Hospital fights to beat economic blues

By Sri Wahyuni

YOGYAKARTA (JP): Running a hospital in an economic slump is no easy task, but the Dr. Sardjito Hospital says it is struggling not to raise its fees while maintaining its high service standards.

"We are suffering from skyrocketing prices of food and medical supplies. But as this is a state-run hospital, we cannot raise the service fees," director Achmad Sujudi said.

That is until the end of next month when the new fiscal year begins. In the meantime, the hospital is subsidizing its operations and economizing without lowering the quality of its service.

The hospital now uses as many generic medicines as possible; a juggle in itself as there are only 150 kinds of generic drugs among the 6,000 on the market.

The hospital also economizes by using certain medical appliances several times, for example the tubes, catheters and filters of dialysis machines four or five times. This saves more than a third of the total cost of the treatment.

The hospital charges Rp 180,000 (US$19) for Askes health insurance holders undergoing dialysis, and Rp 250,000 for uninsured patients.

Another step being taken is simplifying and cutting down on the number of medical procedures.

The hospital was built in 1951 with facilities scattered in six different places -- Pugeran, Mangkubumen, Mangkuwilayan, Mangkuyudan, Jenggotan and Loji Kecil. It was first meant as a teaching hospital for medical students at Gadjah Mada University but later renovated and opened officially by President Soeharto in 1982.

The hospital was changed into a public hospital in 1954 and named after the first rector of Gadjah Mada University, Dr. Sardjito. It now stands on an 8.4-hectare plot inside the university campus, and serves as a referral hospital with 650 beds and 2,500 personnel.

Some 200 specialists and 400 student residents are now on the staff. Among its facilities are 20 clinics, including ones for drug abusers and for impotence sufferers.

According to public relations officer Sri Wahyuni Werdiningsih, two more clinics will soon be opened specializing in dementia and pediatrics.

In order to improve service and staff expertise, the hospital has set up cooperation with both local and foreign medical institutions. At present at least 20 educational institutions are using Dr. Sardjito Hospital as their training facilities.

The hospital has for the past five years intensified cooperation with the OVLG Hospital in Amsterdam, the Netherlands, in handling cardiac disease and spinal cord transplantation treatment.

Links with Adelaide's Queen Elizabeth Hospital in South Australia began two years ago with the aim of producing specialists in sophisticated plastic surgery, kidney failure and kidney transplants. Cooperation with yet another Australian hospital is aimed at improving the staff's expertise in pediatrics and neurology.

"This year we forge ties with several Dutch universities, one of which is Frije University, to train our cancer specialists," Sujudi said.

An Austrian institution has also agreed to give a soft loan in the form of medical instruments for the maternal and prenatal intensive care units (that are still under construction), with a grace period of seven years.

Since December 1993, Dr. Sardjito has been declared a self- funding hospital. This status gives the hospital more freedom to set up enterprises to increase its income.

"With this status, we're allowed to directly use the income to fund our daily operational costs and so we can cut bureaucratic procedures," he said.

One of the enterprises is building VIP rooms -- and using some of the income to subsidize patients who cannot afford to pay.

This is a reasonable option, Sujudi said, because although the VIP rooms, better known as the Pavilion Wijaya Kusuma, account for only 6 percent of the total capacity, they contribute up to 30 percent of the hospital's total revenue.

"The pavilion's consultation service even contributes up to 40 percent of the total revenue of the hospital's consultation services," Sujudi said, adding that the pavilion would be soon expanded from 38 to 80 rooms.

According to Dr. Sardjito's deputy director of public affairs and finance, Chamdani Tauchid, the hospital expects total revenue of Rp 10.5 billion for the 1997/1998 fiscal year.

"But due to the current monetary crisis, I'm afraid the large majority of the revenue will be in the form of patient debts," said Chamdani Tauchid.