The Comparison of Survival, and Cost Effectiveness of Geriatric Patients Admitted in Dr. Cipto Mangunkusumo Hospital Before and During National Health Insurance Program Implementation

Czeresna Heriawan Soejono • Paskalis Gunawan
Journal article eJournal Kedokteran Indonesia • December 2017 Indonesia

Abstract

Comprehensive Geriatrics Assessment (CGA) has been proven to improve the overall outcome of geriatric patients care, and has been implemented in RSCM as the standard geriatric medical care. National Health Insurance Program (NHIP) was implemented in Indonesia in January 2014. It is unclear how NHI program will affect survival and cost effectiveness of geriatric patients receiving CGA. The aim of this study was to compare the survival and cost effectiveness between geriatric patients hospitalized during NHIP and before NHIP era in RSCM. This was a retrospective cohort study with historical control. The subjectswere geriatric inpatients aged ≥60 years old with one or more geriatric giants between July to December 2013 (non NHIP) and January to June 2014 (NHIP). A survival analysis and determination of incremental costeffectiveness ratio (ICER) was used to compare the survival and cost-effectiveness between the two groups. The clinical and demographic characteristics were relatively similar between the NHIP and non NHIP group. No difference in mortaliy rate during hospital care and 30 days survival rate between NHIP and non NHIP group (31.2% vs 28%, p=0.602; 65.2% vs 66.4%, p = 0.086, respectively).  No significant difference was found in the survival curve between the two groups. Calculation of ICER showed that NHIP was associated with an increased cost of 1.4 million rupiah and 1.2 % higher mortality rate. Further research is needed to evaluate this result when NHI Program has been implemented for a longer duration.

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eJournal Kedokteran Indonesia

eJournal Kedokteran Indonesia (eJKI) adalah jurnal resmi Fakultas Kedokteran Universitas Indonesi... see more