Analisa Kesiapan Implementasi Clinical Pathway Sebagai Penunjang Proses Jaminan Kesehatan Nasional Di Rumah Sakit : Literature Review

NILA FIRDAUSI N, Nuryati, S.Far., M.P.H

2021 | Tugas Akhir | D4 MANAJEMEN INFORMASI KESEHATAN

Latar Belakang: Pemerintah berupaya memberikan pelayanan kesehatan terbaik dengan program jaminan kesehatan. Sebagai bentuk tranparasi pelayanan, beberapa rumah sakit telah menggunakan clinical pathway sebagai dokumen berbasis bukti untuk mengendalikan biaya. Dalam praktiknya masih banyak rumah sakit yang terkendala dengan adanya implementasi clinical pathway yang dapat mempengaruhi proses jaminan kesehatan. Tujuan: Mengevaluasi implementasi clinical pathway sebagai penunjang proses jaminan kesehatan nasional di Rumah Sakit. Metode: Analisa deskriptif dengan jenis penelitian Systematic Literature Review. Pencarian literature menggunakan metode prisma yang dilakukan pada bulan Juni sampai Oktober 2021. Sumber data diperoleh dari GoogleScholar, PubMed, Cohrane Library, Science direct, Scopus dan jurnal publikasi lainnya dari manual search engine. Analisa menggunakan unsur compare, contrast, critize, synthesize, dan summarize. Hasil: Hasil pencarian referensi didapatkan 6 artikel lolos eligibilitas dan memenuhi kriteria. Kendala implementasi CP dominan pada faktor Man yakni kepatuhan rendah akibat beban kerja tinggi. Hasil analisa menunjukkan kriteria penilaian CP dapat mempengaruhi jaminan kesehatan antara lain : kelengkapan pendokumentasian, kesesuaian pelayanan, kualitas form CP, ketrampilan petugas, manajemen yang baik. Framework perencanaan manajemen implementasi CP dan problem solving dirancang menggunakan metode PDSA (Plan, Do, Study, Act). Kesimpulan: Kendala pada beban kerja tinggi dan kepatuhan rendah akibat belum dilakukannya perhitungan beban kerja dan sosialisasi. Kendala lain muncul karena perlu evaluasi rutin dan mengopimalkan SDM yang sudah ada.

Background: The government has tried to provide the best health services through the health insurance program. As a form of service transparency, many hospitals have used clinical pathways as evidence-based documentation to control costs. In practice, there are still many hospitals that are restricted in implementing clinical pathways that can affect the health insurance process. Objective: To evaluated implementation of clinical pathways to support the national health assurance process in hospitals. Method: Descriptive analysis with Systematic Literature Review is type of this research. The literature searched using the prism method that was been accsessed out in June until October 2021. The data sources were obtained from GoogleScholar, PubMed, Cohrane Library, Science direct, Scopus and other published journals from manual search engines. The analysis used elements of compare, contraste, critize, synthesize, and summarize. Results: Reference search results found 6 articles that passed the eligibility criteria. The main obstacle in implementing CP is the Man factor, that is low compliance due to the large workload. The results of the analysis show that the criteria for assessing clean production can affect health insurance, including: completeness of documentation, suitability of services, quality of clean production model, skills of officers, good management. The planning and problem solving framework framework is designed using the PDSA (Plan, Execute, Study, Act) method. Conclusion: workload constraints and low compliance based on workload calculations and socialization. Another obstacle appeared because it needs periodic evaluation and optimization of existing human resources.

Kata Kunci : Clinical Pathway, Jaminan Kesehatan Nasional, Quality Framework