Journal of Economics and Public Health

Functional Recovery Following Intensive Multidisciplinary Rehabilitation after Right Gamma Nail Fixation: A Case Report

Thu, 10 Sep 2026 14:26:35 +0000

Proximal femoral fractures are a major cause of morbidity and functional decline, with an incidence of approximately 200 per 100,000 individuals per year and mortality rates of up to 30% in elderly patients. Surgical intervention is mandatory for treatment, preferably within 24 hours according to the Federal Joint Committee (GBA). The gamma nail is recommended for unstable intertrochanteric fractures, but systematic postoperative rehabilitation is poorly documented, although it has an important impact on functional outcomes. We report the case of a patient treated with gamma nail fixation for a right proximal femoral fracture and intensive multidisciplinary rehabilitation, who was admitted approximately 18 days postoperatively with significant limitations in range of motion, muscle strength, balance, and ambulation — specifically, a Berg Balance Scale score of 6, a Functional Status Test score of 45, Visual Analog Scale pain scores of 8/10, and inability to ambulate independently. A comprehensive individualized rehabilitation protocol was implemented over a nine-week period, consisting of active and active-assistive range of motion exercises, progressive resistance training, static and dynamic balance activities, and progressive gait training with weight-bearing as tolerated. Sequential objective assessments were completed at baseline, week 2, week 4, week 6, and week 9. Repeated assessments showed significant and incremental gains in all domains: Berg Balance Scale score increased from 6 to 50, Functional Status Test score increased from 45 to 90, Visual Analog Scale pain ratings decreased from 8 to 0-2, and independent ambulation with a walking frame for 30 meters was achieved, with progressive recovery of range of motion and manual muscle testing grades. This case demonstrates the importance of early, intensive, multidisciplinary rehabilitation following gamma nail fixation and reveals that major functional improvement may be accomplished within nine weeks when rehabilitation is guided by sequential objective assessments, personalized progressive weight-bearing protocols, and comprehensive treatment that simultaneously targets balance, strength, range of motion, gait, and functional independence.

The Relationship Between Patient Safety Incident Reporting Culture and the Implementation of the Six Patient Safety Goals in Primary Healthcare Facilities

Sumiati Sumiati, Harianto Harianto, Supriyono Supriyono — Tue, 22 Sep 2026 00:00:00 +0000

The Patient Safety Incident Reporting Culture (IKP/KNC) is important and required to improve service quality and patient safety. Through open, non-blaming reporting, healthcare professionals are encouraged to report incidents, enabling organizations to conduct root-cause analyses, implement system improvements, and prevent recurrences. Ultimately, this reduces clinical risk, improves service practices, and builds trust among patients and their families. This study aimed to analyze the relationship between the IKP reporting culture and the implementation of six (6) patient safety standards (6 SKP) in accredited First-Level Healthcare Facilities (FKTP) in East Java. This research was an analytic quantitative study using a cross-sectional design. The sample consisted of 62 respondents, selected using a purposive random sampling method. The independent variable was the IKP reporting culture, while the dependent variable was the implementation of the 6 SKP. The research instrument used a Likert scale. Validity testing showed r = 0.50–0.68 (p < 0.05), and reliability measured by Cronbach’s Alpha was 0.84. The analysis was conducted using Spearman’s test with SPSS version 23. The respondents comprised 80.6% women, 59.7% aged >45 years, 50% with bachelor’s degree (S1), 87.1% with >5 years of employment, 50% having received patient safety training, 91.9% from facilities with full accreditation, and 59.7% who had never reported an IKP. The IKP reporting culture was categorized as good (88.70%) and fair (11.29%), whereas the implementation of the 6 SKP was good (98.39%) and fair (1.61%). There was a strong and significant positive relationship between the IKP reporting culture and the implementation of the 6 SKP (ρ = 0.745; p < 0.001; n = 62).

Analysis of Factors Associated with Satisfaction Among Non-JKN Inpatients

Dian Sari Murti, Ahmad Dwi Prayitno, Ferly Oktriyedi — Tue, 22 Sep 2026 00:00:00 +0000

Patient satisfaction is an important indicator in assessing the quality of hospital services, especially for non-JKN patients who have greater freedom in choosing health facilities. This study aims to analyze factors related to satisfaction of non-JKN inpatients at RSUP Dr. Mohammad Hoesin Palembang. The study used an analytical observational design with a cross-sectional approach to 150 patients. Service quality is measured based on the SERVQUAL dimensions, namely tangibility, reliability, responsiveness, assurance, and empathy. Data were analyzed using the Chi-square test and multiple logistic regression. The research results showed that 81 respondents (54.0%) were satisfied with the service. Bivariate analysis showed that tangibility, reliability, responsiveness, assurance, and empathy were significantly related to patient satisfaction, while age, education, and employment were not significantly related. Multivariate analysis shows that education (p=0.034; OR=0.158), tangibility (p=0.024; OR=3.563), responsiveness (p=0.001; OR=6.398), and assurance (p<0.001; OR=10.960) are independently related to satisfaction. Assurance is the most dominant factor, while the model is able to explain 65.7% of the variation in patient satisfaction. Satisfaction of non-JKN inpatients is mainly influenced by service guarantee, responsiveness, physical evidence, and level of education. Hospitals need to improve the competency and professionalism of staff, speed of response, clarity of information, security of services, and comfort of facilities.

Analysis of Healthcare Worker Compliance with Solid Medical Waste Management in the Inpatient

Adhe Anggraini, Gema Asiani, Ferly Oktriyedi — Wed, 23 Sep 2026 22:05:28 +0000

Substandard management of solid medical waste can increase the risk of infections, workplace accidents, and environmental pollution. Healthcare worker compliance is a crucial factor in ensuring the safety of medical waste management in hospitals. This study aimed to analyze factors associated with healthcare worker compliance regarding solid medical waste management in the Inpatient Unit of RSUP Dr. Mohammad Hoesin Palembang. An observational analytic study design with a cross-sectional approach was employed. The study sample consisted of 139 healthcare workers. Data were collected using questionnaires and observation sheets, then analyzed via univariate, bivariate (Chi-square test), and multivariate (multiple logistic regression) methods. The results showed that 104 respondents (74.8%) were compliant, while 35 respondents (25.2%) were non-compliant regarding solid medical waste management. Variables significantly associated with compliance were attitude (p=0.016; OR=2.796), facilities and infrastructure (p=0.006; OR=3.223), training (p=0.007; OR=3.140), Standard Operating Procedures (SOPs) (p=0.003; OR=8.417), and supervision (p=0.006; OR=3.326). Age, education, knowledge, and tenure were not significantly associated with compliance. Logistic regression results indicated that facilities and infrastructure (p=0.046; Exp(B)=2.428; 95% CI 1.017–5.795) and SOPs (p=0.002; Exp(B)=11.628; 95% CI 2.421–55.848) were independently associated with compliance. SOPs were the most dominant factor. The model explained 26.6% of the variation in compliance based on the Nagelkerke R-Square value. It is concluded that healthcare workers' compliance with solid medical waste management is primarily influenced by the availability of Standard Operating Procedures (SOPs) and facilities. Hospitals need to ensure that SOPs are available and implemented in every unit, equip facilities according to standards, conduct periodic training, and enhance supervision and evaluation.

Analysis of Dyspepsia Incidence in the Emergency Department

Maya Fitriani, Gema Asiani, Ferly Oktriyedi — Thu, 24 Sep 2026 01:50:55 +0000

Dyspepsia is a collection of upper gastrointestinal symptoms that can interfere with daily activities and reduce patients' quality of life. This study aimed to analyze factors associated with the incidence of dyspepsia in the Emergency Department of Palembang BARI Regional General Hospital. The study used an analytical observational design with a cross-sectional approach. The sample consisted of 85 respondents selected using consecutive sampling. Data were collected through questionnaires and medical records and were analyzed using the Chi-square test and multiple logistic regression. The results showed that 51 respondents (60.0%) experienced dyspepsia. Variables significantly associated with dyspepsia were dietary pattern (p=0.013; OR=3.656), smoking habit (p=0.024; OR=3.429), exercise activity (p=0.035; OR=3.327), and stress (p=0.021; OR=3.380). Age, sex, alcohol consumption, and medication use were not significantly associated with dyspepsia. Multivariate analysis showed that dietary pattern was the only factor independently associated with dyspepsia (p=0.048; OR=2.789; 95% CI 1.010-7.699). The model explained 14.0% of the variation in dyspepsia incidence. An unhealthy dietary pattern was the dominant factor associated with dyspepsia.