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Cost-Effectiveness Analysis of Multidisciplinary Care in Chronic Heart Failure: Insights from an Indonesian Tertiary Hospital

ACTA MEDICA INDONESIANA · Vol. 58 No. 3 (2026)

ISSN
2338-2732, 0125-9326
Terbit
2026-09-28
Penerbit
The Indonesian Society of Internal Medicine
Bahasa
eng
Lisensi
creativecommons.org/licenses/by/4.0

Abstrak

Background: Chronic heart failure (CHF) is the leading cause of morbidity and healthcare expenditure in Indonesia, largely due to recurrent hospitalizations. Multidisciplinary Programs (MDSs) have been introduced to provide clinical and economic advantages by reducing hospitalizations. This study aimed to compare direct medical cost trajectories between patients managed under MDP and standard care (SC) at a tertiary referral hospital. Methods: The retrospective cohort study was conducted at Dr. Cipto Mangunkusumo National Hospital and included 189 patients with CHF who completed at least eight consecutive outpatient visits. Patient demographics, clinical data, and direct medical costs were obtained from medical records and hospital billing data. Results: Patients in the MDP group were younger (median age 55 vs 60 years) and had a more frequent ischemic etiology compared with SC. Outpatient costs were higher in MDP, mainly due to medications and consultation fees, while inpatient costs were substantially lower, particularly for procedures, consumables, and ward charges. The total direct medical cost per patient was significantly lower in MDP compared with SC (Rp 19.4 million vs Rp 31.3 million), reflecting a 38% reduction. Conclusion: Implementation of an MDP reduced overall direct medical costs by shifting expenditures toward outpatient management and lowering costly inpatient utilization. These findings support MDP as a feasible and cost-efficient strategy in resource-limited health systems.

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  • University of Indonesia
  • Institut Agama Islam Negeri Bone
  • Hasanuddin University
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Kuntjoro HarimurtiAfiliasi tidak diketahui6
Hamzah ShatriAfiliasi tidak diketahui3
Muhammad YaminInstitut Agama Islam Negeri Bone3
Eka GinanjarAfiliasi tidak diketahui3
Taufik IndrajayaAfiliasi tidak diketahui3
Arif MansjoerAfiliasi tidak diketahui3
Sally Aman NasutionAfiliasi tidak diketahui3
Cosphiadi IrawanAfiliasi tidak diketahui2
Ika P WijayaAfiliasi tidak diketahui2
Siti SetiatiAfiliasi tidak diketahui2
Simon SalimAfiliasi tidak diketahui2
Suzanna ImmanuelAfiliasi tidak diketahui2
Aida LydiaAfiliasi tidak diketahui2
Suhendro SuhendroAfiliasi tidak diketahui2
Em YunirUniversity of Indonesia2
Dita AditianingsihAfiliasi tidak diketahui2
Suhendro SuwartoAfiliasi tidak diketahui2
Lies Dina LiastutiAfiliasi tidak diketahui2
Fairuz RabbaniyahUniversity of Indonesia1
Dedi WihandaAfiliasi tidak diketahui1
E. Mudjaddid E. MudjaddidAfiliasi tidak diketahui1
Teguh SantosoAfiliasi tidak diketahui1
Ardian SaputraHasanuddin University1
Aru W SudoyoAfiliasi tidak diketahui1
Djumhana AtmakusumahAfiliasi tidak diketahui1
Agus KosasihAfiliasi tidak diketahui1
Auda AzizAfiliasi tidak diketahui1
Abdulmuthalib AbdulmuthalibAfiliasi tidak diketahui1
Lyana LyanaAfiliasi tidak diketahui1
Sri InggrianiAfiliasi tidak diketahui1
Merry WinteryAfiliasi tidak diketahui1
Linda LisonAfiliasi tidak diketahui1
Ary H ReksodiputroAfiliasi tidak diketahui1
Faisal YunusAfiliasi tidak diketahui1
Nury NusdwinuringtyasAfiliasi tidak diketahui1
Widjajalaksmi WidjajalaksmiAfiliasi tidak diketahui1

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Sumber metadata: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">Cost-Effectiveness Analysis of Multidisciplinary Care in Chronic Heart Failure: Insights from an Indonesian Tertiary Hospital</dc:title>
	<dc:creator>Lusiani, Lusiani</dc:creator>
	<dc:creator>Prihartono, Nurhayati Adnan</dc:creator>
	<dc:creator>Nadjib, Mardiati</dc:creator>
	<dc:creator>Alwi, Idrus </dc:creator>
	<dc:subject xml:lang="en-US">Cost-benefit analysis</dc:subject>
	<dc:subject xml:lang="en-US">heart failure</dc:subject>
	<dc:subject xml:lang="en-US">patient care team</dc:subject>
	<dc:subject xml:lang="en-US">tertiary care centers</dc:subject>
	<dc:subject xml:lang="en-US">Indonesia</dc:subject>
	<dc:subject xml:lang="en-US">quality-adjusted life years</dc:subject>
	<dc:description xml:lang="en-US">Background: Chronic heart failure (CHF) is the leading cause of morbidity and healthcare expenditure in Indonesia, largely due to recurrent hospitalizations. Multidisciplinary Programs (MDSs) have been introduced to provide clinical and economic advantages by reducing hospitalizations. This study aimed to compare direct medical cost trajectories between patients managed under MDP and standard care (SC) at a tertiary referral hospital. Methods: The retrospective cohort study was conducted at Dr. Cipto Mangunkusumo National Hospital and included 189 patients with CHF who completed at least eight consecutive outpatient visits. Patient demographics, clinical data, and direct medical costs were obtained from medical records and hospital billing data. Results: Patients in the MDP group were younger (median age 55 vs 60 years) and had a more frequent ischemic etiology compared with SC. Outpatient costs were higher in MDP, mainly due to medications and consultation fees, while inpatient costs were substantially lower, particularly for procedures, consumables, and ward charges. The total direct medical cost per patient was significantly lower in MDP compared with SC (Rp 19.4 million vs Rp 31.3 million), reflecting a 38% reduction. Conclusion: Implementation of an MDP reduced overall direct medical costs by shifting expenditures toward outpatient management and lowering costly inpatient utilization. These findings support MDP as a feasible and cost-efficient strategy in resource-limited health systems.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2026-09-28</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/3152</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 58 No. 3 (2026): Acta Medica Indonesiana; 402</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/3152/890</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2026 Lusiani Lusiani, Nurhayati Adnan Prihartono, Mardiati Nadjib, Idrus  Alwi</dc:rights>
	<dc:rights xml:lang="en-US">https://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>