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All Journal Integritas: Jurnal Antikorupsi Indonesian Journal of Cardiology PREPOTIF : Jurnal Kesehatan Masyarakat The Journal of Hospital Accreditation (JHA) Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management) JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit)
Hanevi Djasri
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Dentistry Economics, Econometrics & Finance Health Professions Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Nursing Public Health

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Korupsi dalam Pelayanan Kesehatan di Era Jaminan Kesehatan Nasional: Kajian Besarnya Potensi dan Sistem Pengendalian Fraud Djasri, Hanevi; Rahma, Puti Aulia; Hasri, Eva Tirtabayu
Integritas : Jurnal Antikorupsi Vol. 2 No. 1 (2016): INTEGRITAS Volume 02 Nomor 1 Tahun 2016
Publisher : Komisi Pemberantasan Korupsi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (250.579 KB) | DOI: 10.32697/integritas.v2i1.127

Abstract

Sejak berlakunya Jaminan Kesehatan Nasional, potensi fraud dalam layanan kesehatan semakin nampak di Indonesia. Potensi ini muncul dan dapat menjadi semakin meluas karena adanya tekanan dari sistem pembiayaan yang baru berlaku di Indonesia, adanya kesempatan karena minim pengawasan, serta ada pembenaran saat melakukan tindakan ini. Fraud layanan kesehatan berpotensi merugikan dana kesehatan negara dan menurunkan mutu layanan kesehatan. Kajian ini dilakukan untuk menjawab pertanyaan: (1) bagaimana gambaran potensi fraud layanan kesehatan di Indonesia, dan (2) upaya-upaya pemberantasan fraud layanan kesehatan yang sudah dilakukan di Indonesia serta tantangannya. Kajian dilakukan dengan membandingkan antara teori pencegahan, deteksi dan penindakan fraud dengan hasil pengamatan pelaksanaan program JKN di media massa dan situs-situs gerakan anti korupsi, maupun melalui berbagai hasil kegiatan yang terkait dengan topik pencegahan, deteksi, dan penindakan fraud layanan kesehatan yang diselenggarakan oleh PKMK FK UGM baik dalam bentuk penelitian serta diskusi-diskusi dalam seminar maupun blended learning. Kajian menunjukkan bahwa fraud layanan kesehatan berpotensi, bahkan sebagian sudah terbukti, terjadi di Indonesia. Di seluruh Indonesia, hingga pertengahan tahun 2015 terdeteksi potensi fraud dari 175.774 klaim Rumah Sakit atau Fasilitas Kesehatan Rujukan Tingkat Lanjut (FKRTL) dengan nilai Rp. 440 M. Potensi fraud ini baru dari berasal dari kelompok provider pelayanan kesehatan, belum dari aktor lain seperti staf BPJS Kesehatan, pasien, dan supplier alat kesehatan dan obat. Nilai tersebut juga belum menunjukan nilai sesungguhnya mengingat sistem pengawasan dan deteksi yang digunakan masih sangat sederhana. Bentuk potensi fraud yang umum ditemui dikelompok provider adalah upcoding, inflated bills, service unbundling, no medical value dan standard of care. Bentuk fraud standard of care selain merugikan biaya kesehatan negara juga berdampak buruk bagi pasien. Sistem pengendalian fraud layanan kesehatan sudah mulai berjalan terutama sejak terbitnya Permenkes nomor 36 tahun 2015, namun masih perlu diiringi dengan berbagai kegiatan dan instrumen detail untuk pencegahan, deteksi, dan penindakan.
Perbaikan Layanan Pneumonia Anak Di Fasilitas Kesehatan: Tindak Lanjut Deklarasi Global Untuk Pneumonia Anak Muhammad Hardhantyo; Hanevi Djasri
The Journal of Hospital Accreditation Vol 5 No 01 (2023): Pengalaman dan Kepuasan Pasien
Publisher : Komisi Akreditasi Rumah Sakit (KARS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35727/jha.v5i01.166

Abstract

Forum Global Pneumonia Anak ke-2 baru saja terlaksana pada April 2023 di Kota Madrid, menghasilkan sebuah deklarasi yang menjadi arahan dan protokol untuk manajemen pneumonia anak global secara komprehensif. Indonesia sendiri telah mencapai target dari Sustainable Development Goals (SDG) 3.2 untuk menurunkan angka kematian bayi baru lahir setidaknya hingga 12 per 1.000 kelahiran hidup dan angka kematian anak usia di bawah lima tahun dibawah 25 per 1.000 kelahiran hidup1,2. Meskipun sudah memenuhi target, pemerintah Indonesia dalam forum tersebut menunjukkan komitmen kuat untuk terus menurunkan angka kematian anak dengan meningkatkan sistem informasi kesehatan dan memberikan pelayanan kesehatan anak yang terintegrasi secara komprehensif di berbagai fasilitas kesehatan. Pemerintah Indonesia melalui Kementerian Kesehatan berkomitmen untuk mengatasi pneumonia anak dan menurunkan angka kematian balita. Pemerintah terus mempercepat cakupan dari vaksinasi Pneumococcal Conjugate Vaccine (PCV) di seluruh Indonesia1,3. Komitmen ini tercantum dalam Rencana Strategis Kementerian Kesehatan yang kemudian diperdalam dalam Rencana Aksi Nasional untuk Pneumonia dan Diare di tahun 2023. Rencana ini menekankan tentang pentingnya peningkatan cakupan vaksinasi PCV, DTP, dan campak hingga di atas 90% di setiap provinsi
Timeframe Factors of Door-to-Device Time During Pandemic Situation in a Tertiary Cardiovascular Centre in Indonesia Firdaus, Isman; Juzar, Dafsah Arifa; Dewanggi, Bunga; Nurfitri, Syafira; Utarini, Adi; Djasri, Hanevi
Jurnal Kardiologi Indonesia Vol 44 No 4 (2023): Indonesian Journal of Cardiology: October - December 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1649

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has greatly affected every aspect of life, especially in the field of cardiovascular services. This creates many challenges in the treatment of highly time-sensitive and potentially lethal conditions such as ST-elevation acute myocardial infarction (STEMI). STEMI patients at high risk for COVID-19 are recommended to be evaluated with additional testing for COVID-19 and possibly require respiratory support, all of which can delay Door-to-device time (DTDT). Objective: In this study, we sought to determine the DTDT for primary percutaneous coronary intervention (PCI) in acute STEMI, the various timeframes influencing the DTDT, and which time factor has the most significant correlation to DTDT in the COVID-19 pandemic era. Methods: A longitudinal retrospective study was conducted at the largest tertiary referral hospital in Indonesia from March 2020 to February 2021. The following timeframes were measured during the study: Door-to-Diagnosis Time [Δt1], Diagnosis-to-Activation Time [Δt2], Informed Consent Time [Δt3], Preparation at Emergency Room (ER) Time [Δt4], Preparation at Catheterization Laboratory Time [Δt6], and PCI Initiation-to-Balloon Time [Δt7]. Spearman’s correlation (ρ) was used to ascertain the correlation among time factors. Results: 238 patients met the inclusion criteria of this study. The observed DTDT was 110 [47 – 437] minutes. Of the variables, DTDT had a strong positive correlation with preparation at the ER time (median 28,0 (1 – 344) minutes; r = 0.702; p-value < 0.0001). Conclusion: This study sheds light on preparation at the ER time as a significant influencing factor for Door-to-device time in the COVID-19 pandemic era.
Strategy to Improve Electronic Medical Certification of Cause of Death at Rumah Sakit Persahabatan, Jakarta, Indonesia Meilia, Putri Dianita Ika; Djasri, Hanevi; Sanjaya, Guardian Yoki
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol. 13 No. 2 (2024): August 2024
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.v13i2.420

Abstract

Proper death certification has broad medical and public health benefits. Therefore, death certificates should be completed accurately according to the medical certification of cause of death (MCCD) scheme. To improve the data quality of MCCD, Rumah Sakit Persahabatan (RSP) has implemented an electronic form (e-SMPK) since 2023. Although equipped with a user manual and coordination support system, incomplete and inaccurate e-SMPKs are still found. This study aims to identify interventions that can improve the quality (completeness and accuracy) of e-SMPK in RSP using one action research cycle consisting of 4 stages, i.e., diagnosing, planning, taking, and evaluating action. Qualitative data was collected through focused group discussions and field observations. Quantitative data was collected by comparing the completeness and accuracy of e-SMPKs before and after the intervention agreed upon with the participants. Triangulation of the data was carried out to maintain the credibility of the research. This study found that obstacles to e-SMPK consist of system and regulatory factors, skills, practical tools, and processes. Interventions are implemented by adjusting regulations, providing guidance and training, revising electronic forms, improving coordination, and facilitating consultation and verification to overcome obstacles. An increase in the completeness and accuracy of filling in the e-SMPK elements was obtained, most of which were statistically significant.
ANALISIS MANFAAT IMPLEMENTASI CLINICAL PATHWAY SECTIO CESAREA TERHADAP TAGIHAN MEDIS (MEDICAL BILL) DI RUMAH SAKIT IBU DAN ANAK CEMPAKA AZ-ZAHRA KOTA BANDA ACEH Mahady, Taufik Wahyudi; Kristin, Erna; Djasri, Hanevi
PREPOTIF : JURNAL KESEHATAN MASYARAKAT Vol. 9 No. 2 (2025): AGUSTUS 2025
Publisher : Universitas Pahlawan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/prepotif.v9i2.48351

Abstract

Angka tindakan Sectio Caesarea (SC) terus meningkat secara global, termasuk di Indonesia yang telah melebihi ambang batas ideal WHO (10–15%) dengan prevalensi lebih dari 20% di beberapa wilayah. Di RSIA Cempaka Az-Zahra Banda Aceh, jumlah pasien SC tercatat sebanyak 263 kasus pada tahun 2022 dan 2023. Clinical Pathway (CP) diyakini dapat menurunkan variasi pelayanan, memperpendek lama rawat inap (Length of Stay/LOS), dan mengendalikan biaya perawatan. Menilai tingkat kepatuhan terhadap CP, variasi layanan, efisiensi biaya, serta dampaknya terhadap mutu pelayanan tindakan SC. Penelitian ini menggunakan desain cross-sectional dengan pendekatan kuantitatif, menggunakan data sekunder rekam medis tahun 2022–2023. Parameter yang dianalisis mencakup kepatuhan terhadap CP, LOS, variasi pelayanan, dan total tagihan medis. Hasil dari penelitian ini Tingkat kepatuhan CP pada tahun 2023 mencapai 92,4%. Variasi layanan masih ditemukan, namun tidak signifikan (p = 0,999). Rata-rata LOS menurun dari 2,73 hari (2022) menjadi 2,69 hari (2023) (p = 0,317). Rata-rata biaya meningkat dari Rp9.906.681 menjadi Rp10.160.713 (p < 0,001). Namun, pasien yang patuh terhadap CP menunjukkan biaya perawatan yang lebih rendah. Komponen biaya terbesar adalah kamar operasi (45,2% di 2022; 47,2% di 2023), sementara biaya obat-obatan menurun dari 11,9% menjadi 7,8%. Kesimpulan Implementasi Clinical Pathway pada tindakan SC berkontribusi terhadap efisiensi biaya dan peningkatan konsistensi layanan, meskipun belum seluruh indikator menunjukkan perubahan signifikan. Optimalisasi pelaksanaan CP tetap diperlukan untuk peningkatan mutu dan kendali biaya rumah sakit.
ANALISIS FAKTOR YANG MEMPENGARUHI PELAPORAN INSIDEN KESELAMATAN PASIEN DI RS MATA JEC-CANDI, SEMARANG Uswatunnisa Arfiningtyas; Djasri, Hanevi; Bismantara, Haryo
Journal of Health Service Management Vol 28 No 03 (2025)
Publisher : Departemen of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpk.v28i03.17262

Abstract

Background: The Patient Safety Incident (PSI) reporting system is a recommended method for enhancing patient safety, and it has been implemented by hospitals. However, the reporting rate of PSI remains low. Objectives: This study aims to analyze the impact of individual, team, and organizational factors on PSI reporting at JEC-Candi, Semarang eye hospital and to develop recommendations to improve PSI reporting. Methods: A mixed-methods sequential explanatory design was used. Quantitative data were obtained through a cross-sectional questionnaire survey and analytical observations using secondary data. Qualitative data were gathered from focus group discussion (FGD) with four separate groups: daily practitioner doctors, daily practitioner healthcare workers, daily practitioner non-healthcare workers, and managerial staff. Quantitative data were analyzed using chi-square or Fisher's exact tests and multivariate logistic regression, while qualitative data were analyzed using thematic analysis. Results: The study involved 85 subjects for the quantitative study and 25 subjects for the qualitative study. Individual factors (knowledge and motivation), team factors (teamwork), and organizational factors (feedback) significantly influenced PSI reporting (p<0.005). Motivation emerged as the most dominant factor influencing PSI reporting (p=0.008; OR 47.294; CI 95% 2.678-835.190). The qualitative results provided several recommendations for improving PSI reporting, including regular socialization and training, patient safety awareness campaigns, selecting patient safety champions, establishing reward and incentive systems, organizing team-building and cross-unit collaborative activities, and improving access to PSI reporting feedback information. Conclusions: Individual, team, and organizational factors significantly influence PSI reporting. Therefore, management should implement the recommended strategies to enhance patient safety and quality in the hospital.
ANALISIS KASUS KEMATIAN RAWAT INAP DI RSAU dr. EFRAM HARSANA MAGETAN Cahyawati, Nunuk; Djasri, Hanevi
Journal of Health Service Management Vol 28 No 03 (2025)
Publisher : Departemen of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpk.v28i03.17737

Abstract

Background : Patient mortality is one of the indicators of hospital service quality. Analyzing inpatient mortality is important to determine whether the death was due to a terminal illness and was justified or whether it could have been prevented with better and more advanced treatment so that corrective measures can be taken. Objective: Conduct a mortality audit at dr. Efram Harsana Air Force Hospital to determine strategies and efforts to improve the quality and management of patient services based on the results of the mortality audit. Method : The research method used in this research is the clinical audit method. The type of research used is a retrospective audit and this research uses a descriptive approach. Result and Discussion : The most common immediate cause of death was sepsis/shock sepsis (54.3%) and shock of other conditions (15.2%). The underlying causes of death were DM (21.9%) and stroke (20%). Unreasonable deaths accounted for 46.7% due to untimely diagnosis underlying disease (7.6%), inadequate treatment underlying disease (25.7%), untimely knowing cause of death (27.6%) and inadequate treatment of cause of death (37.1). Conclusion : Improvement efforts are aimed at timely recognition of sepsis/shock sepsis as a direct cause of death and the provision of adequate sepsis therapy.
Co-Authors Adi Utarini Bismantara, Haryo Cahyawati, Nunuk Dewanggi, Bunga Eri Supriyanti Erna Kristin Guardian Yoki Sanjaya Hasri, Eva Tirtabayu Isman Firdaus Juzar, Dafsah Arifa Mahady, Taufik Wahyudi Meilia, Putri Dianita Ika Muhammad Hardhantyo Nurfitri, Syafira Rahma, Puti Aulia Tabita Rionica Ayu Wijayani, Tabita Rionica Ayu Uswatunnisa Arfiningtyas