Pengaruh Readmisi Terhadap Biaya pada Pasien PPOK Eksaserbasi Akut dan Faktor-Faktor yang Mempengaruhinya

https://doi.org/10.22146/farmaseutik.v17i3.65382

Trirahmi Hardiyanti(1), Nanang Munif Yasin(2*), Tri Murti Andayani(3)

(1) Faculty of Pharmacy UGM
(2) Faculty of Pharmacy UGM
(3) Faculty of Pharmacy UGM
(*) Corresponding Author

Abstract


Peningkatan beban ekonomi pada Penyakit Paru Obstruktif Kronik (PPOK) tidak terlepas dari adanya pengaruh readmisi dan faktor-faktor yang berhubungan seperti lama rawat inap, komorbid, dan pekerjaan. Penelitian ini bertujuan untuk mengetahui adanya hubungan lama rawat inap, komorbid, dan pekerjaan dengan readmisi serta mengetahui pengaruh readmisi terhadap biaya pada pasien PPOK eksaserbasi akut di Rumah Sakit Paru Respira Yogyakarta. Penelitian ini merupakan penelitian analitik observasional dengan pendekatan cross sectional. Data diambil secara retrospektif melalui rekam medik dan data dari bagian keuangan yang berisi biaya perawatan pasien rawat inap PPOK eksaserbasi akut di RS Paru Respira Yogyakarta periode 1 Januari 2014 sampai 31 Desember 2019. Data readmisi diperoleh dari rekam medik, diamati dalam kurun waktu satu sampai tiga tahun setelah pasien dilakukan rawat inap. Analisis biaya dilakukan dari perspektif rumah sakit meliputi biaya medis langsung, yaitu biaya kamar, biaya keperawatan, biaya jasa pelayanan medik, biaya tindakan non medik, biaya penunjang medik, dan biaya obat serta barang medik.  Analisis faktor faktor yang berhubungan dengan readmisi dan seberapa besar pengaruh frekuensi readmisi terhadap biaya menggunakan uji Chis-square dan Mann-whitney. Penelitian ini terdiri dari 100 pasien dengan 74 pasien tanpa readmisi dan 26 pasien readmisi. Karakteristik pasien yang dominan meliputi berusia ≥ 66 tahun; berjenis kelamin laki-laki; memiliki lama rawat inap < 4 hari; memiliki komorbid ≥ 1; bekerja sebagai petani, buruh, dan pekerja swasta; dan anggota program BPJS kelas tiga. Sekitar 26% pasien readmisi dengan frekuensi readmisi 1-2 kali selama satu tahun. Biaya rata-rata terapi tiap pasien PPOK rawat inap readmisi dan tanpa readmisi yaitu Rp3.056.551 dan Rp2.829.114. Hasil penelitian menunjukan bahwa lama rawat inap berhubungan dengan readmisi pasien PPOK eksaserbasi akut (p = 0,004). Readmisi mempengaruhi biaya pasien PPOK eksaserbasi akut. Biaya tindakan non medis adalah biaya yang paling berpengaruh (p = 0,005).

Keywords


PPOK eksaserbasi akut; readmisi; analisis biaya

Full Text:

PDF


References

Abdulfattah, O., Dahal, S., Alnafoosi, Z., Lixon, A., Datar, P. b., Bhattarai, B., dkk., 2018. Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Factors Influencing Length of Hospital Stay in a Community Hospital, dalam: B21. Exacerbations and Readmission Issues in Copd, American Thoracic Society International Conference Abstracts. American Thoracic Society, hal. A2768–A2768. Alqahtani, J.S., Njoku, C.M., Bereznicki, B., Wimmer, B.C., Peterson, G.M., Kinsman, L., dkk., 2020. Risk Factors for All-Cause Hospital Readmission Following Exacerbation of Copd: A Systematic Review and Meta-Analysis. European Respiratory Review, 29: 1–16. Cerezo Lajas, A., Gutiérrez González, E., Llorente Parrado, C., Puente Maestu, L., dan de Miguel-Díez, J., 2018. Readmission Due to Exacerbation of COPD: Associated Factors. Lung, 196: 185–193. GOLD, 2019. Pocket Guide to COPD Diagnosis, Management, and Prevent A Guide for Health Care Professionals. Global Initiative for Chronic Obstructive Lung Disease. Hansell, A., Ghosh, R.E., Poole, S., Zock, J.-P., Weatherall, M., Vermeulen, R., dkk., 2014. Occupational Risk Factors for Chronic Respiratory Disease in a New Zealand Population Using Lifetime Occupational History. Journal of Occupational and Environmental Medicine, 56: 270–280. Harries, T.H., Thornton, H., Crichton, S., Schofield, P., Gilkes, A., dan White, P.T., 2017. Hospital Readmissions for COPD: a Retrospective Longitudinal Study. npj Primary Care Respiratory Medicine, 27: 1–6. Herse, F., Kiljander, T., dan Lehtimäki, L., 2015. Annual Costs of Chronic Obstructive Pulmonary Disease in Finland during 1996–2006 and a Prediction Model for 2007–2030. npj Primary Care Respiratory Medicine, 25: 1–6. Kong, C.W. dan Wilkinson, T.M.A., 2020. Predicting and Preventing Hospital Readmission for Exacerbations of Copd. ERJ Open Research, 6: 1–13. Mehta, A.J., Miedinger, D., Keidel, D., Bettschart, R., Bircher, A., Bridevaux, P.-O., dkk., 2012. Occupational Exposure to Dusts, Gases, and Fumes and Incidence of Chronic Obstructive Pulmonary Disease in the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults. American Journal of Respiratory and Critical Care Medicine, 185: 1292–1300. Putri, F., 2009. 'Analisis Biaya Penyakit Paru Obstruksi Kronis Pasien Rawat Inap Rsud Dr. Moewardi Surakarta Berdasarkan Jenis Pembiayaan Periode Tahun 2008', , Thesis, . Universitas Gadjah Mada, Yogyakarta. Qaseem, A., 2011. Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: a Clinical Practice Guideline Update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Annals of Internal Medicine, 155: 1–14. Rinne, S.T., Graves, M.C., Bastian, L.A., Lindenauer, P.K., Wong, E.S., Hebert, P.L., dkk., 2018. Association Between Length of Stay and Readmission for Copd. American Journal of Managed Care, 23: e253–e258. Riset Kesehatan Dasar (Riskesda), 2013. Badan Penelitian Dan Pengembangan Kesehatan. Jakarta. Rogliani, P., Ora, J., Puxeddu, E., Matera, M.G., dan Cazzola, M., 2017. Adherence to Copd Treatment: Myth and Reality. Respiratory Medicine, 129: 117–123. Tandon, Dr.S., Budhraja, Dr.A., PG Student, Department of Pulmonary Medicine, Peoples College of Medical Sciences & RC, Bhanpur, Bhopal, India, Nagdeote, Dr.S.T., Professor, Department of Pulmonary Medicine, Peoples College of Medical Sciences & RC, Bhanpur, Bhopal, India, Sharma, Dr.K., dkk., 2016. Assessment of Length of Hospital Stays of Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease. International Journal of Medical Research and Review, 4: 97–103. Torabipour, A., Hakim, A., Ahmadi Angali, K., Dolatshah, M., dan Yusofzadeh, M., 2016. Cost Analysis of Hospitalized Patients with Chronic Obstructive Pulmonary Disease: a State-Level Cross-Sectional Study. Tanaffos, 15: 75–82. Wang, Y., Stavem, K., Dahl, F., Humerfelt, S., dan Haugen, T., 2014. Factors Associated with a Prolonged Length of Stay After Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD). International Journal of Chronic Obstructive Pulmonary Disease, 9: 99–105. Wong, A.W., Gan, W.Q., Burns, J., Sin, D.D., dan van Eeden, S.F., 2008. Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Influence of Social Factors in Determining Length of Hospital Stay and Readmission Rates. Canadian Respiratory Journal, 15: 361–364. Yunanda, E.E., 2018. 'Cost of Illness pada Pasien Penyakit Paru Obstruktif Kronis di RSUP Dr. Sardjito Yogyakarta', . Fakultas Farmasi Universitas Gadjah Mada, Yogyakarta. Zhang, W., Higgins, M., Wongtrakool, C., Yang, J., dan Sadikot, R., 2018. Identifying High Comorbidity Index in COPD Hospital Re-Admission. Medical Research Archives, 6: 1–13. Zulkarni, R., Nessa, N., dan Athifah, Y., 2019. Analisis Ketepatan Pemilihan dan Penentuan Regimen Obat pada Pasien Penyakit Paru Obstruktif Kronis (PPOK). Jurnal Sains Farmasi & Klinis, 6: 158–163.



DOI: https://doi.org/10.22146/farmaseutik.v17i3.65382

Article Metrics

Abstract views : 2275 | views : 1238

Refbacks

  • There are currently no refbacks.


Majalah Farmaseutik Indexed by:

   
 
 
 
web analytics 
 
 
Creative Commons Licence
 
 
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.