title: Assessment of the quality of hospital care for children in Indonesia.
abstract: OBJECTIVE
  To obtain an overview of the quality of care for children in Indonesia, by assessing hospitals with a view to proceed to a quality improvement mechanism for child care.
  
  
  METHODS
  Stratified two-stage random sampling in six regions identified 18 hospitals (provinces Jambi, East Java, Central Kalimantan, South-East Sulawesi, East Nusa Tenggara, North Maluku). Three randomly selected hospitals in each province were visited by trained assessors who scored each assessed service (expressed as a percentage of achievement) and grouped into good (≥ 80%), requiring improvement (60-79%) and urgently requiring improvement (< 60%).
  
  
  RESULTS
  The overall median result score across all areas was 43% (IQR 28%-53%). Case management for common childhood illnesses had a median score of 37% (IQR18-43%), neonatal care 46% (IQR 26-57%) and patient monitoring 40% (IQR 30-50%), all indicating an urgent need for improvement. Qualitative data showed as main problems inadequate use of standard treatment guidelines, irrational prescribing of antibiotics, poor progress monitoring and poor supportive care.
  
  
  CONCLUSIONS
  We found serious shortcomings in the quality of hospital care for children. Finding and documenting those is the first step in a quality improvement process. Work is needed to start an improvement cycle for hospital care.
authors: Indonesian Commission for Hospital Accreditation, Jakarta, Indonesia.
authors: Nurul A
authors: NA
authors: Sidik
authors: Lilliana
authors: L
authors: Lazuardi
authors: Fransisca H
authors: FH
authors: Agung
authors: Kirana
authors: K
authors: Pritasari
authors: Hanny
authors: H
authors: Roespandi
authors: Tini
authors: T
authors: Setiawan
authors: Udjiani
authors: U
authors: Pawitro
authors: Waldi
authors: W
authors: Nurhamzah
authors: Martin W
authors: MW
authors: Weber
mesh_terms: D002648:Child; D002662:Child Health Services / Q000592:standards* / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006761:Hospitals / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007214:Indonesia; D017410:Practice Guidelines as Topic / Q000592:standards; D058996:Quality Improvement / Q000592:standards / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data