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Abstract
Repeated hospitalization is one of the performance indicators of global budget payments. Unplanned repeated hospitalization is a preventable event and its interval is influenced by several factors including the patients, the patients’ clinical condition, and the policy. This research is aimed at analyzing the effect of disease severity, Length of Stay (LOS), and patient discharge status on the repeated hospitalization interval among JKN patients at hospitals BPJS Kesehatan Semarang Branch Office in 2021. This study contributes to the claim management literature by focusing on repeated hospitalization as an evaluation tool to improve the quality of inpatient care. This research was a quantitative study with a cross-sectional design involving hospitalized patients returning for hospitalization within 30 days. Patients who were discharged being referred to other health facilities and those with transplantation, delivery, physiotherapy, and chronic diseases were excluded. Univariate and bivariate analyzes were then performed using the STATA software. The majority of repeated hospitalized patients were aged 12-25 years (69.47%), women (53.88%), and found in type C hospitals (32.85%). There was an association between disease severity and LOS with the repeated hospitalization interval. Increasing severity of illness was found to show a higher risk of repeated hospitalization < 12 days (OR=1.23). Patients with LOS ≥ 4 days increased the risk of repeated hospitalization < 12 days (OR = 1.33). There was no association between discharge status with repeated hospitalization. Conclusion: There is a significant association between disease severity and LOS with repeated hospitalization interval.
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References
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References
Anggraini, S.(2021).Pasien BPJS Pulang Atas Permintaan Sendiri (PAPS) (Studi Kasus Pada Pasien Rawat Inap di RS Rumkit TK II Putri Hijau KESDAM I/BB Medan Tahun 2019).Excellent Midewifery Journal Volume 4 No 1
Berry J.G.et al.(2018).Age Trends in 30 Day Hospital Readmissions: US National Retrospective Analysis. British Medical Journal 360 :k497
Carey,K dan Lin,M.Y.(2014). Hospital Length of Stay and Readmission: An Early Investigation.Medical Care Research and Review Vol 71
Cholack, G.,et al.(2022).Predictors of Early (0-7 Days) and Late (8-30 Days) Readmission in a Cohort of Acute Coronary Syndrome Patients.International Journal of Medical Student olume 10 Issue 1
Conway, R., et al.(2015). Emergency Readmissions are Substantially Determined by Acute Illness Severity and Chronic Debilitating Illness: A single Centre Cohort Study. European Journal of Internal Medicine 26
Darma, A.R.(2013).Trombositopenia Sebagai Faktro Prognostik Pada Penderita Yang Dirawat Di Perawatan Intensif.Makassar : Universitas Hassanudin
DJSN dan BPJS Kesehatan.(2021).Statistik JKN 2015–2019.Jakarta:DJSN
Fisher, S.V.,et al.(2016).Predictors of 30-Day Readmission Following Inpatient Rehabilitation for Patients at High Risk for Hospital Readmission.Physical Therapy Volume 96 Number 1
Herdiana, T.(2021). Determinan Rawat inap berulang Pasien Jaminan Kesehatan Nasional di Fasilitas Kesehatan Rujukan Tingkat Lanjut: Analisis Data Sampel BPJS Kesehatan 2015/2016.Social and Health Protection 1:1(13-21)
Idris, F., et al.(2020). Sistem Pembayaran Mixed Method INA-CBGs dan Global Budget di Rumah Sakit: Tahap 1 Uji Coba Mixed Method INACBGs-Global Budget di Indonesia.Jurnal Ekonomi Kesehatan Indonesia Volume 5 Nomor 2
Isfandari, S dan Lolong, D.B.(2014).Analisa Faktor Risiko Dan Status Kesehatan Remaja Indonesia Pada Dekade Mendatang.Buletin Penelitian Kesehatan Vol. 42 No. 2
Joynt K.E dan Jha A.K.(2012).Thirty-Day Readmissions–Truth anda Consequences.The New England Journal of Medicine 366:15
Kurniawan, Y.(2018).Hubungan Antara Tingkat Pengetahuan Tentang Anemia dengan Kepatuan Konsumsi Tablet Tambah Darah Pada Remaja Putri Kelas XI SMA 2 Kota Malang.Skripsi.Malang: Universitas Brawijaya
Maali Y., et al.(2018).Predicting 7-day, 30-day and 60-day All Cause Unplanned Readmission: a Case Study of a Sydney Hospital.BMC Medical Informatics and Decision Making 18:1
Menteri Kesehatan Republik Indonesia.(2012).Permenkes RI Nomor 1 Tahun 2012 tentang Sistem Rujukan Pelayanan Kesehatan Perorangan
Rachoin, J.S.,et al.(2020).Impact of Length of Stay on Readmission in Hospitalized Patients.Cureus 12(9)
Razak, P. N. A.(2020).Gambaran Kejadian Thirty Days–Hospital Readmission Pada Pasien BPJS Di Ruang rawat Inap RSUD Haji Kota Makassar.Skripsi.Makasssar: Universitas Hassanudin
Rinne, S.T.et al.(2018).Association Between Length of Stay and Readmission for COPD.American Journal of Managed Care 23: e253–e258
Yale New Haven Health Services Corporation Center for Outcomes Research & Evaluation (YNHHSC/CORE).(2013).Centers for Medicare & Medicaid Services Planned Readmission Algorithm – Version