Gambaran Terapi Dan Biaya Medis Langsung Ulkus Diabetikum Pada Pasien Diabetes Melitus Tipe 2 Di RSUP Dr. Sardjito Yogyakarta

David Rofiudin Arizky, Prof. Dr. apt. Tri Murti Andayani, Sp.FRS

2025 | Skripsi | FARMASI

Beban ekonomi pasien ulkus diabetikum penting untuk dipertimbangkan karena ulkus diabetikum memerlukan perawatan yang rumit dan menghabiskan waktu yang panjang, mulai dari pencegahan dan amputasi. Biaya medis langsung menjadi salah satu kontributor terbesar dari beban ekonomi pasien ulkus diabetikum dan dipengaruhi oleh beberapa faktor. Penelitian ini bertujuan untuk mengetahui gambaran terapi yang diterima pasien komplikasi ulkus diabetikum, besar biaya medis langsung, dan mengetahui faktor-faktor yang mempengaruhi besar biaya medis langsung pasien komplikasi ulkus diabetikum.

Penelitian ini merupakan jenis penelitian observasional analitik dengan pengambilan data dilakukan secara retrospektif. Subjek penelitian adalah semua pasien ulkus diabetikum yang menjalani terapi rawat inap di RSUP Dr. Sardjito Yogyakarta pada tahun 2023-2024 yang berusia diatas 18 tahun. Analisis gambaran terapi digunakan untuk mengetahui pola terapi dan jenis antibiotik yang diterima pasien komplikasi ulkus diabetikum dengan hasil analisis disajikan dalam bentuk tabel dan persentase. Analisis biaya digunakan untuk mengetahui besarnya rata-rata biaya medis langsung pasien komplikasi ulkus diabetikum per episode rawat inap, serta dilakukan analisis statistik inferensial terhadap beberapa faktor yang diduga dapat mempengaruhi besarnya biaya medis langsung. Analisis korelasi bivariat dilakukan menggunakan uji Mann-Whitney dan uji Kruskal-Wallis serta analisis multivariat menggunakan uji korelasi regresi linier berganda untuk mengetahui hubungan antara faktor yang diduga berpengaruh terhadap biaya medis langsung pasien ulkus diabetikum.

Subjek penelitian yang digunakan dalam penelitian sebanyak 100 pasien dengan 100 episode rawat inap. Gambaran pola terapi antibiotik tunggal lebih banyak diresepkan dibandingkan dengan antibiotik kombinasi. Golongan antibiotik paling banyak diterima pasien selama periode penelitian adalah sefalosporin dan flourokuinolon, masing-masing sebanyak 59 dan 57 kali. Biaya medis langsung (maen ± SD) per episode sebesar Rp. 24.899.251,84 ± 18.121.727. Faktor yang mempengaruhi biaya medis langsung ulkus diabetikum secara signifikan adalah durasi rawat inap (P-value = 0,000) dan pembedahan (P-value = 0,000). 

The economic burden of diabetic foot ulcers is important to consider because diabetic ulcers require complex care and prolonged treatment, ranging from prevention to amputation. Direct medical costs are one of the major contributors to the economic burden of diabetic foot ulcer patients and are influenced by several factors. This study aims to understand the therapy received by patients with diabetic foot ulcer complications, the magnitude of direct medical costs, and to identify the factors affecting the direct medical costs for patients with diabetic foot ulcer complications.

This study is an analytical observational study with data collection performed retrospectively. The research subjects were all diabetic foot ulcer patients who received inpatient therapy at RSUP Dr. Sardjito Yogyakarta in 2023 2024, aged over 18 years. The analysis of therapy patterns was used to identify the types of therapy and antibiotics received by patients with diabetic foot ulcer complications, with the results presented in tables and percentages. A cost analysis was conducted to determine the average direct medical cost per episode of hospitalization for patients with diabetic foot ulcer complications. Inferential statistical analysis was performed on several factors suspected to influence the magnitude of direct medical costs. Bivariate correlation analysis was conducted using the Mann-Whitney test and the Kruskal-Wallis test, while multivariate analysis was performed using multiple linear regression to determine the relationship between factors that may influence the direct medical costs for diabetic foot ulcer patients.

The research subjects included 100 patients with 100 episodes of hospitalization. The analysis of antibiotic therapy patterns showed that single antibiotics were more frequently prescribed than combination antibiotics. The most commonly used classes of antibiotics during the study period were cephalosporins and fluoroquinolones, prescribed 59 and 57 times, respectively. The average direct medical cost (mean ± SD) per episode was IDR 24,899,251.84 ± 18,121,727. The factors significantly affecting the direct medical costs of diabetic foot ulcers were the duration of hospitalization (P-value = 0.000) and surgery (P-value = 0.000). 

Kata Kunci : biaya medis langsung, gambaran terapi, ulkus diabetikum