189-Article Text-605-2-10-20190308
189-Article Text-605-2-10-20190308
Email: aisyah@akfar-isfibjm.ac.id
ABSTRAK
ABSTRACT
pay month, cancer ranks second after the heart disease which requires the most
medical expenses, which is Rp1.8 trillion. The purpose of this study was to find out
the description of chemotherapy and find out how much the difference in real costs
with INA-CBGs rates in patients with breast cancer chemotherapy hospitalized
JKN participants in Ulin Banjarmasin Hospital.
This research was a pharmacoeconomic analysis research with a hospital
perspective on direct medical costs, and the data was taken retrospectively. The
object of this study was the financial file of hospital inpatient services and medical
records of JKN participants' breast cancer patients for the period of January-October
2017 in Ulin Banjarmasin Hospital. The samples were 259 episodes of care. Data
analysis was carried out with one sample test to compare the average real cost with
the INA-CBGs rate.
The results showed the description of chemotherapy in breast cancer patients
hospitalized participants with the National Health Insurance at Ulin Banjarmasin
Hospital in January – October 2017 period was docetaxel 62.36%,
cyclophosphamide 52.35% and epirubicin 40%. The magnitude of the difference
between the real cost and the INA-CBGs package tariff was Rp662,143,091 (259
episodes of care). The average real cost of chemotherapy per episode of treatment
at the level of severity I was Rp4,502,210, at the severity level II was Rp8,239,624,
and at the severity level, III was Rp7,403,713.
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Jurnal Ilmiah Ibnu Sina, 3(2), 333-342 Noor Aisyah.
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Jurnal Ilmiah Ibnu Sina, 3(2), 333-342 Noor Aisyah.
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Jurnal Ilmiah Ibnu Sina, 3(2), 333-342 Noor Aisyah.
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Jurnal Ilmiah Ibnu Sina, 3(2), 333-342 Noor Aisyah.
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Jurnal Ilmiah Ibnu Sina, 3(2), 333-342 Noor Aisyah.
Tabel 1. Komponen biaya pasien per episode rawat inap dengan kode INA CBGs
C-4-13 di RSUD Ulin Banjarmasin periode Januari - Oktober 2018
Rata-
Biaya (n =
Komponen Biaya rata (n = SD (%) Min Max
259)
259)
Tingkat Keparahan I (n = 132)
Obat Kemoterapi 290.570.087 2.201.289 1.060.980 48.9% 324.995 9.804.017
Akomodasi (Rp) 11.800.000 89.394 45.201 2.0% 75.000 375.000
Visite Dokter 5.983.500 45.330 22.326 1.0% 37.500 150.000
Tindakan Non
Operatif (Rp)
a. MPK (manajemen
42.795.000 324.205 2.350 7.2% 324.000 351.000
pemberian kemo)
b. Kemoterapi 68.578.125 519.531 44.879 11.5% 515.625 1.031.250
Tindakan
51.720.000 391.818 134.969 8.7% 360.000 960.000
Keperawatan (Rp)
Pemeriksaan
2.886.200 21.865 28.113 0.5% 15.000 185.000
Penunjang (Rp)
Obat dan Bahan
109.698.763 831.051 280.175 18.5% 265.500 2.141.483
Medis (Rp)
Sitostatika Handle
10.260.000 83.415 10.545 1.7% 60.000 90.000
(Rp)
Total Biaya Rill (Rp) 303.721.588 2.300.921 377.676
Total Biaya Rill
dengan Kemoterapi 594.291.675 4.502.210 298.348
(Rp)
Tingkat Keparahan II (n = 100)
Obat Kemoterapi 529.875.894 5.298.759 4.369.095 64.3% 554.950 12.757.967
Akomodasi (Rp) 8.475.000 84.750 28.625 1.0% 75.000 175.000
Visite Dokter 4.337.000 43.370 21.200 0.5% 10.000 112.500
Tindakan Non
Operatif (Rp)
a. MPK (manajemen
32.427.000 324.270 2.700 3.9% 324.000 351.000
pemberian kemo)
b. Kemoterapi 52.078.125 520.781 51.563 6.3% 515.625 1.031.250
Tindakan
41.520.000 415.200 169.208 5.0% 360.000 960.000
Keperawatan (Rp)
Pemeriksaan
1.734.600 17.521 10.071 0.2% 15.000 100.000
Penunjang (Rp)
Obat dan Bahan
146.519.731 1.465.197 897.159 17.8% 300.500 3.075.133
Medis (Rp)
Sitostatika Handle
6.995.000 80.402 12.371 0.8% 60.000 110.000
(Rp)
Total Biaya Rill (Rp) 294.086.456 2.940.865 943.631
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Jurnal Ilmiah Ibnu Sina, 3(2), 333-342 Noor Aisyah.
Rata-
Biaya (n =
Komponen Biaya rata (n = SD (%) Min Max
259)
259)
Total Biaya Rill
dengan Kemoterapi 823.962.350 8.239.624 695.705
(Rp)
Tingkat Keparahan III (n = 27)
Obat Kemoterapi 128.130.485 4.745.574 3.576.657 64.1% 1.500.000 12.668.867
Akomodasi (Rp) 2.400.000 88.889 41.795 1.2% 75.000 250.000
Visite Dokter 1.237.500 45.833 24.019 0.6% 37.500 112.500
Tindakan Non
Operatif (Rp)
a. MPK (manajemen
8.748.000 324.000 0 4.4% 324.000 324.000
pemberian kemo)
b. Kemoterapi 14.231.250 527.083 59.539 7.1% 515.625 825.000
Tindakan
11.760.000 435.556 221.139 5.9% 360.000 1.200.000
Keperawatan (Rp)
Pemeriksaan
460.000 17.037 6.086 0.2% 15.000 40.000
Penunjang (Rp)
Obat dan Bahan
31.398.015 1.162.889 769.196 15.7% 300.500 3.138.133
Medis (Rp)
Sitostatika Handle
1.535.000 56.852 12.049 0.8% 60.000 110.000
(Rp)
Total Biaya Rill (Rp) 71.769.765 2.658.139 894.466
Total Biaya Rill
dengan Kemoterapi 199.900.250 7.403.713 1.082.146
(Rp)
Tabel 2. Selisih total biaya riil dengan total tarif INA-CBGs pada pasien
kemoterapi kanker payudara di RSUD Ulin Banjarmasin periode Januari –
Oktober 2017
Kode INA-CBG'S C-4-13-I C-4-13-II C-4-13-III Jumlah
Jumlah episode perawatan 132 100 27 259
Total biaya rill (Rp) 303.721.588 294.086.456 71.769.765 669.577.809
Total tarif paket INA-CBGs (Rp) 446.982.900 646.515.800 238.222.200 1.331.720.900
Selisih paket (positif) (Rp) 143.261.312 352.429.344 166.452.435 662.143.091
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Jurnal Ilmiah Ibnu Sina, 3(2), 333-342 Noor Aisyah.
INA CBGs terdapat selisih positif. bahwa rata-rata biaya riil pengobatan
Berdasarkan analisis one sample t test kanker payudara dengan semua
menunjukkan hasil bahwa pada tingkat keparahan dan kelas
tingkat keparahan I, II dan III pada perawatan berbeda secara bermakna
semua kelas perawatan diperoleh berdasarkan tarif INA-CBGs.
hasil p < 0.05. Dapat dinyatakan
Tabel 3. Perbandingan antara rata-rata biaya riil RSUD Ulin Banjarmasin dengan
tarif paket INA-CBGs periode Januari – Oktober 2017
Tingkat Total Biaya Riil Rata-rata Tarif INA-
Kelas p
keparahan (Rp) Biaya Riil (Rp) CBGs (Rp)
1 23.018.613 3.288.373 4.642.200 0.000
I
2 - - - -
(n=132)
3 280.702.975 2.245.624 3.315.900 0.000
1 29.132.166 3.641.521 8.736.700 0.000
II
2 7.175.583 3.587.792 7.488.600 0.043
(n=100)
3 257.778.707 2.864.208 6.240.500 0.000
1 11.899.358 3.966.453 11.826.600 0.001
III
2 - - - -
(n=27)
3 59.870.407 2.494.600 8.447.600 0.000
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Jurnal Ilmiah Ibnu Sina, 3(2), 333-342 Noor Aisyah.
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