ABSTRACT
Background. As a producer of hazardous waste, hospitals have the responsibility to manage the waste they produce. Hospital non-compliance in managing hazardous waste can have a negative impact on the environment and public health, especially during the COVID-19 pandemic, when the amount of hazardous waste produced by healthcare facilities is increasing. To protect the environment and public health from the negative impact of hazardous medical waste, this study was conducted to determine the level of compliance of hazardous waste management in hospitals in Indonesia before and during the COVID-19 pandemic, from 2019 to 2020. Study design. Cross-sectional. Methods. This study was conducted at 343 hospitals in Indonesia using secondary data obtained from Sikelim (Medical Waste Management Information System), which is owned and operated by the Ministry of Health. The data have been analyzed using chi-square tests and logistic regressions of the determinant model. Results. There was an increase in the level of compliance of hazardous waste management in hospitals from 82% to 86% during the pandemic. Furthermore, the availability of environmental documents and environmental health units were determinant factors of hazardous waste management compliance by hospitals before the pandemic in 2019. The only factor in 2020 was the availability of environmental health units. Conclusions. Despite the good level of compliance, additional efforts are needed to increase the activities of the treatment of hazardous medical waste by hospitals, as before the pandemic (i.e., in a normal situation) only 8% of hospitals was able to independently manage hazardous medical waste using authorized incinerators, a percentage that was reduced to 6% during the pandemic. © Società Editrice Universo (SEU), Roma, Italy
ABSTRACT
Before the COVID-19 pandemic, the Bogor City Government regulated to cover the health financing claim during the Indonesian National Health Insurance (NHI) integration period due to the lower amount of health care claim per episode in regional hospitals compared to ones that NHI paid. This study aimed to address post-COVID-19 health financing at two hospitals in Bogor City, West Java Province, Indonesia. Descriptive analysis using the aggregate statistical summaries was taken to explore the medical care episodes of the data series at two hospitals for the last two years. Of the 890 checked medical records data, the deficit occurred in 197 (22.1%) medical care episodes, while five (0.6%) exceeded the hospitals' tariffs. The remaining 688 (77.3%) medical care episodes had suits with the Indonesian-Case Based Groups. Almost a quarter of medical care episodes in aggregate experienced a deficit in the two years before the pandemic. This study is the first to provide new insight into the discussion on medical care financing in a developing country's post-pandemic era in a newly-implemented NHI system.
ABSTRACT
BACKGROUND: As a producer of hazardous waste, hospitals have the responsibility to manage the waste they produce. Hospital non-compliance in managing hazardous waste can have a negative impact on the environment and public health, especially during the COVID-19 pandemic, when the amount of hazardous waste produced by healthcare facilities is increasing. To protect the environment and public health from the negative impact of hazardous medical waste, this study was conducted to determine the level of compliance of hazardous waste management in hospitals in Indonesia before and during the COVID-19 pandemic, from 2019 to 2020. STUDY DESIGN: Cross-sectional. METHODS: This study was conducted at 343 hospitals in Indonesia using secondary data obtained from Sikelim (Medical Waste Management Information System), which is owned and operated by the Ministry of Health. The data have been analyzed using chi-square tests and logistic regressions of the determinant model. RESULTS: There was an increase in the level of compliance of hazardous waste management in hospitals from 82% to 86% during the pandemic. Furthermore, the availability of environmental documents and environmental health units were determinant factors of hazardous waste management compliance by hospitals before the pandemic in 2019. The only factor in 2020 was the availability of environmental health units. CONCLUSIONS: Despite the good level of compliance, additional efforts are needed to increase the activities of the treatment of hazardous medical waste by hospitals, as before the pandemic (i.e., in a normal situation) only 8% of hospitals was able to independently manage hazardous medical waste using authorized incinerators, a percentage that was reduced to 6% during the pandemic.
ABSTRACT
BACKGROUND: In anticipation of coronavirus disease (COVID)-19’s transmission peak, Eid-al-Fitr homecoming (mudik) has officially been banned by the Indonesian government interlocal but not local in welcoming this religious Muslim celebration. This local Mudik is held by traveling among regional provinces and is still allowed by each local government, including Java, which has the highest transmission of COVID-19 in Indonesia. AIM: This study aims to present the difference between COVID-19 status before and during local Mudik on Java during Ramadhan with the implementation of large-sale social distancing applied in Jakarta, Indonesia. METHODS: This research was employed by secondary data analysis that was obtained from surveillance data from related authorities, including the Ministry of Health and all local governments of Java, which consisted of four provinces and Jakarta. Incidence and suspect statuses of COVID-19, which were examined in the study, were presented in daily rates with before and during local Mudik in four provinces: Jawa Barat, Yogyakarta, Banten, and Jawa Tengah. RESULTS: The number of positive confirmed patients differed significantly with before and during local Mudik (p < 0.05;mean difference = −/negative values). CONCLUSION: This study’s findings showed that the local Mudik increased the number of COVID-19 cases in four provinces in Java, which these provinces were designated as Mudik destinations by travelers coming from Jakarta during the end of Ramadhan season. © 2020 Meita Veruswati, Al Asyary, Rony Darmawansyah Alnur, Guspianto Guspianto.
ABSTRACT
Social distancing shall be effective to control Covid-19 spread. However, its effectiveness is doubtfully due to late response of authority in a low-resource setting such as Indonesia. This study aims to present the effectiveness of large-sale social restriction (LSSR) as the social distancing policy by analyze the chronological as well as the difference between before and after LSSR implementation in Jakarta, Indonesia. The secondary data analysis was derived from surveillance data for Covid-19 from government authorities, including the Ministry of Health and the local government of Jakarta. Two statuses related to Covid-19 were examined in the study: incidence and suspect. These Covid-19 statuses were presented in daily rates with pre and post of LSSR policy in Jakarta, Indonesia. LSSR policy had just implemented over a month after the first multiple cases found. The number of positive confirmed patients increased significantly after the LSSR (p-value = 0.000;mean difference = -70.532). This study's findings showed that social distancing was not effective to control Covid-19 incidence which indicates the late response of the authorities. © The Authors, published by EDP Sciences, 2020.