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All Journal The International Journal of Medical Science and Health Research The Indonesian Journal of General Medicine
Ermi Girsang
Department of Public Health, Universitas Prima Indonesia, Medan, Indonesia
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Analysis of Activity-Based Costing (ABC) Implementation for Inpatient Operational Cost Control in 2025 Ongky Harianto; Ermi Girsang; Sri Lestari Ramadhani Nasution
The International Journal of Medical Science and Health Research Vol. 39 No. 1 (2026): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/13z7dt40

Abstract

Background: Hospitals require accurate cost information to set service tariffs, prepare budgets, and control operational costs. At RS Pratama Krayan, inpatient tariff determination may still create cost distortion because it has not fully applied an activity-based approach. Objective: This study aimed to analyze the implementation of Activity Based Costing (ABC) in controlling inpatient operational costs at RS Pratama Krayan, North Kalimantan, in 2025. Method: This study employed a quantitative descriptive method with a case study approach. Data were collected through documentation and interviews, then analyzed using ABC procedures, including activity identification, cost pooling, cost driver determination, activity rate calculation, and cost allocation to each inpatient class to obtain the unit cost. Results: The findings identified nine major cost activities with a total inpatient operational cost of IDR 2,744,000,000. Activity rates were calculated using inpatient days, room area, and electricity consumption as cost drivers. ABC calculation produced inpatient unit costs per day of IDR 179,494 for VIP, IDR 107,782 for Class I, IDR 88,608 for Class II, and IDR 86,881 for Class III. All values were lower than the existing tariffs, with reductions of 48.7% for VIP, 46.1% for Class I, 50.8% for Class II, and 42.1% for Class III. Conclusion: The implementation of ABC provides more detailed, proportional, and transparent inpatient cost information and can serve as a basis for tariff evaluation and hospital operational cost control.
Peran Tenaga Kesehatan dalam Penanganan Penyakit Degeneratif pada Lansia di Puskesmas Negeri Lama: Sebuah Studi Kasus Dhyta Nurhasanah Janas; Ermi Girsang; Sri Lestari Ramadhani Nasution
The Indonesian Journal of General Medicine Vol. 33 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/rew5sq66

Abstract

Pendahuluan: Populasi lansia di Indonesia meningkat pesat, diikuti oleh peningkatan prevalensi penyakit degeneratif. Puskesmas sebagai fasilitas kesehatan primer memiliki peran krusial, namun seringkali menghadapi keterbatasan sumber daya, terutama di daerah terpencil seperti Puskesmas Negeri Lama, Kabupaten Labuhanbatu. Penelitian ini bertujuan untuk menganalisis secara mendalam peran tenaga kesehatan serta tantangan dan dampaknya dalam penanganan penyakit degeneratif pada lansia. Metode: Penelitian kualitatif dengan desain studi kasus ini dilakukan pada September-Desember 2025. Tujuh informan dipilih secara purposive sampling, terdiri dari petugas rekam medis, petugas klaster lansia (perawat dan dokter), apoteker, dan ahli gizi. Data dikumpulkan melalui wawancara mendalam semi-terstruktur, observasi, dan triangulasi. Analisis data menggunakan model analisis tematik. Hasil Penelitian: Tenaga kesehatan menjalankan peran kuratif terintegrasi (anamnesis, pemeriksaan KGD/tekanan darah, pemberian obat seperti amlodipin dan metformin) dan peran preventif (skrining rutin via aplikasi E-pus/P-care, penyuluhan pola hidup sehat, konseling gizi). Tantangan utama meliputi karakteristik lansia (susah komunikasi, rendahnya pemahaman), hambatan struktural (jalan rusak, banjir, jarak tempuh jauh, kekosongan obat dari Dinkes), dan keterbatasan fasilitas. Pola komunikasi yang digunakan adalah komunikasi terapeutik dengan adaptasi bahasa sederhana, kesabaran, dan pelibatan keluarga. Dampak positif terlihat pada pengendalian penyakit dan dukungan sosial-emosional, namun terhambat oleh diskontinuitas pengobatan dan keterbatasan akses. Kesimpulan: Peran tenaga kesehatan di Puskesmas Negeri Lama bersifat komprehensif namun menghadapi tantangan signifikan. Diperlukan penguatan sistem logistik obat, pelatihan geriatri berkelanjutan, dan inovasi layanan seperti kunjungan rumah terstruktur untuk mengatasi hambatan geografis dan meningkatkan kualitas hidup lansia.
Co-Authors Dhyta Nurhasanah Janas Ongky Harianto Sri Lestari Ramadhani Nasution