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Abstract

Clinical Pathway (CP) was implemented at the RSI NU Demak Hospital as quality and cost control in health services. One of the quality of services can be seen from the Average Length of Stay (AvLOS), so the implementation of CP is very important to measure its effectiveness and efficiency in reducing AvLOS as well as its efficiency in financing. This study aims to determine the effectiveness and efficiency of using CP for AvLOS as well as its efficiency in financing SC patients at the RSI NU Demak Hospital for the period October 2022-May 2023. The type of this research is qualitative with used case study method. Sample data was done by documentation study in 296 SC patient medical resume document and patient transaction data as well as in-depth interviews with purposive sampling samples. The AvLOS before CP implementation was 5.2 days, after CP implementation (for seven months from November 2022 to May 2023) the AvLOS decreased to 4 days. The average efficiency of SC financing is IDR 874,670.00 (Real Hospital Tariff with LOS of 5.2 days is IDR 7,025,130.00 and with LOS of 4 days is IDR 6,150,460.00) AvLOS before and after the implementation of CP in SC patients at RSI NU Demak Hospital shows its effectiveness as seen from the reduction in AvLOS, as well as having an impact on the efficiency of treatment costs. To further increase the efficiency of financing for SC patients, including the efficiency of drug and disposable material (BHP) packages for SC operations as well as monitoring and evaluating the compliance of medical staff in using CP.

Bahasa Abstract

Implementasi Clinical Pathway (CP) sudah dijalankan di Rumah Sakit Islam NU Demak sebagai kendali mutu dan biaya dalam pelayanan kesehatan. Salah satu mutu pelayanan dapat dilihat dari AvLOS, maka implementasi CP menjadi sangat penting diukur efektivitas dan efisiensinya dalam menurunkan rata-rata hari perawatan serta efisiensinya dalam pembiayaan. Penelitian ini bertujuan mengetahui efektivitas dan efisiensi penggunaan CP terhadap AvLOS serta efisiensinya dalam pembiayaan pada pasien SC di Rumah Sakit Islam NU Demak Periode Oktober 2022-Mei 2023. Jenis penelitian ini adalah kualitatif dengan menggunakan metode studi kasus (case study). Data sampel diperoleh melalui studi dokumentasi pada 296 berkas resume medis pasien SC dan data transaksi pasien serta wawancara mendalam dengan sampel purposive sampling. Rata-rata hari perawatan sebelum implementasi CP adalah 5,2 hari, sesudah implementasi CP (selama tujuh bulan dari November 2022 sampai Mei 2023) rata-rata hari perawatan mengalami penurunan menjadi 4 hari. Rata-rata efisiensi pembiayaan SC sebesar Rp 874.670,00 (Tarif Riil RS dengan LOS 5,2 hari sebesar Rp Rp 7.025.130,00 sedangkan LOS 4 hari sebesar Rp 6.150.460,00) AvLOS sebelum dan sesudah implementasi CP pada pasien SC di Rumah Sakit Islam NU Demak menunjukkan efektivitasnya dilihat dari penurunan rata-rata hari perawatan, juga berdampak adanya efisiensi biaya perawatan. Untuk lebih meningkatkan efisiensi pembiayaan pasien SC diantaranya dengan efisiensi obat dan bahan habis pakai (BHP) paket untuk operasi SC serta monitoring dan evaluasi terkait kepatuhan para staf medis dalam menggunakan CP.

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