TEMPO.CO, Cirebon-Sepasang bayi kembar yang baru dilahirkan dari keluarga miskin meninggal, setelah sebelumnya ditolak mendapatkan perawatan di RSUD Indramayu. Pihak rumah sakit menyatakan ruang inkubator untuk merawat bayi itu penuh.

Berdasarkan informasi yang berhasil dihimpun pasangan Nursidi dan Darsiti,16, warga blok Koncong Desa Pabean Ilir Kecamatan Pasekan baru saja memiliki anak kembar. Darsiti melahirkan pada Ahad, 5 Mei 2013 di rumahnya. Bayi yang dilahirkan dalam kondisi prematur 7 bulan.

Karena kondisi bayi kembar laki-laki yang mengkhawatirkan, keduanya pun dibawa ke puskesmas Pasekan. Namun karena keterbatasan alat membuat kedua bayi kembar itu akhirnya dirujuk ke RSUD Indramayu. Saat tiba RSUD Indramayu bayi kembar tersebut malah tidak bisa dirawat. Alasannya, ruang perawatan bayi penuh.

“Alat inkubatornya penuh,” kata Nursidi, orangtua bayi. Bayi kembar yang bobotnya hanya 1 kg itu dirujuk ke Rumah Sakit Putra bahagia Cirebon. “Jangankan untuk membawa ke Cirebon, untuk makan sehari-hari saja kami sulit,” kata Nursidi.

Akhirnya dengan pasrah Nursidi pun membawa bayi kembarnya pulang ke rumah. Namun di tengah perjalanan nyawa bayi kembarnya meninggal. Bayi kembar itu pun dimakamkan di pemakaman umum di desa mereka.

Plt Direktur RSUD Indramayu Zaenal Arifin menyatakan belum mendengar adanya penolakan yang dilakukan oleh bagian perinatologi RSUD Indramayu. Tapi, dia membenarkan bahwa rumah sakit itu memiliki keterbatasan alat inkubator khusus. “Kami sudah mengajukan anggaran untuk pembelian inkubator NICU tahun ini ke DPRD,” katanya.

Sumber: tempo.co

Pontianak – PT Bank Ekonomi Raharja Tbk (BAEK) dan PT Hexa Daya Medika (HDM) menandatangani nota kesepahaman (memorandum of understanding/MoU) terkait pemberdayaan RS Mitra Medika.

“Kerjasama ini merupakan langkah strategis untuk mengoptimalkan potensi bisnis Bank Ekonomi dan HDM,” ujar Head of Corporate Banking Bank Ekonomi, Dadi Budiana, dalam siaran persnya, Senin (6/5).

Dalam kerjasama ini, Bank Ekonomi akan mendanai pembangunan Rumah Sakit Mitra Medika di Pontianak. Selanjutnya, perseroan juga akan membiayai pembelian alat-alat kesehatan, termasuk untuk masa pra-operasional dan setelah operasional.

Dadi mengatakan, dengan kerjasama ini diharapkan dapat membantu RS Mitra Medika untuk memberikan pelayanan terbaik di Pontianak. Selain itu, dari sisi Bank Ekonomi, kerjasama ini bisa memperkuat bisnis perseroan hingga ke pelosok Pontianak.

Sementara itu, Direktur PT Hexa Daya Medika Suwandi Tjia mengatakan, proyek pembangunan rumah sakit ini akan melengkapi kebutuhan masyarakat akan pelayanan rumah sakit yang berkualitas dengan akses yang mudah dan efisien.

Sumber: beritasatu.com

About 500 children each year arrive at the Boston Children’s Hospital emergency room with chest pain, a symptom that is rarely serious. In the past, many of them received tests they didn’t need, including EKGs, echocardiograms, stress tests, and around-the-clock monitoring using electrodes attached to a portable device. “There is a lot of anxiety among parents and children that this could be a heart problem,’’ said Dr. Michael Farias, a senior resident.

And other children who should have had certain tests for cardiac trouble never got them.

Doctors from Children’s set out to reduce this inconsistency and also to save money on care with something called a Standardized Clinical Assessment and Management Plan, or SCAMP. In an article online today in the journal Health Affairs, doctors laid out evidence that their approach works.

The management plans have been developed for 49 medical conditions at Children’s and other hospitals, including Brigham and Women’s in Boston. Doctors like the approach, according to surveys at six hospitals, because the plans start with existing practice recommendations, but allow physicians to diverge from the guidelines as long as they document their rationale. Their decisions are tracked and then used to update the guidelines.

For example, most children who come to the emergency room complaining of chest pain have growth-related sore muscles and bones, or asthma or other breathing problems. Doctors discovered after reviewing the hospital data’s that fewer than 1 percent of the children had a heart condition, and those children primarily had pain when they exercised or exerted themselves, Farias said. “We looked back and asked, ‘What do we really need to worry about?’ ’’ he said.

Now, the children who have chest pain when they exercise get an echocardiogram first. If the results are abnormal, doctors order a more-expensive stress test.

The average cost per episode of care for chest pain since Children’s adopted the management plan was $1,200, compared to $1,506 for cases handled the old way, a savings of 20 percent, the hospital reports in Health Affairs. These are the hospital’s estimated costs and not the amount that insurers pay for the care, although Children’s says it expects the savings to eventually translate into lower payments from insurers — and savings to consumers.

Children make up only a tiny percent of patients overall, but as hospitals apply these types of plans to adult patient, they should have a broader impact on medical costs, said Dr. Kathy Jenkins, senior vice president of safety and quality at Children’s. “We all know adult conditions account for an enormous amount of resources in the US,’’ she said.

Source: boston.com

Get off the No. 7 train at the Seventy fourth Street-Broadway stop, in Queens, walk past La Abundancia Bakery, the Bollywood Beauty Salon, the New Hae Woon Dae Korean restaurant, the offices of Vishwanath Puttaswamygowda, M.D., and then past the New York Seventh-Day Adventist Chinese church (advertising free conversational-English classes), and you will find yourself at Elmhurst Hospital Center, in Elmhurst, the most diverse neighborhood in New York City and maybe in the world. The hospital serves 1.7 million patients a year, and offers translation services in a hundred and fifty-three languages. The Colombians, Bangladeshis, Koreans, Belarussians, Burmese, Chinese, Vietnamese, Croatians, Mexicans, and other immigrants who live nearby use Elmhurst for their care, and their communities back home often know about the hospital as well. It is not unusual for the exotically sick to fly to LaGuardia or J.F.K. from overseas to check in to Elmhurst. Diseases rare enough to merit special-case-study attention in The New England Journal of Medicine are, at Elmhurst, relatively common. If a young Southeast Asian is brought to the emergency room one morning because he is suddenly unable to move, even a junior physician knows to list familial periodic paralysis—an obscure disease that is considerably more common in the Philippines—as a possible diagnosis. An ambitious pedagogue of medicine couldn’t dream up a more diverse patient population for physicians-in-training.

The hospital was started on Roosevelt Island (then known as Blackwell’s Island), in the early nineteenth century, as a public institution that cared for prisoners and the poor; it went on to tend to soldiers in the Civil War and both World Wars. In 1950, the hospital, preparing for a postwar population boom in Queens, moved to Broadway between Seventy-seventh and Eightieth Streets, where it inhabits the kind of unremarkable complex of brick buildings in which filings for building-code exceptions might be processed. In the early nineteen-sixties, when the city could no longer afford to staff its public hospitals (of which Elmhurst is the second largest, after Bellevue), Elmhurst entered into an arrangement with Mount Sinai Hospital and School of Medicine, a private institution on the Upper East Side of Manhattan. Today, most physicians practicing at Elmhurst are interns, residents, and faculty professors at Mount Sinai. Elmhurst gets inexpensive staff; Sinai gets a unique training center. “It is pretty much universally residents’ favorite place to rotate,” Dr. David Muller, the dean for medical education at Mount Sinai, told me. If you want to learn not to be misled by the glittering chest X-ray of a Korean patient—in Korean acupuncture, the tips of the needles break off and remain lodged under the skin—go to Elmhurst.

Doctors also like to train at Elmhurst because of Dr. Joseph Lieber, a diagnostician and clinical educator who has been at Elmhurst, working from 4 A.M. until late at night, almost every day for the past twenty-five years. Practicing medicine at Elmhurst entails a daunting workload—at times, the hospital runs at a-hundred-and-forty-per-cent capacity—and the pay is not competitive with that of a private hospital or office. Yet an unusual number of doctors who train at Elmhurst choose to return to work there full time; they invariably cite Lieber as one of their main reasons for returning. His office is cluttered with tchotchkes from all over the world—a peaceful alpaca, a monkey in a toboggan, a miniature Taj Mahal—but, when I asked him about his travels, he said, “Maybe twice a month, I travel over to Sinai for teaching. Also, on Sundays, it’s true, I tend to go home earlier.”

Source: newyorker.com

The state Health Department has approved a major facelift of a western Queens hospital.

Mount Sinai Hospital Queens in Long Island City is moving forward with a sweeping $113 million expansion that would erect a state-of-the-art five-story medical building on its campus.

“We need a medical facility to accommodate the growing neighborhood,” Assemblywoman Aravella Simotas told the Daily News on Monday. “There are many young families moving in.”

The state issued a contingent approval letter last month, an important hurdle before construction can begin on the facility, agency officials said.

The operator, which is part of the larger Mount Sinai hospital network, will still have to submit legal documentation to the agency before final approval, Health Department spokesman Peter Constantakes said.

“The project will provide significant improvements to emergency and urgent services, imaging, endoscopy, ambulatory surgery, physician space, operating rooms and patient support spaces,” according to an executive summary prepared following an April hearing.

The hospital expects to break ground in September and complete construction in 2016.

A coalition of nine elected officials have been pushing for approval since 2012.

Mount Sinai spokeswoman Shelly Felder said in a statement that they were “delighted” the project is moving forward.

The 235-bed primary care center on 30th Ave. in Long Island City has seen an increase in visits in recent years, according to hospital figures provided to the state.

Between 2007 to 2011, emergency room visits have jumped by 6,000 more patients, or more than 13%. In that same period, surgeries spiked by 1,459, with Mount Sinai staff conducting 5,144 procedures in 2011, data shows.

“The emergency room is overflowing,” said Rose Marie Poveromo, president of the United Community Civic Association. “It is a long time coming.”

Under the current parameters, the expansion would add four more operating rooms and a new emergency department that would comprise 36 “treatment bays” and eight “observation beds,” according to the summary.

Queens Borough President Helen Marshall said the expansion is a vital lifeline for an area that has seen an influx of new residents in recent years.

“I have been a longtime advocate for Mt. Sinai’s expansion in western Queens where it remains today the only hospital in an area that has seen a dramatic growth in housing and new residents,” Marshall said in a statement.

Source: nydailynews.com

Jakarta, PKMK. Peserta lelang aset peralatan medis milik rumah sakit pemerintah di Kantor Pelayanan Kekayaan Negara dan Lelang (KPKNL) Jakarta cenderung terbatas. Umumnya, peserta merupakan kalangan yang benar-benar mengetahui fungsi peralatan medis tersebut. Setelah dibeli, peralatan medis itu mungkin dijual lagi ataupun diperbaiki. Melalui proses ini, mereka benar-benar mengetahui pihak yang berminat membeli, ungkap M. Subagyo, Pejabat KPKNL Jakarta V di Jakarta (6/5/2012).

Subagyo menjelaskan pihaknya sering berupaya ekstra mendatangkan peserta. Dalam hal ini, pihak rumah sakit selaku pemilik aset diminta membantu mendatangkan peserta lelang. “Kalau kami kan kurang tahu persis tentang siapa yang kira-kira meminati peralatan medis. Terlepas dari itu, lelang tersebut seperti biasa juga diumumkan melalui surat kabar beberapa hari sebelumnya. Peminat harus membayar uang jaminan,” kata Subagyo.

Peralatan medis yang dilelang, biasanya memang yang sudah tidak ataupun kurang berfungsi. Maka dari itu, manajemen rumah sakit lantas mengusulkan agar itu dimasukkan sebagai aset yang dihapuskan, lantas dilelang. Ia pun berkata, peralatan medis tersebut sering dijual per paket. Dengan demikian, peralatan medis yang bernilai sangat rendah dan tidak bisa berfungsi, terdongkrak oleh yang masih berfungsi. Berbeda dengan semua itu, lelang aset non-peralatan medis milik rumah sakit pemerintah ataupun Kementerian Kesehatan biasanya lebih ramai. Misalnya, lelang aset mobil milik Kementerian Kesehatan diikuti banyak peserta, jumlah peserta lelang tersebut bisa mencapai ratusan orang, ungkap Subagyo.

1. Ten Steps to a Result Based Monitoring and Evaluation System

Citing the real impact cutting the safety net would have on the most vulnerable residents, San Diego County Supervisors Greg Cox and Dianne Jacob joined with local hospital leaders today to call on the California Legislature and Governor Brown to spare hospital-based skilled-nursing facilities and other health care providers from devastating Medi-Cal cuts. Both Assembly Bill 900 by Assemblymember Luis Alejo (D-Salinas) and Senate Bill 640 by Senator Ricardo Lara (D-Long Beach) would reverse the Medi-Cal cuts that were enacted in 2011.

“As I’ve said before, what happens in Sacramento doesn’t stay in Sacramento,” said Cox, Chairman of the Board of Supervisors. “Unless the Legislature and Governor Brown take action, the health and safety of California’s most medically complex patients, frail seniors and disabled people will be at risk. Here in San Diego County, these cuts would come to $6.6 million moving forward and $10.4 million in retroactive repayments. We have a moral obligation to care for the most vulnerable. It’s time for Sacramento to assist local governments by restoring this critical funding.”

“If the state fails to stop its pending cuts to Medi-Cal, the most vulnerable members of our community will pay the biggest price,” said Supervisor Jacob. “These are courageous people who face challenges every day and need the intense level of care that comes at a place like the Edgemoor Skilled-Nursing Facility in my district. The cuts would be a travesty and we must not allow a special place like Edgemoor to become a victim of the state’s budget problems.”

Cox and Jacob spoke at a press conference at Edgemoor Hospital/DPSNF in Santee, where they were joined by Steve Escoboza , CEO of the Hospital Association of San Diego and Imperial Counties; Walter Hekimian , CEO of Edgemoor Hospital; Tony Guerra , CFO of Sharp Coronado; Pablo Velez , CEO of Sharp Chula Vista Medical Center and Marilyn Bailey , nursing director at Palomar’s Villa Pomerado. Together, they are dedicated to raising awareness of the issue as attention shifts to the Governor’s May Budget Revision and subsequent deliberations to enact the 2013-14 State Budget. They encouraged the public to learn more about the issue by going to www.CaringisourCalling.org, a website sponsored by the California Hospital Association. Visitors can watch a series of videos featuring patients and their families across California who rely on skilled-nursing facilities for their health care needs, and directly connect with their legislator to urge them to protect patients.

“The Medi-Cal cuts are not just bad for health care providers and patients, they also pose a risk to the state’s overall economy,” said Escoboza. “Although the state projects the cuts to hospital-based skilled-nursing units will result in a $58 million per year savings in the General Fund, that is only an educated guess. What we do know is that these cuts could translate into a loss of up to 36,000 jobs (16,000 direct caregiver jobs, plus the ripple effect in the broader economy) and a decline of up to $2 billion in statewide economic activity. These cuts are a classic example of the state being penny-wise and pound-foolish.”

Medi-Cal beneficiaries make up nearly 80 percent of the patients receiving hospital-based skilled- nursing care. These patients require specialized and medically complex care that freestanding nursing facilities and other health care providers will not or cannot provide. In the last five years, approximately 40 hospital-based skilled-nursing facilities in California (about one-third) have closed due to financial issues that further jeopardize California’s health care safety net.

Unless the Legislature approves AB 900 or SB 640 and Governor Brown signs it into law, hospital-based skilled- nursing facilities, already decimated by low Medi-Cal rates that don’t cover the cost of current care, will lose another 25-40 percent of their funding. That means millions of dollars in losses to acute care hospitals that provide essential care to the elderly and poor patients. The consequence would be cutbacks and closures that would tear a hole in California’s safety net, rip families apart, and punish the most vulnerable and sick among us. Families would be forced to relocate their loved ones to another facility, perhaps hundreds of miles away.

Other health care providers, including physicians, clinics, and emergency medical transport firms, also warn that the cuts jeopardize access to quality care.

Both AB 900 and SB 640 require a two-thirds vote in both the State Assembly and Senate before going to Governor Brown for action. AB 900 passed unanimously out of the Assembly Health Committee and now awaits consideration in the Assembly Appropriations Committee. SB 640 passed unanimously out of the Senate Health Committee and is pending in the Senate Appropriations Committee. It is likely that the two bills will be combined into one final bill during budget negotiations in June and considered an “urgency” bill, meaning that it will take effect immediately if the Governor signs it into law by July 1st.

Source: news-medical.net

TEMPO.CO , Yogyakarta:Penderita kelainan saraf otak, seperti tumor otak dan stroke di Indonesia bisa bernafas lega. Lantaran proses operasi tak lagi harus dengan cara membedah tempurung kepala. Melainkan cukup membuat sayatan pada alis mata sebesar lubang kunci atau yang dikenal dengan teknik operasi lubang kunci (keyhole surgery).

“Kenapa di alis mata? Karena bekas sayatan bisa disembunyikan di alis mata, sehingga tidak terlihat,” kata dokter spesialias bedah saraf Rumah Sakit Mitra Keluarga Surabaya Asra Al Fauzi saat dihubungi Tempo di sela acara Symposium on Cerebrovascular Disease; Enhancing Neuroendovascular Management in Indonesia di Sahid Rich Hotel di Jalan Magelang kabupaten Sleman, Ahad 5 Mei 2013.

Keuntungan lain dari teknik tersebut, sayatan akibat proses pembedahan minimalis, proses operasi berlangsung singkat, dan pasien tak membutuhkan waktu lama berada di rumah sakit. Jika pada operasi kepala secara konvensional membutuhkan waktu 4-5 jam, maka teknik bedah lubang jarum hanya berlangsung dua jam.

“Risiko perdarahannya sedikit. Sehingga banyak pasien yang memilih teknik ini. Pasien saya banyak yang usia tua, di atas 50 tahun,” kata Asra yang tergabung dalam Tim Brain and Spine Center (BSC) RS Mitra Keluarga Surabaya.

Pemahaman publik selama ini, penyakit akibat kelainan syaraf seperti tumor otak dan stroke dimaknai sebagai jenis penyakit yang sangat menakutkan dan fatal. Selain penanganannya sangat serius, tindakan operasi yang biasa dilakukan terhadap pasien berupa operasi besar dan menyeramkan. Inovasi pembedahan dengan resiko terkecil dan tingkat keberhasilan yang lebih baikmenjadi amat penting. Bedah lubang kunci, menurut Asra, merupakan salah satu inovasi dalam penanganan kasus minimally invasive neurosurgery.

“Prosedur tindakan dengan bedah lubang kunci ini lebih ringan dan lebih acceptable bagi pasien. Kami sarankan pasien untuk menggunakan metode ini,” kata Asra.

Teknik bedah lubang jarum adalah membuat satu lubang sebesar lubang kunci pada alis mata, tepatnya di antara bagian atas mata dan di bawah otak. Dari lubang tersebut kemudian dimasukkan alat mikro dan endoskopi untuk melihat sejumlah saraf yang mengalami kelainan. Proses operasi dilakukan dengan alat tersebut. Pasien harus menjalani bius total agar proses operasi berjalan tenang.

Hanya saja, teknik operasi tersebut tidak dapat diterapkan pada semua kelainan saraf. Hanya kelainan saraf pada stadium dini atau yang cepat terdeteksi yang bisa diterapkan metode tersebut.”Kalau tumornya sudah membesar atau stadium lanjut, jangan menggunakan cara ini,” kata Asra.

Kendala lainnya, metode bedah lubang kunci belum diterapkan di semua rumah sakit di Indonesia. Hingga saat ini, baru Rumah Sakit Mitra Keluarga Surabaya yang menerapkannya. Bahkan metode tersebut baru dikenal di Indonesia sejak tiga tahun lalu. Asra adalah dokter yang mempelopori penggunaan metode tersebut di Indonesia.

“Saya mempelajari teknik tersebut di Jepang. Semoga segera menyusul rumah sakit lain di Indonesia yang menggunakan teknik ini,” kata Asra.

Dia menjelaskan, teknik tersebut pertama kali diterapkan di Jerman sejak 10 tahun lalu. Beberapa negara di Asia yang sudah turut menerapkan adalah Cina, Korea Selatan, India, dan Jepang. Beberapa dokter di Filipina juga dikabarkan telah mempraktikkannya. Asra mempelajari teknik tersebut pada 2008 di rumah sakit Aizawa di Matsumoto, Jepang.

“Pertama kali saya kabarkan pada pasien saya soal metode ini, mereka terkejut. Tapi antusias dan ingin mencoba,” kata Asra.

Sumber: tempo.co