Perbandingan Kualitas Pelayanan Poli Bedah Anak RSUP Dr. Sardjito Sebelum dan Selama Pandemi COVID-19

SEFRINA ASKHANISSA PRAMESTI, Prof. dr. Gunadi, Sp. BA., Subsp., DA (K); dr. Guardian Yoki Sanjaya, M. Health. Info.

2024 | Skripsi | PENDIDIKAN DOKTER

Latar belakang : Pandemi COVID-19 mempengaruhi berbagai sektor di dalam kehidupan, salah satunya kesehatan. Pelayanan poli bedah anak berperan dalam pemberian konsultasi mengenai kondisi anak yang membutuhkan tindakan bedah, kontrol pascaoperasi, maupun pemberian obat atau penentuan tindakan. Pelayanan rawat jalan lanjutan atau follow-up outpatient berkaitan dengan penurunan readmisi dalam 30 hari. Pandemi COVID-19 telah menyebabkan penurunan frekuensi tindakan operasi bedah anak di berbagai negara berkembang, termasuk Indonesia. Suatu pelayanan kesehatan hendaknya berkualitas untuk menjamin kepuasan maupun kesembuhan pasien. 

Tujuan : Mengetahui kualitas pelayanan poli bedah anak RSUP Dr. Sardjito sebelum dan selama terjadinya outbreak pandemi COVID-19 dari segi persepsi pasien maupun status klinis (laju readmisi 30 hari dan infeksi pascaoperasi). Metode : Penelitian ini menggunakan metode comparative cross-sectional study dan mixed-method (kuantitatif dan kualitatif). Subjek penelitian adalah pasien pediatrik (0-18 tahun) sebelum pandemi COVID-19 (n = 24) dan selama pandemi COVID-19 (n = 32). Data penelitian didapatkan dengan pengisian kuesioner SERVQUAL untuk mendapatkan data kualitas pelayanan berdasarkan persepsi pasien dan data rekam medis untuk mengetahui persentase status klinis pasien (laju readmisi 30 hari dan kejadian infeksi pascaoperasi). Analisis data dilakukan dengan uji SPSS normalitas data (Shapiro-Wilk) dan Mann-Whitney.

Hasil : Tidak terdapat perbedaan signifikan (p> 0,005) pada nilai persepsi dan ekspektasi pasien selama masa pandemi dibandingkan dengan sebelum pandemi COVID-19. Tidak ditemukan perbedaan signfikan pada laju readmisi 30 hari dan kejadian infeksi pascaoperasi selama masa pandemi COVID-19. Nilai kesenjangan antara persepsi dan ekspektasi pasien pada keempat dimensi (tangibles, assurance, reliability, dan responsiveness) tidak menunjukkan hasil signfiikan, sedangkan dimensi “empathy” menunjukkan hasil signifikan selama periode pandemi COVID-19 (p = 0.042). 

Kesimpulan : Kualitas pelayanan di poli Bedah Anak RSUP Dr. Sardjito termasuk baik, namun masih terdapat kesenjangan negatif yang signifikan (menunjukkan ketidakpuasan pasien) pada dimensi “empathy”.

Title : Comparison of the Quality of Pediatric Surgical Services at Dr Sardjito Hospital Before and During the COVID-19 Pandemic Background: The COVID-19 pandemic affects various sectors in life, one of which is health. Pediatric surgical services play a role in providing consultations regarding children's conditions that require surgical treatment, post-operative control, as well as administering medication or determining action. Advanced outpatient services or outpatient follow-up are associated with a decrease in readmissions within 30 days. The COVID-19 pandemic has caused a decrease in the frequency of pediatric surgical operations in various developing countries, including Indonesia. A health service should be of high quality to ensure patient satisfaction and recovery. 

Objective: To determine the quality of pediatric surgical services at RSUP Dr. Sardjito before and during the COVID-19 pandemic outbreak in terms of patient perception and clinical status (30-day readmission rate and postoperative infections). Method: This research uses comparative cross-sectional study and mixed-method (quantitative and qualitative) methods. Research subjects were pediatric patients (0-18 years) before the COVID-19 pandemic (n = 24) and during the COVID-19 pandemic (n = 32). Research data was obtained by filling out the SERVQUAL questionnaire to obtain service quality data based on patient perceptions and medical record data to determine the percentage of patient clinical status (30-day readmission rate and incidence of postoperative infections). Data analysis was carried out using the SPSS data normality test (Shapiro-Wilk) and Mann-Whitney. 

Results : There was no significant difference (p> 0.005) in patient perception and expectation scores during the pandemic compared to before the COVID-19 pandemic. No significant differences were found in the 30-day readmission rate and the incidence of postoperative infections during the COVID-19 pandemic. The gap value between patient perceptions and expectations in the four dimensions (tangibles, assurance, reliability, and responsiveness) did not show significant results, while the "empathy" dimension showed significant results during the COVID-19 pandemic period (p = 0.042). Conclusion: The quality of service at the Pediatric Surgery Polyclinic, RSUP Dr. Sardjito is considered good, but there is still a significant negative gap (indicating patient dissatisfaction) in the "empathy" dimension.  

Kata Kunci : Poli bedah anak, pandemi COVID-19, kualitas pelayanan, persepsi, ekspektasi, laju readmisi, infeksi pascaoperasi.