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All Journal Medula Jurnal Ilmu Kedokteran dan Kesehatan Jurnal Jaminan Kesehatan Nasional
Kylalona, Gracylia
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Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Literature Review: Faktor-Faktor Penyebab Kejadian Rehospitalisasi Pada Pasien Congestive Heart Failure (CHF) Kylalona, Gracylia; Suri, Nurma; Aulia Ramdini, Dwi; Sukohar, Asep
Medula Vol 14 No 3 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i3.1039

Abstract

Congestive Heart Failure (CHF) is a health disorder with a poor prognosis due to functional or structural heart defects that interfere with ventricular filling or blood ejection into the systemic circulation. CHF remains a significant global health concern with high rates of morbidity and mortality. The number of diagnosed CHF leading to frequent rehospitalization or re-admission due to symptom recurrence. Patients who experience readmitted to the hospital after initial admission have a risk of mortality, with about 50% dying within 6 months and 25-35% passing away within 12. In this review focuses on exploring the factors contributing to rehospitalization among CHF patients. The methodolgy involved analyzing electronic database for relevant studies published over the past decade. Factors identified as leading to rehospitalization in CHF patients include a history of hypertension, non-compliance with taking medication, and an unhealthy lifestyle. Pharmacists play an important role in providing education to patients and helping to fulfill patient medication compliance.
Analysis of Factors Affecting Medical Cost and Insurance Reimbursement Gaps in Hypertension Heart Failure Patients Suri, Nurma; Kylalona, Gracylia
Jurnal Jaminan Kesehatan Nasional Vol. 5 No. 1 (2025): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v5i1.303

Abstract

Hypertension with congestive heart failure (CHF) results in high disease-related costs, placing a burden on patients, families, and healthcare facilities. Direct medical costs are known to be the highest proportion. This study aims to identify factors associated with direct medical costs in patients with hypertension and CHF and the difference in payment amounts compared to insurance reimbursements. This research uses a cross-sectional design at Hospital X in Lampung Province. The study population consists of patients diagnosed with hypertension and CHF within the period 2020-2022, with samples selected using total sampling. From 101 samples, the total direct medical cost for all cost components was IDR 908,700,216, with an average direct medical cost of IDR 8,997,032. The highest cost component was cardiac catheterization, with a total IDR of 473,081,000 and an average IDR of 36,390,846. The lowest cost component was additional medical expenses, with a total IDR 16,348,780 and an average IDR 166,824. Bivariate analysis showed a significant relationship between direct medical costs and length of hospital stay, insurance classes, and comorbid conditions. In addition, bivariate analysis showed a significant difference between direct medical costs and insurance reimbursement, with a positive discrepancy of IDR 4.437.619. This study concludes that length of stay, insurance classes, and comorbidities are significantly associated with direct medical costs. There is also a significant difference between direct medical costs and the amount of insurance reimbursement.
Evaluasi Efektivitas Biaya Penambahan Bisoprolol Dalam Kombinasi Terapi Antihipertensi Pada Pasien Hipertensi Dengan Komorbid Congestive Heart Failure Kylalona, Gracylia; Suri, Nurma; Ramdini, Dwi Aulia; Sukohar, Asep
Jurnal Ilmu Kedokteran dan Kesehatan Vol 12, No 8 (2025): Volume 12 Nomor 8
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v12i8.18530

Abstract

Hipertensi merupakan penyakit yang dikaitkan dengan konsekuensi sosial dan ekonomi khususnya di negara berpendapatan rendah dan menengah. Penelitian ini bertujuan untuk mengetahui cost effectiveness dari 2 pilihan antihipertensi yang paling dibanyak digunakan pasien hipertensi dengan penyakit penyerta congestive heart failure (CHF). Sampel terdiri dari seluruh pasien rawat inap dengan diagnosis hipertensi dan CHF selama periode 2020–2022, yang dipilih melalui metode total sampling. Analisis efektivitas biaya (Cost-Effectiveness Analysis/CEA) dilakukan dengan menggunakan perspektif rumah sakit, mencakup perhitungan biaya medis langsung dan luaran klinis berupa penurunan tekanan darah sistolik dan diastolik. Regimen yang dibandingkan adalah Terapi A (kombinasi furosemide, ramipril, dan spironolakton) dan Terapi B (kombinasi bisoprolol, furosemide, ramipril, dan spironolakton). Hasil penelitian menunjukkan bahwa dari 45 sampel yang diperoleh, nilai Average Cost-Effectiveness Ratio (ACER) pada Terapi A lebih rendah dibandingkan Terapi B. Nilai ACER Terapi A untuk penurunan tekanan darah sistolik dan diastolik masing-masing sebesar Rp212.395/mmHg dan Rp346.948/mmHg, dengan nilai p sebesar 0,46 dan 0,424 secara berurutan. Sementara itu, nilai Incremental Cost-Effectiveness Ratio (ICER) Terapi A dibandingkan Terapi B untuk tekanan darah sistolik sebesar Rp425.476/mmHg dan untuk tekanan darah diastolik sebesar Rp402.478/mmHg. Kesimpulan dari penelitian ini adalah bahwa Terapi A lebih cost-effective dibandingkan Terapi B, meskipun tidak terdapat perbedaan yang signifikan secara statistik pada nilai ACER antara kedua pilihan terapi.
Co-Authors Asep Sukohar Aulia Ramdini, Dwi Ramdini, Dwi Aulia Suri, Nurma