Analisis Perbedaan Kelengkapan Berkas Rekam Medis Pasien BPJS dan Umum Pada Kasus Dengue Haemorrhagic Fever (DHF) di RSD Balung Jember Triwulan 1 Tahun 2015

RACHMAWATI, RENNY (2016) Analisis Perbedaan Kelengkapan Berkas Rekam Medis Pasien BPJS dan Umum Pada Kasus Dengue Haemorrhagic Fever (DHF) di RSD Balung Jember Triwulan 1 Tahun 2015. Undergraduate thesis, Politeknik Negeri Jember.

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Abstract

The complete medical record contains of the whole patients’ information included medical resume, nursing, and all supported checkup results which has been marked by the responsible doctor. The indicator of filling the medical record is 1X24’s after giving a service, with 100% completed standard of medical record. The incompleteness of medical record files become a problem because medical record can give complete and accurate information; also directly affect the proposal of BPJS submission claim. Based on the early survey, it was found differences medical records files completeness between BPJS and general patients in the case of DHF at RSD Balung Jember in the first quarter in 2015. The purpose of this research is analyzing the differences medical record files completeness between BPJS and general patients in the case of DHF at RSD Balung Jember in the first quarter of 2015. The kind of this research is observational analytic research which uses cross sectional approach. The research objectives are 59 medical record files in the case of DHF. The samples consist of 23 medical record files of BPJS and 28 medical record files of general patients. This analysis used Mann-Whitney test by SPSS 16 version program. The result of this research shows that there are differences medical records file completeness between BPJS and general patients in the case of DHF at RSD Balung Jember in the first quarter of 2015 with analysis value p = 0,004. It causes BPJS claim submission obstracted and also the unappropriate diagnose code can give a big impact to the BPJS claim cost. Key words: Completeness, Medical Record, DHF

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