A Comparison of the Clinical Picture of Stroke Before and Afternoon Implementation of National Health Insurance (BPJS) in RSUP Dr Sardjito Yogyakarta

ANGELA N PERKASA, Dr. dr. Ismail Setyopranoto, Sp.S(K); dr. Abdul Ghofir, Sp.S(K)

2020 | Skripsi | S1 KEDOKTERAN

Latar Belakang: Indonesia merupakan negara yang menduduki ranking pertama dari pasien stroke di Asia. Pada 01 Januari 2014, Indonesia menerapkan Jaminan Kesehatan Nasional (JKN). Saat ini penemuan kasus stroke lebih efektif dan efisien. Tetapi penanganannya masih belum efektif karena sering kali kasus stroke yang ditemukan di fasilitas kesehatan tersier sudah merupakan kasus berat. RSUP Dr Sardjito Yogyakarta merupakan rumah sakit rujukan utama, yaitu tipe A, sehingga pasien yang dirujuk cenderung memiliki derajat keparahan stroke yang lebih buruk. Tujuan: Penelitian ini bertujuan untuk melihat apakah terdapat perbedaan gambaran klinis stroke sebelum dan setelah implementasi JKN (BPJS) di RSUP Dr Sardjito Yogyakarta. Metode: Penelitian ini menggunakan desain deskriptif dan studi cross sectional. Data diambil dari rekam medis di RSUP Dr Sardjito pada tahun 2014 dan 2016. Hasil: Tanda dan gejala stroke yang paling sering ditemukan adalah hemiparesis, yaitu 35,26% (2014) dan 31,36% (2016). Faktor risiko stroke yang paling sering ditemukan adalah hipertensi, yaitu 49,02% (2014) dan 41,58% (2016). Sedangkan komplikasi yang paling sering ditemukan, yaitu infeksi saluran kemih, sebesar 27,78% (2014) dan pneumonia, sebesar 41,03% (2014). Kesimpulan: Terdapat hubungan yang signifikan antara tanda dan gejala klinis, faktor risiko dan komplikasi terhadap gambaran klinis stroke.

Background: Indonesia is the leading country in the number of stroke patients throughout Asia. On the first of January, 2014, the Indonesian government implemented Jaminan Kesehatan Nasional (JKN) as their national health insurance. Since then, the early detection of stroke has become more effective and efficient. However, the management of stroke remains insufficiently effective as stroke cases found in tertiary healthcare facilities are often already severe. As a third-tier healthcare facility, RSUP Dr Sardjito Yogyakarta is a main referral hospital, which means patients that are referred there are often those with a greater severity of stroke. Aim: The general aim of this study is to examine whether there is a difference in the clinical picture of stroke before and after the implementation of JKN (BPJS) in RSUP Dr Sardjito Yogyakarta. Method: This study uses a descriptive design and cross-sectional study. The data used in this study was taken from patients' medical records in RSUP Dr Sardjito in the years 2014 and 2016. Results: The sign and symptom most often commonly found was hemiparesis, found in 35,26% and 31,36% of patients in 2014 and 2016 respectively. The risk factor for stroke most commonly found was hypertension, found in 49,02% of patients in 2014 and in 41,58% of patients in 2016. Meanwhile, the most common complications of stroke were found to be urinary tract infections in 2014, found in 27,78% of patients, and pneumonia in 2016, found in 41,03% of patients. Conclusion: A significant correlation was found between clinical signs and symptoms, risk factors, and complications and the clinical picture of stroke.

Kata Kunci : Clinical Picture of Stroke, Jaminan Kesehatan National, Universal Health Coverage, Signs and Symptoms, Risk Factors, Complications