Penyakit Kardiovaskular pada Pasien Rawat Inap Dewasa: Studi Kasus dari Data Klaim BPJS Rumah Sakit Pemerintah di Jakarta
Cardiovascular Diseases in Adult Hospitalized Patients: a Case Study of BPJS Claims Data for Government Hospitals in Jakarta
Abstract
Cardiovascular disease (PKV) is the most common non-communicable disease and is the leading cause of death globally. This study aimed to determine the description of cardiovascular disease in adult JKN patients who were treated at the hospital. This observational study with cross sectional design was carried out in a type A of government hospital in Jakarta. The sample was selected purposively using BPJS claim data for the period of January-December 2017. All hospitalized patients with aged ≥18 years and suffering from PKV according to Indonesia Case Base Groups (INA-CBG) code were included in the analysis. The results found that number of BPJS patients were hospitalized in the PKV group was 2,005 patients with with a total of 2,561 visits. More men than women, with the largest age range 56-65 years. More than half of BPJS patients utilize class 3 care facilities with an average length of stay of around 9 days. Mostly at desease I and II. The number of patients who died was 16.06%. Most cases and comorbidities were acute myocardial infarction with type 2 diabetes mellitus. Meanwhile the main cause of death was cardiac arrest with no known cause. In terms of financing, the average hospital tariff is higher than the average of INA-CBG tarrif. In conclusion, the most cases of PKV in hospitalized JKN patients were acute myocardial infarction with severity at level I and II in type A government hospitals, which should have been handled by a lower types of hospital. Diabetes mellitus is a major comorbid, and unknown cardiac arrest is the leading cause of death. The average of hospital tarif in PKV cases is higher than the INA-CBG tariff.
Abstrak
Penyakit kardiovaskular (PKV) merupakan penyakit tidak menular yang paling sering ditemukan dan menjadi penyebab utama kematian secara global. Penelitian ini bertujuan untuk mengetahui gambaran penyakit kardiovaskular pada pasien Jaminan Kesehatan Nasional (JKN) usia dewasa yang mendapatkan perawatan di rumah sakit (RS). Metode penelitian observasional dengan desain potong lintang di salah satu RS pemerintah tipe A di Jakarta. Sampel dipilih secara purposif menggunakan data klaim periode Januari-Desember 2017. Seluruh pasien yang dirawat inap, berusia 18 tahun ke atas, dan menderita PKV menurut kode Indonesia Case Base Groups (INA-CBG) diikutkan dalam analisis. Hasil penelitian menemukan jumlah pasien Badan Penyelenggara Jaminan Sosial (BPJS) yang dirawat inap pada kelompok PKV sebanyak 2.005 pasien, dengan total kunjungan sebanyak 2.561. Laki-laki lebih banyak dibandingkan perempuan, dengan rentang usia terbanyak 56-65 tahun. Lebih dari separuh pasien BPJS memanfaatkan fasilitas perawatan kelas 3 dengan rata-rata lama rawat sekitar 9 hari. Terbanyak pada tingkat keparahan penyakit I dan II. Jumlah pasien meninggal sebesar 16,06%. Kasus dan komorbid terbanyak adalah infark miokard akut dan diabetes melitus tipe 2. Sedangkan penyebab kematian utama adalah cardiac arrest tanpa diketahui penyebabnya. Dalam hal pembiayaan, rata-rata tarif RS lebih tinggi dari rata-rata tarif INA-CBG. Kesimpulan, kasus terbanyak PKV pada pasien JKN yang dirawat inap adalah infark miokard akut dengan tingkat keparahan pada level I dan II di RS Pemerintah tipe A, yang seharusnya ditangani oleh tipe RS lebih rendah. Diabetes melitus adalah komorbid utama dan cardiac arrest tanpa diketahui penyebabnya sebagai penyebab kematian tertinggi. Rata-rata tarif RS pada kasus PKV lebih tinggi dari tarif INA-CBG.
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