ANALISIS BIAYA MEDIS LANGSUNG PASIEN RAWAT INAP BEDAH UROLOGI DI RSUD KOTA YOGYAKARTA

Authors

  • Yanti Fitriani Feangi Magister Farmasi Klinik Komunitas, Universitas Ahmad Dahlan Yogyakarta
  • Woro Supadmi Fakultas Farmasi Universitas Ahmad Dahlan Yogyakarta
  • Adriyanto Rochmad Basuki Rumah Sakit Umum Daerah Kota, Yogyakarta
  • Susi Ari Kristina Fakultas Farmasi Universitas Gadjah Mada, Yogyakarta

DOI:

https://doi.org/10.36387/jiis.v10i2.2657

Keywords:

urological surgery, direct medical cost, INA-CBG’s

Abstract

Urological surgical procedures, such as urolithiasis and benign prostatic hyperplasia (BPH), continue to increase with high recurrence rates. Limited treatment facilities and the risk of antibiotic resistance can affect the cost burden. This study aims to determine the alignment of direct medical costs with INA-CBG’s claim rates and to identify variables influencing total direct medical costs. The study employs an observational approach with a retrospective design. Samples were selected using purposive sampling with inclusion criteria. Data were collected from electronic medical records and financial reports. Direct medical costs were calculated based on all cost components using a hospital perspective approach. Data analysis used univariate, bivariate, and multivariate tests. The average total direct medical costs for urology patients were Rp 9,962,325 ± Rp 1,699,707.79, while the INA-CBG’s claim rates were Rp 9,600,328 ± Rp 1,853,291.26. There were differences in direct medical costs based on age (p-value 0.024), care class (p-value 0.035), and length of stay (LOS) (p-value 0.000). Regression analysis shows that LOS and care class have a statistically significant impact on total direct medical costs (p-value < 0.05). There is a difference between the actual costs borne by the hospital and the INA-CBG’s claim rates.

Author Biographies

  • Yanti Fitriani Feangi, Magister Farmasi Klinik Komunitas, Universitas Ahmad Dahlan Yogyakarta

    Pharmacist

  • Woro Supadmi, Fakultas Farmasi Universitas Ahmad Dahlan Yogyakarta

    Faculty of Pharmacy

  • Adriyanto Rochmad Basuki, Rumah Sakit Umum Daerah Kota, Yogyakarta

    Pharmacist

  • Susi Ari Kristina, Fakultas Farmasi Universitas Gadjah Mada, Yogyakarta

    Faculty of Pharmacy

References

Ahmad, M., Arsalan, Chaudhary, B., Rehman, A. U., Khan, F., & Sultan, A. (2023). Protocol based Surgical Antimicrobial Prophylaxis in Endo-Urologic Surgeries: An Attempt to Convince the Surgeons to Follow the Guidelines. Journal of Pure and Applied Microbiology, 17(1), 627–635. https://doi.org/10.22207/JPAM.17.1.60

Asali, M. (2022). Sheathed flexible retrograde intrarenal surgery without safety guide wire for upper urinary tract stones. Archivio Italiano Di Urologia e Andrologia, 94(2), 186–189. https://doi.org/10.4081/aiua.2022.2.186

Asmarawati, T. P., Djojodimedjo, T., Andhika, D. P., Rusli, M., Qibtiyah, M., Mahdi, B. A., Novendrianto, D., Martani, O. S., Paraton, H., Wertheim, H., & Kuntaman, K. (2023). The use of antibiotic prophylaxis in patients undergoing urologic procedures in an academic hospital Surabaya: A retrospective study. Journal of Infection in Developing Countries, 17(6), 874–880. https://doi.org/10.3855/jidc.17180

Bal, D. S., Chung, D., Dhillon, H., Fidel, M., Shah, J., Pandian, A., Nayak, J. G., & Patel, P. (2024). The safety and efficacy of ambulatory urologic surgery. Canadian Urological Association Journal, 18(12), 398. https://doi.org/10.5489/cuaj.8806

Bratzler, D. W., Dellinger, E. P., Olsen, K. M., Perl, T. M., Auwaerter, P. G., Bolon, M. K., Fish, D. N., Napolitano, L. M., Sawyer, R. G., Slain, D., Steinberg, J. P., & Weinstein, R. A. (2013). Clinical practice guidelines for antimicrobial prophylaxis in surgery. American Journal of Health-System Pharmacy, 70(3), 195–283. https://doi.org/10.2146/ajhp120568

Cardoso, R. B., Marcolino, M. A. Z., Marcolino, M. S., Fortis, C. F., Moreira, L. B., Coutinho, A. P., Clausell, N. O., Nabi, J., Kaplan, R. S., Etges, A. P. B. da S., & Polanczyk, C. A. (2023). Comparison of COVID-19 hospitalization costs across care pathways: a patient-level time-driven activity-based costing analysis in a Brazilian hospital. BMC Health Services Research, 23(1), 1–11. https://doi.org/10.1186/s12913-023-09049-8

Elmaboud.A, A. M., Abd-ellateef, E. A., Elhalwagy, A. M., Hamoudy, A., & Hashem, H. (2025). Ondansetron versus Pregabalin in Control Emetic Attacks during Surgery with Spinal Anesthesia: Review Article. The Egyptian Journal of Hospital Medicine, 99(1), 2173–2178. https://doi.org/10.21608/ejhm.2025.430877

Goller, A. A. W., & Telussa, A. S. (2021). Fresh Graduate Urologist in Eastern Indonesia: First Year Surgery Experience. Indonesian Journal of Urology, 28(1), 66–73. https://doi.org/10.32421/juri.v28i1.677

Hadibrata, E., Farishal, A., Ali, Z., & Danarto, R. (2021). Tamsulosin and Sodium Diclofenac as an Effective Therapy to Reduce Pain After Ureteral Stent Removal: A Prospective, Double Blinded Randomized Placebo Controlled Trial. Urology Journal, 18(1), 111–116. https://doi.org/https://doi.org/10.22037/uj.v18i01.5190

Jannah, M. K., & Firmanda, D. (2022). Perbandingan Ondansetron Dan Ranitidin Untuk Hilangkan Rasa Mual Muntah Post Operasi Di Rumah Sakit Yosua Lubuk Pakam Tahun 2021. Jurnal Kedokteran Ibnu Nafis, 11(2), 88–91. https://doi.org/10.30743/jkin.v11i2.302

Kemenkes. (2021). Pedoman Penggunaan Antibiotik (Permenkes, Issue 217). Kemenkes Republik Indonesia. https://farmalkes.kemkes.go.id/unduh/permenkes-28-2021/

Kemenkes RI. (2023). Peraturan Menteri Kesehatan Republik Indonesia Nomor 3 Tahun 2023 Tentang Standar Tarif Pelayanan Kesehatan Dalam Penyelenggaraan Program Jaminan Kesehatan. In Handbook. https://peraturan.bpk.go.id/Details/275518/permenkes-no-3-tahun-2023

Kranz, J., Bartoletti, R., Bruyère, F., Cai, T., Geerlings, S., Köves, B., Schubert, S., Pilatz, A., Veeratterapillay, R., Wagenlehner, F. M. E., Bausch, K., Devlies, W., Horváth, J., Leitner, L., Mantica, G., Mezei, T., Smith, E. J., & Bonkat, G. (2024). European Association of Urology Guidelines on Urological Infections: Summary of the 2024 Guidelines. European Urology, 86(1), 27–41. https://doi.org/10.1016/j.eururo.2024.03.035

Lightner, D. J., Wymer, K., Sanchez, J., & Kavoussi, L. (2020). Best Practice Statement on Urologic Procedures and Antimicrobial Prophylaxis. Journal of Urology, 203(2), 351–356. https://doi.org/10.1097/JU.0000000000000509

Lukito, J. I. (2019). Antibiotik Profilaksis pada Tindakan Bedah. Analisis-Cermin Dunia Kedokteran, 46(12), 777–783. https://doi.org/https://doi.org/10.55175/cdk.v46i12.398

Mahardika, I. G. A. P. D., Nita, Y., & Priyandani, Y. (2024). A comparative study of real hospital costs and INA-CBG rates for stroke in Indonesia. Pharmacy Education, 24(3), 166–172. https://doi.org/10.46542/pe.2024.243.166172

Manuba, Ratih, W., & Dwiprahasto, I. (2006). Faktor risiko Klinik pada Tindakan Pembedahan Urologi di Unit Bedah Sentral Badan Rumah Sakit Umum Tabanan. In Jurnal Universitas Gadjah Mada (Vol. 37). https://etd.repository.ugm.ac.id/penelitian/detail/29672

Mu, Y., Edwards, J. R., Horan, T. C., Berrios-Torres, S. I., & Fridkin, S. K. (2011). Improving Risk-Adjusted Measures of Surgical Site Infection for the National Healthcare Safely Network. Infection Control & Hospital Epidemiology, 32(10), 970–986. https://doi.org/10.1086/662016

Mucha, L., Hoppe, B., Silber, A., Wang, Z., Miyasato, G., Skaar, J. R., & Langman, C. (2022). Clinical and economic impact of primary hyperoxaluria: a retrospective claims analysis. Journal of Managed Care & Specialty Pharmacy, 28(3), 316–323. https://doi.org/10.18553/jmcp.2022.28.3.316

Noer, T. M. S., Pribadi, F., & Dion, A. (2024). Clinical Benefits of Ketorolac in Postoperative Pain Control Management: A Comprehensive Review. AVERROUS: Jurnal Kedokteran Dan Kesehatan Malikussaleh, 10(1), 35–45. https://doi.org/10.29103/averrous.v10i1.14909

Odah, A., Alhusban, H., Kaff, A. A., Alkhawaldeh, F., Alwraikat, S., & Alshoufeen, S. (2023). Proper Timing for Administration of Prophylactic Intravenous Antibiotics for Elective Surgical Procedures. SAS Journal of Surgery, 9(04), 309–314. https://doi.org/10.36347/sasjs.2023.v09i04.017

Ortner, G., Mavridis, C., Bouchalakis, A., Nakou, M. C., Yuan, Y., Nagele, U., Mamoulakis, C., Herrmann, T. R. W., Biyani, C. S., Tokas, T., & Kailavasan, M. (2025). The incidence and classification of intraoperative adverse events in urological surgery: a systematic review. World Journal of Urology, 43(1), 129. https://doi.org/10.1007/s00345-025-05509-4

Pai, U. A., Kesavelu, D., Shah, A. K., Manglik, A. K., Wadhwa, A., Acharya, B., Goyal, D., Bharadia, L., Verma, L., Franklyn, N., Shah, R. C., H. R., S., & Bhattacharyya, S. (2022). Ranitidine use in pediatrics: current evidence-based review and recommendations. International Journal of Contemporary Pediatrics, 9(10), 987. https://doi.org/10.18203/2349-3291.ijcp20222434

Raheem, O. A., Khandwala, Y. S., Sur, R. L., Ghani, K. R., & Denstedt, J. D. (2017). Burden of Urolithiasis: Trends in Prevalence, Treatments, and Costs. European Urology Focus, 3(1), 18–26. https://doi.org/10.1016/j.euf.2017.04.001

Riedinger, C. B., Fantus, R. J., Matulewicz, R. S., Werntz, R. P., Rodriguez, J. F., & Smith, N. D. (2019). The impact of surgical duration on complications after transurethral resection of the prostate: an analysis of NSQIP data. Prostate Cancer and Prostatic Diseases, 22(2), 303–308. https://doi.org/10.1038/s41391-018-0104-3

Riyanto, R. D. S., Endarti, D., & Nugroho, A. E. (2024). Analisis Kesesuaian Biaya Medis Langsung Terhadap Tarif INA-CBGs Pada Pengobatan Pasien Bedah Digestif Di Rawat Inap RSUD Undata. Generics: Journal of Research in Pharmacy, 4(1), 181–189. https://doi.org/https://doi.org/10.14710/genres.v4i1.22497

Sari, S., Suhada, Z., & Triagustini, T. (2023). Cost of illness pasien gagal ginjal kronis di Rumah Sakit Umum Daerah Arifin Achmad Provinsi Riau. Jurnal Ilmiah Farmasi, 19(2), 113–125. https://doi.org/https://doi.org/10.20885/jif.vol19.iss2.art10

Sarjito, A. (2024). Dampak Kemiskinan Terhadap Akses Pelayanan Kesehatan Di Indonesia. Journal Ilmu Sosial, Politik Dan Pemerintahan, 13(1), 397–416. https://doi.org/10.37304/jispar.v13i1.10520

Schulz, C., Becker, B., Netsch, C., Herrmann, T. R. W., Gross, A. J., Westphal, J., Knoll, T., & König, H.-H. (2022). Outcomes and costs of ureteroscopy, extracorporeal shockwave lithotripsy, and percutaneous nephrolithotomy for the treatment of urolithiasis: an analysis based on health insurance claims data in Germany. World Journal of Urology, 40(3), 781–788. https://doi.org/10.1007/s00345-021-03903-2

Shemesh, A., Raz, O., Goldberg, H., Cooper, A., & Golomb, D. (2024). Exploring the economic landscape of ureteric stones: impact of age and gender on direct healthcare costs. Urolithiasis, 52(1), 79. https://doi.org/10.1007/s00240-024-01584-1

Silalahi, M. K. (2020). Faktor-Faktor yang Berhubungan Dengan Kejadian Penyakit Batu Saluran Kemih Pada di Poli Urologi RSAU dr. Esnawan Antariksa. Jurnal Ilmiah Kesehatan, 12(2), 205–212. https://doi.org/10.37012/jik.v12i2.385

Solange, M., Figueroa, M., Marina, A., Carrillo, P., Steeven, K., & Rios, E. (2024). Urolitiasis: epidemiología, diagnóstico y manejo Urolithiasis: epidemiology, diagnosis and management. Ibero-American Journal of Health Science Research, 4(2), 352–359. https://health.iberojournals.com/index.php/IBEROJHR/article/view/682

Stamatelou, K., & Goldfarb, D. S. (2023). Epidemiology of Kidney Stones. Healthcare, 11(3), 424. https://doi.org/10.3390/healthcare11030424

Sukarni, M. H. (2024). Karakteristik Pasien Urologi Rsud Undata Provinsi Sulawesi Tengah Tahun 2021 - 2023. Journal of Afiyah Health Research (JAHR), 5(1), 248–253. https://doi.org/https://doi.org/10.52103/jahr.v5i1.1731

Sunayya, M. M. (2024). Analisis Perbedaan Tarif Riil Rumah Sakit Dengan Tarif INA CBG’S Di Rumah Sakit X Ponorogo Pada Semester Pertama Tahun 2024. Journal Of Social Science Research, 4, 7609–7621. https://j-innovative.org/index.php/Innovative

Tjahjodjati, I. S., Noegroho, B. S., & Sihombing, A. T. (2021). Urinary Tract Stones Risk Factors in Patients with Benign Prostatic Hyperplasia in West Java, Indonesia. Althea Medical Journal, 8(2), 93–98. https://doi.org/10.15850/amj.v8n2.2257

Varghese, J., Chang, D. L., Mirman, B. D., Capodice, J., & Shehebar, M. (2024). Acute and Chronic Pain Management of the Urologic Patient. International Journal of Anesthesia and Critical Care, 3(1), 6–16. https://doi.org/10.33696/Anesthesia.3.008

Wang, A., Shen, J., Rodriguez, A. A., Saunders, E. J., Chen, F., Janivara, R., Darst, B. F., Sheng, X., Xu, Y., Chou, A. J., Benlloch, S., Dadaev, T., Brook, M. N., Plym, A., Sahimi, A., Hoffman, T. J., Takahashi, A., Matsuda, K., Momozawa, Y., … Haiman, C. A. (2023). Characterizing prostate cancer risk through multi-ancestry genome-wide discovery of 187 novel risk variants. Nature Genetics, 55(12), 2065–2074. https://doi.org/10.1038/s41588-023-01534-4

Wulansari, C., Ambarasti, H., D, N. A., & Ernawati, E. (2024). Resiko Finansial Impelementasi Tarif INA-CBGs Pelayanan Medis Spesialis Dasar Pasien BPJS Kesehatan Kelas III RSU X. Malahayati Nursing Journal, 6(9), 3734–3752. https://doi.org/10.33024/mnj.v6i9.13596

Published

2025-10-31

How to Cite

ANALISIS BIAYA MEDIS LANGSUNG PASIEN RAWAT INAP BEDAH UROLOGI DI RSUD KOTA YOGYAKARTA. (2025). JIIS (Jurnal Ilmiah Ibnu Sina): Ilmu Farmasi Dan Kesehatan, 10(2), 155-168. https://doi.org/10.36387/jiis.v10i2.2657

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