The Health Care Referral System is a service system that controls the delegation of authority and responsibility for health problems which is carried out reciprocally vertically or horizontally, in the sense of a unit with less capability to a more capable unit. The purpose of this study was to determine the implementation of the health service referral system in terms of regulations, health personnel resources and infrastructure. This research is a systematic review (Systematic Literature Review). The data synthesis process was carried out by comparing 15 literatures that met the quality assessment as well as inclusion and exclusion criteria with the database sources used, namely, Google Scholar, Pubmed, ScienceDirect. The data is processed and presented in tabulated form. The results showed that several countries such as Indonesia, Iran, Northern Tanzania, Riyadh, Ghana, Zambia and Hoduras from the articles reviewed used a referral system starting from the basic level (Primary), secondary level (Secondary) and tertiary level (Tertiary). Judging from the three aspects of the implementation of the health service referral system reviewed, it shows that there are problems in its implementation, including; the regulatory aspect found only 2 literatures that discussed regulations in the implementation of the referral system, the aspect of health personnel resources was found to be unavailability of health workers in health services causing patient referral and infrastructure aspects found obstacles in inadequate infrastructure resulting in referral.Keywords: implementation, referral system, health care AbstrakSistem Rujukan Pelayanan Kesehatan merupakan sistem pelayanan yang mengendalikan pelimpahan wewenang serta tanggung jawab atas permasalahan kesehatan yang dilakukan secara timbal balik secara vertikal ataupun horizontal, dalam makna dari unit yang berkemampuan kurang ke unit yang lebih, terjangkau dan rasional. Tujuan penelitian ini untuk mengetahui implementasi sistem rujukan layanan kesehatan dilihat dari aspek regulasi, sumber daya tenaga kesehatan dan sarana prasarana. Penelitian ini merupakan tinjauan sistematis (Systematic Literature Review). Proses data sintesis dalam penelitian ini dilakukan dengan cara membandingkan 15 literature yang memenuhi penilaian kualitas serta kriteria inklusi dan ekslusi dengan sumber database yang digunakan yaitu, Google Scholar, Pubmed, ScienceDirect. Data diolah dan disajikan dalam bentuk tabulasi. Hasil penelitian menunjukan beberapa negara seperti Indonesia, Iran, Tanzania Utara, Riyadh, Ghana, Zambia dan Hoduras dari artikel yang direview menggunakan sistem rujukan yang dimulai dari tingkat dasar (Primary), tingkat menengah (Secondary) dan tingkat tersier (Tertiary). Dilihat dari ketiga aspek implementasi sistem rujukan layanan kesehatan yang direview menunjukkan adanya permasalahan dalam pengimplementasiannya diantaranya; aspek regulasi ditemukan hanya 2 literature yang membahas regulasi dalam pengimplementasian sistem rujukan, aspek sumber daya tenaga kesehatan ditemukannya ketidaktersediaan tenaga kesehatan di layanan kesehatan sehingga menyebabkan terjadinya rujukan pasien dan aspek sarana prasarana ditemukannya hambatan pada infrastruktur yang tidak memadai sehingga menyebabkan terjadinya rujukanKata Kunci: implementasi, sistem rujukan, layanan kesehatan
: KEK merupakan salah satu masalah kurang gizi yang disebabkan oleh asupan gizi yang tidak seimbang sehingga menyebabkan kekurangan energi dalam waktu yang cukup lama. Tujuan kegiatan pengabdian masyarakat ini yaitu meningkatkan daya guna pangan lokal singkong sebagai pangan lokal sebagai alternatif makanan tambahan bagi ibu hamil yang mengalami KEK. Kegiatan ini dilaksanakan di wilayah kerja Puskesmas Parung Panjang, dihadiri 26 peserta terdiri dari bidan dan kader. Metode yang digunakan yaitu metode ceramah, diskusi dan melatih bidan dan kader dalam membuat PMT Cookies untuk ibu hamil yang mengalami KEK. Berdasarkan hasil pengetahuan sebelum dan setelah diberikan pelatihan terdapat peningkatan yang signifikan (p<0.05), dengan rata-rata skor diawal yaitu 38 menjadi 98. Selama kegiatan berlangsung peseta terlihat sangat antusias mengikuti kegiatan ini, yang dibuktikan dengan peserta sangat aktif pada sesi diskusi. Pengetahuan yang meningkat akan mendukung peningkatan keterampilan peserta dalam membuat PMT, keterampilan peserta dalam membuat PMT cookies sudah sangat baik.
Every country needs to develop Universal Health Coverage (UHC) to promote optimal levels of public health. But in realizing UHC, there must be some problems, one of which is fraud. Based on the Corruption Eradication Commission (KPK) data, potential fraud is detected from 175,774 claims of Advanced Referral Health Facilities (FKRTL) or worth Rp. 440 billion until June 2015. This review article describes the incidence of fraud in health care facilities. Out of a total of 12,736 cases of fraud, readmission occupies the most cases of fraud, which is 4,827 cases or 37.9%.
Electronic Integrated Antenatal Care (e-iANC) was built as a web-based application to assist midwives in recording Antenatal Care (ANC) data including Patient Registration; Anamnesis; Physical Examination; Laboratory Test, Screening of Risk Pregnancy; Communication, Information and Education; Treatment and follow-up; Patient Disposition. To ensure e-iANC becomes a safe system, security system testing was needed. Our goals were to test the security system by using the Open Web Application Security Project (OWASP). It was conducted in computer laboratory at Universitas Esa Unggul Jakarta in August 2017. The OWASP detect include Injection, Broken Authentication and Session Management, Cross-Site Scripting (XSS), Insecure Direct Object References, Security Misconfiguration, Sensitive Data Exposure, Missing Level Access Control, Cross Site Request Forgery (CSRF), Using Known Vulnerable Components, Unvalidated Redirects and Forwards. The results indicated the risk level of e-iANC was the low category in the aspect of Cross-Domain JavaScript Source File Inclusion, Private IP Disclosure, XSS Protection Not Enabled Web Browser.
The quality of diagnosis code is very important in the area of clinical data management, billing costs, and other matters relating to health care services. However, still often found inaccurate diagnosis codes resulting from a clinical coder. For this reason, it is necessary to conduct a clinical coding audit to improve the quality of the diagnosis code. In Indonesia some hospitals never conducted clinical coding audits because there are no instruments available for doing that. Fatmawati General Hospital never conducted a clinical coding audit. The purpose of this study is to design a clinical coding audit instrument in Fatmawati General Hospital. This is "Research & Development" study, the Delphi technique used to validate the clinical coding audit instrument design. Subjects of this study were clinical coder experts who had at least 5 years of experience as a clinical coders and the object of this research is clinical coding audit instrument. The results of the first round Delphi technique, the seven coding quality elements of the audit instrument were approved by all clinical coder experts and used in second round questionnaires. The results of second round 2, is known that the encoding quality elements recommended for use are reliability, completeness, timeliness, accuracy, relevance, and legibility. Element definition is not used because 80% of clinical coder experts didn't recommend it. This clinical coding audit instrument needs to be considered for use in conducting clinical coding audits in health care services. However, previously this instrument need to be tested for its implementation.
Sultan Thaha Saifuddin Hospital is heading towards the implementation of SNARS-1. The first phase of accreditation in 2016 uses the 2012 version with only four services (SKP, HPK, KPS, PPI) so that there is no medical record review assessment as in the MIRM 13.4 SNARS-1 assessment element. Currently, Sultan Thaha Saifuddin Hospital must adjust the medical record review with the MIRM standard on SNARS-1. Field Study Practices at the Sultan Thaha Saifuddin Hospital, Tebo Jambi Regency on April 1, 2019 to April 20, 2019 with the aim of knowing the implementation of medical record reviews based on the SNARS-1 accreditation standard. Methods of data collection are carried out by observation and interviews using observation sheets and interview guides. The results of the field study practice are: there is a team responsible for reviewing medical records called the medical record committee; there is an SPO regarding medical record review; review of medical records using an open, closed, and recapitulation review form; There was an increase in the quality of medical records based on the results of reviews between period 1 and period 2, namely from 89.65% to 96.8% on timeliness, an increase from 95.4% to 97.6% in legibility, and an increase from 97, 6% to 99.2% on completeness of medical records. The implementation of reviewing medical records at Sultan Thaha Saifuddin Hospital is in accordance with the applicable SPO. The implementation of the review is also in accordance with the SNARS-1 assessment elements.Keyword: medical record, completness, Accreditation Assessment SNARS-1 AbstrakRSUD Sultan Thaha Saifuddin sedang menuju implementasi SNARS-1. Akreditasi tahap pertama tahun 2016 menggunakan versi 2012 baru sebatas empat pelayanan (SKP, HPK, KPS, PPI) sehingga belum ada penilaian review rekam medis seperti pada elemen penilaian MIRM 13.4 SNARS-1. Saat ini, RSUD Sultan Thaha Saifuddin harus menyesuaikan review rekam medis dengan standar MIRM pada SNARS-1. Praktik Belajar Lapangan dilakukan di RSUD Sultan Thaha Saifuddin Kabupaten Tebo Jambi pada tanggal 01 April 2019 sampai 20 April 2019 dengan tujuan untuk mengetahui pelaksanaan review rekam medis berdasarkan standar akreditasi SNARS-1. Metode pengumpulan data dilakukan dengan observasi dan wawancara menggunakan lembar observasi dan panduan wawancara. Hasil praktik belajar lapangan yaitu: terdapat tim yang bertanggung jawab pada review rekam medis disebut panitia rekam medis; terdapat SPO tentang review rekam medis; review rekam medis menggunakan form review terbuka, tertutup, serta rekapitulasi; terdapat kenaikan kualitas rekam medis berdasarkan hasil review antara periode 1 dan periode 2 yaitu dari 89,65% menjadi 96,8% pada ketepatan waktu, terjadi kenaikan dari 95,4% menjadi 97,6% pada keterbacaan, serta terjadi kenaikan dari 97,6% menjadi 99,2% pada kelengkapan rekam medis. Pelaksanaan review rekam medis di RSUD Sultan Thaha Saifuddin telah sesuai dengan SPO yang berlaku. Pelaksanaan review juga telah sesuai dengan elemen penilaian SNARS-1.Kata Kunci: rekam medis, kelengkapan, akreditasi SNARS-1
Hasil Survei Demografi Kesehatan Indonesia tahun 2012 AKI 359 per 100.000 kelahiran hidup naik dibandingkan tahun 2002 sebesar 307 per 100.000 kelahiran hidup. Angka tersebut berbanding terbalik dengan pencapaian cakupan pelayanan pada periode yang sama, yaitu angka pencapaian cakupan periksa kehamilan (92%-98%); persalinan oleh tenaga kesehatan (66%-83%); persalinan di fasilitas pelayanan kesehatan (40%-63%). Saat ini pencatatan hasil pemeriksaan antenatal masih sangat lemah, sehingga data tidak dapat dianalisa untuk peningkatan kualitas pelayanan antenatal. Penelitian bertujuan merancang prototype Sistem Informasi Pelayanan Antenatal Terpadu (SIPAT). Perancangan SIPAT dengan metode System Development Life Cycle (SDLC). Wawancara mendalam dan Focus Group Discussions (FGD) dilakukan untuk memperoleh data yang diperlukan. Prototipe SIPAT berbasis web dirancang dengan menggunakan PHP 5 dan Javascript, Firebird database, and Apache web server. Prototype SIPAT berbasis web dirancang bagi bidan dalam melakukan pencatatan ANC terpadu secara elektronik yang meliputi registrasi pasien; anamnesis dan pemeriksaan fisik; laboratium; penatalaksanaan kebidanan termasuk KIE; diagnosis dan saran tindak lanjut. Output berupa informasi kesehatan individual skor risiko kehamilan metode Poedji Rochjati dan grafik pertumbuhan BB bumil berdasarkan IMT sebelum hamil. Informasi kesehatan aggregat berupa Kohort Ibu dan laporan PWS ANC. Kesimpulan penelitian SIPAT menghasilkan informasi kesehatan bumil individual dan agregat yang diperlukan bidan dalam manajemen ANC terpadu.
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