Gambaran Biaya dan Kunjungan Rawat Inap Tingkat Lanjut Rehabilitasi Pasien Skizofrenia
Overview of Costs and Length of Stay for Advanced Inpatient Rehabilitation of Schizophrenia Patients
Abstract
Skizofrenia merupakan penyakit mental yang memiliki beban ekonomi yang besar. Sekitar 26,8 juta penduduk di dunia menderita skizofrenia. Di Indonesia, prevalensi skizofrenia bersifat fluktuatif mulai dari 1,7 permil pada 2013 , kemudian meningkat ke 7,1 permil pada 2018 dan turun menjadi 4,0 permil pada 2023. Peningkatan beban ekonomi program JKN sebab peningkatan utilisasi pelayanan kesehatan, terutama pada pelayanan rawat inap tingkat lanjut (RITL), termasuknya pada pelayanan skizofrenia, mengancam keberlanjutan finansial pada program JKN. Penelitian ini merupakan penelitian deskriptif kuantitatif dengan pendekatan cross-sectional menggunakan data sekunder Sampel BPJS Kesehatan Kontekstual Kesehatan Mental Tahun 2024 yang berisikan data kepesertaan, pelayanan, dan biaya klaim yang terdiri dari 310.609 kunjungan. Data dianalisis secara deskriptif menggunakan Stata17.0 dan SPSS. Analisis kode diagnosis primer dan sekunder menunjukkan bahwa gangguan dan infeksi pencernaan, kelainan pergerakan dan ekstrapiramidal, diabetes mellitus, dan hipertensi kerap menyertai skizofrenia. Jumlah kunjungan RITL Skizofrenia terdapat terbanyak pada provinsi Jawa Tengah, DKI Jakarta, Jawa Timur, dan Aceh. Biaya harian tertinggi terdapat pada provinsi Maluku Utara dan Banten, masing-masing disebabkan oleh kekurangan sumber daya kesehatan dan pemanfaatan pelayanan berlebih. Terdapat variasi biaya kunjungan RITL Skizofrenia di Indonesia berdasarkan tipe regional, kepemilikan FKRTL, Hak Kelas Rawat, Keparahan, status perkawinan, durasi rawat, status administrasi wilayah, frekuensi utilisasi, umur, jenis kelamin, tipe skizofrenia, komorbiditas, dan segmentasi kepesertaan. Perlu dilakukan pemerataan infrastruktur dan sumber daya kesehatan antar wilayah, serta evaluasi sistem tarif pelayanan kesehatan FKRTL untuk mengendalikan biaya RITL Skizofrenia.
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