Faktor-Faktor yang Mempengaruhi Biaya Obat Pasien Kanker Payudara di Rumah Sakit di Indonesia

https://doi.org/10.22146/jkki.v4i3.36110

Diah Ayu Puspandari(1*), Ali Ghufron Mukti(2), Hari Kusnanto(3)

(1) Pusat Kebijakan Pembiayaan dan Manajemen Asuransi Kesehatan, Fakultas Kedokteran, Universitas Gadjah Mada
(2) Program Studi Ilmu Kesehatan Masyarakat, Fakultas Kedokteran, Universitas Gadjah Mada
(3) Program Studi Ilmu Kesehatan Masyarakat, Fakultas Kedokteran, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Background: Currently non communicable disease becomes one of the ten major diseases in Indonesia. Cancer chemotherapy reported as the ninth rank out of ten major diseases, and shared as the ten most expensive hospital cost. Drugs expenditures are clearly the main source of cost pressure. Drug cost of breast cancer is important for benefit package design. Objectives: The research need to know on what are the influencing factors of drug cost for breast cancer during hospitalization in Indonesia, and the drug cost based on the selected factors. Research Methodology : The design of research was a cross sectional descriptive analysis using health facilities costing study that was conducted in Indonesia in 2011. The drug cost was calculated as a cost of illness based on a provider’s perspective. Results: Determinant factors for drug cost in breast cancer were age, length of stay, ICU, drugs availability and hospital location. The most expensive was the drug cost for patient at age 40 - <70. Drug cost for patient with ICU care found 1,8 times higher. Hospitals who had a drug supply problems were lower in cost. Hospital in Java had a lower cost. Conclusions: Age, length of stay, ICU, drugs availability and hospital location were the determinant factors of drug cost for hospitalized breast cancer patient. Drug cost for in-patient that was based on actual cost was Rp. 2,545,881,- . Drug cost for out patient care was Rp 9,127,824,-. The total drug cost per patient per year was calculated as Rp 11,673,705,- and the total drug cost for all patient per year was Rp 150,415,869,362,-. These factors will be useful for drug cost estimation purpose and for benefit package design.

 

Latar belakang: Saat ini penyakit tidak menular merupakan salah satu dari 10 penyakit terbesar di Indonesia. Kemoterapi kanker dilaporkan di urutan ke 9 pada pasien rawat inap, serta di posisi ke 10 penyakit termahal. Biaya obat adalah komponen biaya kesehatan dengan proporsi signifikan. Biaya obat kanker payudara diperlukan dalam penentuan paket benefit JKN. Tujuan: Mengetahui faktor apa saja yang mempengaruhi biaya obat pada pasien kanker payudara di rumah sakit, dan memperoleh besaran biaya obat berdasarkan faktor-faktor yang mempengaruhinya. Metode Penelitian: Penelitian merupakan desain analisis deskriptif cross sectional menggunakan hasil studi pembiayaan fasilitas kesehatan yang dilaksanakan di Indonesia pada tahun 2011. Biaya obat dihitung sebagai cost of illness dari sisi pemberi layanan. Hasil: Variabel yang berpengaruh terhadap biaya obat adalah umur, lama dirawat, penggunaan ICU, gangguan ketersediaan obat dan lokasi rumah sakit. Biaya obat pada usia 40 -<70 tahun tertinggi. Biaya obat di ICU lebih tinggi 1,8 kali. Rumah sakit dengan gangguan ketersediaan obat lebih rendah biaya obatnya. Biaya obat di luar pulau Jawa lebih mahal. Kesimpulan: Umur, lama dirawat, penggunaan ICU, gangguan ketersediaan obat dan lokasi rumah sakit adalah faktor yang mempengaruhi biaya obat pasien kanker payudara di rumah sakit. Biaya obat rawat inap berdasarkan biaya aktual, hasilnya menunjukkan besaran Rp754.243,00 per pasien. Biaya obat untuk rawat jalan diperoleh sebesar Rp9.127.824,00. Total biaya obat per pasien per tahun adalah Rp9.882.067,00 sehingga biaya obat seluruh pasien per tahun sebesar Rp118.723.158.312,00. Faktor tersebut bermanfaat untuk estimasi biaya dan penentuan paket pengobatan pasien kanker di era JKN.


Keywords


Drug cost; Breast cancer; Hospital; Indonesia; Biaya obat; Kanker payudara; Rumah sakit; Indonesia

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References

Chee, G., Borowitz, M. & Barraclough, A., 2009.

PRIVATE SECTOR HEALTH, Maryland.

Barer, M., Morgan, S. & Evans, R., 2003. Strangulation or Rationalization? Costs and Access in Canadian Hospitals. Healthcare Quarterly, 7(1), pp.10–19. Available at: http:// www.longwoods.com/content/17241.

Moroney, S.D. & Kual, A.R., 2003. Understanding Health Care Cost Drivers, Minnesota.

Arozullah, A.M. et al., 2004. The Financial Burden of Cancer/ : Women With Breast Cancer. The Journal of Supportive Oncology, 2(3), pp.271–

Available at: www.SupportiveOncology.net. Hussein, O. et al., 2013. Breast Cancer/ : Basic and Clinical Research Hormone Receptors and Age Distribution in Breast Cancer Patients at a University Hospital in Northern Egypt. Breast Cancer/ : Basic and Clinical Research, 7, pp.51–

Available at: http://www.la-press.com.

Leong, S.P.L. et al., 2010. Is breast cancer the same disease in Asian and Western countries? World journal of surgery, 34(10), pp.2308–24. Available at: http://www.pubmedcentral.nih.gov/articleren der.fcgi? artid=2936680&tool=pmcentrez& rendertype=abstract [Accessed May 24, 2014].

Downing, A. et al., 2009. Changes in and predictors of length of stay on hospital after surgery for breast cancer between 1997 / 98 and 2004 / 05 in two regions of England/ : a population-based study. BMC, 9, pp.1–9.

Taccone, F.S. et al., 2009. Characteristics and outcomes of cancer patients in European ICUs. Critical care (London, England), 13(1), p.R15. Available at: http://www.pubmedcentral.nih.gov/ articlerender.fcgi?artid=2688132&tool=pm centrez&rendertype=abstract [Accessed May 29, 2014].

Tfayli, A. et al., 2010. Breast cancer in low- and middle-income countries: an emerging and challenging epidemic. Journal of oncology, 2010, p.490631. Available at: http://www. pubmedcentral.nih.gov/articlerender.fcgi?artid= 3010663&tool=pmcentrez&rendertype=abstract [Accessed May 29, 2014].

Vydelingum, N.A., 2004. Economic Cost of Cancer Health Disparities. In E. Taylor, ed. Economic Costs of Cancer Health Disparities. US Department of Health and Human Services.

Budiarto, W. & Sugiharto, M., 2013. Biaya Klaim INA CBGs dan Biaya Riil Penyakit Katastropik Rawat Inap Peserta Jamkesmas di Rumah Sakit Studi di 10 Rumah Sakit Milik Kementerian Kesehatan. Buletin Penelitian Sistem Kesehatan, 16(1), pp.58–65.

Mclaughlin, M. et al., 2013. Effects on Patient Care Caused by Drug Shortages: A Survey. Journal of Managed Care Pharmacy, 19(9), pp.783–788.

Saokaew, S., Maphanta, S. & Thangsomboon, P., 2009. Impact of pharmacist ’ s interventions on cost of drug therapy in intensive care unit. Pharmcy Practice, 7(2), pp.81–87.

Eniu, A. et al., 2006. Breast cancer in limited- resource countries: treatment and allocation of resources. The Breast Jurnal, 12(Suppl. 1), pp.S38–53. Available at: http://www.ncbi. nlm.nih.gov/pubmed/16430398.

Ensor, T. & Indrajaya, S., 2012. The Costs of Delivering Health Services in Indonesia/ : Report on a Prospective Survey, Jakarta.



DOI: https://doi.org/10.22146/jkki.v4i3.36110

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