Key result
The average direct medical cost for 7 days of outpatient treatment for coronary heart disease (IDR 130,593) and heart failure (IDR 128,587) was within the INA-CBGs budget allocation of IDR 165,400.
Why the study?
It was uncertain whether the Indonesian Government's Jaminan Kesehatan Nasional health budget allocation sufficiently covers outpatient medical costs for long-term cardiovascular disease treatment.
Observational (n=390)
No
The INA-CBGs tariff generally covers the 7-day direct medical costs for outpatients with coronary heart disease and heart failure in an Indonesian public hospital, with medication being the largest cost driver.
Answers are grounded in this paper and cite their sources.
INA-CBGs tariffs cover average CHD/HF outpatient costs but exceed limits for some patients; leaves open whether refined tariffs or cost controls are needed.
Long-term treatment of cardiovascular disease may give impact in a high burden of medical cost for the patient. A concern arises whether the health budget allocation prepared by the Indonesian Government through "Jaminan Kesehatan Nasional" program is enough to cover medical cost for the outpatient treatment. This study aims to calculate the direct medical cost of patients with coronary heart disease and heart failure and compare it with the Indonesian Case Base Groups (INA-CBGs) tariff. This is a prospective and observational study carried out in one of the public hospitals in East Java between February and April 2015. All data related to outpatients with coronary heart disease and heart failure were analysed. Direct medical cost analysis in this study calculated from a combination of cost of medication, health professional services, electrocardiography, emergency care services, and laboratory test component, then it was compared with INA-CBGs tariff from ICD 10. Total of 390 patients included were 387 patients with coronary heart disease (99.23%) and three (3) patients with heart failure (0.77%). Average direct medical cost for patients with coronary heart disease and heart failure were IDR 130.593,6 (range IDR 50.282 – IDR 385.911) and IDR 128.587 (range IDR 112.832 – IDR 140.103), respectively. Even though this study showed that budget allocation of INA-CBGs could cover the average direct medical cost of patients with both of diseases, some patients had a direct medical cost higher than the limit of INA-CBGs allocation. Therefore, an optimal interprofessional collaboration between physician and pharmacist needed to provide medical treatment based on patient needs and keep it within budget allocation range.
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Kumalasari et al. (2019) conducted an observational in Coronary heart disease and heart failure (n=390). Outpatient treatment for coronary heart disease and heart failure vs. INA-CBGs tariff limit was evaluated on Average direct medical cost. The average direct medical cost for 7 days of outpatient treatment for coronary heart disease (IDR 130,593) and heart failure (IDR 128,587) was within the INA-CBGs budget allocation of IDR 165,400.
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