Nasution, Sri Lestari Ramadhani
Department of Public Health, Universitas Prima Indonesia, Medan, Indonesia and COE for Degenerative Disorders and Integrated Health, Universitas Prima Indonesia, Medan, Indonesia

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HOME-BASED CARE AND LIFE QUALITY FOR ELDERLY COPD PATIENTS: A MIXED-METHODS EVALUATION IN A COASTAL HOSPITAL Siregar, Winda Sari; Girsang, Ermi; Nasution, Sri Lestari Ramadhani
Journal of Gender and Social Inclusion in Muslim Societies Vol 7, No 1 (2026): Journal of Gender and Social Inclusion in Muslim Societies (JGSIMS)
Publisher : Pusat Studi Gender dan Anak

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/jgsims.v7i1.29008

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a significant global health challenge, particularly among the elderly population, who are at high risk of exacerbations and have limited mobility. Home care services have emerged as an innovative strategy to improve the accessibility and sustainability of care outside of hospital settings. This study aims to analyze the effectiveness of a home care program on the quality of life and medication adherence of elderly patients with COPD at RSAL Dr. Komang Makes Belawan. This study employed a mixed-methods design with a sequential explanatory approach. The quantitative phase involved 35 respondents selected via a total sampling approach. The instruments used included the VQ11 questionnaire to measure quality of life and the MMRC scale to assess dyspnea severity. The qualitative phase was conducted through in-depth interviews with patients, families, and healthcare providers to explore subjective experiences during the intervention. Data analysis integrated inferential statistical tests and thematic analysis to obtain a comprehensive understanding. Findings demonstrated significant clinical improvement, with patients’ dyspnea levels decreasing from an average MMRC Grade 3 to Grade 1 post-intervention. Quality of life scores (VQ11) improved from the moderate/severe category to the good/very good category. Additionally, the frequency of monthly exacerbations decreased drastically, from an average of 3 to 1. Qualitative data reinforced these findings by identifying three main themes: increased psychological safety, professionalism in healthcare services, and strengthening the family’s role in monitoring treatment adherence. The home-based care program proved effective in improving the quality of life and treatment adherence among elderly COPD patients. This success was driven by integrating routine clinical monitoring at home and empowering families as the primary support system. This study recommends home-based care as a standard model in the management of long-term chronic diseases to optimize patient health outcomes and healthcare system efficiency.
SWOT ANALYSIS OF THE SERVICE DEVELOPMENT STRATEGY FOR PUTRI HIJAU TYPE II HOSPITAL IN MEDAN Syahna, Priscilia Ade; Girsang, Ermi; Nasution, Sri Lestari Ramadhani
Journal of Gender and Social Inclusion in Muslim Societies Vol 7, No 1 (2026): Journal of Gender and Social Inclusion in Muslim Societies (JGSIMS)
Publisher : Pusat Studi Gender dan Anak

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/jgsims.v7i1.29010

Abstract

The hospital industry faces intense competition and rapid technological changes. Military-affiliated hospitals, such as Putri Hijau Type II Hospital in Medan, must balance their dual role of serving both military personnel and the general public under the national health insurance scheme while maintaining a competitive edge. This study aims to analyse the strategic position of Putri Hijau Type II Hospital and formulate service development strategies using a SWOT-based analytical approach. A mixed-methods case study design was employed. Data were collected through interviews with management, field observations, and structured questionnaires. Analysis was conducted using Internal Factor Evaluation (IFE), External Factor Evaluation (EFE), and the Internal-External (IE) Matrix. The research findings indicate that the hospital holds a strong internal position (IFE score: 2.86) and adequate external responsiveness (EFE score: 2.51). Positioned in Quadrant I (Grow and Build), the institution is recommended to pursue an aggressive strategy. Key strengths include clinical professionalism and military discipline, while primary weaknesses involve infrastructure constraints and service wait times. To maintain market dominance, the hospital must prioritise digital transformation and infrastructure modernisation to synergise its humanistic care with operational efficiency.
PREDICTORS OF MIDWIFE PERFORMANCE IN LOW BIRTH WEIGHT PREVENTION: A MULTI-FACTORIAL ANALYSIS IN RURAL NIAS, INDONESIA Buulolo, Eduard; Girsang, Ermi; Nasution, Sri Lestari Ramadhani; Ginting, Liani Br
Journal of Gender and Social Inclusion in Muslim Societies Vol 7, No 1 (2026): Journal of Gender and Social Inclusion in Muslim Societies (JGSIMS)
Publisher : Pusat Studi Gender dan Anak

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/jgsims.v7i1.28785

Abstract

Low Birth Weight (LBW) remains a significant public health issue in Indonesia, contributing to high neonatal mortality rates. This study aims to analyze the influence of tenure, supervision, compensation, and training on midwives’ performance in efforts to reduce the risk of LBW at Community Health Centers (Puskesmas) in Nias Regency. This study employed a cross-sectional design with an analytical approach. A total of 281 active midwives at Community Health Centers in Nias Regency were selected as the study sample through a questionnaire survey conducted from July to August 2025. Data were analyzed using the Chi-Square test and logistic regression to determine the most dominant factors. The results indicate that length of service, supervision, compensation, and training have a significant influence on midwives’ performance (p < 0.05). Among these four variables, compensation was identified as the most dominant factor influencing midwives’ performance in managing the risk of LBW. These findings underscore the importance of strengthening reward systems and managerial support to optimize the role of midwives on the front lines of maternal and child health care.
THE IMPACT OF ADMINISTRATIVE CASE MANAGEMENT ON HOSPITAL OPERATIONAL EFFECTIVENESS: A QUALITATIVE CASE STUDY Sitohang, Vivi Amastasya; Girsang, Ermi; Nasution, Sri Lestari Ramadhani
Journal of Gender and Social Inclusion in Muslim Societies Vol 7, No 1 (2026): Journal of Gender and Social Inclusion in Muslim Societies (JGSIMS)
Publisher : Pusat Studi Gender dan Anak

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/jgsims.v7i1.28852

Abstract

Effective hospital care is determined not only by clinical factors but also by the efficiency of administrative processes that support the smooth flow of patient care. Administrative issues such as delays in the discharge process, incomplete medical records, and challenges with BPJS claims can impact the quality of care and the hospital’s efficiency. This study aims to analyze the role of Case Managers in improving the effectiveness of hospital services from an administrative perspective at Murni Teguh Hospital in Medan. This study employs a qualitative method with a descriptive approach. Data collection was conducted through in-depth interviews, observations, and document analysis involving eight informants, comprising Case Managers, RMD Coordinators, and the Head of Medical Records. Data analysis was conducted through the stages of data reduction, data presentation, and drawing conclusions using triangulation techniques to ensure the validity of the findings. The results of the study indicate that Case Managers play a strategic role in controlling length of stay (LOS), coordinating with the attending physician (DPJP) and other healthcare personnel, ensuring the completeness of medical records, and facilitating the smooth processing of BPJS claims. In the administrative aspect, the Case Manager serves as a liaison between units to minimize barriers that arise in the service delivery process. Challenges faced include a high patient-to-staff ratio, time constraints, and interprofessional communication barriers. However, through effective communication, intensive coordination, and continuous monitoring, Case Managers contribute to expediting administrative processes, improving documentation completeness, and reducing the potential for pending or rejected claims. The conclusion of this study confirms that the role of the Case Manager contributes significantly to improving the effectiveness of hospital services from an administrative perspective. Optimizing the number of Case Managers and strengthening their functions is recommended as a strategy to improve the quality of hospital administrative management on an ongoing basis.