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Strategy For Developing Fraud Prevention In The Implementation Of National Health Insurance At The Medan Baru Special Eye Hospital Meliala, Sri Agustina; Sulisna, Aida; Humairoh, Rahma; Fitria, Dilla
Jurnal Kesmas Prima Indonesia Vol. 9 No. 2 (2025): July Edition
Publisher : Program Studi Sarjana Kesehatan Masyarakat Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jkpi.v9i2.7633

Abstract

Fraud In health, fraud is a form of fraud that includes misuse of assets and falsification ofstatements, which can be carried out by all parties involved in the service. BeBased on the initialsurvey conducted by the researcher, Medan Baru Eye Specialist Hospital has implemented apolicy to prevent fraud, one of the fraud incidents that has occurred is, patients using otherpeople's health insurance cards. The research method used in this study is a Mixed Method,namely a method that combines quantitative and qualitative approaches. The purpose of this studyis to analyze the implementation of prevention policies carried out by Medan Baru Eye SpecialistHospital in implementing health insurance programs. The results of qualitative research show thatthe hospital has built a fraud prevention system in accordance with PERMENKES No. 16 of 2019,and the results of quantitative research show that out of 100 respondents, 6% of patients stillcommit fraud. The conclusion in this study is that the preparation of fraud prevention policies andguidelines has been carried out with the formation of a Director's Decree, the development of afraud prevention culture, such as special socialization related to fraud has not been made., Thedevelopment of health services that are oriented towards quality control and cost control, stillneeds to be improved due to the many potential frauds that can be committed by patients andofficers, A fraud prevention team has been formed at Medan Baru Eye Specialist Hospital, MedanRumah, in accordance with the Director's Decree which regulates the duties of each member. Theimplementation of fraud prevention policies for patients has been successful, as evidenced byquantitative research showing that only 6% of patients still commit fraud. Hospitals are expectedto conduct specific outreach regarding fraud to all staff
Sosialisasi Pentingnya Tracer sebagai Kartu Pelacak Berkas Rekam Medis Keluar dari Rak Penyimpanan Sulisna, Aida; Meliala, Sri Agustina
Jurnal Pengabdian Masyarakat Ilmu Kesehatan Vol 3, No 2 (2022): Edisi Juli
Publisher : LPPM Institut Kesehatan Helvetia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33085/.v3i2.5580

Abstract

Tracer rekam medis merupakan sarana yang dimanfaatkan guna mengontrol penggunaan rekam medis. Biasanya digunakan untuk menggantikan dokumen rekam medis yang keluar dari rak penyimpanan. Dalam rekam medis yang lengkap dan benar dapat diperoleh informasi yang dapat digunakan untuk berbagai keperluan tersebut antara lain untuk bahan bukti di pengadilan, pendidikan dan pelatihan serta dapat digunakan untuk bahan analisis dan evaluasi mutu pelayanan rumah sakit. Mengingat kegunaan rekam medis yang banyak maka diperlukan pengendalian terhadap pengisian formulir rekam medis. Filling dalam bidang rekam medis adalah suatu ruangan yang bertanggung jawab terhadap penyimpanan, retensi dan pemusnahan dokumen rekam medis. Selain itu filling juga menyediakan dokumen rekam medis yang telah lengkap isinya sehingga dapat memudahkan penggunaan mencari informasi sewaktu-waktu jika diperlukan. Pentingnya Tracer sebagai kartu pelacak berkas rekam medis keluar dari rak penyimpanan berkas rekam medis sangat pelu untuk disosialisasikan kepada masyarakat tenaga kesehatan dalam hal ini Klinik Pratama Klambir. Tujuan dari kegiatan ini adalah memberikan pengetahuan tentang pentingnya tracer sebagai kartu pelacak berkas rekam medis keluar dari rak penyimpanan di Klinik Pratama Klambir. Kegiatan ini diharapkan dapat menciptakan budaya pemanfaatan tracer sebagai kartu pelacak berkas rekam medis ketika keluar dari rak penyimpanan dikarenakan tracer rekam medis begitu penting sebagai kartu pelacak ketika berkas keluar dari rak penyimpanan. Dengan begitu, berkas rekam medis akan dengan mudah ditemukan kembali saat dibutuhkan. Metode yang digunakan dalam kegiatan ini yaitu sosialisasi dengan memberikan penyuluhan berupa ceramah dan tanya jawab mengenai pentingnya tracer rekam medis.
Faktor Yang Berhubungan Dengan Terjadinya Komplain Di Instalasi Farmasi Rumah Sakit Umum Daerah (RSUD) Kota Subulussalam Meliala, Sri Agustina; Muhammad Adiul Ilham; Hana Dhini Julia Pohan
Jurnal Ilmiah Multidisiplin Nusantara (JIMNU) Vol. 1 No. 1 (2023): JIMNU - MARET
Publisher : PT. Padang Tekno Corp

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (249.769 KB) | DOI: 10.59435/jimnu.v1i1.35

Abstract

Pelayanan kefarmasian Rumah Sakit merupakan kegiatan yang berperan penting dalam menunjang pelayanan kesehatan. Ketepatan waktu dalam pelayanan dapat meningkatkan kepuasan pasien dan mengurangi komplain dari pasien. Adapun hasil observasi di RSUD Kota Subulussalam dibuktikan dengan adanya pasien yang berdiri dan ada juga yang duduk di tangga untuk menunggu nomor antrean nya. Menggunakan rancangan kuantitatif dengan desain cross-sectional. Populasi penelitian ini yaitu seluruh pasien rawat jalan yang melakukan pengobatan di RSUD Kota Subulussalam sebanyak 6550 orang dengan sampel sebanyak 98 orang yang diambil menggunakan teknik accidental sampling. Analisis data menggunakan analisis univariat dan bivariat dengan statistik uji chi-square. menunjukkan bahwa variabel bukti nyata dengan dengan p-value 0,002<0,05, kehandalan dengan p-value 0,003<0,05, daya tanggap dengan p-value 0,000<0,05, jaminan dengan p-value 0,004<0,05, empati dengan p-value 0,003<0,05. Penelitian ada hubungan pengetahuan bukti nyata, kehandalan, daya tanggap, jaminan, dan empati terhadap faktor-faktor yang berhubungan dengan terjadinya komplain di instalasi farmasi RSUD Kota Subulussalam dengan p sig> 0,05. Disarankan agar petugas di instalasi farmasi tetap mempertahankan mutu pelayanan yang sudah baik dan meningkatkan mutu pelayanan yang masih kurang, sehingga pasien akan tetap merasa puas.
Hubungan Mutu Pelayanan dengan Minat Kunjung Pasien Rawat Jalan di RSU Hidayah Deli Tua Melinda, Rima; Meliala, Sri Agustina
MAHESA : Malahayati Health Student Journal Vol 3, No 8 (2023): Volume 3 Nomor 8 (2023)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v3i8.10905

Abstract

ABSTRACT The quality of health services is something that can satisfy every user of health services in accordance with the level of satisfaction of the average population and the implementation is in accordance with standards. Interest in visiting is a behavior that appears as an object response that shows the customer's desire to make a repeat purchase. Based on the results of interviews and observations made with 10 patients who were being treated at Hidayah Hospital Deli Tua, 4 of them were interested in making a revisit, 6 others stated that they were not interested in making a revisit. This study aimed to determine the relationship between service quality and interest in outpatients visit at Hidayah Hospital Deli Tua. This is a quantitative using a cross sectional approach. The research was conducted at Hidayah Hospital Deli Tua. The study population was all old outpatients who were undergoing treatment at the Hospital and the sample was 98 people. Showed that tangible variables (physical evidence) had a p-value of 0.001 <0.05, reliability p-value 0.001 <0.05, responsiveness p-value 0.000 <0.05, assurance) p-value 0.000 <0.05, empathy p-value 0.000 <0.05. shows that there is a tangible relationship, reliability, responsiveness, assurance, empathy with the interest in outpatients visit. It is suggested to the Hospital to always pay attention and maintain the quality of service both in terms of facilities, infrastructure, time, cleanliness, and patient comfort by providing facilities to get services to increase interest in patient visits. Keywords: Quality of Service, Interest of Outpatients Visit  ABSTRAK Mutu pelayanan kesehatan adalah pelayanan kesehatan yang dapat memuaskan setiap pemakai jasa pelayanan kesehatan yang sesuai dengan tingkat kepuasan rata-rata penduduk serta penyelenggaraanya sesuai dengan standar. Minat kunjung merupakan perilaku yang muncul sebagai respon objek yang menunjukkan keinginan pelanggan untuk melakukan pembelian ulang. Berdasarkan hasil wawancara dan observasi yang dilakukan kepada 10 pasien saat berobat ke Rumah Sakit Umum Hidayah Deli Tua, 4 orang diantaranya berminat melakukan kunjungan ulang. 6 orang lainnya menyatakan tidak berminat melakukan kunjungan ulang. Penelitian ini bertujuan untuk mengetahui hubungan mutu pelayanan dengan minat kunjung pasien rawat jalan di Rumah Sakit Umum Hidayah Deli Tua. Jenis penelitian yang digunakan kuantitatif dengan menggunakan pendekatan Cross Sectional. Lokasi penelitian di RSU Hidayah Deli Tua. Populasi penelitian seluruh pasien lama rawat jalan yang melakukan pengobatan di Rumah Sakit Umum Hidayah Deli Tua dan sampel sebanyak 98 orang. Hasil penelitian menunjukkan variabel tangible (bukti fisik) memiliki nilai p-value 0,001 < 0,05, reliability (reliabilitas) p- value 0,001 < 0,05, responsiveness (daya tanggap) p-value 0,000 < 0,05, assurance (jaminan) p-value 0,000 < 0,05, emphaty (empati) p-value 0,000 < 0,05. Kesimpulan ada hubungan tangible (bukti fisik), reliability (reliabilitas), responsiveness (daya tanggap), assurance (jaminan), emphaty (empati) dengan minat kunjung pasien rawat jalan. Saran yang diberikan adalah agar selalu memperhatikan dan tetap menjaga kualitas pelayanan baik dari segi sarana, prasarana, waktu, kebersihan, dan kenyamanan pasien dengan memberikan fasilitas untuk mendapatkan pelayanan sehingga dapat meningkatkan minat kunjung pasien. Kata Kunci: Mutu Pelayanan, Minat Kunjung Pasien Rawat Jalan
Analisis Autentifikasi Dokumen Rekam Medis di RSU Tere Margareth Pohan, Hana Dhini Julia; Meliala, Sri Agustina; Ilham, Muhammad Adiul
MAHESA : Malahayati Health Student Journal Vol 3, No 8 (2023): Volume 3 Nomor 8 (2023)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v3i8.10813

Abstract

ABSTRACT Medical record is a form of health service documentation. Qualified medical records contain complete data, thus it can be processed into information. Authentication of medical record documents includes a clear name, signature, seal/stamp and initials recorded in the medical record or a code of individual for computerization. This research was conducted to realize the authentication of medical record documents at Tere Margareth General Hospital in 2023. This research was a quantitative research with a cross sectional approach. This research was an analytic form of research using primary data and secondary data with a total sample of 67 respondents selected through a random sampling technique. The results showed that health workers with a good knowledge in the authentication of medical record documents were 35 respondents (52.2%), while 32 respondents (47.8%) had a poor knowledge with p = 0.002 < α = 0.05. The attitudes of health workers towards the authentication of medical record documents were good for 28 respondents (41.8%) and unfavourable for 39 respondents (58.2%) with a value of p = 0.000 < α = 0.05. The actions of health workers towards the authentication of medical record documents were good by 31 respondents (46.3%) and unfavourable by 36 respondents (53.7%) with p = 0.003 < α = 0.05. The conclusion of this research is that knowledge, attitudes and actions are influential in completing the data for the authentication of medical record document. Hence, there are still many incomplete data of medical record authentication at Tere Margareth General Hospital.  Keywords: Authentication, Medical Record  ABSTRAK Rekam medis sebagai bentuk dari pendokumentasian layanan kesehatan. Rekam  medis  yang  berkualitas berisi  data  secara  lengkap, sehingga dapat diolah menjadi sebuah informasi. Autentifikasi dokumen rekam medis berupa nama terang, tanda tangan, cap/stempel dan inisial yang dicatat dalam rekam medis atau kode seseorang untuk komputerisasi. Penelitian ini dilakukan bertujuan untuk mengetahui autentifikasi dokumen rekam medis di RSU Tere Margareth Tahun 2023. Penelitian ini merupakan penelitian kuantitatif dengan pendekatan cross sectional. Penelitian ini bersifat analitik dengan menggunakan data primer dan data sekunder dengan total sampel 67 responden menggunakan teknik random sampling. Hasil penelitian menunjukkan Pengetahuan tenaga kesehatan terhadap autentifikasi dokumen rekam medis dari pengetahuan baik sebanyak 35 responden (52,2%) dan pengetahuan kurang baik sebanyak 32 responden (47,8%) dengan nilai p = 0,002 < α = 0,05. Sikap tenaga kesehatan terhadap autentifikasi dokumen rekam medis sikap baik sebanyak 28 responden (41,8%) dan sikap kurang baik sebanyak 39 responden (58,2%) dengan nilai p = 0,000 < α = 0,05. Tindakan tenaga kesehatan terhadap autentifikasi dokumen rekam medis tindakan baik sebanyak 31 responden (46,3%) dan tindakan kurang baik sebanyak 36 responden (53,7%) dengan nilai p = 0,003 < α = 0,05. Kesimpulan dalam penelitian ini pengetahuan, sikap dan tindakan berpengaruh  dalam melakukan pengisian kelengkapan data autentifikasi dokumen rekam medis sehingga masih banyaknya data autentifikasi rekam medis yang belum lengkap di RSU Tere Margareth. Kata Kunci: Autentifikasi, Rekam Medis
Hubungan stres kerja tenaga kesehatan dengan kualitas pelayanan di UPT Puskesmas Medan Sunggal Fitria, Dilla; Salmira, Cut Saura; Meliala, Sri Agustina
Journal of Pharmaceutical and Sciences Suppl. 1, No. 1 (2023)
Publisher : Fakultas Farmasi Universitas Tjut Nyak Dhien

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36490/journal-jps.com.v6i5-si.414

Abstract

Introduction: The quality of healthcare services hospital staff provides is essential for advancing a hospital as a healthcare service provider. Work-related stress experienced by healthcare workers due to heavy workloads can impact patient care quality. This study examines the relationship between work-related stress among healthcare workers and service quality at UPT Puskesmas Medan Sunggal in 2023. Method: This study employs a quantitative research design with a cross-sectional approach. The population consists of 50 respondents, and a total sampling technique was applied, resulting in a sample size of 50 respondents. Data analysis includes univariate and bivariate analyses. Results: The chi-square statistical test revealed a significant relationship between work-related stress and service quality, with a p-value of 0.006 < α (0.05). This indicates a significant correlation between healthcare workers' stress levels and the quality of services at UPT Puskesmas Medan Sunggal in 2023. Conclusion: There is an important relationship between healthcare workers' stress levels and service quality at UPT Puskesmas Medan Sunggal. Most healthcare workers experience moderate stress (52%), while 66% of respondents express dissatisfaction with the services. The chi-square test confirms a significant association between these variables (p-value 0.006 < 0.05), highlighting the need for effective stress management strategies to improve service quality.
Persepsi Perawat Rawat Inap terhadap Persiapan Akreditasi di RSU Sultan Abdul Aziz Syah Peureulak Tahun 2023 Ilham, Muhammad Adiul; Meliala, Sri Agustina; Faradita, Falia Nabila
PubHealth Jurnal Kesehatan Masyarakat Vol. 3 No. 1 (2024): Edisi Juli
Publisher : Ilmu Bersama Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56211/pubhealth.v3i1.581

Abstract

Perawat memberikan kontribusi besar terhadap keberhasilan pelayanan kesehatan paripurna kepada pasien. Oleh karena itu, pembentukan persepsi positif terhadap persiapan akreditasi ini perlu dikembangkan dalam diri perawat demi memaksimalkan mutu pelayanan terhadap pasien sebagaimana yang menjadi tujuan utama penyelenggaraan akreditasi rumah sakit itu sendiri. Tujuan penelitian ini untuk mengetahui persepsi perawat rawat inap terhadap persiapan akreditasi di RSU Sultan Abdul Aziz Syah Peureulak tahun 2023. Penelitian ini menggunakan jenis survey analytic dengan pendekatan cross-sectional. Lokasi penelitian di RSU Sultan Abdul Azis Syah Peureulak. Populasi dalam penelitian ini adalah seluruh perawat Rawat Inap di RSU Sultan Abdul Aziz Syah Peureulak sebanyak 117 perawat dan sampel sebanyak 54 responden menggunakan teknik simple random sampling. Teknik pengumpulan data dilakukan dengan melakukan penyebaran kuesioner. Analisa data dilakukan secara univariat dan bivariat menggunakan uji chi square. Penelitian menunjukkan bahwa pengetahuan (0,000<0,05), kepercayaan dan keyakinan (0,000<0,05) dan asumsi (0,000<0,05) memiliki pengaruh secara signifikan dengan persepsi perawat terhadap persiapan akreditasi. Kebutuhan (0,091>0,05) dan sikap (0,308>0,05) tidak memiliki hubungan secara signifikan dengan persepsi perawat terhadap persiapan akreditasi. Faktor kepercayaan dan keyakinan yang paling berhubungan dengan persepsi perawat terhadap persiapan akreditasi yaitu sebesar 70,4 kali. Kesimpulan dari penelitian ini ada hubungan secara signifikan antara pengetahuan, kepercayaan dan keyakinan dan asumsi dengan persepsi perawat terhadap persiapan akreditasi dan tidak ada hubungan secara signifikan antara kebutuhan dan sikap dengan persepsi perawat terhadap persiapan akreditasi di RSU Sultan Abdul Aziz Syah Peureulak tahun 2023. Saran yang diberikan adalah agar rumah sakit dapat meningkatkan partisipasi, komitmen dan kinerja karyawan terkait akreditasi rumah sakit sehingga dapat tercapai standar akreditasi demi peningkatan kualitas pelayanan dan keselamatan pasien.
Factors Affecting the Not Implementation of Medical Record Tracer Sulisna, Aida; Meliala, Sri Agustina; Fauzi, Muhammad
Jurnal Perilaku Kesehatan Terpadu Vol. 2 No. 1 (2023): Jurnal Perilaku Kesehatan Terpadu (Jupiter)
Publisher : Hasanuddin Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61963/jpkt.v1i2.25

Abstract

Tracer is an important tool in controlling the use of medical record files. Usually used to replace medical records that are out of storage. These exit instructions remain in storage until the borrowed medical records are returned and stored again. This exit sign is equipped with a pocket for storage of request slips. The purpose of this study was to determine the factors that influence the non-application of a medical record tracer at the Pratama Klambir clinic in 2021. This research method used a descriptive qualitative method which was carried out from November to completion. The informants of this research were 6 informants, namely 1 key informant, 4 main informants and 1 triangular informant obtained by purposive sampling technique.The study obtained the man factor (human resources), namely the education of officers who did not graduate from medical records and had never attended training, machines (machines) that had not been applied to the use of tracers and lacked storage racks, materials (raw materials), namely the folders used were still made of plastic and had not used color codes, methods (methods/procedures), namely SPO had not been carried out properly, and money, namely there was a shortage of money. The conclusion in this study is that there are many factors (human resources), machines (machines), materials (raw materials), method (methods/procedures) and money (money) which causes the medical record tracer not to be applied at the Pratama Klambir clinic.
Factors Affecting Waiting Time for Completion of BPJS Patient Administration Meliala, Sri Agustina; Nur, Fauziah; Marliani Lase, Ester
Jurnal Perilaku Kesehatan Terpadu Vol. 2 No. 1 (2023): Jurnal Perilaku Kesehatan Terpadu (Jupiter)
Publisher : Hasanuddin Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61963/jpkt.v1i2.27

Abstract

Waiting time is the grace period when the patient is allowed to go home by the doctor in charge of the patient until they leave the hospital. Based on the Regulation of the Minister of Health of the Republic of Indonesia Number 129 of 2008 concerning Minimum Service Standards for Hospitals, it is stated that the standard waiting time for repatriation patients is not more than 2 hours. This study aimed to determine the factors that affect the waiting time in completing the administration of repatriation of BPJS inpatients at Mitra Medika Hospital Tanjung Mulia in 2022. This is quantitative research with a cross sectional approach. The population in this study was all inpatient nurses’ amount 93 people. The sample in this study was the entire population of inpatient nurses. The data analysis technique was done by using univariate and bivariate analysis. The results showed that there was an influence of human resources with waiting time for discharge of patients with p-value 0.009 < 0.05, Administration with waiting time for discharge of patients with p-value 0.005 < 0.05, Facilities and Infrastructure with waiting time for discharge of patients with p -value 0.007 < 0.05. The conclusion shows that there is an effect of waiting time for discharge of patients with human resources, administration, and facilities and infrastructure at Mitra Medika Hospital Tanjung Mulia. It is expected that the hospital provides routine programs to improve the skills and abilities of nurses in completing the repatriation administration of patient, standardize waiting times, as well as add facilities at the nurse station and improve the quality of the information system to make it better.
Hospital-based rehabilitation services for drug disorders: Challenges and policy implications Fitriani, Arifah Devi; Febriantika, Febriantika; Meliala, Sri Agustina; Yanti, Fitri
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.v8i10.2029

Abstract

Background: Substance use disorder (SUD) imposes a complex, multidimensional burden that necessitates comprehensive and integrated rehabilitation services. Hospitals play a pivotal role in the delivery of rehabilitation; however, implementation remains constrained by limited specialized human resources, inequitable access to services, fragmented intersectoral policy coordination, and persistent stigma toward individuals with SUD. Purpose: To examine hospital-based rehabilitation for substance use disorders, with particular attention to service availability and conditions, program effectiveness, and the roles of key stakeholders. Method: A qualitative case study was conducted between April and June 2025 at Prof. Ildrem Psychiatric Hospital, selected primary health centers, and related institutions, including the Provincial National Narcotics Agency of North Sumatra, the Health Office, National and Political Unity Agency, Regional Research and Innovation Agency, the police, and community-based organizations. Fifteen key informants and ten triangulation informants were purposively recruited. Data were collected through in-depth interviews, non-participant observations, and document review, and were analyzed thematically using NVivo 12 through open, axial, and selective coding processes. Results: Seven major themes were identified: workforce capacity and competence, access to rehabilitation services, social vulnerability, program effectiveness, post-rehabilitation and community reintegration, policy processes, and stigma. Key barriers included shortages of addiction-trained professionals, complex and bureaucratic referral mechanisms, high non-medical costs, weak cross-sector collaboration, and insufficient aftercare services and community support systems. Conclusion: The findings indicate that hospital-based rehabilitation alone is inadequate to address the complex needs of individuals with substance use disorders. An integrated rehabilitation model that combines medical treatment, psychosocial interventions, community-based support, and coherent policy frameworks is essential. Enhancing professional capacity, streamlining referral pathways, expanding community-based aftercare, and implementing systematic stigma-reduction initiatives are critical to improving rehabilitation outcomes and promoting sustainable recovery.