Cost Analysis of Chronic Kidney Disease Patients in Indonesia

Endang Sunariyanti,1,2 Tri Murti Andayani,3 Dwi Endarti,4 Diah Ayu Puspandari5 1Doctoral Program in Pharmaceutical Science, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia; 2Universitas Muhammadiyah A.R.Fachruddin, Tangerang, Banten, Indonesia; 3Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Gadjah Mada University, Yogyakarta, Indonesia; 4Department of Pharmaceutics, Faculty of Pharmacy, Gadjah Mada University, Yogyakarta, Indonesia; 5Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada, Yogyakarta, IndonesiaCorrespondence: Tri Murti Andayani, Department of Pharmacology and Clinic, Faculty of Pharmacy, Universitas Gadjah Mada, Sekip Utara, D. I., Yogyakarta, 55281, Indonesia, Email [email protected]: The cost of treating chronic kidney disease requires large funds. Chronic kidney disease financing ranks 2nd in BPJS as the highest financing. All cost components in the treatment of chronic kidney disease are considered high, so adjustments and efficiency are needed. This study aims to perform a cost analysis in chronic kidney patients. In this article, we will discuss the cost components in treatment and see whether there are differences in the cost of treatment in each hospital.Methods: The study used a cross-sectional design with a hospital perspective and was conducted in 6 hospitals selected based on class in different regions: Sardjito Central General Hospital (class A), Yogyakarta Regional General Hospital (class B) and PKU Muhammadiyah Hospital (private class) represent hospitals in regional 1. Meanwhile, Makassar Central General Hospital (class A), Labuang Hospital Baji (class B) and Faisal Islamic Hospital (private class) represent hospitals in regional 3. The study lasted for 14 months from October 2019-December 2020. The total sample involved in this study was 582 samples. The cost components analyzed include hemodialysis costs, serious procedures and operations, services, radiology, laboratories, blood transfusions, drugs, medical devices, hospitalization and supplies.Results: Chronic kidney patient profile data, calculations and cost components are presented descriptively. The Mann–Whitney test was used to see whether there were differences in costs between hospitals in each region. The results showed that the total cost of treating chronic kidney disease was higher in class A hospitals compared to class B and private class hospitals.Conclusion: The highest cost component is the cost of hemodialysis, followed by severe procedures and services. The highest total cost of hemodialysis reached Rp. Rp.840,132,546, heavy action Rp. 423,156,000 and services Rp. 792,155,000. The results of statistical tests showed that there were differences in the cost of treating chronic kidney disease in hospitals in regional 1 and regional 3 (p < 0.05).Keywords: cost of illness, chronic kidney, hemodialysi

Analisis Tingkat Pengetahuan Masyarakat terhadap Penyakit dan Vaksin Hepatitis A di Indonesia: Analysis Of Community's Knowledge On Hepatitis A Disease And Vaccines In Indonesia

Hepatitis A is a viral disease with a high potential for morbidity and mortality. It is also the second highest viral disease in Indonesia after hepatitis B. Community's knowledge regarding Hepatitis A disease dan vaccine is required to support such program for eradication of Hepatitis A. The aims of this study was to measure the knowledge of Indonesian community about hepatitis A disease and its vaccine indicated from knowledge score of correct answer towards questionnaire, as well as to analyze the factors that can influence it indicated from difference of mean of knowledge scores among groups of respondents characteristics. This study used an observational survey research design applying a cross-sectional multi-center approach. The number of sample was 500 respondents located in 5 provinces in Indonesia, namely DIY, Lampung, West Java, Central Kalimantan, and Central Sulawesi. Data collection was carried out using a questionnaire that was modified from the questionnaire in a similar previous study. The results showed that public knowledge related to diseases and hepatitis A vaccine in Indonesia was considered sufficient with the mean score obtained was 75.2% ± 12.2%. Statistical analysis using Mann-Whitney test showed that there were significant differences in score of knowledge between groups on the characteristics of experience of hearing a disease (p=0,000), experience of hearing a vaccine (p=0,000) and the experience of the child being vaccinated (p=0,000). There are 2 items of knowledge that werelack understood by respondents, namely treatment of hepatitis A that cannot be treated with antibiotics and immunizations and hepatitis A is not included yet in the national immunization program in Indonesia. It is concluded that community knowledge regarding hepatitis A disease and vaccine was fair (mean knowledge score between 65 – 80%). However, the government still needs to conduct educational programs for the Indonesian community about disease prevention through the vaccination process and provide counseling about the types of vaccines that are not included in the national health insurance program in Indonesia

Tingkat Pengetahuan terhadap Vaksin Tifoid: Survei pada Orang Tua di Indonesia

Demam tifoid merupakan infeksi sistemik yang disebabkan oleh bakteri Salmonella typhi. Vaksin dapat melindungi anak dari penyakit yang mematikan. Pengetahuan tentang vaksinasi penting bagi orang tua untuk mengembangkan sikap positif sehingga mendukung pada program vaksinasi. Tujuan penelitian ini adalah untuk melihat faktor-faktor yang mempengaruhi tingkat pengetahuan demam tifoid dan vaksin tifoid orang tua di Indonesia. Penelitian ini termasuk dalam penelitian observasional survei dengan pendekatan multi-center cross sectional yang dilakukan pada orang tua di 5 Provinsi di Indonesia yaitu DI Yogyakarta, Lampung, Jawa Barat, Kalimantan Tengah, dan Sulawesi Tengah. Pengumpulan data menggunakan kuesioner yang terdiri dari 28 pertanyaan yang meliputi pertanyaan informasi sosiodemografi dan tingkat pengetahuan tentang demam tifoid dan vaksin tifoid. Pengambilan data dilaksanakan pada bulan Oktober 2019 sampai Desember 2019. Data dianalisis menggunakan software IBM SPSS Statistics 25, untuk analisis karakteristik sampel digunakan analisis deskriptif yang menggambarkan keseluruhan data sampel penelitian berupa data sosiodemografi dan data pengetahuan. Analisis inferensial yang digunakan yaitu uji Mann Whitney untuk melihat perbedaan tingkat pengetahuan responden tentang demam tifoid dan vaksin tifoid antar kelompok pada karakteristik sosiodemografi responden. Rata-rata nilai pengetahuan dari 500 responden adalah 77%. Item pengetahuan yang masih kurang pada pertanyaan tentang cara penularan penyakit, dosis vaksin tifoid dan vaksin tifoid tidak termasuk dalam program jaminan kesehatan nasional. Hasil uji Mann Whitney menunjukkan terdapat perbedaan bermakna nilai pengetahuan antar kelompok pada karakteristik kepemilikan asuransi kesehatan (p=0,039), pernah mendengar tentang vaksin tifoid (p=0,000) dan pernah melakukan vaksinasi tifoid (p=0,002). Diperlukan adanya program intervensi kesehatan untuk meningkatkan pengetahuan masyarakat tentang penyakit demam tifoid dan vaksin tifoid

Kesesuaian Penggunaan Obat Golongan Analgetik terhadap Formularium Nasional dan Formularium Rumah Sakit di RS Akademik UGM YOGYAKARTA

Peraturan Menteri Kesehatan Nomor 72 Tahun 2016 mengatur bahwa setiap tenaga farmasi rumah sakit yang memberikan pelayanan kefarmasian harus memenuhi standar pelayanan. Berdasarkan Standar Pelayanan Minimal Rumah Sakit, penulisan resep seluruhnya harus mengacu pada formularium dengan standar 100%. Jika resep tidak sesuai dengan formularium maka akan mempengaruhi mutu pelayanan obat serta mampu meningkatkan biaya penggunaan obat di instalasi farmasi. Penelitian ini bertujuan untuk mengetahui kesesuaian penggunaan obat golongan analgetik dengan formularium nasional dan formularium rumah sakit di Rumah Sakit Akademik UGM Yogyakarta. Jenis penelitian ini merupakan penelitian deskriptif dengan rancangan penelitian cross sectional dan pengumpulan data secara retrospektif. Data penggunaan obat golongan analgetik yang telah diperoleh dari sistem informasi manajemen rumah sakit pada periode tahun 2013, 2016, dan 2019 kemudian diolah dan dianalisis menggunakan microsoft excel. Hasil penelitian menunjukkan kesesuaian penggunaan obat golongan analgetik terhadap formularium rumah sakit untuk tahun 2013 dan 2016 sebesar 100%, sedangkan untuk tahun 2019 yakni sebesar 98,84% dengan rata-rata sebesar 99,6%. Sementara untuk persentase kesesuain penggunaan obat terhadap formularium nasional untuk tahun 2016 dan 2019 yakni sebesar 64,57% dan 86,25% dengan rata-rata sebesar 74,41%. kesesuaian penggunaan obat terhadap formularium nasional dan formularium rumah sakit belum memenuhi standar yang ditetapkan yakni 100%, sehingga rumah sakit masih perlu melakukan upaya untuk meningkatkan persentase kesesuaian penggunaan obat di Rumah Sakit Akademik UGM Yogyakarta