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

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