ANALISIS BIAYA RAWAT JALAN HEMODIALISIS DAN PERITONEAL DIALISIS MANDIRI BERKESINAMBUNGAN PADA PESERTA ASKES DI PT ASKES (PERSERO) DIVISI REGIONAL VI

Abstract

Background: End Stage Renal Diseases (ESRD) becomes a
serious healthcare problem because of the increasing
prevalence of RRT andhealthcare costs. ESRD patients need
Renal Replacement Therapy (RRT). There are two types of
RRT: Hemodialysis (HD) and Continuous Ambulatory Peritoneal
Dialysis (CAPD). Several previous studies showed that CAPD
has more advantage than HD, but it was stilldebated.The
background of the country and the healthcare cost system
influenced the treatment results CAPD and HD.
Aims: The aim of the study wasto comparebetween HD costs
and CAPD cost covered by PT Askes (Persero) or known as
the insurance medical cost and out of pocket cost from the
patients.
Methods: This study was an observational comparative study
with descriptive analytical design. The data of insurance cost
was obtained from Askes database, whereas the patient cost
was taken by questionnaires. The subjects were 59 patients
undergoing HD and 50 patients undergoing CAPD in the center
of HD provided by PT Askes (Persero) Regional Division VI.
Random sampling was conducted with consecutive sampling
system.
Results: The medianof HD insurance medical cost was Rp
5.949.234,00/person/month, while CAPD was Rp5.023.792,00/
person/month. There were also medical and non-medical
costspaid by the patients. these median were Rp287.208,00/
person/month for HD patients and Rp323.000,00/person/month
for CAPD patients.30,5% of HD patients and 22% of CAPD
patients got their income decreased, whereasthe patient family
that got decreased their income were 10% of HD patient family
and 6% of CAPD patient family. The median of the income
reduction among HD patients and HD patient family was
Rp2.250.000,00/person/month, whereas CAPD patients and
CAPD patient family was Rp2.125.000,00/person/month.
Conclusion: The HD insurance medical expenseswere higher
than that of CAPD. Compared to CAPD, thepatient
expenses(medical and non-medical) werelower in HD. The
income deduction among HD patients and HD patient family
was bigger than the one in CAPD patient andCAPD patient
family.
Keywords: hemodialysis, continuous ambulatory perytoneal
dialysis, healthcare costs, cost-minimization analyses.