ANALISIS BIAYA SATUAN PASIEN MENINGITIS TUBERKULOSIS YANG DIRAWAT INAP DI RSUP PROF. DR. R. D. KANDOU MANADO

UNIT COST ANALYSIS OF TUBERCULOUS MENINGITIS PATIENTS ADMITTED IN R.D. KANDOU HOSPITAL MANADO

Abstract

Latar Belakang:Meningitis tuberkulosis (TB) banyak ditemukan di Indonesia dan perawatan pasiennya memerlukan biaya yang cukup besar. Untuk uji diagnostik awal, World Health Organization merekomendasikan pemeriksaanXpert MTB/Rif cairan serebrospinal. Namun demikian, analisis biaya satuan belum pernah dilakukan untuk kasus ini di RSUP. Prof. dr. R.D Kandou (RS RDK).Kami hendakmengetahui biaya satuan pasien meningitis TB di RS RDK, tanpa dan dengan menggunakan pemeriksaanXpert MTB/Rif. Metode: Dilakukan analisis biaya satuan dengan metode satu langkah.Biaya langsung dihitung dengan melihat data rekam medis dan billing system pasien meningitis TB nonoperatif yang dirawat inap di RS RDK tahun 2017.Biaya tidak langsung diestimasi dari hasil wawancara metode semi-structured interview pada responden yang sesuai. Biaya satuan dihitung dari penjumlahan rerata biaya dari setiap komponen biaya yang ditemukan. Dicatat juga biayakomponen tertinggi dan terendah masing-masing. Hasil: Didapatkan 25 subjek yang memenuhi kriteria penelitian. Persentase laki-laki 60% dengan rerata usia 46tahun dan rerata lama rawat adalah 12 hari. Biaya satuan langsung adalah Rp.14.779.178 dan biaya satuan tidak langsung Rp. 3.369.767. Biaya pemeriksaan Xpert MTB/Rif di RS RDK ditanggung oleh pemerintah tetapi pemeriksaan dari sampel cairan serebrospinal belum dapat dikerjakan. Kesimpulan: Biaya satuan meningitis TB di RS RDK lebih besar dari paket Indonesian Case-Based Group dengan selisih Rp. 1.564.278. Pemeriksaan Xpert MTB/Rif tidak dikenakan biaya sehingga perbedaannya dapat diabaikan.

Kata kunci: Meningitis tuberkulosis, biaya satuan, Xpert MTB/Rif, Manado.

ABSTRACT

Background: Tuberculous (TB) meningitis is commonly seen across Indonesia and its treatment requires a huge cost. World Health Organization recommends the utilization of Xpert MTB/Rif from the cerebrospinal fluid as the initial diagnostic test. However, the unit cost analysis for this case has never been done in Kandou Hospital. We intend to find out the unit cost of TB meningitis patient in R.D. Kandou Hospital, without and with the utilization of Xpert MTB/Rif. Method: We performed a unit cost analysis using the simple distribution method. Direct cost was calculated from medical record and billing system data of nonsurgical TB meningitis patients admitted in Kandou Hospital in the year 2017. Indirect cost was estimated from the result of interviews using the semi-structured interview method on appropriate respondents. Unit cost was calculated from the sum of average costs from each cost component found. The highest and lowest cost for each cost component were also recorded. Result: We found 25 eligible subjects. The male percentage was 60% with average age 46 years old and average length of stay 12 days. The direct unit cost was Rp. 14.779.178 and the indirect unit cost was Rp. 3.369.767. The cost of the Xpert MTB/Rif examination was paid by the government, but the cerebrospinal fluid sample was still unable to be tested. Conclusion: The unit cost of TB meningitis in Kandou Hospital was higher than the Indonesian Case-Based Group package with Rp. 1.564.278 cost difference. The Xpert MTB/Rif examination was not charged so the difference is negligible.

Keywords: Tuberculous meningitis, unit cost, Xpert MTB/Rif, Manado.