FACTORS CONTRIBUTING TO THE DECLINE IN BED OCCUPANCY RATE IN THE NEONATAL INTENSIVE CARE UNIT OF NGIMBANG REGIONAL GENERAL HOSPITAL, LAMONGAN
DOI:
https://doi.org/10.62354/jurnalmedicare.v5i4.593Abstract
Background: Bed occupancy rate (BOR) is an indicator of inpatient-bed utilization and hospital efficiency. The Neonatal Intensive Care Unit (NICU) of Ngimbang Regional General Hospital experienced a substantial decline in BOR, requiring an examination of internal management and external service factors.
Objective: To analyze factors contributing to the decline in BOR in the NICU of Ngimbang Regional General Hospital using the Input–Process–Output (IPO) framework. Methods: This descriptive qualitative study was conducted at Ngimbang Regional General Hospital, Lamongan, from December 2025 to July 2026. Five informants were purposively selected: the NICU head, a service-management staff member, a marketing staff member/editor, a parent of a BPJS-insured infant, and a parent of a general-pay patient. Data were collected through in-depth interviews, observation, and document review, and analyzed using the Miles and Huberman model.
Results: The input findings indicated that human resources, tariffs, and facilities generally supported NICU services. The factors identified as contributing to lower BOR were the reduced number of maternity referrals and deliveries, as well as community preference for a particular obstetrician–gynecologist. Process-related findings included coordination and administrative-document delays, while monitoring and recording of the “5 in 1 Bayi Lawas Aku Foto” program were not fully integrated. Document review showed that monthly BOR declined from 95% in January 2026 to 26% in June 2026, falling below the stated 60–85% benchmark from March onward.
Conclusion: The decline in NICU bed utilization is influenced by referral patterns, patient provider preferences, and administrative coordination factors. Strengthening inter-facility referral engagement, cross-unit communication, and integrated monitoring effectively supports service utilization and optimizes inpatient care management.
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Keywords:
Bed occupancy rate, hospital management, input–process–output, neonatal intensive care unit, referral systemReferences
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