Analisis Biaya dan Outcome Intervensi Biomekanik pada Nyeri Punggung Bawah Non-Spesifik di Bidang Rehabilitasi Medik: Studi Kuasi-Eksperimental

Wahju Hidajati, Dr. Dra. Diah Ayu Puspandari, Apt., M.Kes., M.B.A., A.A.K; dr. Firdaus Hafidz As Shidieq, MPH, Ph.D., A.A.K

2026 | Tesis | MAGISTER KEBIJAKAN DAN MANAJEMEN KESEHATAN

Latar Belakang: Nyeri punggung bawah non-spesifik merupakan salah satu penyebab utama disabilitas dengan beban klinis dan ekonomi yang tinggi. Informasi mengenai outcome klinis dan biaya intervensi diperlukan untuk mendukung pengambilan keputusan dalam pelayanan rehabilitasi medik.

 

Tujuan: Menganalisis outcome klinis dan biaya pelayanan intervensi biomekanik pada peserta dengan nyeri punggung bawah non-spesifik dari perspektif pemberi layanan.

 

Metode Penelitian: Penelitian ini merupakan primary costing study dengan desain kuasi-eksperimental satu kelompok pre–post. Intervensi biomekanik diberikan dalam empat kunjungan. Outcome klinis dinilai berdasarkan perubahan skor Visual Analogue Scale (VAS) dan proporsi peserta yang mencapai Minimal Clinically Important Difference (MCID), yang ditetapkan sebagai penurunan VAS ?30%. Analisis biaya dilakukan menggunakan pendekatan Time-Driven Activity-Based Costing (TDABC) dari perspektif pemberi layanan. Analisis ekonomi dilakukan secara deskriptif menggunakan Cost-Effectiveness Ratio (CER) berdasarkan biaya per episode dan rerata penurunan skor VAS, serta biaya per peserta yang mencapai MCID.

 

Hasil: Sebanyak 13 peserta direkrut dan 12 peserta menyelesaikan penelitian. Rerata skor VAS menurun dari 66,5 ± 11,3 mm menjadi 32,7 ± 19,1 mm, dengan rerata penurunan (?VAS) sebesar 33,8 ± 22,5 mm (p <0>

 

Kesimpulan: Intervensi biomekanik menunjukkan penurunan intensitas nyeri yang bermakna secara statistik dan sebagian besar peserta mencapai MCID. Pendekatan TDABC menghasilkan estimasi biaya pelayanan per episode, sedangkan CER dan biaya per peserta yang mencapai MCID memberikan gambaran deskriptif hubungan antara biaya dan outcome klinis.

 

Background: Non-specific low back pain is one of the leading causes of disability and is associated with a substantial clinical and economic burden. Information on clinical outcomes and intervention costs is needed to support decision-making in physical and rehabilitation medicine.

 

Objective: To analyze the clinical outcomes and service costs of a biomechanical intervention for participants with non-specific low back pain from the healthcare provider perspective.

 

Methods: This was a primary costing study using a single-group pre–post quasi-experimental design. The biomechanical intervention was delivered over four visits. Clinical outcomes were assessed based on changes in pain intensity using the Visual Analogue Scale (VAS) and the proportion of participants achieving the Minimal Clinically Important Difference (MCID), defined as a ?30% reduction in VAS score. Costs were analyzed using the Time-Driven Activity-Based Costing (TDABC) approach from the healthcare provider perspective. The economic analysis was conducted descriptively using the Cost-Effectiveness Ratio (CER), calculated based on the cost per episode and mean reduction in VAS score, as well as the cost per participant achieving the MCID.

 

Results: Thirteen participants were recruited, and 12 completed the study. The mean VAS score decreased from 66.5 ± 11.3 mm to 32.7 ± 19.1 mm, with a mean reduction (?VAS) of 33.8 ± 22.5 mm (p < 0>

 

Conclusions: The biomechanical intervention was associated with a statistically significant reduction in pain intensity, and most participants achieved the MCID. The TDABC approach provided an estimate of service costs per episode, while the CER and cost per participant achieving the MCID provided a descriptive measure of the relationship between costs and clinical outcomes.

Kata Kunci : nyeri punggung bawah non-spesifik, intervensi biomekanik, Time-Driven Activity-Based Costing, outcome klinis, Visual Analogue Scale.