Faktor-Faktor yang Mempengaruhi Rawat Inap Ulang Pasien Skizofrenia pada Era Jaminan Kesehatan Nasional di Rumah Sakit Jiwa Grhasia Pemda DIY

https://doi.org/10.22146/jkki.v6i1.29005

Suri Herlina Pratiwi(1*), Carla Raymondalexas Marchira(2), Julita Hendrartini(3)

(1) Mahasiswa Pasca Sarjana Ilmu Kesehatan Masyarakan, Fakultas Kedokteran Universitas Gadjah Mada
(2) Bagian Psikiatri, Rumah Sakit Sardjito, Yogyakarta
(3) Pasca Sarjana Ilmu Kesehatan Masyarakat, Fakultas Kedokteran, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


ABSTRACT

Background: The implementation of National Health Insurance (JKN) applies a quality and cost control system services aimed at improving the efficacy and effectivity of health insurance with managed care principle. Readmission is used as an indicator for effectivity and technical competence of a hospital. The increasing cases of readmission, specifically in schizophrenia patients, leads to an increase in health care costs in the hospital. The aim of this study is to know the determinant factors of readmission of schizophrenia patients.

Methods: This study was a non-experimental research using a case control study plan. The study was conducted in Grhasia Mental Hospital. The samples were 53 groups of readmission and 53 group of non-readmission. The respondents were the schizophrenia patients and their caregivers. The data collecting used questionnaire and in-depth interview.

Result: Bivariate analysis showed the incidence of readmission of schizophrenia patients to some risk factors as follows: (1) Marriage OR 2.822; CI95% 1.082 – 7.630; p-value 0.018; (2) Work OR 2.709; CI95% 1.063 – 7.106; p-value 0.021; (3) Medication Adherence OR 14.692; CI95% 5.245 – 42.221; p-value <0.001; (4) Caregiver Level of Knowledge OR 8.571; CI95% 2.213 – 47.927; p-value 0.0003. Multivariate analysis showed that risk factors affecting incidence of readmission of schizophrenic patients are medication adherence (OR13.556, CI95% 5.037 - 36.480; p-value <0.001) and caregiver level of knowledge (OR 7.175; CI95% 1.628 – 31.605; p-value 0.009).

Conclusion: Determinant factors of the readmission of schizophrenia patients are the lack of medication adherence of the patients and caregiver’s lack of knowledge. Demographic factors (age, gender, marital status, education, and job) and ownership of health insurance are not statistically significant to the readmission of schizophrenia patients.

 

Keywords: schizophrenia, readmission, medication adherence, caregiver level of knowledge, national health insurance

 

ABSTRAK

Latar Belakang: Implementasi Jaminan Kesehatan Nasional (JKN) menerapkan sistem kendali mutu dan biaya pelayanan bertujuan untuk meningkatkan efisiensi dan efektifitas jaminan kesehatan dengan prinsip managed care. Readmission sebagai dimensi mutu efektivitas dan kompetensi teknis rumah sakit. Meningkatnya kasus readmission pasien skizofrenia di rumah sakit meningkatkan biaya pelayanan kesehatan. Tujuan penelitian ini adalah mengetahui faktor-faktor yang mempengaruhi rawat inap ulang (readmission) pada pasien skizofrenia.

Metode: Penelitian ini merupkan studi non eksperimental menggunakan rancangan case control study. Penelitian dilakukan di RSj Grhasia. Jumlah sampel 53 pasien kelompok readmission dan 53 pasien pada kelompok non readmission. Responden penelitian ini adalah pasien skizofrenia dan caregiver. Pengumpulan data dengan kuesioner dan wawancara mendalam.

Hasil: Analisis bivariat menunjukkan kejadian readmission terhadap faktor resiko perkawinan diperoleh nilai OR 2,822, CI 95% 1,082-7,630, p-value 0,018; pekerjaan diperoleh nilai OR 2,709, CI 95% 1,063-7,106, p-value 0,021; kepatuhan minim obat diperoleh nilai OR 14,692, CI 95% 5,247-42,221, p-value <0,001; tingkat pengetahuan caregiver diperoleh nilai OR 8,571, CI 95% 2,213-47,927, p-value 0,0003. Hasil analisis multivariat menunjukkan bahwa faktor resiko yang berpengaruh terhadap kejadian readmission pasien skizofrenia adalah kepatuhan minum obat (OR 13,556, CI 95% 5,037-36,480, p-value <0,001) dan tingkat pengetahuan caregiver (OR 7,175, CI 95% 1,628- 31,605, p-value 0,009).

Kesimpulan: Faktor-faktor yang mempengaruhi readmission pasien skizofrenia adalah kepatuhan minum obat dan tingkat pengetahuan caregiver. Faktor demografi (usia, jenis kelamin, status perkawinan, pendidikan dan pekerjaan) tidak bermakna secara statistik terhadap readmission pasien skizofrenia.

 

Kata Kunci: skizofrenia, readmission, kepatuhan minum obat, pengetahuan caregiver, jaminan kesehatan.


Keywords


schizophrenia, readmission, medication adherence, caregiver level of knowledge, national health insurance

Full Text:

PDF


References

Pamjaki. (2014). Managed Care Bagian A. Jakarta : Pamjaki. Hunt, G.E., Bergen, J., Bashir, M. (2002). Medication Compliance and Comorbid Substance Abuse in Schizophrenia: Impact on Community Survival 4 Years after Relaps. Schizophrenia Res : 54 (3):253-264. Care Systems. J Ment Health Policy Econ. 18(3): 115-124. Moss Jay, Li Abby, Tobin James, Weinstein Izak.S., Harimoto Tetsuhiro, Lanctot Krista, L. (2014). Predictors of readmission to a Psychiatry Inpatient Unit. Comprehensive Psychiatry 55 (2014) 426 – 430 Byrne, S.L., Hooke, G, R., Page A. C. (2010). Readmission : A useful indicator of the Quality of Inpatient Psychiatric Care. Journal of Affective Disorder 126 206-213 Kluge, M. (2008). Family Functioning and Coping Behaviors in Parents of Children with ASD. Journal Psychology. USA : Spinger Scinece. Pozo, KT., Oller, MJ., Lewczuk, A., Montanes- Rada, F. (2015). Understanding the Direct and Direct Cost of Patients with Schizophrenia. F1000Research 2015,4:182. American Psycological Association. (2015). Family Caregiving. Dikutip pada tanggal 3 Januari 2016. Di http: www.apa.org. Desai, PR., Lawson, KA., Barner, JC., Rascati, KL. (2013) Estimating the Direct and Indirect costs for Community_Dwelling Patients With Schizophrenia. Journal of Pharmaceutical Health Services Research. Volime 4, Issue 4:187-194. 3. Linden, M., Godemann, F., Gaebel, W., 14. Townsend, M. C. (2010). Psychiatric Kopke, W., Muller, P., Sphan, F., Pietzcker, A., Tegeler, G. (2001). A Prospective Study of Factors Influencing Adherence to a Continuous Neuroleptic Treatment Program in Schizophrenia Patients During 2 Years. Berlin: Oxford Journal. Arif, I.S. (2006). Skizofrenia : Memahami Dinamika Keluarga Pasien. Bandung: Rafika Aditama Trisnantoro, L., Hendrartini, J., Susilowati, T., Miranti, PA., Aristianti, V. (2015). A Critical Analysis Of Selected Healthcare Purchasing Mechanisms In Indonesia. Center for Health Policy and Management, Faculty of Medicine, Universitas Gadjah Mada Amoah, D. and Mwanri, L. (2016). Determinan of Hospital Readmission of Medical Conditions in Developing Countries. Austin Journal of Public Health and Epidemiology. Volume 3(5):id1049 Bush, A.B., Epstein, A.M., McGuire, T.G., Normand, S.T., Frank, R.G. (2015). Thirty Day Hospital Readmission for Medicaid Enrollees with Schizophrenia: The Role of Local Health Mental Health Nursing. 6th Ed. USA: F. A. DavisCompany. Magliano, L. (2008). Families of People with severe mental disorders: difficulties and Resources. Diakses dari http//www.euro. who.int/document/MNH/family-burden. Pada tanggal 12 Juli 2016. Nosé, M., Barbui, C., Gray, R. , et al . (2003). Clinical Interventions For Treatment Non- Adherence In Psychosis: Meta-Analysis. British Journal of Psychiatry, 183, 197– 206. Marchira, CR. (2012). Pengaruh Intervensi Psikoedukasi Interaktif Singkat Tentang Skizofrenia terhadap Pengetahuan Caregiver, Keteraturan Kontrol, Ketaatan Pengobatan, dan Kekambuhan pada Penderita Gangguan Psikotik Fase Awal di Jogjakarta (Disertasi). Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta. Weiden, PJ., Kozma, C., Grogg, A., Locklear, J. (2004). Partial Compliance and Risk of Rehospitalization Among California Medicaid Patients With Schizophrenia. Psychiatric Service. Volume 55, Issue 8; pp.996-891. Fleischhacker, WW., Oehl, MA., Hummer, M. (2003). Factors Influencing Compliance in Schizophrenia Patients. J Clin Psychiatry, 64 (suppl 16). p.10-3. Kaplan, H.I & Sadock, B.J. (1997). Sinopsis Psikiatri Ilmu Pengetahuan Perilaku Psikiatri Klinis. Jilid1 .Jakarta: Binarupa Aksara. World Health Organization. (2002). Prevention and Promotion Mental Health. Diakses pada Desember, 28, 2016. http://who.int Christodoulou, N.G., Christodoulou, G.N. (2013). Financial Crises: Impact On Mental Health Andsuggested Responses. Psychother Psychosom. 2013;82(5):279-84. Mitchell, AJ., Selmes, T. (2007). Why don’t Patients Take Their Medicine? Reason and Solutions in Psychiatry. Advances in Psychiatric Treatment. Volume 13 : 336-346. Shinde, M., Desai, A., Pawar, S. (2014). Knowledge, Attitudes and Practices among Caregivers of Patients with Schizophrenia in Western Maharashtra. International Journal of Science and Research (IJSR). ISSN (Online): 2319-7064 Edward, J., McGorry, PD. (2002). Implementing Erly Intervention in Psychosis. A Guide to Establising Early Psycosis Services. Volume 52. No.7. pp 903-910.



DOI: https://doi.org/10.22146/jkki.v6i1.29005

Article Metrics

Abstract views : 1986 | views : 2957

Refbacks

  • There are currently no refbacks.


Copyright (c) 2017 Jurnal Kebijakan Kesehatan Indonesia

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

The Jurnal Kebijakan Kesehatan Indonesia : JKKI [ISSN 2089 2624 (print); ISSN 2620 4703 (online)] is published by Center for Health Policy and Management (CHPM). This website is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. Built on the Public Knowledge Project's OJS 2.4.8.1.
 Web
Analytics View My Stats