Ketepatan admisi dan ketepatan hari rawat inap pasien persalinan pervaginam peserta jaminan kesehatan nasional di RSUD Liwa Lampung Barat

DWI MELIASTUTI, dr. Tjahjono Kuntjoro, MPH., Dr.PH; dr. Hanevi Djasri, MARS

2016 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Program Jaminan Kesehatan Nasional di Indonesia menerapkan konsep managed care, salah satu cirinya telaah utilisasi yang bertujuan untuk mengontrol pelayanan dan biaya kesehatan. Salah satu metode telaah utilisasi di rumah sakit adalah Appropriateness Evaluation Protocol (AEP), yang selanjutnya dikembangkan Obstetric Appropriateness Evaluation Protocol (OAEP). Dalam peraturan JKN, persalinan normal diutamakan di FKTP dan penjaminan persalinan normal di FKRTL dapat dilakukan dengan kondisi darurat. Selama 2014, dari 550.000 persalinan di rumah sakit, 250.000 persalinan berkategori normal. Pasien rawat inap JKN di RSUD Liwa tahun 2014 tercatat 457 kasus kebidanan (58%) diantaranya138 persalinan vaginal ringan (30%). Tujuan Penelitian: Mengidentifikasi ketepatan admisi dan ketepatan hari rawat inap serta faktor-faktor yang berhubungan dengan ketepatan admisi dan ketepatan hari rawat inap pasien persalinan pervaginam peserta JKN di RSUD Liwa. Metode Penelitian: Jenis penelitian analitik dengan rancangan cross sectional, menggunakan data rekam medis pasien persalinan pervaginam di RSUD Liwa tahun 2014 (n=127) dengan menggunakan instrumen OAEP. Hasil dan pembahasan: Dari 127 pasien, terdapat enam pasien (4,7%) tidak tepat admisi dan 37 pasien (29,1%) tidak tepat hari rawat inap. Jumlah seluruh hari rawat inap 227, terdapat 54 hari rawat inap yang tidak tepat (23,8%). Hasil uji statistik menunjukkan bahwa tipe admisi secara bermakna ada hubungan dengan ketepatan admisi (p 0,004), tetapi tidak ada hubungan dengan ketepatan hari rawat inap. Jenis pembayaran, pemberi pelayanan medis, dan pemberi pelayanan keperawatan/kebidanan tidak ada hubungan dengan ketepatan admisi dan ketepatan hari rawat inap. Kesimpulan: Ketepatan admisi pasien persalinan pervaginam tahun 2014 sebesar 95,3% dan ketepatan hari rawat inap pada hari pertama 100%, hari kedua 50,7%, hari ketiga 31,2%, hari keempat dan kelima 33,3%. Kata Kunci: Telaah Utilisasi, Ketepatan admisi, Ketepatan hari rawat inap, Appropriateness Evaluation Protocol (AEP), Obstetric Appropriateness Evaluation Protocol (OAEP).

Background: National Health Insurance Program in Indonesia to implement the concept of managed care, one character utilization review that aims to control utilization and costs of health care. One utilization review methods in hospitals is appropriateness Evaluation Protocol (AEP), which further developed Obstetric appropriateness Evaluation Protocol (OAEP). In JKN regulation, normal delivery precedence in FKTP and guarantee normal delivery in FKRTL to do with emergencies. During 2014, 550,000 births in hospitals, 250,000 deliveries categorized as normal. JKN inpatients in hospitals Liwa in 2014 recorded 457 cases of obstetric (58%) diantaranya138 mild vaginal delivery (30%). Objective of the study: Identify appropriateness admission and days of hospitalization and the factors associated with the appropriateness admission and hospitalization of patients vaginal deliveries JKN participants in Liwa hospital. Methods: Type of analytical research with cross sectional design, using medical records of patients in hospitals Liwa vaginal deliveries in 2014 (n=127) and using instruments OAEP. Results and discussion: Of the 127 patients, there were six patients (4.7%) is inappropriate admissions and 37 patients (29.1%) is inappropriate days of hospitalization. The total number of days of hospitalization 227, there are 54 days of hospitalization inappropriately (23.8%). Statistical analysis showed that the type of admission was significantly there is a relationship with the appropriateness of admission (p 0.004), but no association with the appropriateness of days of hospitalization. Type of payment, medical service providers, and service providers of nursing/midwifery no association with the appropriateness admission and days of hospitalization. Conclusion: The appropriateness of patient admission vaginal deliveries in 2014 amounted to 95.3% and the appropriateness of the first day of hospitalization at 100%, 50.7% the second day, the third day of 31.2%, fourth and fifth days of 33.3%. Keywords: Utilization Review, Appropriateness Admission, Appropriateness days of hospitalization, Appropriateness Evaluation Protocol (AEP), Obstetric Appropriateness Evaluation Protocol (OAEP).

Kata Kunci : Utilization Review, Appropriateness Admission, Appropriateness days of hospitalization, Appropriateness Evaluation Protocol (AEP), Obstetric Appropriateness Evaluation Protocol (OAEP)