There was a significant but weak correlation between the types of febrile seizure or fever and age of children (r = 0.279; p = 0.012). CONCLUSIONS: Children aged 6–24 months had higher risk of developing febrile seizure, compared to children aged 25–59 months. Further, for each unit decrease in NLR, we expected a 0.883 decrease in the odds for febrile seizures in the case group, compared to control group.

Management sewakadharma nurses in wangaya regional public hospitals

The research was intended to know the management of sewakadharma nurses important to be carried out. To explore the process of implementing the management of sewakadharma and to discuss the implications of the implementation of nurse management sewakadharma on nursing and patient satisfaction at RSUD Wangaya Hospital, Denpasar City. The results show to provide sincere service following srada bhakti nurses to patients selflessly as a form of getting closer to God. To achieve patient safety and health, serving patients according to their obligations as a nurse will get the reward (pahala) according to good deeds which are conducted. It can lighten the burden on the patient and can even speed up the patient's recovery. Taking into account the biological, psychological, social and spiritual care of nursing services. Serving patients with sincerity, enthusiasm, and love. This accelerates the patient's healing process. The sincere empathy with professional services so that the patient's recovery rate increases.

The effect of information technology innovation on good public governance: a case study in Indonesia

This study touches upon fraud prevention at the Regional Public Hospital (RSUD) in Sumatra Region in 2021. The authors used a quantitative approach to conduct the study. This research is based on a survey of 421 respondents, namely the personnel of the Medical Recording Department, the Internal Inspection Unit, the Medical Committee, the Coder, and the Accounting Department at RSUD. Sumatra was chosen to be the region under research because, according to data from the Indonesia Corruption Watch (ICW), Sumatera Region has 6 provinces where most cases of fraud have been reported in government hospitals. The data analysis technique uses Structural Equation Modelling (LISREL). The results of the study show that: (1) information technology innovation has a positive and significant impact on public governance; (2) fraud prevention has a positive and significant impact on public governance; (3) information technology innovation has a positive and significant impact on public governance in terms of fraud prevention.

Improving the leptospirosis disease burden assessment by including ambulatory patients from outpatient departments: a cross-sectional study

Background: In Sri Lanka, the disease burden of leptospirosis is estimated based on a routine notification system, which is predominated by patients ill enough to be hospitalized. The notification system does not function well with ambulatory patients in outpatient departments (OPDs). The objective of this study was to determine the proportion of leptospirosis in an OPD setting in a regional public hospital in Sri Lanka to provide further estimation of disease burden. Methods: This study was conducted in the OPD of the Rathnapura Provincial General Hospital from August to September 2017. Suspected leptospirosis patients were recruited based on standardized criteria and tested using the microscopic agglutination test and quantitative polymerase chain reaction. The number of OPD patients was compared with the reported patient numbers with leptospirosis from the hospital during the same period as the denominator, and the 95% confidence interval was calculated for the proportions using Poisson distribution. Results: During the study period, of 2,960 fever patients presenting to the OPD, 33 (1.1%) were suspected to have leptospirosis; 8/33 suspected (22.3%) cases were confirmed as being due to leptospirosis. There were 82 notifications of leptospirosis cases from hospital inpatients during the same period, none from the OPD. The total missing proportion from the surveillance system was 28.6% (95% CI, 19.4-40.4%). Among OPD patients, 12 (36.4%) had been given antibiotics from a primary care center prior to the OPD visit. No OPD patient was admitted to the hospital for inward care. Conclusions: More than 25% of cases of leptospirosis were not identified because they were not sick enough to be admitted nor subjected to routine leptospirosis diagnostic testing.These data have public health implications if the sources of leptospirosis transmission are to be controlled.

An Analysis of the Online Registration System at Caruban Hospital in 2020

Backgorund.Information technology can support medical record services in hospitals, especially in patient registration places. The implementation of this technology can be done by applying an online registration system. This system will be able to save waiting time for patients to register&#x0D; Purpose. This study aims to determine the implementation of the online registration system at Caruban Regional Public Hospital, Madiun District&#x0D; Method. This study uses a qualitative method with a case study approach. The sampling technique used was purposive sampling with an informant of 6 registration officers and 20 patients.&#x0D; Result.. The online registration system starts in July 2020. The results of the interview show that the system has not been optimally used. Some of the problems are that many patients are elderly so they are not technologically literate, geographic location of the patient causes difficult signals, the patient's electronic devices, and the lack of socialization from registration officer to patients. Patients know only from brochures or banners, so patients do not know the steps to use the system in detail&#x0D; Conclussion. The online registration system at Caruban Regional public Hospital is not optimal because there are several problems, such as the large number of elderly patients, the reluctance of the community to try to use the system and the lack of socialization

11. PREVALENCE OF HYPERTENSIVE HEART DISEASE COMPARED TO CORONARY ARTERY DISEASE BASED ON ECHOCARDIOGRAPHY FINDINGS IN BANDUNG REGIONAL PUBLIC HOSPITAL FROM SEPTEMBER 2020-DECEMBER 2020

Background: Hypertension was defined as SBP 140 mmHg and/or DBP 90 mmHg. The prevalence according to Indonesia Family Life Survey-5, among males and females were 31.0% and 35.4%. Hypertension could cause cardiac manifestations, including Hypertensive Heart Disease (HHD) and Coronary Artery Disease (CAD). HHD was a heart response to the afterload burden on the left ventricle caused by the progression of arterial pressure and total peripheral resistance, characterized by increased left ventricular mass associated with left ventricular hypertrophy (LVH), which was recommended echocardiography by ESH/ESC 2013 Guideline. This research was conducted to find out the prevalence of HHD compared to CAD based on echocardiography in Bandung Regional Public Hospital. Methods: This is a descriptive study. We conducted a search of echocardiograph from all inpatients and outpatients that came first time to the cardiology clinic, from September 2020-December 2020. The patients included all gender and age. Data collected included Posterior Wall (PW) thickness, Inter Ventricular Septum (IVS) thickness and Left Ventricle Ejection Fraction (LVEF). LVH was defined if the PW or IVS thickness was greater than 11 mm as measured by M-mode echocardiography. LVH with LVEF &gt;55% was interpreted as HHD. Results: A total of 205 patients were analyzed. There were 75 (36.58%) diagnosed with HHD, 81 (39.52%) diagnosed with CAD, and 49 (23.90%) diagnosed with others. From 75 patients with HHD, 36 (48%) were males and 39 (52%) were females. Conclusion: The prevalence of HHD was 36.58%, with 48% males and 52% females. This study matched with the IFLS-5 findings.

The Effect of Drug Types, Facility, and Infrastructure against the Waiting Times at the Pharmacy Installation of Caruban General Hospital

Backgorund. Waiting time is one indicator of pharmacy service. The initial study with 5 patients in the pharmacy installation, of Caruban Hospital, concluded that all patients stated that they were tiring and queued for a long time. This study aims to examine whether there is an effect of type of drug, facility, and infrastructure to waiting time to get pharmacy service at Caruban Regional Public Hospital. The Design of this research used quantitative research The sampling technique was purposive sampling with total sample are 100 respondents. The statistical analysis used dummy regression. The average waiting time for pharmacy service is about 60 minutes for concocted drug, Average waiting time for packaged drugs is 46.5 minutes, and mixed drug is 69.5 minutes. 72 respondents stated that the infrastructure was in the good category and the rest said it was moderate.The results of the dummy regression analysis concluded that facilities and infrastructure had a significant effect simultaneously on the waiting time for services. The partial test results showed that the significance value for the facilities and infrastructure variable was 0.000, and for the variable dosage forms in mixed prescriptions it had a significance value of 0.023. The means variable is the variable that most influences the waiting time for the prescription service. The types of drugs in the prescription and waiting room infrastructure have a significant effect simultaneously on the length of queuing for drugs.

DRP EVALUASI DRUNG RELATED PROBLEMS (DRPs) ANTIBIOTIK PADA PASIEN PNEUMONIA RAWAT INAP ANAK RUMAH SAKIT UMUM DAERAH DELI SERDANG

Background: Infection is one of the top ten diseases in Indonesia, so that antibiotic therapy is quite high. The increasing use of antibiotics may lead to an increase in the use of irrational antibiotics. Drug Related Problems (DRPs) are events that are not expected from the patient's experience or are suspected to be due to drug therapy so that they have the potential to interfere with the desired healing success.&#x0D; Objective: This study aims to determine the number of occurrences of DRPs which include dosage inaccuracy, namely under and over dose, indication without drug, drug without indication, potential interactions and inaccuracy of drug selection in inpatient pneumonia treatment for children at the Deli Serdang Regional public hospital. In 2019&#x0D; Method: This study is retrospective in which data is obtained through secondary data in the form of patient medical records for the period January-December 2019 with a cross-sectional study design. The data collection technique was in the form of total sampling, obtained 50 samples that fit the inclusion criteria. &#x0D; Results: Drung Related Problems (DRPs) research that occurred in the under-dose category of drugs (4.0%), and excessive drug doses (2.0%) and no DRPs (94.0%). This shows that the role of pharmacists is important in monitoring patient drug therapy to minimize the occurrence of DRPs.

PENGARUH PENDELEGASIAN WEWENANG DAN BIROKRASI TERHADAP KEPUASAN KERJA PEGAWAI RSUD (SURVEY PADA RUMAH SAKIT UMUM DAERAH KABUPATEN CIREBON, KOTA CIREBON, KABUPATEN INDRAMAYU,DAN KABUPATEN KUNINGAN)

The background of this research is based on the phenomenon that local government-owned hospitals, the focus is on serving the community in the field of Health, so, chasing profit is not the top priority for hospitals, as a result sometimes slow service, facilities, and administration are also slow. This study aims to analyze the influence of Delegation of Authority, and Bureaucracy, on The Job Satisfaction of Employees of Regional Public Hospitals, both simultaneously and partially. This study describes causal (causal) relationships between variables and tests research hypotheses. Data determination techniques are done by probability sampling technique. Analysis method using SEM (StructureEquation Modelling). The results of the study obtained that there is a significant influence of delegation of authority and bureaucracy terhadap kepuasan kerja Employees by 66,89 %. There is a positive and significant influence, either directly or indirectly from the Delegation of Authority to employee job satisfaction (39,57 %), and bureaucracy to employee job satisfaction (27,32%)&#x0D; Keyword : Division of Work, Delegation of Authority, Bureaucracy, Officer Job Satisfaction, and Officer Performance