Master of Hospital Administration, Universitas Muhammadiyah Yogyakarta, Yogyakarta 55183, Indonesia.
Department of Child Health, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya 60285, Indonesia.
Comput Math Methods Med. 2022 Sep 13;2022:2495064. doi: 10.1155/2022/2495064. eCollection 2022.
This study is aimed at calculating the magnitude of the effect of clinical practice guidelines (CPG) and supervision in inhibiting the negative impact of the COVID-19 pandemic on clinical and financial outcomes of non-COVID-19 inpatient care by pediatric residents in academic medical center (AMC) hospitals during the COVID-19 pandemic.
The cohort retrospective study was conducted. This study collected patient data from pediatric residency programs. A research cohort consisted of non-COVID-19 pediatric patients at Dr. Soetomo General Academic Hospital. This study compared the subgroup of patients treated during the pandemic with those treated before the pandemic. The results were analyzed using SPSS 26.0 and Smart-PLS.
There was a 41.4% decrease in pediatric inpatients during the pandemic with an increased severity level and complexity level, a reduction of 7.46% availability of supervisors, an increase of 0.4% in readmission < 30 days, an increase of 0.31% in-hospital mortality, an increase the total costs of care, and a decrease of insurance claim profit. CPG did not moderate the effect of the COVID-19 pandemic on the clinical outcomes ( = -0.006, = 0.083) but moderated the financial outcomes ( = -0.022, = 0.000), by reducing the total cost of care and increasing insurance claim profit. Supervision moderated the effect of the COVID-19 pandemic on the clinical outcomes ( = 0.040, = 0.000) by increasing aLOS and on the financial outcomes ( = -0.031, = 0.000) by reducing the total cost of care and increasing insurance claim profit. This study model had a 24.0% variance of explanatory power for clinical outcomes and 49.0% for financial outcomes. This study's structural model effectively predicted clinical outcomes ( = 0.238) and financial outcomes ( = 0.413).
Direct supervision inhibited the negative impact of the COVID-19 pandemic on both clinical and financial outcomes of non-COVID-19 inpatient care by pediatric residents, while CPG only inhibited the negative impact on financial outcomes. . In a disaster, the availability of CPG and direct supervision makes AMC hospitals able to inhibit the negative impact of disasters on clinical and financial outcomes.
本研究旨在计算临床实践指南（CPG）和监督对学术医疗中心（AMC）医院儿科住院医师在 COVID-19 大流行期间抑制 COVID-19 对非 COVID-19 住院患者临床和财务结果负面影响的作用大小。
本研究采用回顾性队列研究。本研究从儿科住院医师项目中收集患者数据。研究队列由苏托莫综合学术医院的非 COVID-19 儿科患者组成。本研究将大流行期间治疗的亚组与大流行前治疗的亚组进行比较。使用 SPSS 26.0 和 Smart-PLS 对结果进行分析。
大流行期间儿科住院患者减少了 41.4%，严重程度和复杂程度增加，监督人员可用性减少了 7.46%，30 天内再入院率增加了 0.4%，住院死亡率增加了 0.31%，医疗费用增加，保险索赔利润减少。CPG 并未调节 COVID-19 大流行对临床结果的影响（ = -0.006， = 0.083），但通过降低总医疗费用和增加保险索赔利润来调节财务结果（ = -0.022， = 0.000）。监督调节了 COVID-19 大流行对临床结果的影响（ = 0.040， = 0.000），通过增加 aLOS 并降低总医疗费用和增加保险索赔利润来调节财务结果（ = -0.031， = 0.000）。该研究模型对临床结果的解释能力为 24.0%，对财务结果的解释能力为 49.0%。本研究的结构模型有效地预测了临床结果（ = 0.238）和财务结果（ = 0.413）。
直接监督抑制了 COVID-19 对儿科住院医师非 COVID-19 住院患者临床和财务结果的负面影响，而 CPG 仅抑制了对财务结果的负面影响。在灾难中，CPG 和直接监督的可用性使 AMC 医院能够抑制灾难对临床和财务结果的负面影响。
