Analisis Biaya Penyakit dan Evaluasi Penggunaan Obat Psikofarmaka pada Pasien Depresi Rawat Inap Rumah Sakit Jiwa Provinsi Jawa Barat Tahun 2023

Ice Laila Nur, Shifana Tri Armytha, Ira Maulani, Novianti Novianti, Komang Trisna Karang Supri Antari

Abstract


Di Indonesia, prevalensi depresi mencapai 1,4% pada tahun 2023. Jawa Barat (3,3%), Kalimantan Timur (2,2%), dan Banten (1,7%) merupakan tiga provinsi dengan prevalensi depresi tertinggi. Penelitian deskriptif kuantitatif dengan menggunakan data retrospektif, dilakukan untuk menganalisis biaya penyakit dan evaluasi penggunaan obat psikofarmaka pasien depresi rawat inap Rumah Sakit Jiwa Provinsi Jawa Barat tahun 2023. Hasil penelitian menunjukkan komponen biaya medis langsung pasien depresi rawat inap dari yang tertinggi meliputi biaya akomodasi Rp287.350.000 (38,3%), biaya tindakan dan asuhan keperawatan Rp228.920.000 (30,5%), biaya lain-lain Rp102.270.000 (13,6%), biaya obat, alat kesehatan, dan bahan medis habis pakai Rp96.232.329 (12,8%), biaya pemeriksaan penunjang Rp24.754.000 (3,3%), biaya rehabilitasi psikososial Rp7.565.000 (1,0%), dan biaya tindakan medik Rp3.585.000 (0,5%). Komponen biaya akomodasi memiliki persentase tertinggi kemungkinan dipengaruhi oleh lamanya hari perawatan atau length of stay. Rata-rata biaya medis langsung sebesar Rp5.361.974. Perbandingan rata-rata biaya riil rumah sakit dengan tarif Indonesian Case Base Groups pasien depresi ringan, depresi sedang, dan depresi berat, yang seluruhnya berada pada kelas 2, menunjukkan selisih biaya positif sejumlah Rp1.988.826, Rp2.184.026, dan Rp4.314.726. Evaluasi penggunaan obat psikofarmaka dengan metode Anatomical Therapeutic Chemical (ATC) Classification System dan Defined Daily Dose (DDD) menunjukkan sertraline memiliki nilai tertinggi, yaitu 120,80 DDD/100 bed days. Obat psikofarmaka yang termasuk segmen DU 90%, yaitu sertraline (24%), risperidone (17,22%), lorazepam (12,80%), aripiprazole (7,34%), olanzapine (6%), fluoxetine (5,81%), haloperidol (3,99%), quetiapine fumarate (3,60%), vortioxetine (3,49%), olanzapine parenteral (3,09%) dan clozapine (2,68%). Sertraline banyak digunakan karena merupakan terapi lini pertama untuk pasien dengan diagnosis depresi dan memiliki keamanan serta tolerabilitas yang lebih baik. 

Keywords


ATC/DDD; analisis biaya penyakit; depresi; drug utilization 90% (DU90%); Indonesian Case Base Groups

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DOI: https://doi.org/10.15416/ijcp.2024.13.3.64448

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