Manajemen Krisis Pandemi: Evaluasi Kapasitas Rumah Sakit Rujukan COVID-19 di DKI Jakarta

KARINA ORIZA H, Dr. Luthfi Muta'ali, S.Si., MT.

2022 | Tesis | MAGISTER MANAJEMEN BENCANA

Evaluasi diperlukan untuk mengidentifikasi wilayah prioritas penambahan dan faktor yang mempengaruhi jumlah kebutuhan kapasitas RS rujukan COVID-19, terutama saat lonjakan terjadi pada puncak gelombang COVID-19 tahun 2020-2022. Metode kuantitatif diterapkan dengan menganalisis variabel bahaya, kerentanan, dan kapasitas. Analisis data dilakukan dengan analisis risiko melalui penjumlahan skor bahaya dan kerentanan, analisis tabulasi silang skor risiko dengan kapasitas, kalkulasi kebutuhan penambahan kapasitas berdasarkan Bed Occupancy Ratio (BOR) lebih dari 60%, serta analisis regresi linear berganda. Dari 41 kecamatan, diperoleh wilayah dengan risiko COVID-19 tinggi, baik dengan kapasitas sedang maupun tinggi, yang patut diprioritaskan penambahan kapasitasnya, yakni pada 21, 25, dan 6 kecamatan, secara urut saat gelombang pertama, kedua, dan ketiga. Analisis regresi linear berganda terhadap 8 variabel yaitu jumlah kasus aktif, lansia, penderita komorbid, jumlah mobilitas Grab, jumlah area sibuk Google Maps, jumlah penduduk, kepadatan penduduk, dan penduduk vaksin dosis pertama, dilakukan untuk mengidentifikasi kekuatan hubungannya terhadap jumlah kebutuhan tempat tidur isolasi dan ICU saat lonjakan terjadi. Korelasi antara seluruh variabel terhadap kebutuhan tempat tidur isolasi maupun ICU setiap gelombang dikategorikan sangat kuat. Faktor yang berpengaruh signifikan terhadap kebutuhan tempat tidur ICU dan isolasi terbagi menjadi dua skenario. Saat kondisi vaksin belum tersedia, hal yang berpengaruh signifikan adalah jumlah kasus COVID-19 dan jumlah mobilitas Grab, sementara saat vaksin sudah tersedia, hal yang berpengaruh signifikan adalah jumlah lansia. Walaupun demikian, validasi triangulasi sumber menghasilkan bahwa faktor lansia sebagai pengaruh signifkan dalam penentuan jumlah kebutuhan kapasitas RS ketika kekebalan kelompok telah terpenuhi tidaklah valid.

Evaluation is needed to identify additional priority areas and factors that affect the number of capacity requirements for COVID-19 referral hospitals, especially when the spike occurs at the peak of the COVID-19 wave in 2020-2022. Quantitative method is applied by analyzing hazard, vulnerability, and capacity variables. Data analysis was carried out by risk analysis through the addition of hazard and vulnerability scores, cross tabulation analysis of risk scores with capacity, calculation of the need for additional capacity based on Bed Occupancy Ratio (BOR) of more than 60%, and multiple linear regression analysis. Of the 41 sub-districts, there were areas with a high risk of COVID-19, both with medium and high capacity, which should be prioritized for adding their capacity, namely in 21, 25, and 6 sub-districts, respectively during the first, second, and third batches. Multiple linear regression analysis of 8 variables, namely the number of active cases, the elderly, comorbid sufferers, Grab mobility, Google Maps busy areas, the population, population density, and the population of the first dose of vaccination, was conducted to identify the strength of the relationship to the number of isolation and ICU bed needed when the spike occurs. The correlation between all variables on the need for isolation beds and the ICU for each wave is categorized as very strong. Factors that significantly influence the need for ICU beds and isolation are divided into two scenarios. When the vaccine is not yet available, the things that have a significant effect are the number of COVID-19 cases and the number of Grab mobility, while when the vaccine is available, the thing that has a significant effect is the number of elderly people. However, the validation using triangulation showed that the elderly factor as a significant influence in determining the number of hospital capacity needs when group immunity has been met is not valid.

Kata Kunci : Bed Occupancy Ratio (BOR), rawat inap (inpatient), isolasi (isolation), ICU (critical care)