Analisis Efektivitas Biaya Pengobatan Demam Berdarah Dengue pada Pasien BPJS Rawat Inap di RSUD dr. Adjidarmo Kabupaten Lebak Tahun 2014–2015
Abstract
Penderita penyakit Demam Berdarah Dengue (DBD) di Indonesia mencapai 129.650 orang dengan jumlah kematian 1.071 orang pada tahun 2015. Jumlah pendertita DBD di Provinsi Banten pada tahun 2013 mencapai 4.291 kasus dengan jumlah kematian 31 orang. Penyakit DBD memberikan beban ekonomi bagi pemerintah dan masyarakat. Penelitian ini bertujuan untuk menganalisis efektivitas biaya pengobatan DBD pada pasien rawat inap di RSUD dr. Adjidarmo Kabupaten Lebak. Rancangan penelitian ini adalah observasional dengan pengumpulan data secara retrospektif. Data biaya dan penggunaan obat DBD pada pasien rawat inap peserta Jaminan Kesehatan Nasional (JKN) tahun 2014 dan 2015 di RSUD dr. Adjidarmo Kabupaten Lebak diperoleh dari bagian rekam medik dan keuangan. Penilaian kuantitas dan kualitas penggunaan obat menggunakan metode cost/defined daily dose (DDD) drug utilization (DU) 90% dan cost-effectiveness analysis. Jumlah rekam medik pasien yang sesuai kriteria inklusi tahun 2014 dan 2015 masing-masing adalah 134 dan 259 pasien. Hasil penelitian menunjukkan bahwa nilai cost/DDD DU90% tahun 2014 (Rp32.506) lebih kecil dari tahun 2015 (Rp32.800). Rata-rata rasio efektivitas biaya per 1% penurunan hematokrit tahun 2014 (Rp21.624) lebih kecil dibandingkan tahun 2015 (Rp22.640). Persentase perbandingan rata-rata biaya tiap pasien berdasarkan data rumah sakit dengan tarif INA CBG’s tahun 2014 (14,60%) lebih rendah dibandingkan tahun 2015 (15,28%). Pengobatan pasien DBD pada tahun 2014 lebih cost-minimum dan cost-effective dibandingkan tahun 2015.
Kata kunci: Analisis efektivitas biaya, BPJS, DBD, penggunaan obat
Cost-effectiveness Analysis of Dengue Hemorrhagic Fever Treatment on BPJS Patients in dr. Adjidarmo Hospital, Lebak District, Year 2014–2015
Abstract
Dengue Hemorrhagic Fever (DHF) is one of the major infectious diseases in Indonesia, which reached 129.650 cases in 2015 with the death of 1.071 people. In Banten Province, DHF reached 4.291 cases in 2013 and caused death of 31 people. Dengue fever provides an economic burden for government and society. This study was aimed to analyze the effectiveness of medical costs in dr. Adjidarmo hospital, Lebak district, Indonesia. The design of thif study was analytic observational with retrospective data collection. Data were obtained from the medical record section relating to the use of drugs and the financial section for the cost of drug use in DHF patients National Health Insurance (JKN) in year 2014 and 2015. Data were analyzed using cost/defined daily dose (DDD) drug utilization (DU) 90% and cost-effectiveness analysis of hospital perspective and payer perspective (social insurance administration/BPJS). The number of medical records of patients which met the inclusion criteria in the year of 2014 and 2015 was 134 and 259 patients, respectively. The results showed that the value of cost/DDD DU90% in 2014 (Rp32.506) was lower than that in 2015 (Rp32.800). Average Cost-Effectiveness Ratio (ACER) value per 1% decrease in hematocrit in 2014 (Rp21.624) was lower than that in 2015 (Rp22.640). The percentage comparison of the average cost of each patient based on hospital data with the INA CBG’s rate in 2014 (14.60%) was lower than that in 2015 (15.28%). Treatment of DHF in 2014 is more cost-minimum and cost-effective than that in 2015.
Keywords: BPJS, cost-effectiveness analysis, drug use, DHF
Keywords
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Pusat Data dan Informasi Kementerian Kesehatan Republik Indonesia. Buletin jendela epidemiologi topik utama demam berdarah dengue. Jakarta: Kementerian Kesehatan Republik Indonesia; 2010.
Pusat Data dan Informasi Kementerian Kesehatan Republik Indonesia. Situasi DBD di Indonesia. Jakarta: Kementerian Kesehatan Republik Indonesia; 2016.
Dinas Kesehatan Provinsi Banten. Profil kesehatan Provinsi Banten tahun 2013. Banten: Dinas Kesehatan Provinsi Banten; 2014.
Direktorat Jenderal Pelayanan Medik Kementerian Kesehatan Republik Indonesia. Pedoman tata laksana klinis infeksi dengue di sarana pelayanan kesehatan. Jakarta: Kementerian Kesehatan Republik Indonesia; 2005.
Verdeal JCR, Filho RC, Vanzillotta C, de Macedo GL, Bozza FA, Toscano L, et al. Guidelines for the management of patients with severe forms of dengue. Rev Bras Ter Intensiva. 2011;23(2):125–33. doi: 10.1590/S0103-507X2011000200004
World Health Organization. Guidelines for ATC classification and DDD assignment 2016, 19th edition. Oslo: World Health Organization; 2013.
World Health Organization. Drug utilization and their applications: Introduction to drug uilization research. Oslo: World Health Organization; 2003.
Bergman U, Popa C, Tomson Y, Wattermark B, Einarson TR, Aberg H, et al. Drug utilization-90% a simple method for assessing the quality of drug prescribing. Eur J Clin Pharmacol. 1998;54:113–8. doi: 10.1007/s002280050431
Direktorat Jenderal Bina Kefarmasian dan Alat Kesehatan Kementerian Kesehatan Republik Indonesia. Pedoman penerapan kajian farmakoekonomi. Jakarta: Kementerian Kesehatan Republik Indonesia: 2013.
Rascati KL. Essentials of pharmacoeconomics. Philadelphia: Lippincott Williams & Wilkies; 2009.
Beatty M, Beutels P, Meltzer MI, Shepard DS, Hombach J, Hutubessy R, et.al. Health economics of dengue: A systematic literature review and expert panel’s assessment. Am J Trop Med Hyg. 2011;84(3):473–88. doi: 10.4269/ajtmh.2011.10-0521.
Kementerian Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia nomor 27 tahun 2014 tentang petunjuk teknis sistem indonesian case base groups (INA-CBGS). Jakarta: Kementerian Kesehatan Republik Indonesia; 2014.
Pranata IWA, Artini IGA. Gambaran pola penatalaksanaan demam berdarah dengue (DBD) pada anak di instalasi rawat inap rumah sakit umum daerah Kabupaten Buleleng tahun 2013. E-Jurnal Medika. 2017;6(5):21–7.
Herminingrum, Yuniar I, Maliya, Arina. Hubungan antara tingkat pengetahuan masyarakat tentang penyakit DBD dengan upaya pencegahan DBD di Desa Sukorejo Musuk Boyolali. 2011 [diunduh 15 Februari 2018]. Tersedia dari: http://eprints.ums.ac.id/id/eprint/16049
Vo NTT, Phan TND, Vo TQ. Direct medical costs of dengue fever in Vietnam: A retrospective study in a tertiary hospital. Malays J Med Sci. 2017;24(3):66–72. doi: 10.21315/mjms2017.24.3.8.
Tozan Y, Ratanawong P, Louis VR, Kittayapong P, Wilder-Smith A. Use of insecticide-treated school uniforms for prevention of dengue in schoolchildren: A cost-effectiveness analysis. PLoS One. 2014:9(9):e108017. doi: 10.1371/journalpone.0108017.
Vong S, Khieu V, Glass O, Ly S, Duong V, Huy R, et al. Dengue incidence in urban and rural Cambodia: Results from population-based active fever surveillance, 2006–2008. PLoS Negl Trop Dis. 2010;4(11):1–10. doi: 10.1371/journal.pntd.0000903
Rotter T, Kinsman L, James EL, Machotta A, Gothe H, Willis J, et al. Clinical pathways: Effects on professional practice, patient outcomes, length of stay and hospital cost. Cochrane Database Syst Rev. 2010; (3):CD006632. doi: 10.1002/14651858.CD006632.pub2.
Banggai CE, Suliati VL, Kusumowardhani D, Firmansyah I, Montain M. Association between hemoconcentration and longer hospitalization day of dengue patients. Health Sci J Indones. 2017;8(1):19–24. doi: 10.22435/hsji.v8i1.6434.
Suaya JA, Shepard DS, Siqueira JB, Martelli CT, Lum LC, Tan LH, et al. Cost of dengue cases in eight countries in the Americas and Asia: A prospective study. Am J Trop Med Hyg. 2009;80(5):846–55. doi: 10.4269/ajtmh.2009.80.846
Wills BA, Nguyen MD, Ha TL, Dong TH, Tran TN, Le TT, et al. Comparison of three fluid solutions for resuscitation in dengue shock syndrome. N Engl J Med. 2005;353(9):877–89. doi: 10.1056/NEJMoa044057
Dung NM, Day NP, Tan DT, Loan HT, Chau HT, Minh LN, et al. Fluid replacement in dengue shock syndrome: A randomized, double-blind comparison of four intravenous-fluid regimens clinical infectious diseases. Clin Infect Dis. 1999;29(4):787–94. doi: 10.1086/520435
Beg MA Study on drug prescribing pattern in dengue patients in a tertiary care hospital-A tool to teach clinical pharmacology. J Drug Deliv Therapeutics. 2015;5(2):73–6. doi: 10.22270/jddt.v5i2.1093
Edillo FE, Hasala YA, Largo FM, Easmo JNV, Amoin NB, Alera MTP, et al. Economic cost burden of dengue in The Philippines. Am J Trop Med Hyg. 2015;92(2):360–6. doi: 10.4269/ajtmh.14-0139
Shepard DS, Halasa YA, Tyagi BK, Adhish SV, Nandan D, Karthiga KS, et al. Economic and disease burden of dengue illness in India. Am J Trop Med Hyg. 2014;91(6):1235–42. doi: 10.4269/ajtmh.14-0002
Pham DL, Phung NHT, Le NTD, Vo TQ, Economic report on the cost of dengue fever in Vietnam: Case of a provincial hospital Vietnam. Clinicoecon Outcomes Res. 2017;9:1–8. doi: 10.2147/CEOR.S124023
Huy R, Wichmann O, Beatty M, Ngan C, Duong S, Margolis HS, et al. Cost of dengue and other febrile illnesses to households in rural Cambodia: A prospective community -based case-control study. BMC Public Health. 2009;9:155–60. doi: 10.1186/1471-2458-9-155
Tran BX, Thu Vu G, Hoang Nguyen L, Tuan Le Nguyen A, Thanh Tran T, Thanh Nguyen B, et al. Cost-of-illness and the health-related quality of life of patients in the dengue fever outbreak in Hanoi in 2017. Int J Environ Res Public Health. 2018;15(6):2–9. doi: 10.3390/ijerph15061174.
Shalini S, Ravichandran V, Mohanty BK, Dhanaraj SK, Saraswathi R. Drug utilization studies-An overview. Int J Pharmaceuti Sci Nanotech. 2010;3(1):803–10.
Beg MA, Dutta SB, Bawa S, Kaur A, Vishal S, Kumar U. Drug utilization pattern of analgesics as a teaching tool for rational therapy to MBBS students in a medical college at Dehradun, Uttarakhand, India. Int J Basic Clin Pharmacol. 2017;6(4):842–4. doi: 10.18203/2319-2003ijbc p20171089
Rathinavelu M, Satyagama S, Reddy R, Reddy YP. Drug use evaluation of antimicrobials in healthcare resource limited settings of India. Indian J Pharm Pract. 2015;8(4):191–5. doi: 10.5530/ijopp.8.4.8
Low JG, Ooi EE, Vasudevan SG. Current status of dengue therapeutics research and development dengue therapeutics research and development. J Infect Dis. 2017;215(2):S96–102. doi: 10.1093/infdis/jiw423
DOI: https://doi.org/10.15416/ijcp.2016.5.3.196
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