COST OF ILLNESS PASIEN KANKER PAYUDARA DI RUMAH SAKIT UMUM PUSAT PROF DR R.D KANDOU MANADO

Fridly Manawan, Gunawan Pamudji Widodo, Tri Murti Andayani

Abstract


ABSTRACT

Breast cancer still became priority concern in developed country, but 69% the dead incident came from developing country. Many of them been diagnose at advance stage, that make treatment and cost more higly. The objectives of this study were to know the burden cost of breast cancer patient in Prof Dr Kandou Medical Center Manado based on hospital perspective, the difference between the real cost and the INA-CBG’s cost, and the key factors that might drive the burden of the real cost of breast cancer. The study was a pharmacoeconomics analys based on hospital perspective to direct medical cost, using non-experimental analysis with cross-sectional design. Data restropectively collect from breast cancer inpatient registered as member of National Health Insurance (JKN) during September 2017-August 2018 period and from financial department of Prof Dr Kandou Medical Center Manado. The sample was used 329 episode of treatment. the data being analyzed using one sample t-test to compare the congruence between the real cost and INA-CBG’s cost. Multivariat linear regression Analysis to find the various predictor factors that might affect on the real cost. The result of the study showed that the average of the real cost per episode of treatment in chemotherapy patient with C-14-3 code was Rp. 13.806.325, treatment in breast procedure with L-1-50 code was Rp. 24.306.626, and treatment for breast tumor with L-4-11 code was Rp. 11.989.772. The difference value between INA-CBG’s and the real cost was Rp. -668.973.281 for 183 breast cancer patient. The congruence value between the real cost and the INA-CBG’s cost generally significantly different except for C-4-13-II, L-1-50-III and L-4-11-I. Based on multivariat linier regression analysis, severity level, :LOS, and treatment care was the factors that affect the real cost.

 

Keywords : Cost of illness, INA-CBG’s, Breast Cancer, Prof. Dr. R.D Kandou Medical Center Hospital Manado

 

ABSTRAK

Kasus kanker payudara memang menjadi permasalahan penting di negara maju, namun 69% angka kematian terjadi di negara berkembang. Kebanyakan kasus kanker payudara ditemukan berada pada stadium lanjut, dimana menyebabkan upaya dan nilai biaya pengobatan semakin besar. Tujuan penelitian ini adalah untuk mengetahui biaya terapi penyakit kanker payudara di RSUP Prof Dr Kandou Manado berdasarkan perspektif rumah sakit, mengetahui perbedaan antara tarif rumah sakit dengan tarif paket INA-CBGs pada perawatan pasien kanker payudara, dan mengetahui faktor apa saja yang berpengaruh terhadap besarnya biaya terapi penyakit kanker payudara. Penelitian ini merupakan analisis farmakoekonomi berdasarkan perspektif rumah sakit terhadap biaya medis langsung, berupa penelitian analitik noneksperimental dengan rancangan penelitian cross sectional. Data diambil secara retrospektif dari pasien rawat inap kanker payudara peserta Jaminan Kesehatan Nasional (JKN) selama periode September 2017-Agustus 2018 dan dari bagian keuangan di RSUP Prof Kandou Manado. Sampel yang digunakan adalah sebanyak 329 episode perawatan. Analisis data dilakukan dengan one sample t-test untuk membandingkan total biaya riil dengan tarif INA-CBGs. Analisis korelasi multivariat regresi linier untuk mengetahui faktor yang mempengaruhi total biaya riil. Hasil penelitian pasien rawat inap peserta JKN di RSUP Prof Dr Kandou Manado periode September 2017 – Agustus 2018 menunjukkan rata-rata biaya riil pasien kemoterapi per episode perawatan dengan kode C-4-13 sebesar Rp. 13.806.325, tindakan pada payudara dengan kode L-1-50 sebesar Rp. 24.306.626 dan tumor payudara dengan kode L-4-11 sebesar Rp. 11.989.772. Selisih tarif INA-CBG’s dengan total biaya riil adalah sebesar Rp.-668.973.281 untuk total 183 pasien. Kesesuaian total biaya riil dengan tarif INA-CBG’s menggunakan one sample t-test secara umum berbeda bermakna, kecuali pada kode C-4-13-II, L-1-50-III dan L-4-11-I. Berdasarkan analisis korelasi multivariat regresi linier, Faktor tingkat keparahan, LOS dan kelas perawatan mempengaruhi total biaya riil.

 

Kata kunci: Cost of illness, INA-CBG’s, Kanker payudara, Rumah Sakit Umum Pusat Prof. Dr. R.D. Kandou Manado


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DOI: https://doi.org/10.35799/pmj.2.2.2019.26532

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