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All Journal JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice)
I Dewa Putu Pramantara
RSUP Dr. Sardjito Yogyakarta
Health Professions Medicine & Pharmacology Public Health

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COMPARISON THE REAL COST WITH INA-CBG’S PACKAGE TARIFF AND ANALYSIS ON THE FACTORS INFLUENCING THE REAL COST FOR DIEBETES MELLITUS INPATIENTS USING JAMKESMAS IN RSUP Dr. SARDJITO YOGYAKARTA Ratih Pratiwi Sari; Fita Rahmawati; I Dewa Putu Pramantara
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 3, No 1
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.95

Abstract

The problem usually found in the Jamkesmas (Society Health Insurance) realization is the difference between the real cost and INA-CBGs package tariff for patients using Jamkesmas, especially in inpatient department. This study was to find out how much the margin between the real cost and the INA-CBG’s package tariff and the factors influence the real cost, and to know the suitability of drug indications in diabetes mellitus inpatients using Jamkesmas in RSUP Dr. Sardjito Yogyakarta. This study was analytical observation. The data were taken retrospectively from the Jamkesmas claim files and patients’ medical record. Subjects were patients with diabetes mellitus type 2.The research object included the claim files and the medical record of the diabetes mellitus patients using Jamkesmas in RSUP Dr. Sardjito Yogyakarta during period of July 2010 – May 2012 with the diagnosis code INA-CBGs E-4-10-I, E-4-10-II, and E-4-10-III. The data were analyzed descriptively. Moreover, One sample test statistical analysis was conducted to find the difference between the real cost and INA-CBGs tariff and the ifference between hospital LOS and INA-CBGs package LOS. In addition,bivariate correlation test and regression linier test were used to study the relation among the factors that affect the real cost. The result of the study showed that the difference between the real costand INA-CBGs package tariff of the diabetes mellitus Jamkesmas patients with the severity level I was Rp 5,325,126 in 2 episodes of cares; severity level II was Rp -22,411 in 10 episodes of care, and severity level III was Rp -3,038,240 in 12 episodes of care. The factors that affect the real cost of treatment of patients with the severity level II were cost of clinical pathology examination, blood, and drug/medical cost, while in patient with severity level III werethe cost of visite, service in dialysis department, clinical pathology examination and drug/medical cost. From the analysis between the used drug and indication, it was found that 22 episodes of care was appropriate with the diagnosis and 2 episodes of care was not fit with the diagnosis.Keywords: Jamkesmas, INA-CBG’s, diabetes mellitus, cost components, indication of suitability
ESTIMATED LEVELS OF PHENYTOIN IN BLOOD AND RESULTS THERAPY OF EPILEPSY PATIENTS Satrio Wibowo Rahmatullah; Lukman Hakim; I Dewa Putu Pramantara
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 3, No 2
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.111

Abstract

Medicines with a narrow therapeutic range such as phenytoin require individual dose, monitoring, and strict assessment of the patient to maintain the safety of the patient. It is because small changes in systemic concentration can lead significant changes in the pharmacodynamic responses, such as subtherapeutic or toxic. This study aimed to determine the relationship between dose and phenytoin levels in the blood included clinical outcome of patients with epilepsy based on the duration of seizure-free at the Sleman Regional General Hospital, Yogyakarta. This study was a descriptive observational study. The sampling method was purposive sampling. The data was collected retrospectively on epilepsy patients with phenytoin treatment both inpatient and outpatient from January 2010 to December 2012, male or female who were routinely controlled for at least 6 consecutive months. Patients were grouped into monotherapy and combination therapy groups. Clinical outcome was observed through the duration of the seizure-free and devided into 2 categories i.e. < 6 months (poor outcome) and ≥ 6 months (a good outcome). The results showed that male (53.6%) have a greater percentage than female (46.4%). Estimated blood levels of phenytoin was in the average 5.30±4.03 mg/L. Based on the duration of seizure free, the results showed that the percentage of patients in monotherapy group had good and poor outcomes with 71.83% and 28.17% respectively, while only 50% patients in combination therapy group had good outcome.Keywords: phenytoin, epilepsy, nonlinear, clinical outcome
EVALUATION OF VALPROIC ACID DOSE USED FOR PAEDIATRIC WITH EPILEPSY Herningtyas Nautika Lingga; Lukman Hakim; I Dewa Putu Pramantara
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 3, No 2
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.112

Abstract

Epilepsy is a chronic disease in neurology and the second most common disorder after stroke. Valproic acid is categorised to the medicine with a narrow therapeutic index which requires monitoring of plasma drug levels and dose adjustments to prevent toxic effects. This study aimed to determine the estimated value of valproic acid concentration in serum and clinical outcomes in paediatric patients with epilepsy observed from seizure-free duration at Sleman Regional General Hopital, Yogyakarta. This study was a retrospective study with descriptive observational design. Subjects were paediatric patients with epilepsy who received valproic acid treatment over the period of January 2010-December 2012, 1 to 18 years old, boys or girls who were routinely controlled for at least 6 consecutive months. Clinical outcomes were observed through the duration of the seizure-free which were devided into 2 categories i.e. <6 months (unfavorable outcome), and ≥ 6 months (a good outcome). The proportion of 99 patients who met the inclusion criteria were 27.28% less than or equal to 5 years old, whereas 5-12 years and 12-18 years age groups had the same percentage which was 36.36%. From the calculation, average estimated value of valproic acid concentrations in serum for girls group were as much as 86.32±49.25 mg/L and 33.26±22.06 mg/L, while in boys group were as much as 94.91±44.72 mg/L and 38.57±20.72 mg/L. Based on the duration of seizure free, clinical outcome showed that the percentage of patients in monotherapy group had good and poor outcomes with 52.33% and 46.67% respectively, while 61.54% and 38.46% of patients in polytherapy group had good and poor outcome respectively.Keywords: Epilepsy, Valproic Acid, Clinical Outcome, Paediatric
Co-Authors Herningtyas Nautika Lingga Lukman Hakim Rahmatullah, Satrio Wibowo Rahmawati, Fita Ratih Pratiwi Sari