KARAKTERISTIK TERAPI DAN ANALISIS BIAYA PENYAKIT STROKE ISKEMIK DI RUMAH SAKIT BETHESDA YOGYAKARTA

FERDY FIRMANSYAH, Dr. Tri Murti Andayani, Sp.FRS., Apt.;Dr.dr. Rizaldy T. Pinzon, Sp.S., M.Kes.

2016 | Tesis | S2 Ilmu Farmasi

Stroke iskemik merupakan suatu gejala klinis defisit neurologis fokal disebabkan oleh suplai darah yang tidak memadai ke otak. Cost of Illness digunakan untuk menghitung biaya penyakit stroke iskemik pada suatu periode. Tujuan penelitian untuk mengetahui pengaruh cara bayar terhadap karakteristik terapi; mengetahui pengaruh faktor usia, jenis kelamin, komorbid, komplikasi, lama dan kelas perawatan, serta cara bayar terhadap biaya riil; dan mengetahui komponen biaya, rata-rata biaya, dan total biaya penyakit; serta mengetahui perbedaan biaya riil terapi stroke iskemik dengan paket INA-CBG�s 2014 di Rumah Sakit Bethesda Yogyakarta. Jenis penelitian ini menggunakan rancangan penelitian analitik non-eksperimental dengan pendekatan cross sectional study berdasarkan perspektif rumah sakit. Pengambilan data dilakukan dengan melihat rekam medik pasien yang memenuhi kriteria inklusi selama periode Oktober 2014-September 2015. Subyek penelitian terdiri dari 245 pasien rawat inap dan 148 pasien rawat jalan. Variabel terikat dalam penelitian ini adalah total biaya penyakit, dan variabel bebas adalah usia, jenis kelamin, komorbid, komplikasi, lama dan kelas rawat inap, serta cara bayar. Analisis data dilakukan menggunakan multiple regression linier dan t-test. Hasil penelitian menunjukkan bahwa terdapat perbedaan karakteristik terapi antara pasien dengan metode pembayaran prospective payment system dan fee for service. Pada pasien rawat jalan terdapat pengaruh yang signifikan pada variabel cara bayar terhadap total biaya riil. Pada pasien rawat inap terdapat pengaruh yang signifikan pada variabel lama dan kelas perawatan terhadap total biaya riil pasien (p<0,05). Total biaya penyakit stroke iskemik dengan pembayaran Fee for service adalah Rp. 1.528.343.158 dan dengan pembayaran Prospective Payment System adalah Rp. 1.072.471.715. Terdapat perbedaan rata-rata pada pasien rawat jalan (p<0,05) dan tidak terdapat perbedaan rata-rata pada pasien rawat inap (p>0,05) antara metode pembayaran Fee for Service dan Prospective Payment System. Total biaya riil penyakit stroke iskemik rawat jalan (p<0,05) dan rawat inap (p>0,05) lebih tinggi dibandingkan dengan paket INA-CBG�s 2014 di RS Bethesda Yogyakarta.

Ischemic stroke is a clinical symptom of focal neurological deficits due to inadequate blood supply to the brain. Cost of Illness is used to calculate the cost of ischemic stroke in a particular period. The purpose of this study was to determined the impact of payment method on the therapy characteristics; to determined the impact of some factors (groups of ages, sex, comorbidities, length and class of treatment, and payment method) to the real costs; and to calculate the components of cost, the average cost, and the total cost of illness; as well as the determination of differences of the real cost of ischemic stroke therapy with INA-CBG's 2014 package at Bethesda Hospital Yogyakarta. This study was a non-experimental analytical study with cross sectional approach based on the perspective of the hospital. Data retrieval was done by sorting at the medical records of patients which matched the inclusion criteria during the period October 2014 to September 2015. The subjects of the study consisted of 245 inpatients and 148 outpatients. The dependent variable in this study was the total cost of illness, and the independent variables were age, sex, comorbidities, complications, length and class of hospitalization and payment method. Data was analyzed using multiple linear regression and t-test. The results showed that there were differences between patients with therapeutic characteristics of prospective payment system and fee for service method. In outpatients there was a significant impact on the variable payment method to the total real cost. Inpatients had a significant impacts on the variable length of stay and treatment classes to total real cost patients (p<0.05). Total cost of ischemic stroke with payment Fee for service is Rp. 1.528.343.158 and the Prospective Payment System payment is Rp. 1.072.471.715. There were significant differences in the average outpatient (p<0,05) and there was no significant deference in the average inpatient (p>0,05) between payment methods Fee for Service and Prospective Payment System. The total real cost of ischemic stroke outpatients (p<0,05) and inpatients (p>0,05) higher than the INA-CBG's 2014 package at Bethesda Hospital in Yogyakarta.

Kata Kunci : Cost of Illness, stroke iskemik, RS Bethesda