Perbandingan Kesintasan dan Efektivitas Biaya Pasien Geriatri di Ruang Rawat Inap Akut RSUPN dr. Cipto Mangunkusumo Sebelum dan pada Era Jaminan Kesehatan Nasional
| Main Authors: | Czeresna Heriawan Soejono, Paskalis Gunawan; Departemen Ilmu Penyakit Dalam FK Universitas Indonesia/ RSUPN Dr. Cipto Mangunkusumo |
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| Format: | Article application/pdf eJournal |
| Bahasa: | ind |
| Terbitan: |
Faculty of Medicine Universitas Indonesia
, 2018
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| Subjects: | |
| Online Access: |
http://journal.ui.ac.id/index.php/eJKI/article/view/8819 |
Daftar Isi:
- Pendekatan Paripurna Pasien Geriatri (P3G) telah menjadi standar pelayanan di RSCM karena menghasilkan luaran perawatan geriatri yang lebih baik. Sejak awal tahun 2014, di Indonesia diberlakukan sistem pembiayaan Jaminan Kesehatan Nasional (JKN). Tujuan penelitian ini adalah untuk mengetahui kesintasan dan efektivitas biaya pasien geriatri pada era JKN dan pra-JKN yang dirawat di RSCM. Penelitian menggunakan desain kohort retrospektif dengan kontrol historis. Sampel dikumpulkan dari pasien geriatri yang dirawat di RSCM pada bulan Juli 2013-Juni 2014 yang kemudian dibagi menjadi kelompok JKN dan pra- JKN sebagai kontrol. Dinilai perbedaan kesintasan dengan kurva kesintasan dan efektifitas biaya perawatan dengan menghitung incremental cost effectiveness ratio (ICER). Dari total 225 subyek, 100 subyek masuk kelompok era pra-JKN dan 125 subyek di era JKN dengan karakteristik demografis dan klinis yang relatif sama. Tidak ada perbedaan mortalitas selama perawatan dan kesintasan 30 hari antara kelompok JKN dan pra-JKN (31,2% vs 28%, p=0,602 dan 65,2% vs 66,4%, p=0,086). Kurva kesintasan 30 hari antara kedua kelompok tidak menunjukkan perbedaan bermakna. ICER memperlihatkan pada era JKN investasi biaya Rp1,4 juta,- terkait dengan penurunan kesintasan 1,2% dibandingkan kelompok pra-JKN, namun perbedaan tersebut tidak bermakna; hasil tersebut perlu didapatkan saat implementasi JKN masih dalam tahap awal. Diperlukan penelitian lanjutan saat implementasi JKN telah berlangsung dalam waktu yang lebih panjang. The Comparison of Survival, and Cost Effectiveness of Geriatric Patients Admitted in Dr. Cipto Mangunkusumo Hospital Before and During National Health Insurance Program Implementation Abstract Comprehensive Geriatrics Assessment (CGA) has been proven to improve the overall outcome of geriatric patients care, and has been implemented in RSCM as the standard geriatric medical care. National Health Insurance Program (NHIP) was implemented in Indonesia in January 2014. It is unclear how NHI program will affect survival and cost effectiveness of geriatric patients receiving CGA. The aim of this study was to compare the survival and cost effectiveness between geriatric patients hospitalized during NHIP and before NHIP era in RSCM. This was a retrospective cohort study with historical control. The subjectswere geriatric inpatients aged ≥60 years old with one or more geriatric giants between July to December 2013 (non NHIP) and January to June 2014 (NHIP). A survival analysis and determination of incremental cost-effectiveness ratio (ICER) was used to compare the survival and cost-effectiveness between the two groups. The clinical and demographic characteristics were relatively similar between the NHIP and non NHIP group. No difference in mortaliy rate during hospital care and 30 days survival rate between NHIP and non NHIP group (31.2% vs 28%, p=0.602; 65.2% vs 66.4%, p = 0.086, respectively). No significant difference was found in the survival curve between the two groups. Calculation of ICER showed that NHIP was associated with an increased cost of 1.4 million rupiah and 1.2 % higher mortality rate. Further research is needed to evaluate this result when NHI Program has been implemented for a longer duration.