ICU AND HOSPITAL IN INDONESIA 2013 - 2014

INDONESIAN SOCIETY OF INTENSIVE CARE MEDICINE

(ISICM)

OLOAN E. TAMPUBOLON

WFSICCM Congress 2015, Seoul - Korea

MANPOWER and ECONOMY in ICU

INDONESIA perspective

2010 --- 2015

Total Hospital in IndonesiaArea 2013 2014

Sumatera 511 565

Java 1.162 1.252

Borneo 142 151

Celebes 194 209

Bali, Western Lesser Sundas, East Lesser Sundas 121 125

Moluccas, Papua 45 46

Total 2.175 2.348

2013 : 452014 : 46

2013 : 1.162

2014 : 1.2522013 : 121

2014 : 125

2013 : 511

2014 : 565

Hospital Recapitulation By Category2013

Category Government Public Hospital Privat Hospital Total

Public Hopsital Government 749 89 838

Privat Non Profit 522 202 724

Privat Hospital Swasta 387 212 599

BUMN 60 7 67

Total 1.718 510 2.228

Keterangan :

RS. Swasta Terdiri Dari : Perusahaan, Perorangan dan Swasta / Lainnya

Category Government Public Hospital Privat Hospital Total

Public Hopsital Government 771 93 864

Privat Non Profit 539 200 739

Privat Hospital Swasta 485 255 740

BUMN 60 7 67

Total 1.855 555 2.410

Per 1 January 20142014

= has provided ICU

= none

Total ICU in Indonesia

Area 2013 2014

Sumatera 256 284

Java 596 635

Borneo 67 74

Celebes 100 101

Bali, Western Lesser Sundas, East Lesser Sundas 48 51

Moluccas, Papua 11 11

Total 1.078 1.156

3 types of ICU -based on facilities, dr in charge and

powered by a DoH Regulation no.1778/2010 :

- Primary ICU =hosp. type C,

coordinator- director : - general phys./anesthesiologist.

- Secondary ICU = hosp.type B,

coordinator - director : - anesthesiologist / intensivist.

- Tertiary ICU = hosp.type A, (Univ.teaching centre)

supervision / coordinator -

director : - intensivist.

In Indonesia we have

Coordinated Educ.Task

• DoH Regulation – central and - regional

with DoEd:

... Legacy of Intensivist “production House”

• ISICM

• training, • maintaining and improving physician competencies,• implementation of quality assurance practices ,

• Together : optimisation of patient safety

• As a GOAL !!!

ANESTHESIOLOGIST - 18 mnth .

SURGEON, - 24 mnth.

Neorologist, -

Internal Medicine, -

Pulmonologist -

Pediatrician -

EDUCATIONPostgraduate program

Intensive Care Medicine combines physician, nurses and allied health professional in the co-ordinated and collaborative management of patients with life-threatening single or multiple organ system failure. Including stabilisation after severe surgical interventions. It is a continuous (i.e. 24 h) management including monitoring, diagnostic, support of failing vital functions as well as the treatment of the underlying diseases.

Anaesthesiology, internal medicine, paediatrics, pneumology, surgery, etc.

Two additional years of full-time

education and training in Intensive Care Medicine

Multidisciplinary team, ONE Management in ICU

• Solid Multidisciplinary team :

• Intensivist/ coord. (SpAnKIC, SpPDKIC, SpBKIC,.)

• Clinical Microbiology

•Pharmasy/clinical pharmacologist

• ICU Nurse

•Fysioterapist

•Dietician

PROFESIONAL org. Gov./DoH

• Hand in hand:

• support the training, updating to improve

physician competencies,

• implementation of quality assurance practices,

regional and centrally through

scheduled sessions over the year.

• There are always third parties coming to

support… :WHO e.o.

SURGERY

INTERNE

ANESTESIOLO-

GY

CARDIOLOGY

PULMONOLOGY

PEDIATRI

NEUROLO-

GY

BASIC

SCIENCEMULTIDISCIPLINE

&

ONE

MANAGEMENT

1. Guide line

2. Konsensus

3. Evidence base

( IDEAL)

ICU Triage

• Patients should be admitted if they can benefit with decreased risk of death

• patients with reversible medical conditions who have a “reasonable” prospect of substantial recovery

NIH Concensus conference

Prepare referral…

to a larger/higher..better institution…

If the patient is

stabilized and

transportable .

MUST....

Working hours hours

• Team 24/7 available,

• Dedication… for a better time nationwide

• depends on type of ICU/ Hospital/ area,

• Gov. take care of monthly income(remuneration) of

GP’s and Specialist., central or regional.

National Insurance, Private Insurances co.

• Take care of standard & private hospital

ICU finance,

• Monthly/annual based contributions,

• Fixed contribution,

• Clinical ICU pathway set up by

prof.organisation.

Basic Salary2010 2015

GeneralPractioner

Basic USD 120 USD 250

Incentive USD 100 USD 150

Professional Fee (option) INA CBG = USD 450 - $USD 650

Total /monthly THP $ USD 220 $ USD 850- $ USD 950

Specialist Basic USD 360 USD 1000

IncentiveUSD 200

USD 500

Professional Fee (option) $USD :based on RegionInaCBG

Ina CBG : USD1500- 1900

Total /monthly THP USD750 -800

USD 3000 - 4000

Attention & stay focused

• We call for attention to remain focused on the major hurdles facing all physicians in modern-day intensive care medicine:

• defining, training, maintaining and improving physician competencies,

• implementation of quality assurance practices and, ultimately,

• our collective goal of the optimisation of patient safety.

TEAM WORK !!!

In darkness

Light up a candle

When you can not bring in the sun………

Contact :

Oloan E. Tampubolonperdici1@gmail.com

infoperdici@yahoo.co.id

www.world-sepsis-day.orgwww.perdici.org

ISICM

Thank you