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



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

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