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All Journal Pharmaciana: Jurnal Kefarmasian JKKI : Jurnal Kedokteran dan Kesehatan Indonesia
Riana Prastiwi Handayani
Ahmad Dahlan University
Medicine & Pharmacology Public Health

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Cost-Effectiveness analisys on the implementation of clinical pathway of pediatric treatment for dengue hemorrhagic fever in PKU Muhammadiyah Hospital Yogyakarta Riana Prastiwi Handayani; Dyah Ariyani Perwitasari; Didik Setiawan; Auliya Abdurrohim Suwantika
Pharmaciana Vol 10, No 1 (2020): Pharmaciana
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (253.629 KB) | DOI: 10.12928/pharmaciana.v10i1.12332

Abstract

Dengue Hemorrhagic Fever (DHF) remains a concerning world problem especially in Indonesia. This problem particularly deals with therapeutic management of hospitalized children requiring DHF treatment. The current practice of therapeutic management is not in accordance with the standard therapeutic management, which increases the treatment cost. On this account, the application of a clinical pathway is expected to minimize the treatment cost and reduce the length of stay (LoS). However, prior to its the application, it is necessary to analyze the cost effectiveness of the implementation of clinical pathway on pediatric DHF treatment in PKU Muhammadiyah Hospital, Yogyakarta. A retrospective cohort study and cost-effectiveness analysis were applied in this study by considering hospital’s (provider) perspective. Two groups (conform to clinical pathway and not conform to clinical pathway group) were involved in this study. Data of direct medical costs of pediatric DHF treatment, which were suitable with clinical pathways and LoS during 2016-2017 period, were collected in this study. The Incremental Cost Effectiveness Ratio (ICER) between both groups and the Risk Ratio (RR) were calculated as the outcome.  The result confirmed that from 200 patients involved, the treatments of 138 patients (69 %) and 62 patients (31%) were included in the conformed to clinical pathway and not conformed to clinical pathway groups, respectively, with p value of 0,000 and RR of 1,58. The average costs were calculated to be Rp 1.144.024 + Rp 556.372 and Rp 1.989.723 + Rp 1.296.899 for conformity to clinical pathway and non-conformity to clinical pathway groups, respectively. The ICER was calculated to be Rp 826.917. In conclusion, the implementation of clinical pathway on pediatric DHF treatment in PKU Muhammadiyah Hospital, Yogyakarta could reduce LoS and the possibility of having a shorter LoS of up to 1.58 times, it can save cost of Rp 919.238 per one-day reduction in LoS.
Profile of Medication Variations and Dose Adjustment to Diabetes Mellitus Patients Response in PKU Muhammadiyah Hospital dan Panti Rapih Hospital period OctoberDecember 2014 Imaniar Noor Faridah; Dyah Aryani Perwitasari; Desty Kusumaningsih; Riana Prastiwi Handayani
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 9, No 1, (2018)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol9.Iss1.art8

Abstract

Background: Diabetes mellitus patients may have a different response tosimilar medication. Therefore, individualized treatment and monitoringof the therapy is needed to ensure the patients’ response. Alternativemedication or dose adjustment should be considered in order to achievethe therapeutic goal.Objective: The aim of this study was to find out patients’ response tomedication variation or dose adjustment.Methods: This study used descriptive design in PKU MuhammadiyahHospital and Panti Rapih hospital period October-December 2014.Participants are all patients who got pharmacological therapy for treatmentof diabetes mellitus type 2, including oral antidiabetics and/ insulin andmet the inclusion criteria. The response of therapy was checked 2 times,during check-in and check-out.Results: Analysis of response variation showed that individualizedresponse existed, in which positive response occurred in 10 patients andthe other had a negative response. The changes were dose adjustmentand medication alteration or medication addition. From 6 patients whoneeded medication adjusment, 5 patients had a positive response, andothers had a negative response. Whereas from 6 patients whose dosage ormedication was not changed, 5 of them had a positive response while onehad a negative response.Conclusion: Individualized treatment is needed to achieve a therapeuticgoal. Individualized treatment can be done through dose adjustment andmedication alteration, or medications addition.
Co-Authors Auliya Abdurrohim Suwantika Desty Kusumaningsih Didik Setiawan Dyah Ariyani Perwitasari Dyah Aryani Perwitasari Imaniar Noor Faridah