Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar belakang : Pasien penyakit jantung bawaan memiliki risiko untuk mengalamikehilangan berbagai macam mikronutrien sesudah operasi koreksi dengan mesin pintasjantung paru, salah satunya adalah vitamin D. Defisiensi vitamin D dapat memperberatkomplikasi yang terjadi sesudah operasi koreksi dengan mesin pintas jantung paru.Penelitian ini bertujuan untuk menilai efek dari mesin pintas jantung paru terhadapkadar vitamin D sesudah operasi koreksi penyakit jantung bawaan.Metode : Penelitian dilakukan secara kohort prospektif dari bulan Maret-Juli 2020.Pada penelitian ini didapatkan total 30 pasien yang menjalani operasi koreksi denganmesin pintas jantung paru. Pemeriksaan kadar vitamin D dilakukan sebelum operasi dan24 jam sesudah mesin pintas jantung paru dimatikan.Hasil : Rerata kadar vitamin D preoperasi adalah 27,24 ng/mL dengan yang mengalamiinsufisiensi dan defisiensi sebanyak 70%. Rerata kadar vitamin D sesudah operasiadalah 20,73 ng/mL dengan jumlah subjek yang mengalami insufisensi dan defisiensimeningkat sebanyak 90%. Setelah operasi, terdapat penurunan vitamin D sebanyak 6,52ng/mL (24% dari kadar sebelum operasi). Uji korelasi antara penurunan kadar vitaminD dengan penggunaan mesin PJP menunjukkan hasil yang signifikan dengan nilai P <0,001. Sedangkan tidak ditemukan hubungan yang signifikan antara durasi penggunaanmesin pintas jantung paru dan durasi aortic cross clamp dengan penurunan kadarvitamin D.Kesimpulan : Terdapat hubungan yang bermakna antara penggunaan mesin pintasjantung paru dengan penurunan kadar vitamin D, namun penurunan ini tidakdipengaruhi oleh durasi penggunaan mesin pintas jantung paru dan durasi aortic crossclamp.

---

Background: Patients with congenital heart disease are at risk of losing various

micronutrients after corrective surgery with a cardio-pulmonary bypass machine, one

of which is vitamin D. Vitamin D deficiency can exacerbate complications that occur

after corrective surgery with a cardio-pulmonary bypass machine. This study aimed to

assess the effect of the cardio-pulmonary bypass machine on vitamin D levels after

corrective surgery for congenital heart disease.

Methods: This study was conducted in a prospective cohort from March to July 2020.

In this study, a total of 30 patients underwent corrective surgery with cardio-pulmonary

bypass machine. Vitamin D level checks were carried out before surgery and 24 hours

after the machine was turned off.

Results: The mean preoperative vitamin D level was 27.24 ng / mL with insufficiency

and deficiency as much as 70%. The mean postoperative vitamin D level was 20.73

ng/mL with the number of subjects experiencing insufficiency and deficiency increasing

by 90%. After surgery, there was a decrease in vitamin D by 6.52 mg / mL (24% of the

preoperative level). The correlation test between decreased levels of vitamin D and the

use of cardio-pulmonary bypass machines showed significant results with a P-value

<0.001. Meanwhile, there was no significant relationship between the duration of using

the cardio-pulmonary bypass machine and the duration of aortic cross clamp with a

decrease in vitamin D

Conclusion: There is a significant relationship between the use of cardio-pulmonary

bypass machines and a decrease in vitamin D levels, but this decrease was not

influenced by the duration of using the cardio-pulmonary bypass machine and the

duration of the aortic cross clamp."

"Latar belakang: Kejadian klaim pending rawat inap JKN di RS Pelni pada tahun 2022 dari 29.100 berkas yang diajukan pada pengajuan klaim tahap pertama sebanyak 949 berkas (3,26%). Hal ini dapat menghambat operasional, pengembangan pelayanan dan mengganggu arus kas, sehingga perlu dilakukan identifikasi dan analisis terhadap penyebab klaim pending. Tujuan: Diidentifikasi variabel penyebab klaim pending sehingga dapat memperbaiki sistem pengajuan klaim JKN di RS Pelni. Metode penelitian: Desain penelitian deskriptif melalui wawancara mendalam terhadap 8 informan dan telaah terhadap 459 berkas untuk diidentifikasi penyebab masalah berdasarkan teori implementasi kebijakan Van Meter dan Van Horn. Hasil penelitian: Alasan berkas klaim yang pending adalah konfirmasi coding diagnosis dan prosedur sebanyak 38,7%, kesalahan pengisian resume medis sebanyak 23,8%, ketidaklengkapan berkas penunjang sebanyak 13,6%, konfirmasi pembayaran oleh Jasa Raharja sebanyak 5,1%, kesalahan grouping sebanyak 0,4%. Walaupun persentase klaim pending relatif rendah (3.26%), tetapi pembiaran akan mengakibatkan kesehatan arus kas operasional serta potensi keterlambatan arus kas masuk senilai minimal 2% dari total pendapatan per bulan. Kesimpulan: Alasan klaim pending berhubungan dengan tenaga coder baru, clinical pathway belum dijalankan dengan baik, kurangnya supervisi DPJP dalam membuat resume medis. Dibutuhkan pelatihan dan supervisi terhadap SDM, membangun komunikasi efektif antar stakeholder dan melakukan monitoring dan evaluasi terkait pengelolaan klaim.

---

Background: The incidence of JKN inpatient pending claims at Pelni Hospital in 2022 out of 29,100 files submitted in the first stage of claim submission was 949 files (3.26%). This can hinder operations, service development and disrupt cash flow, so it is necessary to identify and analyze the causes of pending claims. Objective: To identify the variables that cause pending claims so that they can improve the system for submitting JKN claims at Pelni Hospital. Research method: Descriptive research design through in-depth interviews with 8 informants and analysis of 459 files to identify the causes of problems based on the theory of policy implementation by Van Meter and Van Horn. The results of the study: The reasons for pending claim files were confirmation of diagnosis coding and procedures as much as 38.7%, medical resume filling errors as much as 23.8%, incomplete supporting documents as much as 13.6%, payment confirmation by Jasa Raharja as much as 5.1%, grouping error of 0.4%. Even though the percentage of pending claims is relatively low (3.26%), neglecting it will result in a healthy operational cash flow and potential delays in cash inflows of at least 2% of total income per month. Conclusion: The reasons for pending claims are related to new coder staff, clinical pathways that have not been implemented properly, lack of DPJP supervision in making medical resumes. HR training and supervision is needed, building effective communication between stakeholders and monitoring and evaluating related to claim management."