ANALISIS MUTU PELAYANAN DAN BIAYA MEDIK LANGSUNG PASIEN STROKE INFARK AKUT DI RUANG UNIT STROKE DAN RUANG RAWAT BIASA DI RS PANTI RAPIH YOGYAKARTA

Esdras Ardi Pramudita, Prof. Dr. Dra. Erna Kristin, Apt, M.Si; Yos Hendra, SE, MM, M.Ec.Dev, Ak, CA., MAPPI

2025 | Tesis | MAGISTER KEBIJAKAN DAN MANAJEMEN KESEHATAN

Stroke merupakan penyakit katastropik yang menyumbang angka kematian dan kecacatan yang tinggi, sehingga membutuhkan perawatan pasien yang komprehesif dan multidisiplin. Unit stroke merupakan pusat dari pelayanan stroke yang terdiri dari asesmen dan pemantauan, manajemen fase akut, tim mutidisiplin dan discharge plan. Pelayanan di Unit Stroke mampu memberikan luaran klinis yang baik serta menurunkan angka kematian dan kecacatan pasien stroke.

Penelitian ini bertujuan untuk menganalisis mutu pelayanan dan biaya medik langsung  pasien stroke infark akut yang berada di Unit Stroke dan di Ruang Rawat biasa, dengan melihat luaran yang terdiri dari luaran klinis menggunakan Modified Rankin Scale (MRS), Length of Stay (LOS)  dan Biaya Medik Langsung  dari kedua ruang rawatan.

Penelitian dilakukan di RS Panti Rapih pada pasien stroke infark di Unit Stroke dan Ruang rawat biasa dengan total sampel 208 pasien, penelitian ini menggunakan metode kohort retrospektif dan data diperoleh melalui rekam medis. Hasil penelitian ini didapatkan bahwa mutu pelayanan pasien stroke infark di unit stroke yang dinilai dengan luaran klinis Modified Rankin Scale (p = 0,466) dan Length of Stay (p = 0,162) tidak lebih baik daripada di raung rawat biasa. Hasil penelitian didapatkan biaya medik langsung pasien stroke infark di Unit stroke tidak lebih rendah daripada di ruang rawat biasa (p = 0,002). 

Kesimpulan dalam penelitian ini adalah mutu pelayanan yang dilihat dengan luaran klinis (Modified Rankin Scale) dan Length of Stay pada pasien stroke infark akut di unit stroke dan ruang rawat biasa tidak berbeda bermakna. Biaya Medik Langsung total pasien stroke infark akut  yang dirawat di unit stroke dan ruang rawat biasa tidak berbeda bermakna.

Stroke is a catastrophic disease that contributes significantly to high mortality and disability rates, thus requiring comprehensive and multidisciplinary patient care. A stroke unit serves as the center of stroke services, consisting of assessment and monitoring, acute phase management, a multidisciplinary team, and discharge planning. Services provided in a Stroke Unit are able to deliver better clinical outcomes and reduce mortality and disability among stroke patients.

This study aims to analyze the quality of care and direct medical costs of acute ischemic stroke patients treated in the Stroke Unit and in General Wards, by evaluating outcomes consisting of clinical outcomes using the Modified Rankin Scale (MRS), Length of Stay (LOS), and Direct medical costs from both care settings.

The study was conducted at Panti Rapih Hospital on ischemic stroke patients treated in the Stroke Unit and General Wards, with a total sample of 208 patients. This research employed a retrospective cohort design, and data were obtained from medical records. The results showed that the quality of care for ischemic stroke patients in the Stroke Unit, as measured by clinical outcome (Modified Rankin Scale, p = 0.466) and Length of Stay (p = 0.162), was not superior to that in the General Ward. The findings also revealed that the direct medical costs of ischemic stroke patients in the Stroke Unit were not lower than those in the General Ward (p = 0.002).

The conclusion of this study is that the quality of care, as assessed by clinical outcome (Modified Rankin Scale) and Length of Stay, for acute ischemic stroke patients in the Stroke Unit and the General Ward did not differ significantly. The total direct medical costs for acute ischemic stroke patients treated in the Stroke Unit and the General Ward did not differ significantly.

Kata Kunci : mutu pelayanan, stroke infark, luaran klinis, modified rankin scale, length of stay, biaya medik langsung