国家健康保险实施后2型DM合并高血压患者参加puskemas慢性病管理项目(PROLANIS)的处方费用分析

Arifin Santoso, I. Sulistyaningrum, Hesti Dwi Widaryanti, Kusuma Arbianti, Chilmia Nurul Fatiha, Elmiawati Latifah
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摘要

为改善公共卫生状况,实施卫生领域的社会保障项目,政府开始实施国民健康保险。该项目采用一级卫生设施卫生中心实行的人头制,为参与者支付医疗费用。在实施国家健康保险后,Kesehatan以人头率的形式向高血压和2型糖尿病患者的一级保健设施分配了一些预算。本研究在Lamper Tengah保健中心、Mangkang保健中心、Mijen保健中心和Karanganyar保健中心4个保健中心进行。这些数据是从800名患者的医疗记录中回顾性收集的。对数据进行描述性分析以确定处方成本,并采用Spearman's rho检验找出影响处方成本的因素。结果显示,2型糖尿病患者的平均处方费用为142,293印尼盾,高血压患者的平均处方费用为112,735印尼盾。Prolanis项目涵盖的2型糖尿病患者的处方模式是格列美脲、二甲双胍联合用药,药价为20,670印尼卢比。影响处方费用的因素为诊断p= 0.033、药品种类(p= 0.000)和药品项目(p= 0.000)。本研究认为,影响三宝垄市卫生中心Prolanis患者药费的因素是患者的诊断、给药种类和给药项目数。
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PRESCRIPTION COST ANALYSIS IN PATIENTS OF TYPE 2 DM AND HYPERTENSION JOINING CHRONIC DISEASE MANAGEMENT PROGRAM (PROLANIS) AT PUSKESMAS AFTER THE IMPLEMENTATION OF NATIONAL HEALTH INSURANCE
To improve the status of public health and carry out social security programs in the health sector, the government started to implement the National Health Insurance. This program covers the participants’ medical care expenses using the capitation system applied in health centers as the First-Level Health Facilities. BPJS Kesehatan has allocated some budget in the form of a capitation rate to first-level health facilities for hypertension and type 2 diabetes mellitus patients after the implementation of National Health Insurance. This research was carried out in 4 health centers, namely Lamper Tengah Health Center, Mangkang Health Center, Mijen Health Center, and Karanganyar Health Center. The data were collected retrospectively from the medical records of 800 patients. The data were analyzed descriptively to determine the prescription cost and Spearman's rho test was used to find the factors that influence the prescription cost. It was revealed that the average prescription cost for type 2 DM patients was IDR 142,293, and for hypertensive patients was IDR 112,735. The prescribing pattern in patients covered by Prolanis program for type 2 DM patients is a combination of glimepiride, metformin with a drug price of IDR 20,670. Factors that have an influence on prescription costs are diagnosis p= 0.033, type of drug (p= 0.000) and drug item (p= 0.000). This study concludes that the factors to influence the drug costs of Prolanis patients at the health centers of Semarang City were the patient's diagnosis, the type of drug given, and the number of drug items given.
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