Jurnal SINTA 1
Clinical Outcomes of Geriatric Care in Cipto Mangunkusumo Hospital, Before and After the Implementation of National Health Insurance Program
ACTA MEDICA INDONESIANA · Vol. 49 No. 4 (2018)
- ISSN
- 2338-2732, 0125-9326
- Terbit
- 2018-01-19
- Penerbit
- The Indonesian Society of Internal Medicine
- Bahasa
- eng
Abstrak
Background: the National Health Insurance (NIH/JKN) has been enacted since January 2014. Various outcomes of geriatric patient care, such as improved functional status and quality of life have not been evaluated. Prolonged hospitalization and re-hospitalization are potentially affecting the efficiency care of this vulnarable group. This study aimed to identify the differences of functional status improvement, quality of life improvement, length of stay, and hospitalization of geriatric patients admitted to CMH between prior to and after NHI implementation.Methods: a cohort study with historical control was conducted among geriatric patients admitted to Acute Geriatric Ward CMH Hospital on two periods of time: January-December 2013 (pre-NHI implementation) and June 2014-May 2015 (after NHI implementation). Patients who died within 24 hours of hospital admission, those with APPACHE II score >24, advance stage cancer, transfer to other wards before they were discharged or have incomplete record were excluded from the study. Data on demographical and clinical characteristics, functional status, quality of life, length of stay, and re-hospitalization were taken from patient’s medical record. The differences of studied outcomes were analyzed using t-test or Mann-Whitney test.Results: there were 102 subjects in pre-NHI and 135 subjects in NHI groups included in the study. Median lengths of stay were not different between two groups (12.5 days in pre-NHI and 10 days in NHI groups, p=0.087), although the proportion of patients with in-hospital stay less than 14 days was higher in NHI group. The difference of functional status of discharged patients in pre-NHI and NHI groups were 3 and 3 (p=0.149) respectively, whereas for health-related quality of life, although NHI group in the beginning showed a lower quality of life compared to the pre-NHI (0.163 [0.480] vs. 0.243 [0.550]; p=0.012). However, after incorporating comprehensive geriatric assessment (CGA) the quality of life improved significantly by the end of in-hospital care in both groups. Re-hospitalization incidence in NHI group was lower compared to pre-NHI (7 [5.2%] vs. 13 [12.7%]; p=0.038).Conclusion: our study shows that there was no significant difference regarding length of stay, functional status, and health-related quality of life between prior to and after national health insurance implementation on admitted geriatric patients. Rehospitalization incidence showed better results in NHI group and hence NHI implementation is favored.
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- Universitas Gadjah Mada
- National Research and Innovation Agency
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| Rekan penulis | Organisasi | Artikel bersama |
|---|---|---|
| Aulia Rizka | Afiliasi tidak diketahui | 2 |
| Kuntjoro Harimurti | Afiliasi tidak diketahui | 2 |
| Arum Wiratri | Universitas Gadjah Mada | 1 |
| Hamzah Shatri | Afiliasi tidak diketahui | 1 |
| Cosphiadi Irawan | Afiliasi tidak diketahui | 1 |
| Rudi Putranto | Afiliasi tidak diketahui | 1 |
| Ratih Arianita Agung | Afiliasi tidak diketahui | 1 |
| Eric Daniel Tenda | Afiliasi tidak diketahui | 1 |
| Mira Yulianti | National Research and Innovation Agency | 1 |
| Ceva Wicaksono Pitoyo | Afiliasi tidak diketahui | 1 |
| Joshua Henrina | Afiliasi tidak diketahui | 1 |
| Andry Setiadharma | Afiliasi tidak diketahui | 1 |
| Raden Fidiaji Hiltono Santoso | Afiliasi tidak diketahui | 1 |
| Siti Setiati | Afiliasi tidak diketahui | 1 |
| Sri Sunarti | Afiliasi tidak diketahui | 1 |
| Roza Mulyana | Afiliasi tidak diketahui | 1 |
| Rensa Rensa | Afiliasi tidak diketahui | 1 |
| Muhammad Khifzhon Azwar | Afiliasi tidak diketahui | 1 |
| Jessica Marsigit | Afiliasi tidak diketahui | 1 |
| Rahmi Istanti | Afiliasi tidak diketahui | 1 |
| IGP Suka Aryana | Afiliasi tidak diketahui | 1 |
| Fatichati Budiningsih | Afiliasi tidak diketahui | 1 |
| Lazuardhi Dwipa | Afiliasi tidak diketahui | 1 |
| Agus Sudarso | Afiliasi tidak diketahui | 1 |
| Yudo Murti Mupangati | Afiliasi tidak diketahui | 1 |
| Henry Setyawan | Afiliasi tidak diketahui | 1 |
| Muhammad Hussein Gasem | Afiliasi tidak diketahui | 1 |
| Ignatius Riwanto | Afiliasi tidak diketahui | 1 |
| Rahmat Cahyanur | Afiliasi tidak diketahui | 1 |
| Findy Prasetyawaty | Afiliasi tidak diketahui | 1 |
| Defriana Lutfi Chusnaifah | Universitas Gadjah Mada | 1 |
| Iva Fitriana | Universitas Gadjah Mada | 1 |
| Indah Nurhayati | Universitas Gadjah Mada | 1 |
| Budi Arianto | Universitas Gadjah Mada | 1 |
| Indira Diah Utami | Universitas Gadjah Mada | 1 |
| Nabhela Ayu Purwaningrum | Universitas Gadjah Mada | 1 |
| Utari Saraswati | Universitas Gadjah Mada | 1 |
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