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COPD is a condition characterized by airflow obstruction that cannot be completely corrected. This limitation generally worsens over time and is associated with abnormal permeability to noxious particles or gases, resulting in narrowing of the airways, increased mucus secretion, and changes in the vascular system. The increase in chest expansion capacity is caused by the activity of respiratory muscle contraction. The activity of the respiratory muscles plays a role in chest expansion, which also affects lung growth. It is stated that the strength of the respiratory muscles decreases with age. Loss of intercostal muscle mass and strength are factors that reduce the ability of chest wall presence or development. This study used a case report design research method. Physiotherapy management for COPD is increasingly focused on exercise-based rehabilitation, both in outpatient and inpatient settings. Some therapies such as breathing exercises, thoracic expansion exercises and muscle release.

 Chronic pain is pain that persistent and will continue beyond the proper healing time, there are two time points used in daily practice, namely 3 months and 6 months after the first injury. Sensitivity of peripheral nociceptive neurons and central underlying the process of transition from acute pain to chronic pain. There are several factors that influence the increasing incidence of postoperative chronic pain including preoperative, intraoperative and postoperative factors. Untreated acute postoperative pain also increases the risk of increasing chronic postoperative pain. In Asia, the prevalence of chronic pain varies widely, between 7% in Malaysia to 60% in Cambodia. The prevalence of postoperative chronic pain in adults is reported to be around 20% in developed countries. The incidence includes all ages with a higher incidence in women and the elderly. The purpose of this study was to describe the characteristics of postoperative chronic pain in outpatients in the surgical polyclinic and obstetrics and gynecology polyclinic at RSU Medan. The type of research used in this study was Observational with a Cross Sectional method approach. Based on the research that has been done, it was found that ages 26-35 years experienced the most chronic pain, namely as much as 29.8% and women experienced more chronic pain compared to men. Based on this study it was found that the majority of respondents experienced moderate pain intensity as many as 36 respondents (63.2%). There were descriptions of characteristics that were mostly 26-35 years old.

This systematic literature review examines queue system simulation in hospitals across four key service areas: emergency departments, outpatient clinics, laboratories, and pharmacies. Following PRISMA methodology, 72 relevant studies (2015-2020) were analyzed to identify simulation models, software tools, performance parameters, and emerging trends. Findings reveal Discrete-Event Simulation dominance (59.7%), with increasing hybrid model adoption integrating System Dynamics and Agent-Based approaches. Emergency departments remain the primary application focus (52.8%), while Arena and AnyLogic emerged as predominant simulation platforms. Patient waiting time (91.7%) and resource utilization (77.8%) constitute the most evaluated performance metrics. Technological convergence trends demonstrate integration of real-time data analytics, machine learning, and digital twin concepts into traditional simulation frameworks. This review contributes methodological insights for optimizing hospital queueing systems while identifying research gaps in cross-departmental model interoperability and comprehensive value-based performance evaluation within contemporary healthcare systems.  

Building an effective and efficient health system is an important effort to improve the quality of health services in Indonesia, the implementation of RME is an integral component in the modern health service system. The government issued the One Healthy policy in efforts to implement Health Data governance. In order to achieve this, data variables and data formats/values ​​determined by the Ministry of Health must be used as a reference in the implementation of RME based on Minister of Health Regulation No. 24 of 2022. The aim of this research is to analyze data variables in the ETI Care application for outpatient registration at Budi Kemuliaan Hospital Jakarta according to the applicable guidelines, that is Minister of Health Decree Number HK.01.07/MENKES/1423/2022. This research uses descriptive qualitative methods. Data variables were obtained and their conformity with the existing meta data in the ETI Care application with government meta data, that is in the general identity there were 13 missing data variables and 2 variables that did not exist in the identity of the newborn baby, and 7 data variables that did not match the general identity and 1 data variable whose format/value did not match the identity of the newborn baby.  It is necessary to develop the system by involving users in adjusting technical and organizational policies. There are still data variables that do not exist in the ETI Care application in the outpatient registration section, and there is also a discrepancy between the format/value of outpatient registration in the ETI Care application and the format/value of Minister of Health Decree Number HK.01.07/MENKES/1423/2022. This requires further communication with the vendor regarding system development in accordance with applicable guidelines.  

This study aims to design and implement a web-based outpatient registration information system at Regional General Hospital (RSUD) X to overcome issues arising from the manual registration system. The current manual registration system at RSUD X causes problems such as long queues, potential data entry errors, lost files, and difficulty in finding patient medical history. As a result, patient waiting times are longer, the administrative staff's workload increases, and the overall effectiveness of services decreases. The research method used is a qualitative one, which describes various processes in the system, from patient data input to the digital registration receipt output. The system design approach uses the waterfall method. Data collection was carried out through purposive sampling, while data gathering was done through interviews with registration officers, direct observation, and a documentation study in the medical records unit. The system is built with a combination of technologies, including PHP as a server-side programming language and MySQL as the database. The result is a web-based outpatient registration information system that can improve the efficiency and quality of hospital services. The advantages of this system include wide accessibility, time efficiency, and effective data management. This system is expected to reduce patient queues, improve the efficiency of the registration process, and simplify patient data management. However, the implementation of this system may face challenges such as limited resources and user skills. Solutions to overcome these challenges are effective resource allocation and user training. Overall, the web-based outpatient registration information system can be an effective solution to improve service quality at RSUD X.

One of the important indicators in hospital quality standards is the level of patient satisfaction with the services provided. Therefore, improving the quality of health services is very crucial, not only in the medical aspect, but also in terms of communication and empathy of health workers to patients. This study aims to determine the description of the quality of service of registration staff at the outpatient polyclinic of General Hospital X, South Jakarta, in 2023, based on patient perceptions. This study is a quantitative study with a descriptive approach, conducted on 50 respondents. Data were collected using a questionnaire covering five dimensions of SERVQUAL: Tangibles, Reliability, Responsiveness, Assurance, and Empathy. Data analysis was carried out by presenting the frequency distribution and percentage of each service dimension. The results showed that: in the Tangibles dimension, 66% of respondents rated it good and 34% less good; Reliability, 70% good and 30% not good; Responsiveness, 52% good and 48% not good; Assurance, 72% good and 28% not good; and Empathy, 66% good and 34% less good. In conclusion, although most respondents rated the service of the registration staff as good, there are still aspects that need to be improved. Improving the overall quality of service, especially in the dimensions of Responsiveness and Empathy, is needed as a strategic step in an effort to increase patient satisfaction and loyalty.

process standardization, and system optimization. The study concludes that the HOT-FIT model is This study evaluates the performance of the outpatient registration information system at RSUD Komodo using the Human-Organization-Technology Fit (HOT-FIT) framework. Hospital Information Systems, particularly in the outpatient registration process, are crucial for supporting service efficiency and data accuracy. However, RSUD Komodo has experienced several challenges in the implementation of its SIMRS module, including system slowdowns, sudden monitor failures, and unstable internet connectivity during service hours. These issues hinder operational effectiveness and risk compromising service quality. The objective of this research is to assess system performance comprehensively across human, organizational, and technological dimensions. A qualitative descriptive design was employed, involving in-depth interviews with five key informants: registration staff, IT personnel, coder, head of the medical records unit, and head of the casemix team. The findings show that in the human dimension, users lacked sufficient training and adaptation strategies. In the organizational aspect, weak coordination and the absence of standardized procedures were identified. In the technology dimension, hardware malfunctions and slow system performance significantly disrupted services. These interconnected issues reveal the need for capacity buildingan effective tool for evaluating hospital information systems, offering a structured approach to identifying and resolving performance gaps in outpatient service modules.

The implementation of Electronic Medical Records (EMR) in healthcare institutions aims to improve the efficiency, accuracy, and accessibility of medical data. RSUD Weda, a regional hospital in Indonesia, has adopted an EMR system in its outpatient services to replace conventional manual processes. However, this transition has faced several challenges, including inadequate training, unstable network infrastructure, and inconsistent adherence to Standard Operating Procedures (SOPs). This study aims to evaluate the performance of the EMR implementation using a qualitative descriptive method based on the 5M framework—Man, Material, Machine, Method, and Money. Data were collected through interviews, direct observation, and document analysis involving stakeholders such as medical staff, administrators, and IT personnel. The findings indicate that while users acknowledge improvements in data accuracy and accessibility, key issues remain, particularly in training quality, infrastructure readiness, and system reliability. The study also observed gradual improvements in SOP compliance and reduced system failures over time. These results suggest that successful EMR adoption requires a balance of technical infrastructure, human resource readiness, financial support, and continuous system monitoring. The use of the 5M framework proved effective in identifying multidimensional challenges and offering holistic insights into the implementation process. This study contributes to the broader literature on EMR evaluation by providing contextualized evidence from a district-level hospital and offers practical recommendations for enhancing EMR system performance in similar healthcare settings.    

Knowledge is the result of the process of understanding and recognizing something obtained through sensing an object. Beta-lactam antibiotics are a type of broad-spectrum antibiotic commonly used to treat bacterial infections, but their use still has the potential to cause side effects in the form of Adverse Drug Reactions (ADRs). This study aims to assess the level of patient knowledge regarding ADRs due to the use of beta-lactam antibiotics at Bendan Pekalongan Regional Hospital in 2024. This study used a prospective correlation design with a non-experimental approach. A total of 29 outpatients taking beta-lactam antibiotics were sampled, selected using a purposive sampling technique. Data were collected through questionnaires, medical records, and analyzed descriptively using Microsoft Excel. The results showed that 41% of respondents had low knowledge regarding ADRs, 28% had sufficient knowledge, and 31% had good knowledge. These findings indicate the need for more intensive education regarding the risks of ADRs in order to improve the safety of antibiotic use.

Self-care is an individual's effort to manage their health condition, especially for people with diabetes mellitus, to keep blood sugar levels under control. One element that influences the effectiveness of self-care is family support. This support can take various forms, such as emotional support, practical assistance, information, and evaluative feedback. This study aims to explore the relationship between family support and self-care practices in elderly people with type 2 diabetes mellitus at the Kedungmundu Health Center. This study design is correlational with a cross-sectional approach. The sample taken consisted of 68 elderly people with type 2 DM who visited the Kedungmundu Health Center. The sample selection used a purposive sampling technique. The inclusion criteria involved outpatients who lived with their families. The instruments used in this study were a questionnaire about family support and SDSCA (Summary of Diabetes Self-Care Activities). To analyze the data, the chi-square test was used in bivariate analysis. The results showed that 60.3% of respondents received positive family support, while 48.5% of respondents showed good self-care practices. Further analysis showed a significant relationship between family support and self-care practices with a p value of 0.000 (p <0.05). Conclusion: Based on the results found, it can be concluded that family support plays an important role in improving the quality of self-care in elderly people with type 2 diabetes mellitus.

Background: Anemia in pregnancy remains a major public health problem and contributes to increased maternal and fetal morbidity and mortality. One of the main causes of anemia in pregnant women is inadequate knowledge regarding anemia prevention, including iron intake, nutrition, and healthy behaviors during pregnancy. Health education is considered an important intervention to improve pregnant women’s understanding and preventive practices against anemia. Objective: This study aimed to determine the effect of health education on anemia prevention among pregnant women at the Gemia Outpatient Health Center. Methods: This study employed an analytical observational design with a cross-sectional approach. The sample consisted of 20 pregnant women selected using a total sampling technique. Data were collected using structured questionnaires to assess knowledge and anemia prevention behaviors before and after receiving health education. Data analysis was conducted using the Chi-square test to determine the effect of health education on anemia prevention among pregnant women. Results: The results showed a statistically significant effect of health education on anemia prevention in pregnant women. The Chi-square test revealed a p-value of 0.000 (p < 0.05), indicating that health education had a significant influence on anemia prevention practices among pregnant women. Conclusion: Health education has a significant effect on anemia prevention in pregnant women. Providing structured and continuous health education can improve knowledge and preventive behaviors related to anemia during pregnancy. Therefore, health education should be strengthened as an integral part of antenatal care services to reduce the incidence of anemia in pregnant women.

Faisal Islamic Hospital Makassar currently has good service quality on the interest in repeat visits to outpatients in polyclinics with an increasing number of outpatient visits. However, there are also services that are desired by patients and families of patients so that the service is said to be bad. This is felt by patients visiting the hospital, namely the better the services provided where before the researchers conducted the research there were still many shortcomings in the form of medical devices and irregular service hours. Where the quality of service can also be said to be good if the service provided is in accordance with what the patient wants and can be said to be satisfactory service. Therefore, to increase the number of patient visits, the hospital tries to provide quality service so that patients feel satisfied. Revisit interest is the behavior that occurs in response to a service that shows the customer's desire to revisit the hospital. This study aims to determine the quality of service and its effect on outpatient revisit interest in polyclinics at Faisal Makassar Islamic Hospital. The population in this study was 750 patients and the sample size was 254 patients who made a repeat visit at the polyclinic of the Faisal Islamic Hospital Makassar. The results of this study are the level of repeat visits on an outpatient basis at the Faisal Makassar Islamic Hospital can be seen from the aspects of tangible (physical evidence) of good value, reliability (reliability) of good value, responsiveness (responsiveness) of good value, assurance (certainty) of good value, and empathy (empathy) of good value.

Background: Hypertension in the elderly is caused by degenerative processes and triggering factors such as poor diet, smoking, and alcohol consumption. The WHO identifies hypertension as a major risk factor for cardiovascular diseases that can lead to serious complications such as stroke and heart disease. Objective: To identify the factors influencing dietary behavior related to hypertension in elderly patients who will be treated as outpatients in the Orchid Room of Bhakti Asih General Hospital, Tangerang, focusing on knowledge, attitudes, health worker support, and family support. Research Method: This quantitative study uses primary data from questionnaires with a Field Research method. The sample consists of 40 respondents, and data analysis was conducted using the Chi-Square Test. Research Results: The results of the Chi-Square test show a significant relationship between knowledge (ρ = 0.000), attitudes (ρ = 0.012), health worker support (ρ = 0.009), and family support (ρ = 0.000) towards dietary behavior related to hypertension in the elderly. Conclusion: Overall, knowledge, attitudes, health worker support, and family support influence dietary behavior related to hypertension in the elderly, which can impact the effective management of hypertension and prevent further complications. Recommendation: For future researchers, this study has limitations, and it is hoped that further research can develop this topic with a more comprehensive research methodology approach.

Hospitals worldwide are increasingly concerned about the performance of outpatient services, which contribute significantly to their revenue and are projected to surpass inpatient services in importance. As the demand for medical care continues to grow, outpatient services could generate even greater financial returns for hospitals. This study aims to evaluate patient service wait times at Stella Maris Hospital Makassar's outpatient department using the lean methodology. A mixed-methods approach was employed, involving the measurement of wait times for 100 patients and interviews with eight informants, including the head of the outpatient department (1 person), admission officers (3 individuals), the hospital director (1 person), and nurses (3 individuals). The interview data were analyzed through processes of data reduction, visualization, and conclusion formulation. A patient care process flowchart was created to assess data quality. Findings indicate the absence of an integrated hospital information system (SIMRS), leading to issues such as long queues at the pick-up counter, delays in doctor availability, and inefficiencies in order processing. Recommendations include integrating SIMRS across the hospital, implementing system improvements, and quantifying outcomes for effective decision-making.  

The reporting system is the presentation of data in the form of the results of activities in an organization as well as data from research results which are arranged systematically, so that it is easier to understand and easier to analyze and draw conclusions from an activity. The method in this research uses secondary data observation. The aim of this study was to determine the 10 most common diseases in outpatient and inpatient care (based on gender and age characteristics) at the Regional General Hospital, dr. Fauziah Bireun, This type of research is quantitative descriptive. The population and sample in this study are medical record recap data from January to December using total sampling. The results of the study showed that the highest number of diseases, namely Urolithiasis cases, had 314 outpatients, while the highest number of inpatients was Cerebral Infarction, there were 425 patients. There were 1,866 inpatients, based on the age range of 45-64 years, there were 1,042 outpatients and 958 inpatients. It is hoped that future researchers will carry out further research on the factors that cause health problems and health problems in patients with the highest cases of disease.

The XYZ Health Center faces challenges in managing the outpatient registration process manually, often resulting in long queues, extended waiting times, and data inaccuracies. To address these issues, this study aims to design and develop an Android-based outpatient registration application. The application is intended to simplify the registration process for patients, allowing them to register for visits without needing to visit the health center in person, while also enabling healthcare staff to manage patient data more efficiently. The methodology employed in this study includes requirements analysis and system design using the Unified Modeling Language (UML). The application features online registration, doctor schedules, visit reminder notifications, and patient data management. This study concludes that the Android-based application can serve as an effective and efficient solution for improving health center services. Further development is recommended to enable integration with other healthcare systems.

The rapid growth of hospitals has intensified competition in the hospital business, making it increasingly challenging. This situation necessitates the need to ensure that patients return to the same hospital, in other words, the need to enhance repeat visitation interest, which has a significant impact on the hospital's business sustainability. This research was conducted due to a significant decrease in the number of outpatient visits at Gandaria Hospital. The study aims to analyze the influencing factors on repeat visitation interest at Gandaria Hospital, with repeat visitation interest as the dependent variable, word of mouth, and social media as independent variables, and brand image as an intervening variable. This research employs a quantitative approach with data analysis techniques, specifically descriptive analysis using Excel & SPSS software and Path Analysis using AMOS software. The sample size, calculated according to Hair's formula, consists of 75 outpatient patients. The results of hypothesis testing indicate that word of mouth and social media have a significant positive impact on repeat visitation interest. Social media has a greater influence compared to word of mouth on repeat visitation interest. The brand image variable is proven to be an intervening variable between word of mouth and repeat visitation interest but not between social media and repeat visitation interest.

Back ground: Autosomal genetic diseases throughout North America are propagated by CF, which is seen in 1 out of 2000 Caucasians. This sickness can in most cases be undetected and is nongendered with a global impact and targets all ages. By the impaired mucocilliary clearance in the trachea and bronchi, and the inability to maintain innate defenses, acute and recurrent bacterial infections, airways obstruction and inflammation and chronic bacterial infections are aggravated. Aim of study: The study aims to isolate and identify bacterial species related to respiratory fibrosis and to do the susceptibility test to those species. Methodology: The study was carried out between January-July 2024, 80 cystic fibrosis patients admitted in Mirjan hospital, 50 came outpatients clinic and 30 found sleeping in the hospital (Eighteen in the respiratory lobbies and 12 in the intensive care unit (ICU)), patient age range between 20-80 years old, and include both gender, 28 females and 52 male.es). By using sterile labeled machines every patient provide sputum that was transported to laboratory directly after collection and stored in 4 C temperatures until culture. All samples of sputum were cultivated for twenty-four hours at 37 degrees Celsius in an incubator utilizing MAConkey and Blood agars. Thereafter, samples were streaked unto several selective and differential media where bacterial colonies matured to reveal their biochemical characteristic after 24hrs of incubation. Results: The current study's results indicated that age has an impact on microbial CF infection. Of the 80 total patients, 9 sample in the age group of 20–30 years had a percentage of 11.25%, while 11 patients in the age group of 31–40 years had a percentage of 13.75%, 16 patients in the age group of 41–50 years had a percentage of 16.25%, and 17 patients in the age group of 51–60 years had a percentage of 21.25%. The current study confirmed that infection rates increase with age. In terms of gender, the study show that males are more likely than females to get infections. with 52 males in the (65%) percentage and 28 females in the (35%), Ten patients are in the 71–80 age range, and twenty patients are in the 61–70 age group. Conclusion: The kind of bacterial strain, the patient's immunological condition, and the usage of contaminated medical equipments are some of the factors that affect transmission. During treatment, all CF patients colonized or infected with the primary pathogens discussed in this article must be kept in a single room to prevent nosocomial dissemination of the microorganism to other patients. Despite the intricacy of the epidemiology of bacterial infections in CF patients, the average lifespan of these individuals continues to increase.

The higher the awareness regarding health, the higher the human need for health services. As a health service center, hospitals have the task of providing complete individual health services, providing inpatient, outpatient and emergency services. Social security provided by the Indonesian state is implemented by the Social Security Administering Body (BPJS) to ensure the certainty of equitable health services. This research is a quantitative descriptive study with an observational method to determine the description of satisfaction of BPJS outpatients regarding pharmaceutical services at Bekasi Hospital using Proportional Random Sampling sampling techniques with sample criteria of BPJS patients aged 17 - 65 years, who receive pharmaceutical services from the Pharmacy Installation Hospital at least 2 times. Based on the data provided, the highest overall satisfaction category is "Satisfied" while the lowest category is "Not Satisfied". These results show that the majority of patients feel a very high level of satisfaction with the services they receive. Based on the results of research conducted at the Bekasi Hospital Pharmacy Installation with 3 hospitals as research objects, it can be concluded that 51% of respondents feel satisfied with the pharmacy services at the hospital.

The purpose of developing an outpatient management information system at Waikabubak Regional Hospital is to improve the efficacy and efficiency of the outpatient health service process. The system created will facilitate recording, managing, and monitoring patient health status in real-time. Current manual procedures often result in inaccurate recording, slow administration, and substandard medical data management. This information system is expected to facilitate medical decision-making and smooth the flow of information from patient registration and health checks to treatment and follow-up.