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"Latar Belakang : Pandemi COVID-19 telah berdampak langsung terhadap pelayanan rumah sakit, terutama rumah sakit yang menyelenggarakan pelayanan COVID-19. Banyak rumah Sakit mengalami masalah keuangan. Hal ini disebabkan penurunan angka kunjungan pasien, baik rawat jalan maupun rawat inap ke rumah sakit. Di samping itu pengeluaran rumah sakit justru semakin meningkat karena besarnya biaya operasional untuk penanganan pasien COVID-19. Pembiayaan pasien yang dirawat dengan Penyakit Infeksi Emerging (PIE) tertentu termasuk infeksi COVID-19 dapat diklaim ke Kementerian Kesehatan melalui Dirjen Pelayanan Kesehatan. Beban rumah sakit yang menangani pasien COVID-19 semakin tinggi ketika dalam pelaksanaannya banyak didapatkan kendala pada saat pengajuan klaim tersebut. Klaim dispute merupakan klaim yang setelah dilakukan verifikasi oleh BPJS Kesehatan terdapat ketidaksesuaian antara RS dan BPJS Kesehatan.Metode : Penelitian ini merupakan penelitian kualitatif dengan pendekatan studi kasus dengan cara mengumpulkan data melalui wawancara mendalam atau observasi. Penelitian ini dilakukan di RSUD HM Rabain pada bulan Juli – September 2022. Informan merupakan pejabat struktural dan fungsional yang terlibat langsung dalam proses penyelesaian dispute klaim pasien covid 19 di RSUD HM Rabain.Hasil : terdapat 127 klaim dispute pasien COVID-19, sebanyak 124 klaim (97,64%) berhasil dibayarkan, sedangkan sebanyak 3 klaim (2,36%) tidak berhasil dibayarkan. Faktor input yang berpengaruh dalam terjadinya klaim dispute COVID-19 adalah jumlah petugas yang kurang, tempat kerja yang belum optimal, belum ada insentif untuk petugas klaim, aplikasi yang terjadi gangguan. Sedangkan faktor proses yang mempengaruhi terjadinya klaim dispute adalah : belum ada perencanaan, SOP maupun kebijakan rumah sakit untuk penyelesaian dispute klaim, pemeriksaan penunjang pasien kritis sering terlewat, belum dilakukan verifikasi berkas, pelaksanaan revisi klaim menunggu tim TPKD dan evaluasi belum dilakukan secara periodik dan kontinu.Kesimpulan : Faktor input, proses dan output berperan dalam terjadinya klaim dispute pasien COVID-19 di RSUD HM Rabain Muara Enim. Penyelesaian klaim dispute di RSUD HM Rabain tahun 2021 telah diselesaikan. Karakteristik klaim pending BPJS mirip seperti klaim dispute COVID-19 sehingga rekomendasi penelitian ini dapat dipakai untuk mengurangi klaim pending BPJS. Upaya yang dapat dilakukan Rumah Sakit antara lain membuat kebijakan dan SOP pengajuan Klaim COVID-19, menambah jumlah koder, meningkatkan kompetensi verifikator, melengkapi dan meperbaiki saran, prasana dan sistem infromasi Rumah Sakit.

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Background: COVID-19 pandemic has given a direct impact on hospital health services, mainly on those who administered COVID-19 services. Financial problem has been an issue to a lot of hospitals. This is due to lower rate of patient visit, both outpatients and inpatients visit. Furthermore, the hospital outcome keeps increasing since operational cost for COVID-19 patient is awfully expensive. Financing of inpatients with certain Emerging Infection Diseases (EIDs) including COVID-19 infection can be claimed by Health Ministry via director of health services. However, in execution, there are many difficulties in proposing those claims which give a burden build up for hospitals who administered COVID-19 services. Dispute claim is a claim which has discrepancy between the hospital and BPJS Kesehatan after the claim has been verified by BPJS Kesehatan. Method: This research is qualitative research with case study approach by collecting data from deep interview or observation. The current research was implemented in RSUD HM Rabain during July – September 2022. Informant is a structural and functional placeman who got involved directly in the process of resolving COVID-19 patients’ dispute claim in RSUD HM Rabain.

Results: There are 127 dispute claims submitted from total of 590 COVID-19 paitents’ claims. As much as 124 claims (97,64%) were paid successfully, while the rest of 3 claims (2,36%) were failed. Input factors of COVID-19 dispute claims are lack of employee, inadequate working place, there is no incentive for claim officers, and application technical difficulties. Moreover, process factors which affect dispute claims are lack of planning, SOP, and hospital policy on settling dispute claims, missed of supporting examination on critical patients, unverified documents, await of TKPD (Tim Penyelesaian Klaim Dispute) officer for claim revision, and lack of periodical and continuous evaluation.Conclusion: Input, process, and output factors have a great impact on COVID-19 patients dispute claims in RSUD HM Rabain Muara Enim. Refinement of those variables is needed to fluent the claims and dispute claims resolution process. Considering the similar characteristics between BPJS pending claim and COVID-19 dispute claim, the current research recommendation can be also used to reduce incidents of BPJS pending claim."

"Latar Belakang: Pandemi Covid 19 telah menyebabkan turbulensi bagi rumah sakit, RSUD Cengkareng ditunjuk menjadi rumah sakit rujukan Covid 19 secara penuh, dengan adanya perubahan layanan dapat terjadi perubahan pada kinerja baik layanan dan kinerja non layanan di rumah sakit. Tujuan: Penelitian ini bertujuan mengetahui adanya dampak pandemi Covid 19 terhadap kinerja RSUD Cengkareng tahun 2019, 2020 dan 2021 menggunakan metode penilaian kinerja Balanced Scorecard.Metode: Penelitian ini menggunakan metode studi kasus di RSUD Cengkareng , data didapat dari data primer yaitu dari wawancara mendalam kepada informan terpilih, dan data sekunder dari telaah dokumen.Hasil : Dari penelitian diketahui dari perspektif proses bisnis internal terdapat penurunan capaian indikator kinerja pelayanan dan peningkatan kemampuan melakukan inovasi. Dari perspektif pembelajaran dan pertumbuhan diketahui adanya peningkatan retensi karyawan, kepuasan kerja karyawan dan produktivitas karyawan namun penurunan dari capaian jam pelatihan karyawan. Dari perspektif pelanggan diketahui adanya penurunan kunjungan di IGD, Rawat Jalan dan Rawat Inap dan peningkatan retensi pelanggan. Pada perspektif finansial didapatkan peningkatan rasio keuangan dan pertumbuhan pendapatan serta penurunan tingkat pengeluaran.Kesimpulan: Dari penelitian ini bahwa pandemi Covid 19 telah memberikan dampak positif dan dampak negatif terhadap kinerja RSUD Cengkareng.

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Background: The Covid 19 pandemic has caused turbulence for hospitals, Cengkareng Hospital has been appointed as a full Covid 19 referral hospital, with changes in the performance of both services and non-service performance in hospitals.

Objective: This study aims to determine the impact of the Covid 19 pandemic in the performance of Cengkareng Hospital in 2019, 2020 and 2021 using Balanced Scorecard performance assessment method.

Method: This study uses a case study method at Cengkareng Hospital, data obtained from primary data, namely from in depth-interviews with selected informants, and secondary data from document reviews.

Result: From the research, it is known from the perspective of internal business processes that there is a decrease in the achievement of service performance indicators and increase in the ability to innovate. From the perspective of learning dan growth, it is known that there is an increase in employee retention, employee job satisfaction and employee productivity but decrease the achievement of employee training hours. From a customer perspective, it is known that there is a decrease in visits in the Emergency Room, Outpatient and Inpatient and an increase in customer retention. From a financial perspective, there is an increase in financial ratios and income growth as well as a decrease in the level of expenditure.

Conclusion: From this study that the Covid 19 pandemic has had positive impacts and negative impacts on the performance of Cengkareng Hospital."

"Penyakit Covid-19 merupakan penyakit yang menyebabkan masalah pernapasan. Covid-19 memiliki beberapa gejala yang biasanya muncul setelah periode inkubasi. Beberapa gejala umum dari Covid-19 yaitu demam, batuk dan kelelahan, gejala lain seperti produksi sputum, sakit kepala, diare, dispnea, dan lymphopenia juga dapat terjadi. Beberapa pasien yang mengalami batuk dengan produksi sputum memiliki keterbatasan untuk mempertahankan kebersihan jalan napas secara mandiri karena sputum yang terlalu kental dan ketidakmampuan untuk batuk secara efektif. Ketidakmampuan untuk mengeluarkan sputum dapat menyebabkan penumpukan sputum di jalan napas yang menyebabkan obstruksi sehingga ventilasi berkurang. Salah satu peran perawat di IGD adalah melakukan stabilisasi pasien dari sisi Airway, Breathing, Circulation, Disability, Exposure (ABCDE). Pada pasien dengan retensi sputum dapat mengalami penyumbatan jalan napas. Salah satu intervensi keperawatan yang umum untuk pasien dengan retensi sputum yaitu kolaborasi pemberian mukolitik dan prosedur suction. Namun prosedur suction ini dapat menimbulkan nyeri dan risiko cedera jalan napas jika sputum terlalu kental, sehingga perlu dipertimbangkan antara manfaat dan efek sampingnya. Intervensi non invasive lain yang dapat dilakukan untuk mengeluarkan dahak adalah fisioterapi dada dan batuk efektif. Pada studi kasus ini mempresentasikan kasus seorang perempuan (45 tahun) dengan demam 4 hari sebelum masuk rumah sakit, lemas, sesak, pusing, mual, anosmia dan tidak bisa tidur, batuk produktif namun kesulitan mengeluarkan sputum, terkonfirmasi positif Covid-19 melalui swab antigen dan PCR. Saat berada di IGD pasien mendapatkan terapi oksigenasi nasal kanul, medikasi dan fisioterapi dada. Setelah dilakukan dua kali fisioterapi dada, pasien dapat mengeluarkan dahak dan saturasi meningkat. Studi kasus ini menunjukkan seberapa kegunaan fisioterapi dada dan batuk efektif sebagai salah satu intervensi untuk membantu mengatasi diagnosa ketidakefektifan bersihan jalan napas pada pasien Covid-19.

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Covid-19 is a disease that causes respiratory problems. Covid-19 has several symptoms that usually appear after the incubation period. Some of the common symptoms of Covid-19 are fever, cough, fatigue, other symptoms such as sputum production, headache, diarrhea, dyspnea, and lymphopenia can also occur. Some patients who have a cough with sputum production have limited ability to maintain a clean airway independently because of excessively thick sputum and an inability to cough effectively. The inability to excrete sputum can lead to a buildup of sputum in the airways which obstructs so that ventilation is reduced. One of the nurse's roles in the ER is to stabilize the patient from the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) side. Patients with sputum retention may experience airway obstruction. One of the common nursing interventions for patients with sputum retention is the collaboration of mucolytic administration and suction procedures. However, this suction procedure can cause pain and the risk of airway injury if the sputum is too thick, so it is necessary to consider the benefits and side effects. Another non-invasive intervention that can be done to remove sputum is chest physiotherapy and effective coughing. In this case study, we present the case of a woman (45 years old) with fever 4 days before hospital admission, weakness, shortness of breath, dizziness, nausea, anosmia and unable to sleep, productive cough but difficulty expel sputum, confirmed positive for Covid-19. While in the ED the patient received nasal cannula oxygenation therapy, medication, and chest physiotherapy. After two chest physiotherapy, the patient was able to expel sputum and increased saturation. This case study shows how effective chest and cough physiotherapy is as an intervention to help overcome the diagnosis of ineffective airway clearance in Covid-19 patients."

"Sebagai upaya dalam merespon dan memulihkan dampak yang diakibatkan oleh pandemi Covid-19, kepala daerah melalui kewenangannya memberikan fasilitas insentif PBB-P2 berupa keringanan pokok pajak dan penghapusan sanksi administrarif yang dituangkan dalam peraturan gubernur. Penelitian ini bertujuan untuk menganalisis implementasi dari implementasi kebijakan serta hambatan yang terjadi selama kebijakan insentif PBB-P2 pada masa pandemi diberlakukan. Penelitian ini menggunakan pendekatan kualitatif dengan teknik pengumpulan data melalui studi kepustakaan dan wawancara mendalam terhadap narasumber terkait. Hasil penelitian menunjukkan bahwa pemberian kebijakan insentif PBB-P2 selama masa pandemi dilaksanakan secara terstruktur dan menimbulkan dampak positif bagi masyarakat yang memanfaatkannya. Kemudian, hambatan yang muncul dari implementasi kebijakan insentif PBB-P2 selama masa pandemi antara lain kebijakan yang dinilai cenderung populis, tarif insentif yang diberikan semakin besar dapat menyebabkan potential loss semakin besar, serta proses perumusan kebijakan yang panjang dan memakan waktu yang cukup lama.

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As an effort to respond and restore the impact caused by the Covid-19 pandemic, regional heads through their authority provide PBB-P2 incentive facilities in the form of tax principal relief and the elimination of administrative sanctions as outlined in governor regulations This study aims to analyze the implementation of the policy implementation and the obstacles that occurred during the PBB-P2 incentive policy during the pandemic. This study uses a qualitative approach with data collection techniques through literature studies and in-depth interviews with relevant informants. The results of the research show that the provision of PBB-P2 incentive policies during the pandemic was carried out in a structured manner and had a positive impact on the people who took advantage of it. Then, the obstacles that arose from the implementation of the PBB-P2 incentive policy during the pandemic included policies that were considered to tend to be populist, higher incentive rates that were given could lead to greater potential losses, and a long and time-consuming policy formulation process."

"COVID-19 merupakan penyakit yang disebabkan oleh virus SARS-CoV-2 yang mengakibatkan pandemi global. Jakarta adalah salah satu kota di Indonesia dengan angka kasus dan kematian tertinggi akibat COVID-19. Salah satu cara paling efektif untuk mengurangi keparahan dan resiko penularan COVID-19 adalah dengan vaksinasi. Vaksin dapat merangsang respons imunitas humoral tubuh yang menghasilkan antibodi netralisasi. Selain vaksin, antibodi netralisasi dapat diinduksi secara natural oleh imunitas tubuh. Hybrid immunity merupakan gabungan antara antibodi netralisasi yang diinduksi secara natural dan yang diinduksi oleh vaksin. SARS-CoV-2 terus bermutasi memunculkan berbagai varian yang menyebabkan peningkatan jumlah kasus dan munculnya gelombang COVID-19 baru di Indonesia, yaitu gelombang Delta pada Juni 2021 dan gelombang Omicron pada Januari 2022. Penelitian ini bertujuan untuk mengevaluasi perubahan antibodi netralisasi 3 bulan setelah vaksinasi dosis lengkap dari beberapa jenis vaksin, yaitu vaksin virus inaktivasi (CoronaVac), vaksin viral vektor (ChAdOx1 nCoV-19), dan vaksin mRNA (BNT162b2) serta pengaruh riwayat infeksi SARS-CoV-2 pada penerima vaksin terhadap berbagai varian SARS-CoV-2 (Wuhan, Delta, Omicron B.1.1.529 dan BA.2). Penelitian dilakukan dengan menggunakan uji Surrogate Virus Neutralization Test (sVNT) yang memiliki prinsip kerja seperti enzyme-linked immunosorbent assay (ELISA) dan meniru interaksi antara receptor binding domain (RBD) dan angiotensin-converting enzyme 2 (ACE2) dalam pelat ELISA dengan RBD dan ACE2 yang telah mengalami pemurnian dengan sampel serum partisipan populasi umum (n = 76). Hasil penelitian menunjukkan adanya perbedaan signifikan antara antibodi netralisasi sebelum dan 3 bulan setelah vaksinasi dosis lengkap, tetapi tidak terdapat perbedaan signifikan pada antibodi netralisasi yang dihasilkan dari masing-masing jenis vaksin. Hal tersebut kemungkinan disebabkan oleh waktu pengambilan sampel setelah terjadi gelombang Omicron COVID-19 sehingga terjadi hybrid immunity yang menyebabkan tingginya kadar antibodi netralisasi yang merata pada setiap jenis vaksin. Partisipan dengan riwayat infeksi SARS-CoV-2 memiliki kadar antibodi netralisasi yang lebih tinggi. Terdapat perbedaan antibodi netralisasi yang signifikan terhadap berbagai varian SARS-CoV-2 dengan penurunan kadar antibodi netralisasi yang signifikan terhadap varian Omicron B.1.1.529 dan BA.2. Kesimpulan dari penelitian ini adalah vaksinasi dosis lengkap berhasil meningkatkan kadar antibodi netralisasi hingga 3 bulan pascavaksinasi yang dipengaruhi oleh riwayat infeksi SARS-CoV-2.

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COVID-19 is a disease caused by the SARS-CoV-2 virus which has resulted in a global pandemic. Jakarta is one of the cities in Indonesia with the highest number of COVID-19 cases and deaths. One of the most effective ways to reduce the severity and transmission risk of COVID-19 is by getting vaccinated. Vaccines can stimulate the body's humoral immune response to produce neutralizing antibodies. Apart from vaccines, neutralizing antibodies can be induced naturally by the body's immunity. Hybrid immunity is a combination of naturally induced neutralizing antibodies and those induced by vaccines. The continuously mutating SARS-CoV-2 has led to the emergence of various variants which have resulted in an increase in the number of cases and the emergence of new COVID-19 waves in Indonesia, namely the Delta variant which appeared in June 2021 and the Omicron variant in January 2022. This study aims to evaluate changes in neutralizing antibodies 3 months after complete doses of several types of vaccines, namely inactivated virus vaccine (CoronaVac), viral vector vaccine (ChAdOx1 nCoV-19), and mRNA vaccine (BNT162b2) and the effect of a history of SARS-CoV-2 infection in vaccine recipients against various variants SARS-CoV-2 (Wuhan, Delta, Omicron B.1.1.529 and BA.2). The study was conducted using the Surrogate Virus Neutralization Test (sVNT) test which has a working principle like the enzyme-linked immunosorbent assay (ELISA) and mimics the interaction between the receptor binding domain (RBD) and angiotensin-converting enzyme 2 (ACE2) in ELISA plates using RBD and ACE2 that had undergone purification with sera samples of general population participants (n = 76). The results showed that there were significant differences between the neutralizing antibodies before and 3 months after the full dose of vaccination, but there were no significant differences in the neutralizing antibodies produced from each type of vaccine. This was probably caused by the sampling time after the Omicron COVID-19 wave occurred, resulting in hybrid immunity which resulted in high levels of neutralizing antibodies that were evenly distributed in each type of vaccine. Participants with a history of SARS-CoV-2 infection had higher levels of neutralizing antibodies. There were significant differences in neutralizing antibodies against various variants of SARS-CoV-2 with a significant decrease in levels of neutralizing antibodies against Omicron B.1.1.529 and BA.2 variants. The conclusion of this study is that full dose vaccination has succeeded in increasing neutralizing antibody levels for up to 3 months after vaccination which are affected by a history of SARS-CoV-2 infection."

"Pandemi COVID-19 membawa perubahan yang sangat besar bagi kehidupan sehari-hari masyarakat. Selain itu kebijakan yang berhubungan dengan pandemi seperti stay-at-home, ataupun pembatasan sosial (lockdown) memberikan dampak positif dan negatif. Dampak negatifnya yang timbul akibat kebijakan tersebut adalah tingkat stress dan tekanan pada seseorang menjadi lebih tinggi pada masa Pandemi COVID-19. Hal ini dapat berujung pada kejahatan familicide. Familicide merujuk pada pembunuhan yang dilakukan oleh anggota keluarga terhadap anggota keluarga lainnya. Penelitian ini menganalisis terkait pola kasus familicide di Indonesia selama masa pandemi COVID- 19. Analisis isi kuantitatif digunakan dalam penelitian ini dan data diperoleh dari laporan berita online serta dokumen lembaga negara. Data kemudian dianalisis menggunakan routine activity theory dan strain theory untuk menjelaskan fenomena familicide dalam konteks pandemi COVID-19. Hasilnya, ditemukan bahwa kasus familicide meningkat selama pandemi di Indonesia. Kebijakan stay-at-home dikatakan memberi kerugian pada korban karena membatasi mobilitas dan akses korban untuk mencari pertolongan. Namun, memudahkan pelaku untuk melakukan tindakan kekerasan atau familicide kepada korban. Pada akhirnya, pandemi COVID-19 memberikan dampak terkait dengan gaya hidup dan tekanan yang signifikan yang berkontribusi pada meningkatnya kasus familicide di Indonesia...... The COVID-19 pandemic has brought tremendous changes to people's daily lives. In addition, pandemic-related policies such as stay-at-home orders and social restrictions (lockdown policies) have had both positive and negative impacts. The negative impacts such as the stress and tension levels in individuals have intensified during the COVID-19. It potentially can stimulate someone to commit the crime of familicide. Familicide refers to murders committed by family members against other family members. This study analyzes patterns of familicide cases in Indonesia during the COVID-19 pandemic from 2019-2022. Quantitative content analysis was utilized, and data was obtained from online news reports and governmental institution documents. The data was then examined through the criminological theories of routine activity theory and strain theory to elucidate the phenomenon of familicide in the context of the COVID-19 pandemic in Indonesia. The findings revealed that familicide cases escalated throughout the pandemic, with greater numbers annually. However, such policies simultaneously enabled offenders to commit violence more easily or familicide against victims. Therefore, the COVID-19 pandemic introduced impactful lifestyle and strain alterations that contributed to the rise in familicide cases in Indonesia. Additionally, stay-at-home policies indirectly intensified interactions between potential offenders and victims within households, while reducing interactions and access to external contacts capable of providing protection."

"Secara umum, jumlah pasien COVID-19 yang mendapatkan perawatan di rawat inap lebih banyak daripada di ICU, sehingga menjadikannya urgensi untuk memberikan pelayanan terbaik dengan memberikan terapi pengobatan yang efektif agar jumlah pasien sembuh terus bertambah. Dalam peresepan obat dapat terjadi kesalahan yang akan menyebabkan pengobatan bagi pasien COVID-19 tidak efektif, salah satunya Masalah Terkait Obat (MTO). Penelitian ini bertujuan untuk mengidentifikasi MTO pada pasien COVID-19 rawat inap di RSUI tahun 2020. Penelitian ini merupakan penelitian deskriptif dengan desain penelitian cross sectional. Data yang digunakan merupakan data sekunder yang diambil secara retrospektif dari resep dan rekam medis pasien. Klasifikasi MTO dalam penelitian ini mengacu pada klasifikasi Hepler dan Strand. Identifikasi dilakukan pada 406 pasien COVID-19 yang memenuhi kriteria inklusi. Hasil dari penelitian menunjukkan adanya MTO sebanyak 26 kejadian pada 22 pasien dari 406 pasien COVID-19 rawat inap di RSUI tahun 2020 dengan persentase indikasi yang tidak diobati sebesar 3,85%, kesalahan pemilihan obat 11,54%, kegagalan dalam penerimaan obat 23,08%, reaksi obat tidak diinginkan 19,23%, potensi interaksi obat 42,31%, dan tidak ditemukan kejadian dosis subterapi, dosis berlebih, serta penggunaan obat tanpa indikasi. Berdasarkan hasil identifikasi tersebut, dapat disimpulkan bahwa terapi pengobatan pasien COVID-19 rawat inap di RSUI berpotensi mengalami MTO.

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In general, the number of COVID-19 patients who are hospitalized is more than in the ICU, thereby this becomes an urgency to provide the best service by providing effective treatment to increase the number of recovered patients. In prescribing drugs, errors can occur which will cause treatment for COVID-19 patients to be ineffective, one of which is Drug-related Problems (MTO). This study aims to identify DRP in hospitalized COVID-19 patients at RSUI in 2020. This study is a descriptive study with a cross-sectional study design. The data used in this study are secondary data taken retrospectively from prescriptions and patient medical records. The DRP classification used in this study refers to the Hepler and Strand classifications. Identification was carried out on 406 COVID-19 patients who met the inclusion and exclusion criteria. The results of the study indicated that there were 26 DRP events in 22 out of 406 hospitalized COVID-19 patients at RSUI with the proportion of events for untreated indications 3,85%, improper drug selection 11,54%, failure to receive drugs 23,08%, adverse drug reactions 19,23%, potential drug interactions 42,31%, and there were no incidence of subtherapeutic dosage, overdosage, and drug use without indication. Based on the results, it can be seen that the treatment for hospitalized COVID-19 patients at RSUI has the potential to experience drug related problems."