Tesis

Cost Comparison of Resection Anastomosis of Urethra in Adam Malik Hospital with Other Studies from 2014-2019: A Retrospective Study = Perbandingan Biaya Reseksi Anastomosis Uretra di Rumah Sakit Adam Malik dengan Studi Lain dari Tahun 2014-2019: Sebuah Studi Retrospektif.

Background: Treatment duration for urethral trauma took on average 3-6 weeks, this extended management duration affects the cost to the procedure. We thought to compare the cost-effective analysis and the mean cost of treatment in urethral injury specially for total disruption of urethral injury in H Adam Malik General Hospital with other studies. Background: The average duration of treatment for urethral trauma is 3-6 weeks. This extended management duration affects the cost of the procedure. We aim to compare the cost-effective analysis and the mean cost of treatment for urethral injury, specifically for total disruption of urethral injury in H Adam Malik General Hospital, with other studies. Methods: This study was conducted at Adam Malik General Hospital between 2014 and 2019. We included every Urethral Resection and Anastomosis procedure. The Cost was calculated from The Department of Social Security, Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS), and then the data compare with data from other countries Result: A total of 18 urethral anastomosis resection between 2014-2019 were included in this study. The mean total cost was Rp21,850,856, with a minimum total cost of Rp8,407,624, and a maximum total cost of Rp74,432,827. The cost was stratified by BPJS into three level from levels: level 3 (lowest), level 2, and level 1 (highest). However, the program only covered a range of 9,567,700 IDR to 21,170,500 IDR, leading to a significant disparity. This disparity has resulted in hospitals across Indonesia having to limit the number of urological services they can provide. In contrast, the mean total urethral resection and anastomosis procedure cost from several studies in USA shows a minimal cost of Rp120,167,068.45, to Rp242,624,550.80. Conclusion: The disparity between the cost reimbursed by BPJS and the actual cost incurred by the hospital for urethral resection and anastomosis procedures results in financial losses to the hospital. As a result, these procedures cannot be performed routinely.
Keywords: Urethral injury, Resection anastomosis of urethra, cost comparison


Latar Belakang: Durasi pengobatan untuk cedera uretra rata-rata memakan waktu 3-6 minggu, durasi pengelolaan yang lebih lama ini memengaruhi biaya prosedur. Kami bermaksud untuk membandingkan analisis efektivitas biaya dan rata-rata biaya pengobatan untuk cedera uretra, khususnya untuk total gangguan cedera uretra di Rumah Sakit Umum H Adam Malik dengan studi lainnya. Metode: Penelitian ini dilakukan di Rumah Sakit Umum Adam Malik antara tahun 2014 dan 2019. Kami mencakup setiap prosedur Reseksi dan Anastomosis Uretra. Biaya dihitung dari Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS), dan kemudian data dibandingkan dengan data dari negara-negara lain. Hasil: Sebanyak 18 reseksi anastomosis uretra antara tahun 2014-2019 dimasukkan dalam penelitian ini. Rata-rata biaya total adalah Rp21.850.856, dengan biaya total minimum sebesar Rp8.407.624, dan biaya total maksimum sebesar Rp74.432.827. Biaya tersebut dibagi oleh BPJS menjadi tiga tingkat: tingkat 3 (terendah), tingkat 2, dan tingkat 1 (tertinggi). Namun, program ini hanya mencakup rentang 9.567.700 IDR hingga 21.170.500 IDR, yang menyebabkan disparitas yang signifikan. Disparitas ini telah mengakibatkan rumah sakit di seluruh Indonesia harus membatasi jumlah layanan urologi yang dapat mereka berikan. Sebagai perbandingan, biaya total rata-rata prosedur reseksi dan anastomosis uretra dari beberapa studi di Amerika Serikat menunjukkan biaya minimal sebesar Rp120.167.068,45, hingga Rp242.624.550,80. Kesimpulan: Disparitas antara biaya yang dikembalikan oleh BPJS dan biaya aktual yang ditanggung oleh rumah sakit untuk prosedur reseksi dan anastomosis uretra mengakibatkan kerugian keuangan bagi rumah sakit. Akibatnya, prosedur-prosedur ini tidak dapat dilakukan secara rutin.
Kata Kunci: Cedera uretra, Reseksi anastomosis uretra, perbandingan biaya