Analisis Biaya Satuan dan Kualitas Hidup Penderita Gagal Ginjal Kronik yang Menggunakan Tindakan Hemodialisis di Rumah Sakit Tebet Tahun 2015

Anggun Nabila

Abstract


ABSTRAK

Penelitian ini bertujuan untuk mengetahui gambaran biaya satuan dan kualitas hidup penderita gagal ginjal kronik yang menggunakan tindakan hemodialisis di Rumah Sakit Tebet tahun 2015. Biaya dihitung berdasarkan perspektif rumah sakit, kemudian dilakukan penyusunan alat ukur kualitas hidup penderita gagal ginjal kronik (Dialysis Health Related Quality of Life) dan clinical pathway tindakan hemodialisis di Rumah Sakit Tebet. Alat ukur kualitas hidup berisikan 13 atribut untuk mengukur utility dan time preference (pertambahan tahun hidup) penderita gagal ginjal kronik yang menggunakan tindakan hemodialisis. Tigabelas atribut tersebut terdiri dari rasa kecap terhadap makanan, gangguan tidur, berjalan, kelelahan, cemas, emosi, nyeri, mandiri, kegiatan sehari- hari (bekerja, belanja, belajar, jalan-jalan, dll), komunikasi, bergaul, terisolasi, beban orang lain. Quality adjusted life years (QALY’s) didapatkan dari perkalian utility dengan time preference. Nilai QALY’s yang didapatkan yaitu 3.35 artinya penderita gagal ginjal kronik yang menggunakan hemodialisis mendapatkan 3 tahun hidup berkualitas, di mana nilai rata-rata utility 0,62 (0 = mati, 1 = sehat), dan nilai rata-rata time preference atau pertambahan hidup yang diperoleh penderita gagal ginjal kronik yang menggunakan hemodialisis yaitu 5 tahun. Biaya yang dikeluarkan rumah sakit untuk satu kali pelayanan hemodialisis dengan single use yaitu Rp 1.315.644,- Dengan asumsi frekuensi hemodialisis rutin 2 kali dalam satu minggu maka biaya yang dikeluarkan oleh rumah sakit yaitu Rp 41.324.355,-. Biaya tersebut mencakup skrinning indikasi dialysis, tindakan dialysis (single use), pemeriksaan lanjutan/ regular, dan virus marker. Penerapan clinical pathway diperlukan sebagai alat kendali mutu dan kendali biaya dalam pemberian pelayanan kesehatan.

 

ABSTRACT

The research aims to describe unit cost of hemodialysis and quality of life of Chronic Kidney Disease patients who use hemodialysis as a therapy at Tebet Hospital in 2015. Unit cost is calculated based on hospital perspective. Developing questioner of quality of life of Chronic Kidney Disease (CKD) patients (Dialysis Health Related Quality of Life) and clinical pathway of hemodialysis. Dialysis Health Related Quality of Life has 13 dimensions (sense of taste, sleep disorders, mobility, fatigue, anxiety, emotional, pain, self-care, daily activities (working, shopping, study, travelling, etc), communication, social interaction, being isolated, the burdens of others), measuring utility and time preference of patients who use hemodialysis as a therapy. QALY’s score is 3,35 which means patient of CKD gets 3 years of quality life. While using hemodialysis, utility score is 0,6, 0 means death and 1 means healthy life, and time preference score is 5,1 years, which means patient of CKD gets 5 more years when they use hemodialysis as a therapy. Unit cost of single use of hemodialysis is Rp 1.315.644,- Unit cost of hemodialysis for 6 months with 2 times a week of hemodialysis is Rp 41.324.355,-. Costs include screening of dialysis indication, single use dialysis, regular medical check up, and virus marker. The implication of clinical pathway is needed for quality and cost control. 

Keywords


unit cost; quality of life; chronic kidney disease patients; hemodialysis; hospital

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DOI: http://dx.doi.org/10.7454/arsi.v1i3.2178

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