Assessment of Disaster Management Through LOS and PAPS Rate Analysis of RSSA ED in Mass Casualty Incident of Kanjuruhan Tragedy

Abstract

Emergency department (ED) is an essential aspect of modern health services in a hospital where it is crucial to maintain the integrity of the health care system during crisis. This study intends to evaluate emergency management of RSSA ED through analysis of patient length of stay (LOS) and discharge against medical advice (PAPS) rates of RSSA ED in mass casualty incidents (MCI). Methodology: This is an analytic observational cross-sectional study to assess the number of patients, LOS and PAPS of patients in the RSSA ED before and during the Kanjuruhan MCI tragedy. Data analysis was carry out with the Wilcoxon test. Results: The number of RSSA ED patients on 7 days before MCI was 440 patients (45.98%) and within 7 days of the response phase were 517 patients (54.02%). Wilcoxon test was performed and obtained P=0.021 (p< 0.05). Average of IGD LOS was 4.61 hours and 4.47 hours respectively. With the same test, P = 0.074 (p> 0.05). PAPS rate was 12 cases and 14 cases respectively with P = 0.059 (p> 0.05) which means that there was no significant difference between the ED LOS and the PAPS rates before and during the response phase of MCI. Conclusion: The significant increase in the number of patients during Kanjuruhan tragedy but not followed by prolonged LOS and PAPS rate for all patients in the RSSA ED shows the disaster management carried out was quite good but there still can be improved in the future.