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All Journal MNJ (Malang Neurology Journal) Journal of Health Policy and Management Medika Kartika : Jurnal Kedokteran dan Kesehatan Jurnal Abdi Insani
Ismiana, Baiq Holisatul
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Determinants of the Difference between Actual Cost and Indonesian Case Based Groups (INA-CBGs) Reimbursement for Birth Delivery at Hospitals in Mataram, West Nusa Tenggara Sulaeman, Endang Sutisna; Ismiana, Baiq Holisatul; Tamtomo, Didik
Journal of Health Policy and Management Vol 4, No 3 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (226.503 KB)

Abstract

Background: Health is the part of the economic and social development of the state. The application of the BPJS Health national social security system in Indonesia is one of the government's efforts to provide health financing protection for all citizens and prevent catastrophic health expenditures. Hospitals as providers of secondary or tertiary health services often suffer losses because the payment system from BPJS Kesehatan uses a case-based payment method or INA-CBGs. This study aimed to examine the factors that influence the difference in rates between INA-CBGs rates and real hospital rates in labor cases.Subjects and Method: This was an analytic observational study with a cross-sectional design.  The study was carried out in Mataram and Siti Hajar Mataram Islamic hospitals, Mataram, West Nusa Tenggara, in May 2019. A sample of 200 postpartum women was selected by stratified random sampling. The dependent variable was the difference between real cost and INA-CBGs reimbursement. The independent variables were the type of hospital, class of treatment, type of birth delivery, length of stay, and severity disease. The data were collected from the medical record and analyzed by a multiple linear regression run on Stata 13.Results: Difference between real cost and INA-CBGs tariff of birth delivery reimbursement was negatively affected by type III of class treatment (b = -390,725; 95% CI= -790,082 to 8,631; p= 0,055), section caesarean (b= -1,429,648; 95% CI= -1,811,275 to -1,048,022; p <0.001), length of stay (b= -211,912; CI (95%) = -427,786 to 3,960; p = 0.054), moderate severity (b= -114,028; 95% CIi= -507,057 to 279,000; p = 0.568), and the high level of severity (b = -1,735,612; CI (95%) = -3,482,347 to 11,123; p = 0.051). The INA-CBGs rate difference and RS real rates of labor cases decreased due to the classification of private hospitals (b = 281,021; CI (95%) = -73,054 to 635,097; p = 0,119), treatment class II (b = 8,736; CI (95 %) = -392,068 to 409,541; p = 0.966).Conclusion: The difference in rates between INA-CBGs rates and hospital real rates in childbirth cases would increase if it serves treatment class III, type of cesarean delivery, care days which are longer, and moderate or severe severity. The difference in rates between INA-CBGs rates and hospital real rates in childbirth cases can decrease in services at private hospitals and serve treatment classes II.Keywords: INA-CBGs rates, hospital real rates, labor costs.                                                                            Correspondence: Baiq Holisatul Ismiana. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami No. 36 A, Surakarta 57126, Jawa Tengah, Indonesia. Email: baiqholis26@gmail.com. Mobile: +6287739031046.Journal of Health Policy and Management (2019), 4(3): 161-169https://doi.org/10.26911/thejhpm.2019.04.03.03
SLEEP DISORDERS AND DIVING-ASSOCIATED DECOMPRESSION SICKNESS Harahap, Herpan Syafii; Indrayana, Yanna; Afif, Zamroni; Landapa, Raditya Rachman; Ismiana, Baiq Holisatul; Gea, Endah Irnanda Ulfa; Wiracakra, I Gusti Lanang Krisna
MNJ (Malang Neurology Journal) Vol. 11 No. 2 (2025): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2025.011.02.09

Abstract

Decompression sickness is considered as an important complication of deep diving. Since the trend of diving activities is increasing throughout the world and is dominated by novice divers, the incidence of decompression sickness should be high. Severe form of decompression sickness can cause damage to the central nervous system with varying manifestations of mild to severe neurological deficits. Recent studies show that sleep disorders need to be considered as an important consequence of decompression sickness. However, the pathophysiology of decompression sickness-associated sleep disorders is currently not well understood. Since sleep disorders are associated with dysfunction of anatomical structures and the neurotransmitter systems in the brain that regulate the sleep-wakefulness cycle, decompression sickness-associated sleep disorders can be postulated to be related to dysfunction of these two regulators of sleep-wakefulness cycle. Sleep disorders found in patients with decompression sickness are more likely to occur in type 2 decompression sickness and may be found in the form of insomnia, hypersomnia, circadian rhythm disorders, obstructive sleep apnea, and narcolepsy. This review aims to discuss the pathophysiology of sleep disorders and decompression sickness as well as possible mechanisms underlying sleep disorders in decompression sickness through theoretical approaches and the results of available studies. In conclusion, decompression sickness-related sleep disorders are thought to involve two pathological conditions in the brain, namely structural lesions and dysfunction of the neurotransmitter system in the brain.
GANGGUAN NEUROPATI AKIBAT PENYELAMAN (NEUROPATHIC DISORDER AFTER UNDERWATER DIVING) Hunaifi, Ilsa; Harahap, Herpan Syafii; Landapa, Raditya Rachman; Ismiana, Baiq Holisatul; Ulfa Gea, Indah Ernanda; Wiracakra, I Gusti Lanang Krisna
Medika Kartika : Jurnal Kedokteran dan Kesehatan Vol 8 No 2 (2025): Medika Kartika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran Universitas Jenderal Achmad Yani

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Abstract

Indonesia memiliki ribuan pulau. Hal ini berdampak pada meningkatnya kegiatan penyelaman bawah laut. Penyelaman yang tidak sesuai prosedur dapat menimbulkan gangguan kesehatan berupa penyakit dekompresi yang salah satunya mengakibatkan neuropati. Emboli gas nitrogen menimbulkan respons inflamasi sistemik yang dapat memicu kerusakan pada saraf perifer. Faktor risiko gangguan dekompresi antara lain kurang pengalaman dalam menyelam, melakukan penyelaman berulang kali dalam waktu yang sama, tidak mematuhi prinsip-prinsip penyelaman dan sering kali melakukan yo-yo diving. Gangguan saraf perifer yang dapat terjadi berupa sindroma terowongan carpal, neuropati nervus peroneus, neuropati nervus ulnaris, mononeuritis multiplex. Pemeriksaan elektrodiagnostik menunjukkan adanya demielinisasi yang ditandai dengan peningkatan kecepatan hantar saraf. Pemberian terapi hiperbarik oksigen sesuai standar Angkatan Laut Amerika (United State Navy Treatment) menjadi standar dalam pengobatan penyakit dekompresi disertai dengan pemberian terapi simptomatik dapat memperbaiki gejala gangguan saraf tepi. Kata kunci: dekompresi, emboli gas nitrogen, neuropati, penyelaman, saraf perifer DOI : 10.35990/mk.v8n2.p198-208
PELATIHAN DETEKSI DINI NEUROPATI AKIBAT KEMOTERAPI Hunaifi, Ilsa; Primayanti, Ika; Sapta Wardhani, Indah; Briliansy, Briliansy; Anggoro, Joko; Setyawati, Indri; Fesmia, Herodya Lajunee; Ismiana, Baiq Holisatul; Wiracakra, I Gusti Lanang Krisna; Gea, Endah Irnanda Ulfa; Jacob, Lusye Diana; Putri, Siti Noururrifqiyati Juna; Wardi, Bq. Prita Riantiani; Suryani, ⁠Dini; Andiyani, Dinda Zahra Putri
Jurnal Abdi Insani Vol 12 No 9 (2025): Jurnal Abdi Insani
Publisher : Universitas Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/abdiinsani.v12i9.2843

Abstract

Cancer is currently a disease that is experiencing significant growth. This has resulted in the number of chemotherapy administrations reaching 9.8 million to 15 million people and increasing by 53%. One of the side effects that can be caused is peripheral nerve disorders called Chemotherapy-Induced Peripheral Neuropathy (CIPN). In connection with the increasing number of cancer patients undergoing chemotherapy and the severe impact on peripheral nerves due to chemotherapy, early detection is very important to prevent severe complications. This training aims to improve the knowledge and skills of medical personnel in the early detection of chemotherapy-induced neuropathy in order to improve the quality of life of patients and reduce complications and disabilities due to neuropathy. This training was carried out in collaboration with the West Nusa Tenggara Province General Hospital and was attended by 62 nurses. The series of training activities included delivering materials and direct practice to patients. Evaluation of participant knowledge was through a pre-test using the Kahoot application and a post-test using the Plataran Sehat application with a pre-test completion time of 5 minutes. The average pre-test score was 59.35, while the average post-test score was 79.35. The simulation sessions are conducted directly with patients using a neuropathy screening questionnaire, accompanied by a physician. The presentation of the material and the simulation sessions are highly beneficial in neuropathy screening, allowing early detection of neuropathy symptoms and prompt treatment.
Co-Authors Afif, Zamroni Andiyani, Dinda Zahra Putri Anggoro, Joko Briliansy, Briliansy Didik Tamtomo, Didik Endang Sutisna Sulaeman Fesmia, Herodya Lajunee Gea, Endah Irnanda Ulfa Herpan Syafii Harahap Ilsa Hunaifi, Ilsa Indrayana, Yanna Jacob, Lusye Diana Landapa, Raditya Rachman Primayanti, Ika Putri, Siti Noururrifqiyati Juna Sapta Wardhani, Indah Setyawati, Indri Suryani, ⁠Dini Ulfa Gea, Indah Ernanda Wardi, Bq. Prita Riantiani Wiracakra, I Gusti Lanang Krisna