Analysis of Real Costs and INA-CBG of Hyperthyroidism in Hasanuddin University Hospital
Abstract
Hyperthyroid disease requires continuous treatment with not cheap medicalcosts. For JKN participants, the cost of treating hyperthyroidism has been fullycovered by BPJS through the INA-CBG package. However, there is often amismatch between the INA-CBG package and the real hospital costs thus causinglosses for the hospital. This research is a comparative study with a hospitalperspective and the purpose of this study is analyze difference between directmedical cost of hospitals and INA-CBG package for the treatment of JKNoutpatient hyperthyroidism patient in Hasanuddin University Hospital (RSUH)Makassar using data from January 2017 to December 2018. Data collection wascarried out by retrospective observational and data analysis using statistical non-parametric tests. The results showed that INA-CBG package cannot cover allcomponents of the costs of treating hyperthyroid disease. The laboratory cost hasa proportion of 83% of the total medical cost, which is an average of IDR465.683,70 every patient. Meanwhile, the INA-CBG rate with code Q-5-44-0 onlycovers medical expenses of IDR 185.500 every patient. The conclusion of thisstudy shows that there is a negative difference (-) between the real cost of thehospital and the INA-CBG rate, which is IDR 34.406.900,00 and an average of IDR373.988.04 every patient. The recommendation is related to adjustment of theINA-CBG rate to cover the riil costs.
References
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2. Kemenkes RI. Situasi dan Analisis Penyakit Tiroid. Jakarta: Pusat Data dan Informasi Kementerian Kesehatan RI; 2015.
3. Kemenkes RI. Riset Kesehatan Dasar (Riskesdes). Jakarta: Kementerian Kesehatan RI; 2013.
4. Yu W, Wu N, Li L, Wang J, OuYang H, Shen H. Side Effects of PTU and MMI in The Treatment of Hyperthyroidism: A systematic Review and Meta-Analysis. Endocrine Practice. 2020;26(2):207-217.
5. Dipiro JoT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM. Pharmacoteraphy, a Phatophysiologic Approach 9th Edition. New York: McGraw-Hill Education; 2015.
6. Caputo M, Pecere A, Sarro A, et al. Incidence and Prevalence of Hyperthyroidism: A Population-Based Study in The Piedmont Region, Italy. Endocrine. 2020;69(1):107-112.
7. Okosieme OE, Taylor PN, Dayan CM. Should Radioiodine Now Be First Line Treatment For Graves’ Disease?. Springer Sci Bus Media New York. 2020;13(3):1-7.
8. BPJS Kesehatan. Paduan Praktis Administrasi Klaim Fasilitas Kesehatan BPJS Kesehatan. Jakarta: Badan Penyelenggara aminan Sosial; 2018.
9. BPJS Kesehatan. Panduan Praktis Pelayanan Kesehatan BPJS Kesehatan. Jakarta: Badan Penyelenggara Jaminan Sosial; 2017.
10. Wulan S, Herman A, Direja S, Reflisiani D. Penghitungan Biaya Satuan pada Instalasi Rawat Jalan di Rumah Sakit X Jambi menggunakan Metode Step Down. Jurnal Ekonomi Kesehatan Indonesia. 2017;3(1):43-50.
11. RS Universitas Hasanuddin. Data Rekam Medis Kunjungan Pasien Rawat Jalan. Makassar; Rumah Sakit Universitas Hasanuddin; 2018.
12. Rahayuningrum IO, Tamtomo DG, Suryono A. Analisis Tarif Rumah Sakit Dibandingkan dengan Tarif Indonesian Case Based Groups Pada Pasien Rawat Inap Peserta Jaminan Kesehatan Nasional Di Rumah Sakit. Pros Semin Nas Int. 2017;1(1):214-223.
13. Sugiyono. Metode Penelitian Kombinasi (Mixed Methods). Bandung: Alfabeta; 2018.
14. Taylor PN, Albrecht D, Scholz A, et al. Global Epidemiology of Hyperthyroidism and Hypothyroidism. Nature Reviews Endocrino-logy. 2018;14(5):301-316.
15. Chiovato L, Magri F, Carle A. Hypothyroidism in Context : Where We’ve Been and Where We’re Going. Adv Ther. 2019;2019(36):47-58.
16. Bové KB, Watt T, Vogel A, et al. Anxiety and Depression Are More Prevalent in Patients with Graves’ Disease than in Patients with Nodular Goitre. European Thyroid Journal. 2014;3(3):173-178.
17. Juwita DA, Suhatri, Hestia R. Antityroid Drug Use Evaluation on Hyperthyroid Patients in Dr. M. Djamil Hospital Padang, Indonesia. Jurnal Sains Farmasi dan Klinis. 2018;5 (1):49-54.
18. Meng Z, Liu M, Zhang Q, et al. Gender and Age Impacts on The Association Between Thyroid Function and Metabolic Syndrome in Chinese. Medicine (United States). 2015;94(50):1-9.
19. Zhang J, Huang C, Meng Z, et al. Gender-Specific Differences on the Association of Hypertension with Subclinical Thyroid Dysfunction. International Journal Endocrinology. 2019;2019:1-9.
20. Samuels M. Hyperthyroidism in Aging. In: Thyroid Disease Manager; 2018.
21. Barbesino G. Thyroid Function Changes in The Elderly and Their Relationship to Cardiovascular Health: A Mini-Review. Gerontology. 2019;65(1):1-8.
22. Ngurah IG, Dwi G, Sudarsa IW. Faktor- Faktor Yang Mempengaruhi Kualitas Hidup Pasien Kanker Tiroid Berdiferensiasi Baik (DTC) Paska Tiroidektomi Total di Rumah Sakit Umum Pusat (RSUP) Sanglah, Denpasar. Intisari Sains Medis. 2019;10(1):197-204.
23. Alexander EK, Pearce EN, Brent GA, et al. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum. Thyroid. 2017;27(3):315-389.
24. Yunitawati D, Santi K. Psychological Counseling And Anxiety In Patients With Hyperthyroidism In Klinik Litbang GAKI Magelang. Media Gizi Mikro Indonesia. 2014;6(1):53-62.
25. Liu J, Fu J, Xu Y, Wang G. Antithyroid Drug Therapy for Graves’ Disease and Implications for Recurrence. International Journal of Endocrinology. treatment; 2017:1-8.
26. Kamsyakawuni A, Gernowo R, Sarwoko EA. Aplikasi Sistem Pakar untuk Diagnosa Penyakit Hipertiroid dengan Metode Inferensi Fuzzy Mamdani. Jurnal Sistem Informasi Bisnis. 2012;2(2): 58-66.
27. Burch HB, Cooper DS. Management of Graves Disease. Journal American Medical Association. 2016;314(23):2544-2554.
28. Klaver EI, Loon HCM Van, Stienstra R, et al. Thyroid Hormone Status and Health-Related Quality of Life in the LifeLines Cohort Study. Thyroid Journal. 2013;23(9):1066-1073.
29. Brown DC. Thyroid Hormones, Antithyroid Drugs [Chapter 37]. Clinical Pharmacology 11th Vol. 4 ed. Elsevier Ltd; 2018.
30. Tjay TH, Rahardja K. Obat-Obat Penting Khasiat, Penggunaan, dan Efek Samping Edisi Ke 7. Jakarta: Elex Media
Komputindo; 2015.
31. Iglesias P, Bajo MA, Selgas R, Díez JJ. Thyroid Dysfunction and Kidney Disease : An Update. Reviews in Endocrine and Metabolic Disor-ders. 2017;18:131-144.
32. Akmal A, Kung J. Expert Opinion on Drug Safety Propylthiouracil, and Related Hepatotoxicity. Journal Expert Opinion on Drug Safety. 2014;13(10):1397-1406.
33. Siddiqui MF, Anwer H, Batool Z, Hasnain S, Imtiaz M. Assessment of Carbimazole, Propylthiouracil & L-Thyroxine For Liver Markers in Thyroid Patients From Punjab, Pakistan. Journal of Applied Pharmacy. 2015;7(1):105-113.
34. Baladi IH, Rai AA, Ahmed SM. ECG Changes in Patients With Primary Hyperthyroidism. Pan African Medical Journal. 2018;30:1-5.
Authors
Abdullah, S. S., Lorensia , A. ., & Suyanto. (2020). Analysis of Real Costs and INA-CBG of Hyperthyroidism in Hasanuddin University Hospital. Media Kesehatan Masyarakat Indonesia, 16(4), 421-429. https://doi.org/10.30597/mkmi.v16i4.10990
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