Potret Kelengkapan Rekam Medis Puskesmas Sebelum dan Setelah Akreditasi

Abstract

This research aims to describe the completeness of filling the community health centers medical record. This type of research is descriptive.The sample size was 240 medical record at each the community Health centers. variables in this study: completeness. Data in the study were collected through observation and interviews. The results showed that the completeness of filling the patient's identity had reached 100%; before & after accreditation at Sukoharjo and Grogol Health Centers. The average completeness of authentication before and after the accreditation increased, although it was still below 65%. The completeness of the most important reports is lowest on the diagnostic items both before accreditation; 83 (69.2%) and after accreditation; 115 (95.8%). The procedure for documenting by giving a fixed line in an empty area has not been done by a medical record officer. The conclusion of this research is the conclusion of this research is the technique of recording medical records of health centers is not in accordance with the provisions and needs to be arranged in operational procedures related to these matters