DAMPAK TERAPI EMPIRIS ANTIBIOTIK IRASIONAL TERHADAP BIAYA PADA PASIEN PNEUMONIA RAWAT INAP DI RSUP DR. SARDJITO (TINJAUAN PUSTAKA DAN LAPORAN PENELITIAN)

DR. EDI SUTRISNO, dr. Rizka Humardewayanti, SpPD-KPTI; dr. Putut Bayupurnama, SpPD-KGEH

2013 | Tesis | SP Ilmu Penyakit Dalam

ABSTRAK Latar belakang: Angka kematian akibat pneumonia masih sangat tinggi, di Amerika mencapai 15 % sedang di Indonesia sebagai penyebab kematian kedua tertinggi pada kasus infeksi 28. Diperlukan strategi pengelolaan terutama terapi empiris antibiotik untuk menekan angka mortalitas pneumonia 10,28. Terapi empiris antibiotik irasional berdampak adanya resistensi kuman, potensial peningkatan efek samping obat, penambahan lama waktu rawat inap dan pemborosan biaya rumah sakit 1,30. Penelitian ini bertujuan untuk meningkatkan mutu pelayanan dengan menghitung prosentase terapi antibiotik empiris irasional berdasar alur Gyssens dan pemborosan biaya antibiotik serta biaya habis pakai. Metode: Desain penelitian secara retrospektif pada 57 pasien pneumonia di Bangsal Penyakit Dalam RS Dr. Sardjito periode November 2011 sampai Januari 2012. Analisis statistik dengan uji Mann-Whitney. Hasil: Dari 57 pasien pneumonia didapatkan terapi antibiotik empiris irasional mencapai 39 pasien atau 68,4%. Irasionalitas terapi didominasi penggunaan azytromisin. Pemborosan biaya antibiotik setiap harinya mencapai Rp 294.000,00 dan biaya habis pakai mencapai Rp 215.000,00 Kesimpulan : Pemberian terapi antibiotik empiris irasional pada pneumonia berdampak pada biaya kesehatan yang berpengaruh pada kepuasan pelanggan.

Background: The death rate from pneumonia remains very high, reaching 15% in the United States while in Indonesia pneumonia is the second leading cause of death in cases of infection. Management strategies mainly in empirical antibiotic therapy to reduce pneumonia mortality rate is necessary. Irrational empirical antibiotic therapy impacts to bacterial resistance, potentially increasing side effects of drugs, prolonged patient’s length of stay and wastage of hospitalization cost. This study aims to improve service quality by calculating the percentage of irrational empirical antibiotic therapy based on Gyssens workflow and wasteful expenses and the cost of consumables antibiotics. Methods: The design of this study is retrospective, including 57 pneumonia inpatients in internal medicine department wards in Dr. Sardjito Hospital, between November 2011 until January 2012. Statistical analysis was established employing Mann-Whitney test. Results: From 57 pneumonia inpatients, the utilization of irrational empirical antibiotic therapy reached 39 patients or 68,4%. Therapy irrationality was dominated by the usage of azithromycin. Daily antibiotic administration wastage reached Rp 294,000.00 and the cost of consumables antibiotics reached Rp 215,000.00 Conclusion: Irrational empirical antibiotic therapy in pneumonia impacts on healthcare costs which affects to customer satisfaction.

Kata Kunci : terapi empiris irasional, biaya kesehatan, dan kepuasan pelanggan