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"Jaminan Kesehatan Nasional yang implementasinya dimulai Januari 2014 membuat perubahan system pembayaran dari Retrospektive Paymant System ke Prospective Payment System dengan tarif INA-CBG`s. Perbedaan tarif INACBG`s dan tarif RS menjadi masalah mendasar sehingga RS harus melakukan upaya agar tercapai kendali mutu dan biaya.Tujuan penelitian ini adalah untuk mengetahui upaya yang diambil RS terkait perbedaan tarif rumah sakit pelayanan rawat jalan dengan tarif INA-CBG`s. Metode penelitian dilakukan secara kuantitatif dan kualitatif.Hasil penelitian menunjukkan bahwa 645(27,1 %) kasus dari total 2384 kasus memiliki selisih negatif dan1739 (72,9%) kasus dengan selisih positif. Rerata tarif RS Rp 221.683 dan rerata tarif INA-CBG`s Rp278.676 dengan rerata selisih tarif Rp56.993. Total selisih tarif Rp135.871.933 atau 25,7% dari tarif RS.Selisih tarif positif ini sangat baik bagi RS dan dapat digunakan untuk peningkatan pelayanan dan pengembangan RS. Klaim obat penyakit kronis diluar tarif paket INA-CBG`s menambah selisih positif menjadi Rp.187.208.274 atau mendapat surplus sebesar 35,42% dari total tarif RS. Komponen tarif RS yang terbesar adalah obat sebesar 37,4%. Pihak manajemen menerapkan upaya efisiensi biaya dari mulai proses perencanaan sampai evaluasi, dengan tetap mengutamakan mutu, mempercepat penyusunan dan implementasi clinical pathway agar pelayanan lebih terstandarisasi dan dapat meningkatkan kualitas pelayanan serta sistem remunerasi yang baik yang mencerminkan asas adil dan layak. Dengan upaya yang diterapkan, diharapkan rumah sakit dapat memberikan pelayanan yang efektif dan rasional serta bermutu dan memberikan nilai tambah bagi rumah sakit dan meningkatkan derajat kesehatan masyarakat.

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There is a fundamental change of hospital`s payment system in Indonesia since the Indonesian National Health Insurance was implemented (January 2014). The former retrospective payment system was changed into prospective payment system with Indonesia Case Base Groups (INA-CBG) as expense base. This change forced hospital to propose a new efforts to adjust the rate difference between the previous hospital-based-tariff system and the latter INA-CBG-basedtariff system in order to assure the health service quality. This study aims to find out hospital`s efforts to adjust the tariff difference between the hospital-basedtariff- system and INA-CBG-based-tariff-system.This is a quantitative as well as qualitative research.

There were 2384 cases analyzed, with 645 cases (27.1%) with positive tariff balance and 1739 cases (72.9%) with negative tariff balance. Tariff differences was Rp. 135.871.977 (27.5% of the total hospital tarif). Average hospital tariff was Rp. 221.683, while the average INA CBG`s tariff was Rp. 278.676 and average difference was Rp 56.993. Hospital claim for chronic disease, which was not included in INA-CBG`s list, increased the positive balance to Rp. 187.208.274 (35,42% of hospital total tariff). Medication became the biggest part of the hospital cost (37.4%). The hospital`s management had worked efficiently to control the cost and assure the quality. Cost-efficiency-efforts as well as good remuneration system had been implemented from planning to evaluation. Hospital had to arrange and implement the clinical pathway as a standardization as well as quality controlhospital`s tariff, INA-CBG`s tariff, efficiency, quality, remuneration."

"[ABSTRAKLatar belakang penelitian ini adalah tingginya tagihan biaya obat rawat jalanjika dibandingkan dengan biaya yang ditanggung oleh BPJS dengan menganut sistemtariff INA CBG?s. Sehingga diperlukan analisis yang lebih mendalam mengenaifaktor-faktor yang mempengaruhi besaran biaya kesehatan tersebut. Penelitian inimenggunakan studi crosssectional dengan metode kuantitatif, dengan melihat faktorusia, jenis kelamin, peresepan obat, status dokter dan jaminan kesehatan sesuaidengan data sekunder yang didapat melalui data rekam medis dan tagihan biaya obatlayanan rawat jalan. Dan berdasarkan hasil penelitian, faktor yang mempengaruhibiaya obat adalah usia, jaminan kesehatan, jumlah item obat (R/), penggunaanantibiotika dan penggunaan obat generik. Sehingga guna menyikapi permasalahan iniperlu adanya clinical previllage untuk kasus rawat jalan dan kebijakan yang mengaturtentang peresepan yang rasional.

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ABSTRACTThe background of this study is the high bill outpatient drug costs when comparedwith the costs borne by BPJS by embracing INA CBG's tariff system. So, we need amore in-depth analysis of the factors that affect the amount of health care costs. Thisstudy uses a cross-sectional study with quantitative methods, by looking at factors ofage, sex, prescription drugs, doctors and health insurance status in accordance withthe secondary data obtained through medical records and bills medicine outpatientservices. And based on the results of the study, factors that affect the cost ofmedication is the age, health insurance, the number of drug items (R /), the use ofantibiotics and the use of generic drugs. So as to address these issues need for clinicalprevillage for outpatient cases and policies that govern rational prescribing, The background of this study is the high bill outpatient drug costs when comparedwith the costs borne by BPJS by embracing INA CBG's tariff system. So, we need amore in-depth analysis of the factors that affect the amount of health care costs. Thisstudy uses a cross-sectional study with quantitative methods, by looking at factors ofage, sex, prescription drugs, doctors and health insurance status in accordance withthe secondary data obtained through medical records and bills medicine outpatientservices. And based on the results of the study, factors that affect the cost ofmedication is the age, health insurance, the number of drug items (R /), the use ofantibiotics and the use of generic drugs. So as to address these issues need for clinicalprevillage for outpatient cases and policies that govern rational prescribing]"

"Perawat sebagai SDM tenaga kesehatan memberikan kontribusi besar terhadappelayanan kesehatan di rumah sakit dalam hal pelayanan langsung kepada pasien Pelayanan keperawatan Unit Pelayanan Intensif merupakan pelayanan keperawatanyang saat ini perlu untuk dikembangkan di Indonesia sejalan denganperkembangan teknologi dibidang perawatan intensif Oleh karena itu demiefisiensi kebutuhan tenaga dan kompetensi perawat Unit Pelayanan Intensif perludikonsentrasikan Penelitian ini membahas tentang analisa kebutuhan tenagakeperawatan di Unit Pelayanan Intensif RS dr Oen Solo Baru berdasarkan bebankerja.

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Nurses as human resources for health also contribute greatly to the health servicesin hospitals and to provide services directly to patients Nursing services atIntensive Care Unit has to be developed along with the technology development Therefore there is a need to concern the effieciency of nurses in term of quantityand competencies This research discussed about the needs analysis nursing staffin the Intensive Care Unit of dr Oen Solo Baru Hospital based on workload."

"Pelayanan rawat jalan merupakan salah satu Unit kerja di rumah sakit yang melayani pasien dengan berobat jalan termasuk seluruh prosedur diagnostik serta terapeutik. Waktu tunggu merupakan salah satu hal penting yang akan menentukan citra awal pelayanan rumah sakit. Salah satu alat untuk mengidentifikasi kebutuhan konsumen rumah sakit adalah dengan Total Quality Service (TQS). Kepuasan pasien merupakan faktor utama dan tolak ukur keberhasilan rumah sakit yang diberikan kepada pelanggan yang berdampak jumlah kunjungan meningkat dan pasien yang puas cenderung akan kembali. Penelitian ini merupakan penelitian Kuantitatif dengan desain potong lintang (cross sectional) dengan melakukan analisis korelasi yang menganalisa hubungan variabel dependen dan variabel independen. Penelitian dilakukan dengan menghitung waktu tunggu poliklinik dan waktu pemeriksaan dokter, kemudian dilakukan survey kuesioner TQS terhadap 135 responden. Hasil penelitian menyatakan bahwa waktu tunggu poliklinik, waktu pemeriksaan dokter tidak mempengaruhi kepuasan pasien. Kualitas personil, pelayanan administrasi, pengalaman perawatan medis, dan tanggung jawab sosial memiliki hubungan yang signifikan dengan kepuasan pasien. Dan faktor tanggung jawab sosial merupakan variabel yang paling dominan dan berpengaruh terhadap kepuasan pasien di RSIA AMC Metro.

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Outpatient services is one of unit working in hospitals that serve patients with outpatient including all diagnostic and therapeutic procedures. The waiting time is one important thing that will determine the initial image of hospital services. One of the tools for identifying customer needs hospital is the Total Quality Service (TQS). Patient satisfaction is a major factor and a measure of the success of the hospital which is given to customers who impact the number of visits increased and patients are satisfied tend to be returned.

This research is a quantitative research with cross sectional design (cross-sectional) with correlation analysis to analyze the relationship the dependent variable and independent variables. The study was conducted by calculating the waiting time and time clinic doctor examination, then conducted a TQS questionnaire survey on 135 respondents.

The study states that the waiting time and the doctor's examination time did not affect patient satisfaction. The quality of personnel, administrative services, medical care experiences, and social responsibility has a significant relationship with patient satisfaction. And the social responsibility factor is the most dominant variable and the effect on patient satisfaction in RSIA AMC Metro."

"Tesis ini membahas analisis kelengkapan rekam medis rawat inap RSKO Jakarta tahun 2014. Penelitian ini adalah penelitian mixed method yaitu penelitian secara kuantitatif dan kualitatif. Penelitian kualitatif digunakan untunk mengetahui nilai kelengkapan rekam medis, dan penelitian kualitatif untuk menggali informasi terhadap input, proses, dan output. Hasil penelitian menunjukkan bahwa nilai kelengkapan rekam medis hanya 62,6% belum mencapai standard 100%. Pada penelitian kualitatif didapatkan hasil bahwa faktor input; sumber daya manusia, material, infrastruktur, dan prosedur, faktor proses; pengisian rekam medis dan monitoring evaluasi, dapat mempengaruhi kelengkapan rekam medis (faktor output). Rumah sakit harus membenahi faktor input dan proses agar neningkatkatkan nilai kelengkapan rekam medis sesuai standar sehingga dapat meningkatkan kualitas pelayanan kesehatan di RSKO Jakarta.

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This thesis describes completeness of inpatient medical records at RSKO Jakarta hospital on 2014. This research used mixed methods, consists of quantitative and qualitative research. Quantitative research is used to determine the completeness value of medical records, and then qualitative research is used to get information from the input, process, and output. The result showed that the completeness value of inpatient medical records only 62,6% and it didn't reach the target of 100 % standard. On qualitative research showed that input factors consisted of human resources, materials, infrastructures, and procedures, Process factors consisted of medical records recording, monitoring and evaluation, are influences by completeness of medical records (output factors). Hospital must improve input factors and process factors in order to increase the good completeness value, to improve the quality of medical services at RSKO Jakarta."

"Clinical Pathway di rumah sakit merupakan pedoman yang mencakup semua aktivitas dari pasien masuk hingga keluar rumah sakit. Tesis ini membahas mengenai pengaruh clinical pathway terhadap lama hari rawat dan biaya resep pasien di RS IMC. Penelitian ini adalah kualitatif dan kuantitatif dengan desain studi kasus analisis deskriptif. Hasil penelitian menggambarkan tahapan proses implementasi clinical pathway di RS IMC dimulai dengan perencanaan, pembentukan tim, penyusunan draft formulir clinical pathway, sosialisasi, uji coba hingga implementasi; serta terjadi penurunan lama hari rawat dan biaya resep pasien hernia inguinalis akibat pengaruh implementasi clinical pathway di RS IMC Bintaro.

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Clinical Pathway in the hospital is a guideline which includes all activities from admission until hospital discharge. This thesis discusses the effect of clinical pathways towards length of stay and cost of prescription patient in IMC hospital. This study is a qualitative and quantitative, analysis of a descriptive case study design. Results of the study illustrate the stages of the process of implementing clinical pathways in IMC Hospital that begins with planning, team building, clinical pathways form drafting, dissemination, trial and implementation; as well as a decline in length of stay and cost of prescription inguinal hernia patients due to the effect of the implementation of clinical pathways in IMC Hospital."