Efektivitas Biaya Terapi Cairan Kristaloid dan Koloid pada Pasien Anak Demam Berdarah di Rumah Sakit PKU Muhammadiyah Bantul

Abstract

Demam berdarah dengue (DBD) merupakan penyakit yang disebabkan oleh virus dengue yang ditularkan melalui gigitan nyamuk Aedes aegypti. Kunci keberhasilan terapi pada penyakit demam berdarah adalah pemberian cairan termasuk jenis dan jumlahnya. Dari aspek biaya terapi, cairan koloid diketahui lebih mahal dibandingkan cairan kristaloid. Tujuan dari penelitian ini adalah untuk mengetahui efektivitas biaya terapi cairan kristaloid dan koloid pada pasien anak demam berdarah periode Januari 2018 sampai Juni 2018 di Rumah Sakit PKU Muhammadiyah Bantul. Penelitian ini menggunakan desain penelitian eksperimental single blind randomized clinical trial. Sejumlah 48 pasien anak yang memenuhi syarat inklusi dibagi menjadi dua kelompok yaitu kelompok intervensi (n=24) yang mendapatkan terapi cairan koloid berupa inisial cairan gelafusal dan kelompok kontrol (n=24) yang mendapatkan terapi cairan kristaloid tunggal berupa ringer laktat. Data efektivitas (lama rawat inap) dan total biaya medis dianalisis menggunakan independent t-test dan rumus average cost-effectiveness ratio (ACER). Terdapat perbedaan yang signifikan lama rawat inap antara kelompok cairan kristaloid dibandingkan kelompok cairan koloid (p<0,05). Hasil penelitian menunjukkan perbandingan nilai ACER yaitu nilai ACER kelompok koloid (Rp28.560/efektivitas) lebih rendah dari nilai ACER kelompok kristaloid (Rp62.328/efektivitas). Kesimpulan dari penelitian ini adalah terapi cairan koloid lebih cost-effective dibandingkan cairan kristaloid.

Kata kunci: Efektivitas biaya, koloid, kristaloid

Cost-Effectiveness of Crystalloid and Colloid Therapy in Children with Dengue Fever in PKU Muhammadiyah Hospital, Bantul

Abstract
Dengue hemorrhagic fever (DHF) is a disease caused by the dengue virus which is transmitted through the bite of the Aedes aegypti mosquito. The key to the success of therapy in dengue fever is the administration of fluids including types and quantities. Based on its cost, colloid fluid therapy are known to be more expensive than crystalloid fluid therapy. The purpose of this study was to determine the cost-effectiveness of crystalloid and colloid fluid therapy in dengue fever patients in the period of January–June 2018 at PKU Muhammadiyah Hospital Bantul. This study employed an experimental single blind randomized clinical trial design. A total of 48 pediatric patients who met the inclusion requirements were divided into two groups, namely the intervention group (n=24) who received colloid fluid therapy in the form of initial gelafusal fluid and control group (n=24) who received single crystalloid fluid therapy in the form of ringer lactate. Effectiveness data (length of stay) and total medical costs were analyzed using independent t-test and the average cost-effectiveness ratio (ACER) formula. There was a significant difference in length of stay between groups of crystalloid fluid compared to the group of colloid fluid (p<0.05). The ACER values of the colloid group (28,560 IDR/effectiveness) was lower than the crystalloid group (62,328 IDR/effectiveness). The conclusion of this study is that colloid fluid therapy group is more cost-effective than crystalloid fluid group.

Keywords: Colloid, cost-effectiveness, crystalloid