The Impact of Obstetrician/Gynecologist Hospitalists on Neonatal Quality of Care in Sardjito General Hospital Yogyakarta, Indonesia: A Retrospective Cohort Study

https://doi.org/10.22146/jkr.28084

Eugenius Phyowai Ganap(1*), Mohammad Hakimi(2), Soerjo Hadijono(3), Ova Emilia(4)

(1) Gadjah Mada University
(2) Departemen Obstetri dan Ginekologi, Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan (FKKMK) UGM
(3) Departemen Obstetri dan Ginekologi, Fakultas Kedokteran, UNDIP
(4) Departemen Obstetri dan Ginekologi, Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan (FKKMK) UGM
(*) Corresponding Author

Abstract


ABSTRACT

Background : The hospitalist model in obstetric care which was introduced over the last decades now has an important role in care delivery management with the potential positive impact on neonatal outcomes.

Methods : This research design was retrospective cohort. Participants included is the patient in the time before and after implementation of obstetrician/gynecologist full-hospitalist policy during October 2013 until September 2014. The outcome measured were mean response time, APGAR score at 5 minutes, , NICU admission. Univariate and multivariable analyses was conducted to evaluate and determine the factor which significantly contribute to neonatal outcomes.

Results and Discussion: We included total 71 patients (37 on-call obstetrician group and  34 full-time hospitalist group).  Univariate analysis indicated  mean response time was significantly differ in full-time hospitalist group when compared to the on-call obstetrician group (65,3 + 25,89 vs. 84 + 22,29 mins; p = 0,002). Implementation of full-time hospitalist did not impact the  NICU admission and APGAR score at 5 minutes.

Conclusion : Implementation of full-time hospitalist model is  not affecting neonatal outcomes.

Keywords :  Infant and Maternal Mortality, Obtericians / Gynecologist Hospitalist, Labor and Delivery, Maternal and Neonatal Care, ICU Response Time.

 


Keywords


Infant and Maternal Mortality; Obtericians / Gynecologist Hospitalist; Labor and Delivery; Maternal and Neonatal Care; ICU Response Time.



References

Badan Pusat Statistik-Statistics Indonesia (BPS) National Family Planning Coordinating Board Ministry of Health ORC Macro: Indonesia Demographic and Health Survey 2007. Calverton, Maryland: BPS and ORC Macro. 2008. https://dhsprogram.com/pubs/pdf/FR218/ FR218%5B27August2010%5D.pdf

Statistics Indonesia (Badan Pusat Statistik— BPS), National Population and Family Planning Board (BKKBN), and Kementerian Kesehatan (Kemenkes—MOH), and ICF International. 2013. Indonesia Demographic and Health Survey 2012. Jakarta, Indonesia: BPS, BKKBN, Kemenkes, and ICF International. https://dhsprogram.com/pubs/pdf/ FR275/FR275.pdf

WHO, UNICEF, UNFPA and The World Bank estimates. Trends in maternal mortality: 1990 to 2013. http://apps.who.int/iris/bitstream/ 10665/ 112682/2/9789241507226_eng.pdf

Putra, M.P., Yudha, editors. Menkes: Angka Kematian Ibu Melahirkan Masih Tinggi [Internet]. Jakarta: Republika;2013 [cited 2013 May 5]. Available from: http://www.republika.co.id/berita/ nasional/daerah/13/02/16/mi9ugy-menkes-angkakematian-ibu-melahirkan-masih-tinggi

Thaddeus S, Maine D. Too far to walk : maternal mortality in context. Soc Scie Med. 1994 Apr; 38(8):m 1091-110.

Widawati. Faktor yang mempengaruhi pola pemilihan penolong persalinan di kecamatan bojongloa kidul, kota bandung tahun 2007 [thesis]. Universitas Indonesia; 2008.

Wachter RM, Goldman L. The emerging role of “hospitalists” in the American health care system. N Engl J Med 1996; 335:514-7.

Olson R, Garite TJ, Fishman A, Andress IF. Obstetrician/gynecologist hospitalists: can we improve safety and outcomes for patients and hospitals and improve lifestyle for physicians?. Am J Obstet Gynecol 2012; 81-6.

Chauhan SP, Roach H, Naef RW, et al. Cesarean section for suspected fetal distress. Does the decision-incision time make a difference? J Reprod Med 1997;42:347-52

National Institute for Health and Care Excellence. Clinical Guideline : Caesarean Section. London, UK : NICE 2011.

Sibuea H. 2007. Manajemen Seksio Sesarea Emergensi: Masalah dan Tantangan. Pidato pengukuhan Guru Besar Bidang Kebidanan dan Penyakit Kandungan Universitas Sumatera Utara.

Olson R, Thomas JG, Fishman A. et al. Obstetrician/ gynecologist hospitalists: can we improve safety and outcomes for patients and hospitals and improve lifestyle for physicians. American Journal of Obstetrics and Gynecology 2012. 81-86

Srinavas SK, Small DS et al. Evaluating the impact of the laborist model of obstetric care on maternal and neonatal outcomes. American Journal of Obstetrics and Gynecology (2016), doi: 10.1016/j. ajog.2016.08.007

Goffman D, Broadman M, Arnold AJ, et al. Improved obstetric safety through programmatic collaboration. J Healthc Risk Manag 2014;33(3):14– 22



DOI: https://doi.org/10.22146/jkr.28084

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