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All Journal Jurnal Mahasiswa Ilmu Kesehatan Malahayati International Journal of Nursing and Health Science
Rahadian Malik
Universitas Sangga Buana Bandung
Health Professions Nursing Public Health

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Clinical pathways in patients with ischaemic stroke: Estimating mean length of stay and hospital costs Reinaldo Bobby Yuwono; Taufik Zulfikar; Rahadian Malik
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 10 (2025): Volume 8 Number 10
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i10.1543

Abstract

Background: Effective and efficient healthcare services have become one of the priorities in the global health system, including in Indonesia. In an effort to improve quality and efficiency of care, various initiatives have been implemented by hospitals, one of which is the application of Clinical Pathways (CP). A Clinical Pathway is a systematic approach designed to provide evidence-based guidelines in managing patients with specific conditions, with the goal of improving quality, efficiency, and patient safety. Purpose: To analyze the effectiveness of clinical pathways on length of stay (LOS) and its implications for hospital costs in ischemic stroke patients. Method: This quantitative, analytical, observational study used a cross-sectional approach. Data collection was conducted retrospectively using secondary data from patient medical records, Clinical Pathway documents, and the Hospital Information System (SIMRS). This included all inpatients with ischemic stroke treated by the Social Security Administration at Hermina Hospital Solo during 2024. The sample size was determined using the Slovin formula with a 5% margin of error, resulting in a sample of 170 respondents. Results: Regression analysis showed that CP significantly affects LOS, with a regression coefficient indicating that increased adherence to CP can reduce LOS. LOS also has a significant effect on hospital costs, with a positive regression coefficient, meaning the longer the LOS, the higher the hospital cost. However, CP does not have a direct effect on hospital costs. Path analysis revealed an indirect effect of CP on hospital costs through LOS, indicating that improved CP adherence can reduce hospital costs by shortening LOS. Conclusion: That higher adherence to CP can shorten LOS and indirectly lower hospital costs. Hospital management is expected to conduct regular socialization, evaluation, and monitoring of CP implementation to achieve optimal service efficiency and cost control.
Eksplorasi Pengalaman Penghentian Fisioterapi Pasien Rawat Jalan: Perspektif Kualitas Pelayanan, Kepercayaan, dan Kepuasan Pasien Rahmi Rachmawati Sari; Farida Yuliaty; Rahadian Malik
Jurnal Mahasiswa Ilmu Kesehatan Vol. 4 No. 3 (2026): Jurnal Mahasiswa Ilmu Kesehatan
Publisher : STIKes Ibnu Sina Ajibarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59841/jumkes.v4i3.4070

Abstract

Discontinuation of outpatient physiotherapy programs may affect continuity of rehabilitation and the achievement of therapeutic goals. This study aimed to explore the experiences of parents or guardians of patients who discontinued physiotherapy programs at the Santia Growth and Development Clinic in Purwakarta, from the perspectives of service quality, trust, and patient satisfaction. A qualitative phenomenological design was employed. Data were collected through semi-structured in-depth interviews with parents or guardians of patients who discontinued physiotherapy programs, supported by information from healthcare personnel. Data were analyzed using Colaizzi’s phenomenological method. The findings revealed that service quality was experienced through physical facilities, service consistency, communication, responsiveness, physiotherapists’ competence, and empathy. Patient trust was shaped by perceived professional competence, openness of information, integrity, and clarity regarding therapeutic goals and progress. Satisfaction with physiotherapy services did not necessarily lead to continued therapy. Discontinuation emerged as a cumulative and contextual process influenced by time constraints, scheduling difficulties, distance, family circumstances, children’s responses during therapy, perceived treatment progress, and unclear therapeutic expectations. Some families gradually discontinued therapy through postponed visits and missed appointments without formal closure communication. This study concludes that the discontinuation of physiotherapy is a complex experience involving interactions among healthcare services, patient-family perceptions, and contextual factors. Strengthening therapeutic communication, progress evaluation, service flexibility, and patient follow-up systems is essential to support continuity of physiotherapy care.
Co-Authors Farida Yuliaty Rahmi Rachmawati Sari Reinaldo Bobby Yuwono Taufik Zulfikar