Analisis Biaya Penyakit Stroke Pasien Jaminan Kesehatan Nasional di RSUD Blambangan Banyuwangi

https://doi.org/10.22146/jmpf.41984

Zulfa Mazidah(1*), Nanang Munif Yasin(2), Susi Ari Kristina(3)

(1) Graduate Program of Pharmacy Management, Faculty of Pharmacy, Universitas Gadjah Mada
(2) Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada
(3) Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Cost analysis of chronic diseases in health care facilities during JKN is needed as quality and cost control. Stroke is a high cost, volume, and risk, catastrophic disease that can cause an increase in medical expenses, which requires special attention. The purpose of this study is to provide an overview of real costs and cost components, providing an overview of the direct medical costs and tariff packages of INA-CBGs based on the type of stroke, and the factors that affect direct medical costs. This study is a descriptive-analytic observational study according to the hospital perspective. Data was taken retrospectively. The subjects of the study were adult JKN patients who were aged ≥18 years old with a stroke diagnosis that entered the inclusion criteria. The research variables included age, gender, type of stroke, comorbidity, hospitalization class, length of stay (LOS), and real costs. Data analysis used univariate, bivariate and multivariate analysis. The research results obtained total real costs of Rp. 1,525,236,503 with an average cost of Rp. 4,872,960, the largest cost component was the cost of drugs and BMHP Rp. 402,248,555 (27.21%). The real cost of hemorrhagic strokes is Rp. 572,969,865 and the INA-CBGs tariff package is Rp. 483,804,000, the real cost of ischemic stroke is Rp. 1,107,055,700. There were significant differences in real cost from class factors and length of stay (p-value <0.005). The concluded that the INA-CBGs tariff package is insufficient to finance hospitalized patients with hemorrhagic strokes (-Rp89.165,865), but sufficient for ischemic stroke (+Rp.154,789,069).


Keywords


analisis biaya; stroke; rawat inap; cost analysis; stroke hospitalization

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References

  1. Kementerian Kesehatan RI BP dan PK. Riset Kesehatan Dasar (Riskesdas) 2013. Jakarta; 2013.
  2. Reich MR, Harris J, Ikegami N, et al. Moving Towards Universal Health Coverage : Lessons from 11 Country Studies. The Lancet. 2016;387(10020):811-816. doi:10.1016/S0140-6736(15)60002-2.
  3. Finkelstein EA, Chay J, Bajpai S. The Economic Burden of Self-Reported and Undiagnosed Cardiovascular Diseases and Diabetes on Indonesian Households. PLOS ONE. 2014;9(6):e99572. doi:10.1371/journal.pone.0099572.
  4. Andayani TM. Farmakoekonomi : Prinsip Dan Metodologi. Pertama. Yogyakarta: Bursa Ilmu Yogyakarta; 2013.
  5. Feladita N, Satibi, Marchaban. Analisis Biaya Terapi Stroke Hemoragi Pada Pasien Rawat Inap. Jurnal Manajemen Pelayanan Farmasi. 2014;4(2):69-76.
  6. Azlin N, Nordin M, Aljunid S, Junid S, Aziz NA, Muhammad A. Direct Medical Cost of Stroke : Findings from a Tertiary Hospital in Malaysia. The Medical journal of Malaysia. 2012;67(5):465-469.
  7. Purbaningsih S, Wahyono D, Suparniati E. Cost Of Illness Pasien Stroke. Jurnal Manajemen Pelayanan Farmasi. 2015;5(2):95-103.
  8. Setyawan IA, Andayani TM, Pinzon RT. Analisis Biaya Penyakit Stroke Perdarahan di Rumah Sakit. Jurnal Manajemen Pelayanan Farmasi. 2015;6(1):41-46.
  9. Firmansyah F, Andayani TM, Pinzon RT. Analisis Biaya Penyakit Stroke Iskemik. Jurnal Manajemen Pelayanan Farmasi. 2016;6(1):27-34.
  10. Chow WL, Tin AS, Meyyappan A. Factors Influencing Costs of Inpatient Ischaemic Stroke Care in Singapore. Proceedings of Singapore Healthcare. 2010;19(4):283-291.
  11. Ng CS, Paul M, Sim H, Ng J, Ko Y. Direct Medical Cost of Stroke in Singapore. World Stroke Organization. 2015;10:75-82. doi:10.1111/ijs.12576.
  12. Budiarto W, Sugiharto M. Biaya Klaim INA CBGs dan Biaya Riil Penyakit Katastropik Rawat Inap Peserta Jamkesmas di Rumah Sakit Studi di 10 Rumah Sakit Milik Kementerian Kesehatan Januari–Maret 2012. Buletin Penelitian Sistem Kesehatan. 2013;16(1 Jan).
  13. Muslimah, Andayani TM, Rizaldy P, Endarti D. Perbandingan Biaya Riil terhadap Tarif INA-CBGs Penyakit Stroke Iskemik di RS Bethesda Yogyakarta. Jurnal Manajemen Pelayanan Farmasi. 2017;7(1):105-115.
  14. Schreiber J, Asner-Self K. Educational Research: The Interrelationship of Questions, Sampling, Design, and Analysis. Hoboken, NJ: Wiley; 2011.
  15. Goldstein LB, Bushnell CD, Adams RJ, et al. AHA / ASA Guideline Guidelines for the Primary Prevention of Stroke A Guideline for Healthcare Professionals From the American Heart Association / American Stroke Association. American Heart Association, Journal. 2011;42(2):517-584. doi:10.1161/STR.0b013e3181fcb238.
  16. Go AS, Mozaffarian D, Roger VL, et al. AHA Statistical Update Heart Disease and Stroke Statistics — 2014 Update A Report From the American Heart Association Writing Group Members. American Heart Association, Journal. 2014;129(3):e28-e292. doi:10.1161/01.cir.0000441139.02102.80.
  17. Koellhoffer EC, Mccullough LD. The Effects of Estrogen in Ischemic Stroke. Translational Stroke Research. 2013;4(4):390-401. doi:10.1007/s12975-012-0230-5.
  18. Gillis EE, Sullivan JC. Sex Differences in Hypertension : Recent Advances. Hypertension. 2016;68(6):1322-1327. doi:10.1161/HYPERTENSIONAHA.116.06602.
  19. Madsen TE, Howard VJ, Jiménez M, Rexrode KM, Acelajado MC, Kleindorfer D. Impact of Conventional Stroke Risk Factors on Stroke in Women. American Heart Association Journal. 2018;49(3):536-542. doi:10.1161/STROKEAHA.117.018418.
  20. Margaret K-H. Influence of Age and Health Behaviors on Stroke Risk: Lessons from Longitudinal Studies. Journal of the American Geriatrics Society. 2010;58(Suppl 2):1-8. doi:10.1111/j.1532-5415.2010.02915.x.
  21. Manna, Dwiprahasto I. Analisis Biaya Jaminan Kesehatan Masyarakat dan Asuransi Kesehatan pada Pasien Stroke Non-Hemoragik di Rumah Sakit Umum Daerah Kabupaten Sleman. Jurnal Manajemen Pelayanan Farmasi. 2013;16(01):30-36.
  22. Mi Kim S, Wan Hwang S, Oh E, Kang J. Determinants of the Length of Stay in Stroke Patients. Korea Centers for Disease Control and Prevention. 2013;4(6):329-343. doi:10.1016/j.phrp.2013.10.008.
  23. Zhang J, Wang Y, Wang G, et al. Clinical Factors in Patients with Ischemic versus Hemorrhagic Stroke in East China. World Journal of Emergency Medicine. 2011;2(1):18-23.
  24. Bottacchi E, Corso G, Tosi P, et al. The Cost of First-Ever Stroke in Valle d ’ Aosta , Italy : Linking Clinical Registries and Administrative Data. BMC Health Services Research. 2012;12(372):1-11.
  25. Ojaghihaghighi S, Vahdati SS, Mikaeilpour A, Ramouz A. Comparison of Neurological Clinical Manifestation in Patients with Hemorrhagic and Ischemic Stroke. World Journal of Emergency Medicine. 2017;8(1):34-38. doi:10.5847/wjem.j.1920.
  26. Tan WS, Heng BH, Health P. Factors Predicting Inpatient Rehabilitation Length of Stay of Acute Stroke Patients in Singapore. YAPMR. 2009;90(7):1202-1207. doi:10.1016/j.apmr.2009.01.027.
  27. Hocker S, Morales-Vidal S, Schneck MJ. Management of Arterial Blood Pressure in Acute Ischemic and Hemorrhagic Stroke. Neurologic Clinics. 2010;28(4):863-886. doi:10.1016/J.NCL.2010.03.021.
  28. Dahlan M, Setyopranoto I, Trisnantoro L. Evaluasi Implementasi Program Jaminan Kesehatan Nasional Terhadap Pasien Stroke Di RSUP RSUP Dr. Sardjito. Jurnal Kebijakan Kesehatan Indonesia. 2017;06(02):73-82.
  29. Wagle L, Thomas AA, Shrestha S. Drug Utilisation Study of Stroke and Other Patients Admitted To General Ward of Neurology Unit at Quaternary Care Private Hospital. International Journal of Current Pharmaceutical Research. 2017;9(4):23. doi:10.22159/ijcpr.2017v9i4.20630.
  30. Turner GM, Calvert M, Feltham MG, et al. Under-prescribing of Prevention Drugs and Primary Prevention of Stroke and Transient Ischaemic Attack in UK General Practice: A Retrospective Analysis. Rahimi K, ed. PLOS Medicine. 2016;13(11):1-17. doi:10.1371/journal.pmed.1002169.
  31. Karuniawati H, Ikawati Z, Gofir A. Pencegahan Sekunder Untuk Menurunkan Kejadian Stroke Berulang Pada Stroke Iskemik. Jurnal Manajemen dan Pelayanan Farmasi. 2015;5(1):14-21.
  32. Misbach J, Lamsudin R, Allah A, et al. Guideline Stroke Tahun 2011. 2011th ed. Jakarta: PERDOSSI; 2011.
  33. Praja DS, Hasmono D, Syifa N. Sudi Penggunaan Obat Neuroprotektan Pada Pasien Stroke Iskemik (Penelitian Di Rumah Sakit Umum Dr. Saiful Anwar Malang). Jurnal Pharmacy. 2013;10(02):147-158.
  34. Santi N, Ikawati Z, Satibi. Analisis Efektivitas Pirasetam pada Pasien Stroke di Bangsal Rawat Inap Rumah Sakit. Jurnal Manajemen Pelayanan Farmasi. 2013;3(4):263-268.
  35. Wahyuddin M, Nurrochmad A, Harjaningsih W. Perbandingan Efek Terapi Pirasetam dan Sitikolin terhadap Perbaikan Fungsi Kognitif Pasien Stroke Iskemik. Jurnal Manajemen Pelayanan Farmasi. 2013;3(4):255-262.



DOI: https://doi.org/10.22146/jmpf.41984

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