Cost-Effectiveness Analysis of ERACS Compared to Non-ERACS at Hospital

https://doi.org/10.22146/jmpf.88568

Balqis Hisyam Saleh Basleman(1), Susiyadi Susiyadi(2), Didik Setiawan(3*)

(1) Departemen Farmasi Sosial dan Administratif, Fakultas Farmasi, Universitas Muhammadiyah Purwokerto, Jl. KH. Ahmad Dahlan PO BOX 202, Kembaran, Banyumas
(2) Fakultas Kedokteran, Universitas Muhammadiyah Purwokerto, Jl. KH. Ahmad Dahlan PO BOX 202, Kembaran, Banyumas
(3) 1) Departemen Farmasi Sosial dan Administratif, Fakultas Farmasi, Universitas Muhammadiyah Purwokerto, Jl. KH. Ahmad Dahlan PO BOX 202, Kembaran, Banyumas, Indonesia 2) Pusat Studi Ekonomi Kesehatan, Universitas Muhammadiyah Purwokerto, Jl. KH. Ahmad Dahlan PO BOX 202, Kembaran, Banyumas
(*) Corresponding Author

Abstract


Background: Cesarean section has a 5 to 7 times greater risk of maternal and child mortality than prevaginal delivery. Several other complications, namely reduced mobility, prolonged pain in the surgical wound, and longer hospital stays affect the patient's quality of life. The ERACS protocol, which is a multidisciplinary approach, is a good strategy to reduce the negative effects of cesarean section.

Objectives: To find out whether the ERACS protocol is more cost-effective than the non-ERACS protocol from a patient’s perspective.

Methods: Researchers took data on costs and quality of life (using EQ-5D-5L) prospectively at private hospitals in Wonosobo which then calculated the value of the ICER. The cost components measured include direct medical and non-medical costs as well as indirect costs. The effectiveness of the measures in this study was reported in terms of reducing the LOS to 1 day, which represents a faster recovery and reduced costs. In this study, there were 2 sample groups, namely the ERACS protocol group with 24 respondents and the non-ERACS protocol group with 75 respondents.

Results: Based on the research, the effectiveness of the protocol in the form of improving the quality of life of patients was seen from the utility value and higher costs in the ERACS group compared to the non-ERCAS group (utility 0.771 vs 0.715; cost IDR.16,127,183 ± 5,023,356 vs IDR. 10,459,562 ± 3,826 .424) and obtained an ICER of 94,311,767 which means that the patient needs to add IDR.94,311,767 to improve the quality of life of post-cesarean section patients, which value is higher than Indonesia's 2022 GDP.

Conclusion: ERACS measures are more cost-effective when compared to non-ERACS measures because the ICER value is below three times Indonesia's 2022 GDP according to the perspective of patients at private hospitals in Wonosobo.


Keywords


ERACS; Incremental Cost Effectiveness Ratio (ICER); non-ERACS

Full Text:

PDF


References

  1. Cameron L, Cornwell K. Understanding the Causes of Maternal Mortality in Indonesia A Review of Research on the Determinants and Trends in Maternal Mortality in the Asia-Pacific Region. MAMPU. Published online 2015.
  2. BPS. Angka Kematian Ibu/AKI (Maternal Mortality Rate/MMR) Hasil Long Form SP2020 Menurut Provinsi, 2020. Badan Pusat Statistik. 2023. https://www.bps.go.id/statictable/2023/03/31/2219/angka-kematian-ibu-aki-maternal-mortality-rate-mmr-hasil-long-form-sp2020-menurut-provinsi-2020.html
  3. Susiana S. Angka Kematian Ibu: Faktor Penyebab Dan Upaya Penanganannya. Published online 2019.
  4. Sissoko A, Traore A, Kante I, et al. The Complications of Cesarean Section at Teaching Hospital Gabriel TOURE, Bamako Mali. Open J Obstet Gynecol. 2020;10(04):546-557. doi:10.4236/ojog.2020.1040049
  5. Ruspita I, Rosyidah R. Pain Score and Quality of Post Cesarean Section Recovery with ERACS Method. Jurnal Ners dan Kebidanan Indonesia (JNKI). 2023;11(1):1-10. doi:http://dx.doi.org/10.21927/jnki.2023.11(1).1-10
  6. Taurchini M, Del Naja C, Tancredi A. Enhanced Recovery After Surgery: a patient centered process. J Vis Surg. 2018;4:40-40. doi:10.21037/jovs.2018.01.20
  7. Gupta S, Gupta A, Baghel A, Sharma K, Choudhary S, Choudhary V. Enhanced recovery after cesarean protocol versus traditional protocol in elective cesarean section: A prospective observational study. Journal of Obstetric Anaesthesia and Critical Care. 2022;12(1):28. doi:10.4103/joacc.joacc_16_22
  8. Tika TT, Sidharti L, Himayani R, Rahmayani F. Metode ERACS Sebagai Program Perioperatif Pasien Operasi Caesaragus. Jurnal Medika Hutama. 2022;03(02):2386-2391.
  9. Patel K, Zakowski M. Enhanced Recovery After Cesarean: Current and Emerging Trends. Published online 2021:136-144. https://doi.org/10.1007/s40140-021-00442-9
  10. Arif Rahmandani , Prih Sarnianto , Yusi Anggriani FDP. Analisis Efektivitas Biaya Penggunaan Obat Antivirus Oseltamivir dan Favipiravir padaPasien Covid-19 Derajat Sedang di Rumah Sakit Sentra Medika Cisalak Depok. Majalah Farmasetika. 2021;6(Suppl 1):133-144.
  11. Suwendar S, Fudholi A, Andayani TM, Sastramihardja HS. Quality of Life Evaluation of Cervical Cancer Inpatients Before and After Chemotherapy by Using the EQ-5D Questionnaire. Indonesian Journal of Clinical Pharmacy. 2017;6(1):1-10. doi:10.15416/ijcp.2017.6.1.1
  12. Selfie, Arrozi M, Mustikawati IS. Analisis Efektivitas Biaya Seksio Sesarea Metode ERACS dan Non ERACS Pada Pasien BPJS Kesehatan. Journals of Ners Community. 2023;13(2):407-422. doi:https://doi.org/10.55129/jnerscommunity.v13i2.2782
  13. KEMENKES RI. Hk.01.07/Menkes/1541/2022 Tentang Pedoman Nasional Pelayanan Kedokteran Tata Laksana Anestesiologi Dan Terapi Intensif. JdihKemkesGoId. Published online 2022:1-504.
  14. Sahid Raharjo. Cara melakukan Uji Validitas Product Moment dengan SPSS. SPSS Indonesia. 2021. Accessed September 6, 2022. https://www.spssindonesia.com/2014/01/uji-validitas-product-momen-spss.html
  15. Susongko P. Uji Validitas Konstruk Tes Prestasi Belajar dengan Penerapan Model Persamaan Struktural. Cakrawala: Jurnal Pendidikan. 2010;4(8):41-52. doi:10.24905/cakrawala.v4i8.32
  16. Susanto Y, Alfian R, Rahim Z, Karani. Uji Validitas dan Reliabilitas Kuesioner EQ-5D Bahasa Indonesia Untuk Mengukur Kualitas Hidup Pasien Hemodialisa Gagal Ginjal Kronik. Jurnal Ilmiah Manuntung. 2018;4(1):41-47.
  17. Purba FD, Hunfeld JAM, Iskandarsyah A, et al. The Indonesian EQ-5D-5L Value Set. Pharmacoeconomics. 2017;35(11):1153-1165. doi:10.1007/s40273-017-0538-9
  18. Badan Pusat Statistik. Pertumbuhan Ekonomi Indonesia Triwulan IV-2022. WwwBpsGoId. 2023;(15/02/Th.XXVI):1-12. https://www.bps.go.id/pressrelease/2020/02/05/1755/ekonomi-indonesia-2019-tumbuh-5-02-persen.html
  19. KEMENKES RI. Pedoman Penerapan Kajian Farmakoekonomi. Vol 7. KEMENKES RI; 2013.
  20. Mursalim K. Faktor Determinan Pemilihan Jenis Persalinan Dan Dampaknya Terhadap Pemberian Asi Di Rumah Sakit Kota Makassar Tahun 2012. Universitas Hasanuddin Makasr; 2012. http://dx.doi.org/10.1016/j.actamat.2015.12.003%0Ahttps://inis.iaea.org/collection/NCLCollectionStore/_Public/30/027/30027298.pdf?r=1&r=1%0Ahttp://dx.doi.org/10.1016/j.jmrt.2015.04.004
  21. Masu PWY. Asuhan Kebidanan Berkelanjutan Pada Ny. J. N Di Puskesmas Oebobo Periode Tanggal 18 Februari Sampai 18 Mei 2019. Politeknik Kesehatan Kemenkes Kupang; 2019.
  22. Setiawan D, Dusafitri A, Galistiani GF, van Asselt ADI, Postma MJ. Health-Related Quality of Life of Patients with HPV-Related Cancers in Indonesia. Value Health Reg Issues. 2018;15:63-69. doi:10.1016/j.vhri.2017.07.010
  23. Yuswar MA, Susanti R, Az-zahra NS. Pengukuran Kualitas Hidup Pasien Pengguna Antihipertensi dengan European Quality of Life 5 Dimensions (EQ5D) Questionnaire dan Visual Analog Scale (VAS). Jurnal Sains dan Kesehatan. 2019;2(2):93-99. doi:10.25026/jsk.v2i2.123
  24. Menteri Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia No. 3 Tahun 2023 Tentang Standar Tarif Pelayanan Kesehatan Dalam Penyelenggaraan Program Jaminan Kesehatan. Menteri Kesehatan RI. Published online 2023:1-721.



DOI: https://doi.org/10.22146/jmpf.88568

Article Metrics

Abstract views : 68 | views : 65

Refbacks

  • There are currently no refbacks.


Copyright (c) 2024 JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

©Jurnal Manajemen dan Pelayanan Farmasi
Faculty of Pharmacy
Universitas Gadjah Mada
Creative Commons License
View My Stats