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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran)
Rizaldy Pinzon
Department of Neurology, Bethesda Hospital, Yogyakarta, Indonesia
Immunology & microbiology Neuroscience

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The role of clinical pathway on the outcomes of ischemic stroke patients at Bethesda Hospital Yogyakarta Francisca Diana Alexandra; Iwan Dwiprahasto; Rizaldy Pinzon
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 02 (2013)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1654.3 KB) | DOI: 10.19106/JMedScie004502201302

Abstract

Stroke becomes world health problem all over the world because it is the causal factor of high mortality and disability. Good and well-organized process of healthcare service will improve the outcome of the patients with stroke. Clinical pathway may be used as clear standard to help reduce unnecessary variations of medical treatment and measure. The study aimed at finding out the correlation between the use of clinical pathway and the outcome of the patients with ischemic stroke in Bethesda Hospital Yogyakarta. It was an observational and analytic study with cohort restorative study design. The author compared the outcomes of acute ischemic stroke between the group with clinical pathway and the group without the clinical pathway. Data was collected using consecutive sampling from the electronic registry and medical record data of the patients from January 1st, 2011 to December 31st, 2011. It was conducted to 124 patients with ischemic stroke assigned to two groups (the first groups of 62 patients with clinical pathway and the second groups of 62 patients without clinical pathway). The basic characteristics of the two groups were the same. The results of the analysis showed that there was a significant decrease in the incidence of complication and a significant increase in the use of antiplatelete drugs, antidiabetic drugs and statin as secondary preventive measure of the recurrent stroke. There was not any significant difference in the duration of the hospitalized healthcare, the financing and the mortality between the two observation groups. The study indicated that the use of the clinical pathway in the stroke treatment improved the outcome of the patients with stroke. It was necessary to conduct further study to evaluate the effectiveness of the clinical pathway in improving the outcome of the patients with bigger number of the subjects and the longer period of time.
The role of clinical reminder system to drug prescribing on patients of the National Health Insurance with ischemic stroke Faramita Hiola; Iwan Dwiprahasto; Rizaldy Pinzon
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 2 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005402202204

Abstract

Since 2014 Indonesia has entered the era of universal health coverage (UHC) and public health financing system managed by the Social Security Organizing Agency Law/SSOAL (Badan Penyelenggara Jaminan Sosial/BPJS) . In this system, a national formulary was used as the basis for prescribing drugs by clinicians. One effort for quality and cost control in UHC was to develop a clinical reminder system (CRS) to help prescriber set treatment options in accordance with the national formulary.  The aim of this study was to measure the role of CRS to the compatibility of drug prescribing in patients with ischemic stroke in Bethesda Hospital Yogyakarta, Indonesia. This study was carried out using quasi-experimental with pre-test and post-test design. The subjects of this study were outpatient ischemic stroke and the National Health Insurance (NHI) participant, age >18 years and had complete medication data. Prescribing data were compared between stroke patients treated at the hospital before and after implementation of CRS. The study was performed in 200 National Health Insurance (NHI) scheme outpatients with ischemic stroke. The groups consisted of 100 patients without CRS and 100 patients with CRS. The basic characteristics of both groups were similar. The results showed that after implementation of CRS, a significant improvement in the compliance of the neurologist prescribing medicine used to be available only in national formulary (RR: 1.02; 95% CI=1.00-1.04; p=0.015). Among others the most significant improvement was the prescription of antidyslipidemic using HMG-CoA medicine available in formulary. In conclusion, CRS can improve the compliance of prescribing with national formulary in stroke ischemic patients.
Co-Authors Francisca Diana Alexandra Iwan Dwiprahasto Iwan Dwiprahasto Selvi Marcellia