Analisis Faktor-Faktor Penyebab Readmisi Dan Beban Pembiayaan Bagi Rumah Sakit Di Rumah Sakit Dr. Oen Kandang Sapi Solo

ONI JUNIAR WINDRASMARA, dr. Vita Yanti Anggraini, M.Sc.,Ph.D., Sp.PD.,KKV., Sp.JP ; dr. Dewi Ratmasari, MPH

2026 | Tesis | MAGISTER KEBIJAKAN DAN MANAJEMEN KESEHATAN

Latar Belakang : Readmisi merupakan masuknya kembali pasien ke rumah sakit dalam waktu kurang dari 30 hari setelah pasien dipulangkan dan menjadi salah satu indikator mutu pelayanan rumah sakit. Tingginya angka readmisi dapat meningkatkan biaya pelayanan kesehatan, memperpanjang lama perawatan, menurunkan efisiensi rumah sakit, serta berdampak pada kualitas hidup pasien. 

Tujuan : Penelitian ini bertujuan untuk menganalisis faktor-faktor yang memengaruhi kejadian readmisi <30>

Metode Penelitian : Penelitian ini menggunakan metode campuran (mixed methods) dengan desain sequential explanatory. Tahap kuantitatif menggunakan desain case control retrospektif dengan jumlah sampel 570 pasien yang terdiri dari 190 pasien kelompok kasus dan 380 pasien kelompok kontrol. Analisis data dilakukan menggunakan uji Chi-Square, Mann-Whitney, dan regresi logistik ganda. Tahap kualitatif dilakukan melalui focus group discussions (FGD) dan wawancara mendalam terhadap 15 informan yang terdiri dari kepala ruang rawat inap, kepala IGD, kepala ruang intensif, Manajer Pelayanan Pasien (MPP), Tim Kendali Mutu dan Kendali Biaya (TKMKB), serta dokter penanggung jawab pelayanan.

Hasil dan Pembahasan : Menunjukkan bahwa usia, pendidikan, status penjamin, polifarmasi, komplikasi, Charlson Comorbidity Index (CCI), lama rawat inap (LOS), discharge planning, kesesuaian clinical pathway, dan keterlibatan MPP berhubungan signifikan dengan kejadian readmisi (p<0 OR=3,92), OR=3,05), OR=2,52), OR=2,25), OR=2,10).>

Kesimpulan : Discharge planning yang tidak lengkap merupakan faktor paling dominan yang memengaruhi kejadian readmisi <30>

Kata Kunci: readmisi, discharge planning, charlson comorbidity index, manajer pelayanan pasien, mutu pelayanan rumah sakit.

Background: Readmission is defined as a patient's return to the hospital within 30 days after discharge and is considered one of the indicators of hospital service quality. A high readmission rate can increase healthcare costs, prolong hospitalization, reduce hospital efficiency, and negatively affect patients' quality of life.

Objective: This study aimed to analyze the factors influencing 30-day readmission among hospitalized patients at Dr. Oen Kandang Sapi Hospital, Solo.

Methods: This study employed a mixed-methods approach with a sequential explanatory design. The quantitative phase used a retrospective case-control design involving 570 patients, consisting of 190 patients in the case group and 380 patients in the control group. Data were analyzed using Chi-Square tests, Mann-Whitney tests, and multiple logistic regression. The qualitative phase was conducted through Focus Group Discussions and in-depth interviews with 15 informants, consisting of inpatient ward heads, including inpatient ward managers, the emergency department manager, the intensive care unit manager, Patient Care Managers (PCM), members of the Quality and Cost Control Team, and attending physicians.

Results and Discussion: The results showed that age, educational level, insurance status, polypharmacy, complications, Charlson Comorbidity Index (CCI), length of stay (LOS), discharge planning, compliance with clinical pathways, and Patient Care Manager involvement were significantly associated with readmission (p<0 OR=3.92), OR=3.05), OR=2.52), OR=2.25), OR=2.10).>

Conclusion: Incomplete discharge planning was identified as the most dominant factor influencing 30-day readmission. Hospitals should strengthen the implementation of discharge planning, enhance the role of Patient Care Managers, optimize patient and family education, and conduct continuous monitoring of high-risk patients to reduce readmission rates and improve the quality of healthcare services.

Keywords: readmission, discharge planning, charlson comorbidity index, case manager, hospital service quality.

Kata Kunci : readmisi, discharge planning, charlson comorbidity index, manajer pelayanan pasien, mutu pelayanan rumah sakit