Premium
Assessment of the quality of hospital care for children in Indonesia
Author(s) -
Sidik Nurul A.,
Lazuardi Lilliana,
Agung Fransisca H.,
Pritasari Kirana,
Roespandi Hanny,
Setiawan Tini,
Pawitro Udjiani,
Nurhamzah Waldi,
Weber Martin W.
Publication year - 2013
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12061
Subject(s) - medicine , quality management , stratified sampling , family medicine , hospital care , pediatrics , emergency medicine , service (business) , health care , economy , pathology , economics , economic growth
Objectives To obtain an overview of the quality of care for children in Indonesia, by assessing hospitals with a view to proceed to a quality improvement mechanism for child care. Methods Stratified two‐stage random sampling in six regions identified 18 hospitals (provinces Jambi, East Java, Central Kalimantan, South–East Sulawesi, East Nusa Tenggara, North Maluku). Three randomly selected hospitals in each province were visited by trained assessors who scored each assessed service (expressed as a percentage of achievement) and grouped into good (≥ 80%), requiring improvement (60–79%) and urgently requiring improvement (< 60%). Results The overall median result score across all areas was 43% ( IQR 28%–53%). Case management for common childhood illnesses had a median score of 37% ( IQR 18–43%), neonatal care 46% ( IQR 26–57%) and patient monitoring 40% ( IQR 30–50%), all indicating an urgent need for improvement. Qualitative data showed as main problems inadequate use of standard treatment guidelines, irrational prescribing of antibiotics, poor progress monitoring and poor supportive care. Conclusion We found serious shortcomings in the quality of hospital care for children. Finding and documenting those is the first step in a quality improvement process. Work is needed to start an improvement cycle for hospital care.